Merck Manual

Please confirm that you are a health care professional

honeypot link

Nutrition in Infants


Deborah M. Consolini

, MD, Thomas Jefferson University Hospital

Reviewed/Revised Sep 2023
Topic Resources

If the delivery was uncomplicated and the neonate is alert and healthy, the neonate can be brought to the mother for feeding immediately. Successful breastfeeding Breastfeeding (See also Nutrition in Infants.) Breast milk is the nutrition of choice for young infants. The American Academy of Pediatrics (AAP) recommends exclusive breastfeeding for a minimum of 6 months... read more is enhanced by putting the neonate to the breast as soon as possible after delivery. Spitting mucus after feeding is common (because gastroesophageal smooth muscle is lax) but should subside within 48 hours. If spitting mucus or emesis persists past 48 hours or if vomit is bilious, complete evaluation of the upper gastrointestinal (GI) and respiratory tracts is needed to detect congenital GI anomalies Overview of Congenital Gastrointestinal Anomalies Most congenital gastrointestinal (GI) anomalies present as intestinal obstruction and frequently manifest as feeding difficulties, distention, emesis, and an inability to pass gas and stool... read more .

Daily fluid and calorie requirements vary with age and are proportionately greater in neonates and infants than in older children and adults (see table ). Relative requirements for protein and energy (g or kcal/kg body weight) decline progressively from the end of infancy through adolescence (see table ), but absolute requirements increase.

Newborns should be fed on demand, typically about 8 to 12 times a day. Average intake per feed in the first few days may be only 15 to 30 mL. After 48 hours, signs that feeding is adequate include the infant seeming satisfied after each feed, having 6 to 8 wet diapers a day and regular bowel movements, sleeping well, being alert when awake, and gaining weight.

Nutritional recommendations are generally not evidence-based. Requirements for vitamins depend on the source of nutrition (eg, breast milk versus standard infant formula Formula Feeding The only acceptable alternative to breastfeeding during the first year is formula; water can cause hyponatremia, and whole cow’s milk is not nutritionally complete. Advantages of formula feeding... read more ), maternal dietary factors, and daily intake.


Feeding Problems

Loss of > 5 to 7% of birth weight in the first week indicates undernutrition. Birth weight should be regained by 2 weeks in breastfed infants (earlier in formula-fed infants), and a subsequent gain of about 20 to 30 g/day (1 ounce/day) is expected for the first few months. Infants should double their birth weight by about 5 months.

NOTE: This is the Professional Version. CONSUMERS: View Consumer Version
quiz link

Test your knowledge

Take a Quiz!