HOME PAGE

Feeding Time 

Feeding is one of your baby’s first pleasant experiences. The baby’s first love for the parents arises primarily from the feeding situation. At feeding time, the baby gets nourishment both from his/her food and from the security that comes from the parents’ loving care. Help nurture your baby by making this a pleasant time for both of you.

Choose a comfortable chair that will help you be calm and relaxed at feeding time. Your baby should be warm and dry so that he/she is also comfortable.  Hold your baby in your lap, with his/her head slightly raised and resting in the bend of your elbow. Whether breastfeeding or bottle-feeding, hold the baby comfortably close. Eye contact and talking to the infant are very important.

Feeding schedules are usually most satisfactory if the baby is allowed to eat when he/she becomes hungry. In newborns, this is usually every 2½ to 4 hours. Each child is different, so be flexible and don’t feel that a precise time schedule is necessary. The amount of formula or the length of time your baby is at the breast will vary. Babies have a right not to be hungry sometimes, just as you and I, and you can’t make a baby want to eat. You should only need to spend about 30 -45 minutes trying to feed your baby.

• Breast Feeding vs. Bottle Feeding

The choice of whether to breast-feed or bottle-feed is up to you. Obviously, human breast milk was made for human babies.  Briarcliff Pediatrics and the American Academy of Pediatrics strongly recommend breast feeding until your child is twelve months of age.  Infant formulas are generally made from cow’s milk and have been modified to be very similar to human milk. We will be happy to counsel you about this decision, and, no matter what the decision, we will try to support you in maintaining the best possible care of your infant.

• Breast Feeding

Nursing should commence shortly after birth and continue as long as comfortable and practical for both mother and the infant. The use of both breasts for each feeding is recommended. Guide the nipple into the baby’s mouth with your fingers.  Sometimes you may need to encourage the baby to nurse by gently stroking the cheek with the nipple. The baby will usually turn his/her head to hunt for it.

It usually takes 48 to 96 hours for the breast milk to come in adequately. During this time you are actually feeding the baby colostrum, a milk that is small in quantity but rich in factors to help the baby fight infection. The amount of milk produced will increase steadily over the next 1-2 weeks and will be directly related to the vigor and frequency of feedings. A balanced calcium enriched diet and plenty of fluids are important to the mother and breast milk supply. Predominantly breast-fed infants should receive Poly-Vi-Sol with iron daily to prevent vitamin D and iron deficiency.  After 6 months, rice cereal provides additional iron, and city tap water provides fluoride.

The milk flow will be greater if both breasts are nursed by a hungry infant. It is best to begin the next feeding at the breast where the last feeding was completed. (Some mothers place a small safety pin in the bra on the side last nursed. ) If your baby does not nurse all the milk available in the breast, you may express the excess milk manually and store it should you wish to go out at the time of another feeding in the next day or so. Don’t nurse too long and tire your baby or yourself. Generally, a baby’s entire feeding time should not exceed 30 to 45 minutes (i.e. 20 minutes maximum on each breast; minimum goal: 15-20 minutes 1st breast, at least 5 minutes 2nd breast).

• Preparation and Positioning

When preparing for nursing your infant, you should wash your hands. It is not necessary to wash nipples unless you have some ointment or emollient that is not safe for ingestion. Lanolin or A&D need not be wiped off. Soap should not be used on the nipples as it is drying and promotes cracking.

Your infant should be cradled in your arms facing you at a 45 degree angle with one of your hands on the buttocks. This is the “en face” position. A pillow under the arm supporting your baby’s head helps. If you cannot be upright, you may lie on your side with the baby beside you. A pillow behind your back gives extra support. If you have abdominal discomfort, a “football hold” may be an alternative. Many women need to try several positions to get comfortable, particularly just after delivery.

To get your baby on the breast, tickle the lower lip with the nipple. As the baby’s mouth opens wide, push the infant toward the breast. If the baby persists in turning the head the opposite way, tickle the cheek nearest the breast utilizing the rooting reflex to get the infant to turn the head. Once the breast is in the baby’s mouth, be sure he/she has taken part of the areola behind the nipple. If your infant takes only the nipple, he/she will chew on it, which is a major cause of nipple soreness. Also, be sure your baby’s lower lip is out and not curled in and be sure the tongue is under the nipple.

When offering the breast, supporting it with the fingers may help. This may be more helpful in women who are large breasted. In getting your baby off the breast, put an index finger in the corner of the mouth to break the suction before pulling your breast away.

• Milk Supply

Many mothers wonder whether the baby is getting enough milk. The mother who expresses this concern can look for several indicators of well-being in her infant. First of all, you should listen to the baby swallowing during a feeding and look for rhythmic jaw movement. Your baby will show signs of relaxation during feeding. Counting wet diapers is very helpful. Your baby may have 3-4 wet diapers per 24 hours before your milk "comes in". After your milk "comes in", the number of wet diapers should double to 6-8 per day.  Next, the baby should gain weight and appear to be filling out. We will be checking for appropriate weight gain. Ten to 12 feedings a day is normal in the beginning and is not an indication of an insufficient milk supply. Again, there are growth spurts around 2, 6 and 12 weeks, at which time your infant will demand to be fed more often.

After the first 8 weeks of nursing, the law of supply and demand is fairly well established, and you may notice a decrease in the size of your breasts.  This may worry you and you may fear you are losing your milk supply. The breast is still producing an adequate supply of milk, but is more efficient, and can begin to resume its normal size.

Common Problems

Sleepy Baby

One of the most common early problems is a sleepy baby who will not nurse well. It is very normal for your newborn to enter a state of perpetual dozing, beginning at 4 to 8 hours of age and lasting 4 to 5 days of age. During this time, your infant may show little or no interest in eating.  Some solutions to this dilemma include unswaddling and unclothing your baby down to the diaper, putting his/her skin to the skin with mother and nursing.  Also, you may try tickling your baby’s feet. Vigorous burping or jostling may help. Sponging a sleepy baby sometimes is effective. If all fails, and your baby insists on sleeping, don’t worry. If the baby is sleeping through 2 consecutive feeding periods, please call. 

Engorgement

Another early problem may be engorgement, which occurs for the first time at 3 to 5 days after delivery as milk comes in. Hot or cold packs and frequent nursing plus a well-fitting brassiere can provide relief. The discomfort will pass in 1 to 2 days. Occasionally, your baby may have a problem grasping the areola. An easy solution is to use hot soaks on the breast followed by hand expression. For the latter, hold the breast as if offering it to your baby, then press beginning at the ribs and moving down to the areola. This should not hurt. Frequent nursing helps relieve the engorgement. 

Leaking

Leaking is common at first, and a new mother is well advised to use a breast pad. Those with a plastic liner are not recommended as they trap moisture and promote maceration of the nipples. A cut-up diaper or a handkerchief works as well as any breast pad.

Sore Nipples

Sore nipples are a common complaint. This may often result from nipple chewing. In this case, check the positioning of your infant while nursing and be sure he/she is getting on the breast correctly. Any nipple engorgement should be relieved before nursing by expression. Holding your baby off in order to rest sore nipples may only make your baby more hungry so he/she attacks the nipple. Lanolin may soothe sore nipples.

Tender Lump

At times, you may notice a tender lump in your breast. This is usually a clogged milk duct and should be treated by warm compresses and frequent nursing to empty the breast. Often, massage and hand expression are helpful.  If the area of tenderness becomes warm and red, mastitis may be developing and antibiotics may be prescribed by your obstetrician. Nursing, with emphasis on emptying the breast, should be encouraged.

Inverted Nipples

Inverted nipples do not prevent successful nursing. An inverted nipple may be diagnosed by squeezing the areola between the thumb and forefinger.  If the nipple goes in, it is inverted. This is best discovered prenatally. You should wear a breast shell in your brassiere. This will allow the nipple to be pushed out. During nursing, your baby will often pull the nipple out.

Weight

Babies lose weight their first few days of life but will regain weight to their birth weight by 2 weeks.

• Weaning

There is no specified time to wean the infant. Most babies will begin to take solids by 4 to 6 months and will naturally decrease their frequency of nursing.  This doesn’t mean nursing should stop. Nursing may continue as long as you and your baby are happy with it.

• Bottle Feeding

There are several standard formulas, such as Similac® With Iron, on the market. Vitamins have been added to the formula and it is best to purchase the formula with added iron. It is preferable to use either powder or liquid concentrated formula, adding local city water. In this way your baby will receive fluoride, which has been added to the water in this region.

Sterilizing the water and the bottle is not necessary; sufficient cleaning entails washing and rinsing with soap and water, with a final hot water rinse. A dishwasher is adequate. Store the bottles with the nipples inverted after cleaning.

Formula, like any milk, will spoil if left out of the refrigerator too long. It is best to leave this formula in the refrigerator until feeding time and then warm it up to room temperature or slightly warmer by running hot tap water over the bottle; microwaving is highly discouraged.  It is best not to use formula after it has sat in the refrigerator for more than 24 hours. The first day, your baby may drink only ½ to 1 ounce per feeding. Gradually, he/she will build up and by the age of 2 months, 4 to 6 ounces per feeding is standard. Propping up the bottle should not be done. It is much better to hold your baby while feeding.

As with breast-fed babies, feeding should be done every 2 to 4 hours until the baby is sleeping through the night. Once that occurs, these 2½ to 4 hours should remain standard during the day. However, after 10:00 p.m., allow your baby to get adequate rest. Human milk and formulas, which are modified to simulate human milk, are very nutritious and quite adequate alone for the first 4-6 months.

• Introduction of Solid Foods

In the early 1900’s solids were not introduced until an infant was a year or two of age. The idea of earlier introduction of food was not in fashion until around 1940. Most pediatricians and The American Academy of Pediatrics have now returned to introducing other foods at around 4 to 6 months of age.  At that time, infants usually outgrow what can be provided by breast milk or formula alone and can indicate whether they want or do not want food. They can control their heads and mouths to accept a spoon readily. Waiting to introduce solids may also help decrease your child’s later problems with obesity or allergy.

Schedule

Begin at 4-6 months of age by introducing a tablespoon of rice cereal mixed with an ounce or so of breast milk or formula once or twice a day (morning and evening). Once the infant has been taking that well for 2 weeks, you may add other foods. We prefer to change or add only 1 food at a time and to use that food at least 3-4 days before changing or adding another. This allows both you and us to see if the baby has a reaction to any food.

You may usually add yellow and then green vegetables next to the evening meal. Stay on that 2-3 days and then you may change to another vegetable.

After the baby has tried several vegetables, add a fruit to breakfast and/or dinner. Begin to try several others in order to expand the baby’s diet. However, avoid citrus fruits and their juices, since these may sensitize your baby.

Once the baby is on cereal, fruit, and vegetables, you may add meat at 6 to 9 months to the diet. You may start juices such as white grape and apple juice also at 6 months. Put these in a sippy cup and reserve the bottle for formula or expressed breast milk. Limit juices to a maximum of 4-6 oz. per day. Full strength juices should be diluted with equal parts water. Also, you may begin to introduce other meats, fruits, cereals, and vegetables as time goes on. We do suggest avoiding the baby desserts as these contain added starch.

Your baby will begin by taking small quantities, often just a tablespoon at a time. This will steadily increase. Often by 8 months of age, he/she may indicate the need for a midday meal also. You needn’t force this, but just adapt to the baby’s desires, just as you did when you began to breast-feed or bottlefeed. 

Index of Medical
Information and FAQ's


Newborn
Infant


Feeding Time


Newborn Care


Infant Safety


Good
Investments for Proper Home Care