Feeding is one of baby's first pleasant experiences. The baby's first love for their mother or father arises primarily from the feeding situation. Both you and the baby should be comfortable. Hold your baby in your lap with the head slightly raised and resting in the bend of your elbow. Whether breast-feeding or bottle-feeding, hold your baby comfortably close. Cereal, juice and other solid foods are not advised until your baby is 4-6 months old. Whole milk is not recommended until 1 year of age. An information sheet about this is available at the baby's check-up.
FOR BREAST FEEDING: Before feeding, get comfortable so you and your muscles will be relaxed. Use pillows to support your arms, back, and the baby's weight. Have something to drink nearby, and a cloth diaper for burping the baby. Support your breast with your free hand. Place your fingers under your breast and rest your thumb gently on the top of the breast. All fingers should be away from the areola (the dark circle around the nipple). You can massage the breast to express a little milk to help the baby get started. Position baby lying on its side, level with your breast. Bring baby's mouth to your nipple and stroke baby's lower lip. When baby's mouth is open wide, bring the infant closer to latch onto the breast. Be sure at least ½ inch of the areola is in the baby's mouth so baby's tongue can stroke the milk storage sacs in the areola while sucking.
Plan to begin breast-feeding your baby immediately after birth. This stimulates milk production. It may take a few days before milk "comes in". The colostrum or watery milk will be enough for your baby for the first day or so. At first, newborns should be fed at least 8 to 12 times in 24 hours. Encourage the baby to nurse from both breasts during each feeding, even if the time on each side is brief. Ideally, baby should nurse for at least 7-10 minutes on each side.
Initially, it is best to allow breast-fed babies to feed on demand, or whenever they cry because they are hungry. For some infants this may be as frequent as every 1 ½ to 2 hours. Until your baby has regained the birth weight, feed at least every 3 hours during the day and every 4 hours at night. As time passes, babies begin to develop a fairly regular timetable on their own.
Marie McDermott, R.N., L.C. provides lactation consultation at PHCA. She is available to help you with any breast-feeding problems that may arise. While you are in the hospital, there are lactation consultants on staff who can provide additional support or assistance with breast feeding.
FOR BOTTLE FEEDING: Seat yourself comfortably and hold your baby supporting the head. Tilt the bottle ensuring that the the neck of the bottle and the nipple are always filled with formula. This helps your baby get formula instead of sucking and swallowing air. Air in the stomach may give a false sense of fullness and result in the baby not getting enough formula. Sucking air may also make the infant very uncomfortable,
Your baby has a strong, natural desire to suck. Sucking is part of the pleasure of their feeding time. Babies will keep sucking on nipples even after they have collapsed, so take the nipple out of the baby's mouth occasionally to keep the nipple from collapsing. This makes it easier for them to suck.
Plan to feed your baby within an hour before or after the scheduled time. For example, if the bottle is due at 6:00, feed between 5:00 and 7:00.
After the first week, a simple schedule to follow is: if formula-feeding and your baby wakes up less than 3 hours after a feeding, give him/her water. If your baby wakes up between 3-5 hours from the last feeding, give formula. Beyond 5 hours, wake the baby for feeding except after the last evening feeding. With this schedule, the baby will learn to sleep through the night sooner. Should your baby occasionally wake up and cry less than 2 1/2 hours after a feeding he/she is probably not hungry. However, if he/she consistently wakes and cries less than 2 1/2 hours after a feeding, the amount of formula may be insufficient.
Never leave a bottle propped in your baby's mouth or put your baby to bed with a bottle, even after your baby can hold the bottle independently. This is an impersonal way to feed a baby and could turn your baby against feedings in general. It also contributes to tooth decay by allowing the sugar in the formula to pool around the teeth and gums for long periods of time.
As you baby gets older and begins holding the bottle independently, avoid using breakable glass bottles. Also, bottles that are designed to promote self-feeding are not recommended as they may contribute to nursing bottle tooth decay.
FORMULA PREPARATION: The formula should be made fresh every day and it must be kept fresh, clean and sterile.
HOW MUCH FORMULA? The amount of formula your baby takes will vary. New babies initially may take small amounts, from ½ to 2 ounces every 1 to 4 hours.
Most babies feed for about 15-20 minutes. You will probably find that sometimes your baby will drink all of the bottle and sometimes not. Don't worry as this is normal. As babies grows and gain weight, they need more formula. When your baby drinks all of the bottle pretty regularly. and occasionally cries for more, try increasing the amount of formula. Eventually, your baby will drink 2 ½ ounces per pound of body weight each day.
BURPING: Burping or bubbling your baby helps release swallowed air. Even if fed properly, both bottle-fed and breast-fed babies swallow some air. Burp your baby by either holding the baby upright over your shoulder, or place your baby face down over your lap. Gently pat or rub the baby's back until you hear or feel the baby burp. Another burping method is to place your baby in a sitting position on your lap and lean him or her slightly forward, supporting his/her stomach with your hand. It isn't always necessary to interrupt a feeding to "burp" baby, but always do so after each feeding. Sometimes baby may not need to burp, so don't try to force it.
AFTER FEEDING: After you have fed and burped your baby, you can hold and talk to your baby for a while and then place baby in the crib. Lying your baby on the back or side position is preferred for the first few months.
WATER: Unless the weather is very hot, your baby gets all the necessary fluids from breast milk or formula up until the age of 3 months. In very hot weather, you can offer water between feedings but don't force the baby to drink or worry if it is refused. Your baby may prefer to get the extra fluid from more frequent feedings.
Do not give honey prior to age one year and do not use artificial sweeteners. Fruit juices should not be introduced until you have checked with us.
ARTICLES YOU WILL NEED:
- Funnel shaped bottle brush
- Can opener
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Jars for storing sterile nipples and caps
- Bottles: Glass, plastic, or plastic with disposable liners (about 8)
- Nipples and caps
KEEPING UTENSILS CLEAN: All utensils used in preparing formula must be clean. Scrub bottles, nipples and caps with hot soapy water and a bottlebrush. Squeeze water through holes in nipples. A detergent removes scum better than soap. Rinse well with hot water. Put nipples and caps in a clean jar. Can openers and other articles used should also be washed and rinsed. Bottles and caps can be washed in a dishwasher.
FORMULAS: Most infant formulas are available in ready-to-use liquid forms, concentrates, and powders. Ready-to-use formulas are very convenient, but are also the most expensive. Formula made from concentrate is prepared by mixing equal amounts of concentrate and sterile water (i.e., one can of concentrate and one can of drinking water). Open cans of concentrate should be kept covered in refrigerator, and should be discarded after forty-eight hours). Powder, the least expensive form, comes either in pre-measured packets or in a can with a measuring scoop. To prepare powdered formula, boil water for five minutes to sterilze it. Measure 1 scoop of powdered formula for every 2 ounces of water. Mix thoroughly, ensuring all clumps have been completely disolved in the bottle. The solution will mix more easily and the powder will dissolve faster if you use slightly warm water.
If you choose a formula that requires preparation, be sure to follow the manufacturer's directions exactly. Adding too much water, won't provide the calories and nutrients needed for proper growth while adding too little water could cause diarrhea or dehydration and give your infant more calories than needed.
Any formula you prepare in advance should be refrigerated to discourage bacterial growth. Discard of unused refrigerated formula after 24 hours. Refrigerated formula doesn't necessarily have to be warmed up for your baby, but most infants prefer it at least at room temperature. You can either leave the bottle out for an hour so it can reach room temperature, or warm it up in a pan of hot water. Do not microwave the bottle. Test the temperature of the formula by shaking a few drops into the inside of your wrist. It should feel warm, but not hot.
Your baby's formula is specifically formulated for individual growth and development. Please consult with us before stopping formula feeding.
TEST NIPPLES REGULARLY: Nipples holes should be the proper size to help baby suck easily. When nipple holes are the right size, warm milk will drip as rapidly as possible without forming a stream.
If nipple holes are too small, baby may tire of sucking before he gets all the formula he/she needs. Holes can be enlarged by pushing a red-hot needle through them. If nipple holes are too large, baby gets too much formula too fast and may not get enough sucking to satisfy. Nipples with large holes are worn out and should be discarded.
VITAMINS AND SOLID FOODS
VITAMINS: If you are breast-feeding your child, we recommend that you provide your child with Vitamin D supplementation. Vitamin D drops can be purchased at your local pharmacy without a prescription. Please consult your provider about proper dosage and administration. Infant formula contains Vitamin D, so babies who are formula fed do not require additional vitamin supplementation.
Your baby is born with iron reserves which protect him/her from anemia for the first 4-6 months. After that time, additional iron is supplied by iron-fortified baby food or formula with added iron.
Fluoride is important to protect the teeth against cavities. Supplements are sometimes prescribed after 5 months of age for breast-fed infants or formula-fed infants not receiving fluorinated water.
When you give the baby vitamins, place the dropper between the cheek and gums and give slowly, a drop at a time.
SOLID FOODS: Solid foods are not usually started until the baby is at least 4-6 months old. There is an information sheet about introduction of solid foods that you will be given at your baby's four-month check up. If you have questions about starting solids earlier, please ask at the baby's check up or call the office.
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