This article was professionally consulted by Nguyen Thi My Linh, Specialist level I, Pediatrician, Neonatologist at the Pediatrics & Neonatology Department, Vinmec Da Nang International General Hospital.
In the womb, the fetus receives nutrients via the umbilical cord. At birth, a newborn’s stomach is very small but will gradually grow in size over the following days.
1. How is the stomach size of a newborn?
- Days 1-2: A newborn’s stomach is not yet well-expanded and is smaller than a pea, holding only about 5-7 ml of milk per feeding on the first day. This amount is equivalent to the precious colostrum that the mother first secretes. Therefore, feeding the baby 30ml of formula per feeding is completely incorrect and can have a significant negative impact on the baby.
- Day 3-6 after birth: The stomach size has grown to roughly the size of a grape and can hold about 30-60ml of milk per feeding.
- 1-month-old baby: The baby’s stomach has grown to about the size of a chicken egg and can hold between 80-150ml of milk per feeding.
- 6 months to 1-year-old: The stomach is now the size of a small grapefruit, about 5 times smaller than an adult’s stomach. By this time, the baby’s stomach can hold approximately 200-250ml of milk (equivalent to one small serving).
2. Feeding needs of newborns at each stage
Based on the stomach size of the newborn, it’s clear that at each stage, the baby’s feeding needs will vary. In fact, exclusively breastfeeding is often enough for the baby to develop optimally, without needing formula milk.
Additionally, while the size of a newborn’s stomach is five times smaller than an adult’s, their nutritional needs are significantly higher—about 3 to 5 times greater. Specifically:
- A newborn will feed around 8-12 times within a 24-hour period on the first day, meaning they feed roughly every 1-3 hours.
- For babies who are starting to eat solid foods, their meals should be divided into 2-3 smaller feedings throughout the day.
The following content is prepared under supervision of Thạc sĩ, Bác sĩ y khoa, Ma Văn Thấm , Nhi , Phòng khám Đa khoa Vinmec Dương Đông(Phú Quốc)
3. Gastroesophageal Reflux in newborns
Gastroesophageal reflux (GER) occurs in about two-thirds of newborns during their early years. Most cases of reflux will resolve by 12-14 months of age, although some children may experience gastroesophageal reflux for a longer period. Gastroesophageal reflux is classified into two types: physiological and pathological.
Gastroesophageal reflux in newborns occurs when food or stomach contents are flow back into the esophagus, leading to vomiting. This phenomenon is often referred to as "spitting up" or "acid reflux." It can occur at any time, day or night. Since newborns primarily consume breast milk or formula, they will typically vomit milk.
When experiencing gastroesophageal reflux, newborns may cry frequently, refuse to feed, have trouble sleeping at night, and sometimes need to be held constantly. Over time, this can lead to malnutrition and poor weight gain.
If an infant under 6 months old spits up several times a day but remains happy, gains weight well, and shows no signs of wheezing, it is likely a case of physiological reflux. However, if the baby continues to spit up after 1 year of age, has slow weight gain, appears underweight, refuses to eat, wheezes, or experiences repeated respiratory infections, it is more likely that the reflux has become pathological.
Caring for newborns with gastroesophageal reflux
For infants who haven’t started solid foods (under 4-6 months old):
- Parents should feed the baby frequently, with the recommended feeding time being around 2 hours after the previous feeding. After feeding, hold the baby upright for 10-20 minutes. It is important to ensure that the baby is feeding in the correct position and latching properly to avoid swallowing air.
- For babies who use a bottle, parents should check if the size of the milk flow is appropriate for the baby.
For Infants starting solids:
Divide meals into smaller portions throughout the day, feeding every 1.5-2 hours.
- Avoid high-fat foods.
- Add 1 tablespoon of cereal and about 50g of formula or expressed breast milk to the bottle. If the mixture is too thick, adjust the nipple size or cut a small "X" in the nipple.
- Gently pat the baby’s back while feeding to prevent spitting up.
- If you suspect a protein allergy, use hydrolyzed protein formula for 2-4 weeks, which can reduce spitting up and promote easier digestion.
- Avoid overfeeding or giving foods that are too thick to prevent constipation and poor calcium absorption from milk.
Feeding the Baby Properly:
- Parents should adjust the baby’s feeding position to ensure that milk flows at a manageable pace. The recommended feeding interval is every 2 hours. After feeding, hold the baby upright for 10-20 minutes.
- Limit the use of pacifiers.
Additionally, help the baby burp during or after feeding. This should be done once the baby has finished one breast or consumed about 50 ml of milk from the bottle. To do this, have the baby sit upright on your lap, gently leaning forward, supporting the chin with one hand, and softly patting the back with the other. This method helps the baby burp easily, reducing the risk of reflux after feeding.
Finally, when putting the baby to sleep, prop the baby’s head slightly higher than the body to prevent gastroesophageal reflux.
Specialist level I, Nguyen Thi My Linh has 12 years of experience in diagnosing and treating pediatric conditions, especially in neonatal resuscitation and pathological newborn care. She also specializes in breastfeeding consultation and provides nutritional counseling and interventions for children.
