From the Guidelines
It is highly unlikely for a newborn to be overfed with colostrum, as the small amounts produced and the baby's natural regulation of intake prevent overfeeding. The composition of colostrum is specifically designed to meet a newborn's initial nutritional needs, and its production is limited to about 2-10 ml per feeding during the first few days after birth 1. Newborns have very small stomachs, approximately the size of a cherry or marble at birth, and they naturally regulate their intake by stopping when full. Colostrum is rich in antibodies, protein, and growth factors but lower in fat and sugar compared to mature milk, making it highly digestible and appropriate for a newborn's immature digestive system.
Feeding on demand rather than on a strict schedule allows babies to self-regulate their intake based on hunger cues, such as tongue sticking out and looking for a nipple, as seen in the newborn in question. If a baby spits up after feeding, this is usually due to an immature digestive system rather than overfeeding, as supported by studies on breastfeeding and human milk 1. Parents should follow their baby's hunger cues, allowing them to feed when showing signs of hunger and stop when showing signs of fullness, such as turning away from the breast or falling asleep.
Key points to consider include:
- Frequent feeding on demand, at least 8 to 10 times in 24 hours, decreases newborn weight loss, the need for supplements, and the risk of clinically significant hyperbilirubinemia 1.
- Continuous rooming-in with frequent, exclusive breastfeeding is recommended to support the establishment of breastfeeding and minimize the need for supplements 1.
- Breast milk supplements should only be recommended when breastfeeding technique and frequency have been optimized first or when supplementation is medically necessary, emphasizing the importance of prioritizing breast milk and colostrum for newborn nutrition 1.
From the Research
Newborn Feeding Patterns
- Newborn babies often show signs of hunger, such as tongue sticking out and looking for a nipple, which is a natural instinct to feed 2.
- Colostrum, the first milk produced by mothers, is rich in immunoglobulins, antimicrobial peptides, and growth factors, making it essential for the growth, development, and immunologic defense of neonates 3.
Colostrum Production and Feeding
- The volume of colostrum produced by mothers can be minimal in the early postpartum period, causing concerns about sufficient milk supply 4.
- Studies have shown that the volume of expressed colostrum decreases initially and then increases dramatically after 30 hours postpartum, a phenomenon known as secretory activation 4.
- It is recommended that mothers be informed about the postpartum trajectory of human milk volume to alleviate concerns about milk supply 4.
Overfeeding with Colostrum
- There is no direct evidence to suggest that a newborn can be overfed with colostrum, as it is naturally packaged to prevent destruction and maintain bioactivity until it reaches the distal gut regions 3.
- However, studies have shown that appropriate addition of formula milk can reduce the incidence of diseases in newborn infants when there is little colostrum secretion in the first 2-3 days of delivery 2.
- Bovine colostrum has been used as a supplement to mother's own milk in preterm infants, and has been shown to increase enteral protein intake and promote growth and development 5.