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Feeding Your Newborn Baby
The closeness associated with feeding should be a caring and pleasant experience. We encourage breastfeeding whenever possible, but realize that it is not appropriate for all mothers. Breastfed babies have a decreased risk of intestinal infections. They also develop fewer allergies. If you are unable to breastfeed, many formulas are available that will provide your baby with excellent nutrition.
Breastfeeding
Breast milk is made especially for babies. Warm and ready to feed at a moment's notice, breast milk digests easily. During the first few months, it is a perfect food for your infant’s early growth.
The first few days will be a learning experience for both you and your baby. Remember, your baby may be sleepy and not be interested in feeding. Or your baby may be hungry and demanding to eat while you may not be producing any milk. Be patient. Keep trying and ask for assistance if necessary.
There are many positions used for nursing. The cradle hold, football hold, or side lying are the most common methods. Most importantly, both you and your baby should be comfortable.
Having tender nipples during the first minute of nursing is normal, but continued soreness may mean the baby is not latched on properly. Make sure your babies mouth is open wide enough that the lower lip will curl down to ensure that the baby latches on correctly. The mouth should be around the nipple and as much of the areola as possible. If soreness persists, release the baby from your breast. Break the suction by pushing in on your breast or gently placing your finger between your baby’s gums, and start again. To avoid sore nipples, initially nurse ten minutes on each breast. Increase the feeding each day by one-minute increments until your baby is nursing a maximum 10-15 minutes per side. Milk is produced on a supply and demand basis. In the first 5 minutes of breastfeeding 90% comes out of the breast, in 10 minutes 95%, in 15 minutes 99%. This sends a message to the pituitary gland to “let down the milk flow”. Short frequent feeding in the first two weeks will help establish your milk flow. The more your baby demands, the more your body produces.
Take about two minutes to burp your baby. Burp your baby in between breasts. Your baby may need more frequent burping if they are fussy and pushing off the breast. If your baby begins to hiccup, wait a few minutes to burp them. Usually a hiccupping baby is content and has a little swallowed air to burp. Just move the baby around and a burp will come up!
Allow your breasts to air for about five to ten minutes after each feeding, before you replace your bra.
Babies learn the differences between types of nipples. Because nipple confusion may result, try not to offer formula or water during the first two weeks. Each baby is treated as an individual and may need formula to prevent other problems. Your milk supply is dependent on the baby nursing frequently. Short frequent feedings stimulate better milk production than long feedings.
Breastfeeding is an art. Success depends on both mother and baby. It is influenced by the temperament of each as well as physical and nutritional factors. In order to be successful at breastfeeding, the mother should rest, maintain an adequate intake of nutritious foods, take prenatal vitamins, and drink plenty of fluids. Most foods and liquids do not cause problems with breastfeeding. If you are having problems with breastfeeding, call us. You might also refer to the book Nursing Mother's Companion, by Kathleen Huggins.
Formula Feeding
If you choose to bottle feed, the same closeness between parent and baby develops as with breastfeeding.
Get comfortable. Relax and enjoy spending time together. When you feed your baby, the baby should be in a semi-upright position with the head higher than the body. Tilt the bottle so the formula fills the nipple. This prevents the baby from swallowing air.
Never prop the bottle or leave the baby alone feeding. Propping can lead to serious choking. Babies feel secure when you hold them close to your body, look them in the eyes, provide warmth, and talk to them.
There are many types of formula available. We recommend a milk-based formula with iron (Carnation Good Start, Enfamil, Similac, Parents Choice, and Kirkland). Offer formula every three to four hours during the day and evening. During the night, feed on demand. If your baby shows signs of allergy to milk based formulas or there is a strong family history of allergies, please let us know. We will advise you of alternate formulas.
Infants have growth spurts. During this time, they eat larger amounts more frequently. The amount of formula your baby takes may vary from one feeding to the next and from day to day. Your newborn will probably take six to eight bottles a day, with about two to four ounces of formula in each bottle. The amount of formula will increase, as your baby grows. Your baby’s growth is the best indicator of how well your baby is eating. Try not to spend more than 30 minutes feeding.
Burp your baby every one to two ounces during a feeding, and after a feeding try to burp your baby to help remove swallowed air. For a minute or two, gently pat or rub their back until your baby burps. Babies do not always need to burp after a feeding. Don't be surprised if your baby spits up a small amount after they have been fed. Some babies spit up one to two tablespoons with each feeding. As long as the baby is growing and there are no signs of illness, there is no need to worry.
Feed formula at room temperature. It is not necessary to warm the bottle unless taken right from the refrigerator. Warm the water then mix it with the formula. A more convenient way to prepare formula is to use room temperature bottle water. The most inexpensive way to purchase any formula is in powder form. You may heat an occasional feeding of already prepared formula in a microwave. Shake the bottle and test the temperature of the formula on your wrist before giving it to the baby. Remember, formula may heat unevenly in the microwave.
Time saving tip #1 - Sterilizing bottles and nipples is not necessary. Thorough washing in a dishwasher or in hot soapy water is sufficient. Be sure to use a baby bottlebrush on the bottle and nipple, then rinse well.
Time saving tip #2 - Use tap or bottled water to mix with the powdered formula. You do not need to boil water.
Water
Babies usually do not need extra water. Water is helpful, however, to settle a fussy baby between feedings. Because infants may be exposed to a very rare infection, do not offer Karo syrup or honey to a baby less than one year of age. If the baby will not take plain water, use 1 teaspoon of table sugar to sweeten 4 ounces of water. Relieve hiccups by offering a few swallows of water or by briefly nursing.
Burping
Some babies swallow air during feeding. Burping helps to relieve this excess. When burping, hold your baby upright against your shoulder, facedown across your lap, or upright on your lap while you support your baby’s head and chest with your hand. As you burp your baby, you may want to place a burp towel on your shoulder, or across your lap or hand. Once in position, gentle patting or rubbing the back results in a burp within one to two minutes.
Urine Output and Bowel Movements
At first, it will seem as if your baby is not urinating much. Two to three wet diapers a day in the first two or three days is normal. As feeding amounts increase, so will the number of wet diapers. Initially, bowel movements also occur only one to two times a day. Baby’s stool starts out black and tarry or dark green, then become loose and yellow. Breastfed babies have stools that look like seeds or cottage cheese. Formula fed babies have thicker, formed stools that range in colors from green to brown. Some babies will grunt and strain when having a bowel movement. This is normal and does not mean they are constipated. If your baby is formula fed and constipated, the stools will look like hard balls that roll. Breastfeeding babies will stool before, during and after feeding. In the first three months, bowel movements occur as frequently as every feeding only to decrease to once every other day. It is not unusual for your baby to pass stool and cry, fuss or turn red in the face. As long as stools are soft or loose, there is usually no problem.
Vitamins
If your child is feeding and growing properly, there is no need for vitamins. We will discuss Fluoride supplements with you at the six-month well child visit. If the municipal water supply contains fluoride and your baby drinks some each day you do not need to worry. Over fluoridation can cause white spotting on your baby’s teeth.
Solid Foods
Generally, your baby does not need additional food other than breast milk or formula. When your baby is four months of age, we talk about introducing solid foods. Your child needs the developmental skills necessary to chew and swallow food. They usually do not appear until that time. Too early an introduction of solid foods may cause food allergies or obesity.
Suggested Reading
Breastfeeding
Nursing Your Baby by Karen Pryor
The Womanly Art of Breast-Feeding by the La Leche League
Breastfeeding Your Baby by J. Walker and J. W. Driscoll
Nursing Mothers Companion by Kathleen Huggins, R.N., and M.S.
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