Feeding a 4–6 month old: milk, night feeds and solids readiness

From 4 to 6 months, breast milk or formula is still the only food your baby needs. Many formula-fed babies work up to about 180–240 mL (6–8 oz) at 4 or 5 feeds a day by around 6 months, and the American Academy of Pediatrics (AAP) suggests no more than about 960 mL (32 oz) a day. Breastfed babies often get quicker at feeding and more easily distracted, and some start waking more at night. Solids begin at around 6 months, once your baby shows the signs of readiness together, and Australian and US guidance say not before 4 months.

This guide covers milk amounts at this stage, distracted feeds, night feeds around the 4-month change, how to tell when your baby is ready for solids, and what starts at around 6 months: iron-rich foods, water and a first cup. For the full picture from birth to 2 years, see the baby feeding schedule by age.

How much milk does a 4- to 6-month-old need?

Milk is still everything. The WHO's feeding fact sheet recommends feeding only breast milk for the first 6 months, and the NHS guide to drinks and cups says breast milk is the only food or drink babies need in the first 6 months. Formula-fed babies need only first infant formula.

Breastfed babies. There's no set number of feeds. The CDC's breastfeeding guide describes most exclusively breastfed babies feeding every 2 to 4 hours over the first months, and says to keep following your baby's hunger and fullness cues as they grow. Feeds often get much shorter at this age: La Leche League GB says a feed that once took around half an hour may now take much less time, because babies become more efficient feeders.

Formula-fed babies. The AAP's feeding guide says many babies take about 180–240 mL (6–8 oz) at each of 4 or 5 feeds in 24 hours by around 6 months. The AAP's formula schedule page says babies should usually have no more than an average of about 960 mL (32 oz) in 24 hours, and that babies adjust how much they take from day to day.

Formula by weight from 3 to 6 months

Victoria's Better Health Channel in Australia says babies need about 120 mL of formula per kg of body weight a day from 3 to 6 months, down from 150 mL per kg in the first 3 months.

The AAP's rule of thumb of about 75 mL (2½ oz) a day for every 453 g (1 lb) gives higher figures at these weights, so its cap of about 960 mL a day is the more useful AAP number here. Both are starting points, not targets. The Better Health Channel says never to pressure your baby to drink a set amount, and lists turning away, frowning or pushing the nipple out as signs of fullness. For more, see how much formula.

Combination-fed babies need less formula than the table, because part of their milk comes from the breast. If you're expressing for bottles, the Australian Breastfeeding Association gives 600 to 1000 mL of breast milk in 24 hours as a rough guide for babies aged 1 to 6 months. See combination feeding.

Is my baby still getting enough?

Keep using diapers and growth rather than feed length. The NHS looks for at least 6 heavy wet diapers a day, and the Australian Breastfeeding Association for at least 5 heavy disposables or 6 very wet cloth diapers, with pale or clear pee. The Australian Breastfeeding Association's weight gains page says breastfed babies often double their birth weight by 4 months and then grow more slowly after the first 3 to 4 months, so a 4-month-old gaining more slowly is probably not a concern. Your doctor or pediatrician will look at the trend on a growth chart. See is my baby getting enough milk?.

Why is my baby so distracted during feeds?

It's a very common stage. The Australian Breastfeeding Association's guide to distractible babies says awareness of the world becomes much stronger around 4 to 6 months, and everyday sounds such as a phone, TV, people talking or pets can make a baby turn away or pull off the breast. La Leche League GB says daytime feeds can become shorter and more sporadic around 4 months, and suggests looking at how much your baby takes over 24 hours rather than at daytime feeds alone.

Things that often help, from those two sources:

1. Feed somewhere calm, away from noise and other people. A darkened room can help.
2. Mask sudden sounds with gentle music or the hum of a fan.
3. Face a plain wall, or put your phone away and focus on your baby.
4. Give older children books or toys to keep them busy while you feed.
5. Offer something to hold, such as a small toy or soft scarf.
6. Use sleepy feeds. The Australian Breastfeeding Association says babies often feed better at night when it's quieter, and La Leche League GB suggests making the most of nap-time and night feeds.

The Australian Breastfeeding Association says this stage doesn't last long, and most babies learn to feed even with distractions around. For bottle-fed babies, the AAP says a baby who gets fidgety or easily distracted during a feed is probably finished, so there's no need to push the rest of the bottle.

What happens to night feeds around 4 months?

Sleep changes at this age, and feeds often change with it. The AAP's sleep guide says babies don't have regular sleep cycles until about 4 months. La Leche League GB says a baby who had been sleeping longer stretches may start waking more often around 4 months, and that babies often breastfeed more at night, which can mean they're taking less during busy days.

Night feeds are still normal. Unicef UK's guide to caring for your baby at night says it is both normal and essential for babies to feed at night in the early months. The AAP's formula page says most formula-fed babies no longer need a middle-of-the-night feed somewhere between 2 and 4 months, or once they weigh more than 5.4 kg (12 lb), but plenty still wake for one. Check with your doctor or pediatrician before cutting night feeds if your baby was premature or has growth concerns. See the 4-month sleep regression and dropping night feeds.

However the night goes, keep every sleep safe. NICHD Safe to Sleep advises placing your baby on their back for every sleep, on a firm, flat, level surface, in their own crib or bassinet in your room for at least the first 6 months, day and night, with nothing soft or loose, no inclined or weighted sleep products, and a smoke-free home. If you fall asleep while feeding in bed, it says to move your baby back to their own sleep space as soon as you wake. See safe sleep.

When is my baby ready for solids?

At around 6 months for most babies. The NHS guide to first solid foods says it's a good idea to wait until around 6 months, and that babies still get most of their energy and nutrients from milk at first. Each source puts the lower limit slightly differently:

The Australia's ASCIA guide to introducing solid foods, from Australia's clinical allergy body, says to start when your baby shows signs of being ready, usually around 6 months and not before 4 months, and to keep breastfeeding if you can. The CDC's solids guide also says introducing foods before 4 months is not recommended.

Signs of readiness

The NHS lists three signs that appear together:

• your baby can stay sitting and hold their head steady
• they can coordinate their eyes, hands and mouth to pick up food and put it in their mouth
• they swallow food rather than pushing it back out.

The CDC adds sitting up alone or with support, and the AAP's guide to starting solids adds opening the mouth when food comes their way.

The NHS says three things are often mistaken for readiness: chewing fists, waking in the night more than usual, and wanting extra milk feeds. It describes these as normal behaviors that don't on their own mean a baby is ready, and La Leche League GB also says 4 months is not the time to start solids. If your baby was premature, the NHS suggests asking your health visitor or doctor when to start; in Australia, ask your doctor or pediatrician. The how-to is in starting solids.

What changes when solids start at around 6 months?

Iron matters from the first meals

The WHO's complementary feeding page explains that at about 6 months a baby's need for energy and nutrients starts to exceed what breast milk alone provides. The Royal Children's Hospital Melbourne iron fact sheet in Australia lists babies who haven't started solids by around 6 months among those at higher risk of low iron, and gives 11 mg a day as the recommended intake from 7 to 12 months, reached over time rather than every day.

The AAP's supplement recommendations go further for US babies: an iron supplement for breastfed and partly breastfed full-term babies from 4 months until iron-containing foods, including iron-fortified cereals, are part of the diet. Ask your doctor before giving any iron. Iron-rich first foods are in first foods and iron. Australia's ASCIA also advises giving well-cooked egg and smooth peanut soon after solids start; see introducing allergens.

At first, the NHS guide to feeding from around 6 months says your baby only needs a small amount of food once a day, and to keep offering breast milk or first infant formula on demand.

Water and a first cup

Before 6 months, babies don't need water. In hot weather, the Sydney Children's Hospitals Network in Australia says babies under 6 months should still have only breast milk or formula, while the NHS says formula-fed babies under 6 months may need small sips of cooled boiled water and breastfed babies may want to feed more often. From around 6 months, small sips with meals are fine:

The Sydney Children's Hospitals Network's guide to introducing fluids in Australia says breast milk or formula should stay the main drink until 12 months. The AAP's drinks guide says babies under 1 shouldn't have juice. See water for babies.

The NHS says an open cup or a free-flow cup without a valve helps your baby learn to sip and is better for teeth, and that bottles should be discouraged once your baby is 1. The AAP's guide to discontinuing the bottle suggests offering a cup when solids start, usually around 6 months, and finishing the move off bottles sometime between 12 and 18 months. See cups and dropping bottles.

Keeping first tastes safe

Sit your baby upright and stay with them while they eat. Gagging is common when solids start, but choking is different: if your baby is choking and can't cough, cry or breathe, call 911. The NHS choking guide says to give up to 5 back blows, then up to 5 chest thrusts, and keep repeating until help arrives; if your baby becomes unresponsive, start CPR and follow the call-taker's instructions. It also says to get medical help afterwards even if the food comes out. An infant first-aid course before solids start is well worth it. See choking vs gagging.

What does a feeding day look like at 4 to 6 months?

These are made-up examples built from the ranges above. Your baby's times and feeds will differ.

5 months, breastfed — Example day — adjust to your baby

6 months, formula-fed, first tastes — Example day — adjust to your baby

For a 7 kg baby, the per-weight figure above would mean about 840 mL across the day. Food at this point is small tastes; milk is still the main source of nutrition.

Common questions at 4 to 6 months

Will solids help my baby sleep through the night?

It isn't a reason to start early. The NHS says waking more in the night is one of the things often mistaken for readiness for solids. Night waking around 4 months is more often linked to sleep changes; see the 4-month sleep regression.

Does my baby still need vitamin D?

Yes, if your local guidance advises it. The NHS guide to vitamins for children says breastfed babies need a daily vitamin D supplement from birth, and that from 6 months all children should have vitamins A, C and D every day, unless they're having more than 500 mL of formula a day. Advice in Australia and the US differs; see vitamin D for babies.

What comes next?

From about 6 months, food builds up gradually alongside milk. The WHO says complementary foods start at 6 months with small amounts and increase gradually, while breastfeeding continues. The next guide, feeding a 7- to 9-month-old, covers more meals, lumpier textures and how milk feeds change.

When to get help

Call 911 now (or go straight to the nearest emergency room) if your baby:

• has had no wet diaper or pee for 12 hours
• is floppy, much sleepier than usual, hard to wake or can't be woken, or is too sleepy to feed
• is struggling to breathe, breathing very fast or grunting, or has blue, gray, pale or blotchy skin, lips or tongue
• is 3 to 6 months old and has a temperature of 39°C (102.2°F) or higher, or has a temperature below 36°C
• has a weak, high-pitched or continuous cry, or has a seizure
• has a bulging or sunken soft spot on their head, or sunken eyes
• has green or yellow vomit, or vomit that is red, black or brown
• has swollen lips, tongue or throat, or trouble breathing, after a food.

These signs come from the NHS guide to urgent help for babies. The Sydney Children's Hospitals Network in Australia says green or yellow vomit can mean a twisted or blocked bowel and needs an ambulance or emergency room, and the NHS diarrhea and vomiting page also treats it as an emergency.

Get medical help today (a same-day doctor, after-hours doctor or your pediatrician's after-hours nurse line; go to an emergency room if you can't be seen) if your baby:

• has fewer wet diapers than usual, or dark, strong-smelling pee
• is refusing feeds or feeding much less than usual, but is alert
• keeps vomiting feeds, or has blood in their poop
• has hives or vomiting after a new food but is breathing normally and has no swelling of the lips, tongue or throat; see introducing allergens.

The Royal Children's Hospital Melbourne in Australia says any baby under 6 months with signs of dehydration should see a doctor, and that severe signs such as lethargy, sunken eyes or cold, mottled hands need an ambulance or emergency room. The NHS dehydration page lists a sunken soft spot as a reason for an urgent doctor appointment rather than an emergency call; we use the stricter tier.

Talk to your doctor or pediatrician soon (or call La Leche League or a lactation consultant (IBCLC) for breastfeeding help) if your baby isn't following their growth curve, regularly wants much more than about 960 mL of formula a day, shows no signs of readiness for solids by around 6 months, was born premature and you're unsure when to start solids, or distracted feeding goes on for weeks and you're worried about intake.

What's useful to note

For a few days, note feeds (or bottle amounts), wet diapers and night wakings. Seeing that 24-hour intake and diapers held steady while daytime feeds got shorter is reassuring. Once solids start, a short note of each new food and how your baby responded makes it easy to spot a reaction.