Feeding Volume for 3-Month-Old, 5kg Infant on Paladai Feeds
A 3-month-old infant weighing 5kg should receive approximately 15-20 mL per feed if feeding every 2 hours (2nd hourly), totaling 180-240 mL over 24 hours, which represents 36-48 mL/kg/day. However, this is substantially below the recommended daily intake for this age group and requires immediate clinical reassessment.
Critical Concern: Inadequate Total Daily Volume
The standard feeding guideline for 2-3 month old infants is 3-4 oz (90-120 mL) per feed every 3-4 hours, totaling approximately 24-32 oz (720-960 mL) per day 1.
For a 5kg infant, this translates to 144-192 mL/kg/day, which is the expected intake for adequate growth and nutrition 1.
Two-hourly feeding schedules (12 feeds per 24 hours) are typically reserved for newborns in the first few days of life or very small preterm infants, not for 3-month-old term infants 1, 2.
Recommended Feeding Approach
This infant should transition to a more age-appropriate feeding schedule:
Feed every 3-4 hours (6-8 feeds per 24 hours) with 90-120 mL per feed to achieve the target daily volume of 720-960 mL 1.
If maintaining 2-hourly feeds for specific medical reasons, each feed should provide 60-80 mL to reach a minimum daily intake of 720 mL (144 mL/kg/day) 1.
Growth and Nutritional Concerns
A 3-month-old weighing only 5kg may indicate failure to thrive or inadequate caloric intake, as average weight at 3 months is typically 5.5-6.5 kg for term infants 1.
The feeding amount should increase by approximately 1 oz (30 mL) per month of age, meaning a 3-month-old should be taking significantly more than a newborn 1.
Inadequate volume intake directly impacts morbidity through poor growth, developmental delays, and increased infection risk 1.
Paladai Feeding Considerations
Paladai feeding is feasible and safe for stable infants, with feeding proficiency improving rapidly with experience 3, 4, 5.
Spillage during paladai feeding averages 3-4 mL per feed, which should be accounted for when calculating prescribed volumes 3.
Caregivers can be effectively taught paladai feeding technique, making it a sustainable option for home feeding 5.
Clinical Pitfalls to Avoid
Do not continue frequent small-volume feeds (2-hourly) beyond the neonatal period without clear medical indication, as this disrupts normal feeding maturation and may indicate underlying feeding dysfunction 1, 2.
Two-hourly feeding schedules in infants >1000g show no benefit over 3-hourly schedules and may unnecessarily burden caregivers 2.
Assess for underlying causes of poor intake: oral-motor dysfunction, cardiac disease requiring fluid restriction, or inadequate caregiver education on feeding cues 1.
This infant requires urgent evaluation for growth faltering - the combination of low weight and potentially inadequate feeding volume suggests either insufficient prescription or feeding difficulties 1.