You may offer 2 - 4 ounces of formula on demand to your newborn. Burp baby at least once during the feeding and at the end of the feeding. Always hold your baby and the bottle; never prop the bottle or use a bottle holder. Test the nipple before feeding the baby. The hole should be large enough to permit the formula to drip freely from the nipple when the bottle is held upside down without shaking the bottle. If the nipple hole is too small, enlarge it with a pin to increase it to the proper size. The bottle cap must be loosened so that air will enter the bottle freely. An alternative is the plastic liner type that decreases the amount of air a baby may swallow. Keep the nipple hole free from clogging with a tooth pick as needed. If these small precautions are not taken, the baby may tire before its hunger is satisfied and your baby will want to eat more frequently. It is not necessary to sterilize the formula or water. Bottles and nipples should be rinsed with hot sudsy water. Use at room temperature. When you use room temperature formula, set out another bottle so it can warm up for the next feeding. It will not harm the formula to warm it in water or the microwave. If you microwave the liquid, it can become hotter than the moment you stopped the oven. Let the bottle rest for two minutes and test it before using it.
How much formula?
The amount of formula your baby takes will vary. Just like you and I, babies have the right not to be hungry, but you can’t make a baby want to eat. Feeding schedules are best when they are roughly set and the baby is allowed to eat when he or she becomes hungry. Most babies will awaken for feeding every 2 - 4 hours; most will feed for 15 to 20 minutes. Babies may take all or just some formula. Don’t worry. This is normal. As your baby grows and gains weight, he or she will need more formula. When your baby takes the entire bottle regularly and sometimes cries for more... increase the amount of formula in each bottle. Wake your baby every 3 to 4 hours during the day (8:00 A.M. to 8:00 P.M.) the first week or until you establish some feeding pattern where daytime feeding are more frequent. It is not necessary to feed this often, but the more the baby is awake during the day the better the baby will sleep at night.
Breast Feeding
Breast feeding is the natural way to feed your baby. You and your
baby will benefit from nursing. A breast fed baby may have fewer infections and fewer allergies and the nursing mother will benefit because her figure returns to normal faster. Most women can successfully nurse their babies. Successful nursing requires that the mother be relaxed and rested. This is absolutely necessary; but even under ideal conditions, it takes several days for a full milk supply to develop. There is not always a lot of colostrum so the baby might not seem completely satisfied. It is the extra desire to nurse longer that induces the milk production. If mother or baby seem too uncomfortable with the amount of colustrum then you can supplement with water, formula, or both. You need not use a bottle to supplement the feeding. A medicine dropper, medicine cup, or medicine spoon may be used to give fluids to the baby. Don’t be impatient. Your baby will get plenty to eat and probably will want to eat often (every two to three hours).
Certain foods ythe mother eats may cause stomach upset or fussiness in your baby, such as : onions, garlic, the cabbage family of foods, chocolate, nuts, highly seasoned foods and large amounts of caffeine. Although these are the most notorious, almost any food can cause a reaction. Eat in moderation and if you suspect there may be a problem, keep a diary of your meals and your medications.
During the day, nurse about every four hours. Most newborns will nurse every two to four hours. Don’t let them go more than four hours without trying to feed them. In the evening, between 11 PM and 6 AM, they may be fed 2 to 3 times but may go for 5 to 6 hours between feedings. Avoid excessive fatigue and stressful activities because this can affect your milk supply. Get enough rest by setting a regular schedule of naps and adequate rest at night. Eat a well balanced diet and avoid excesses of any foods. Do not listen to old wives tales and superstitions you may hear from friends and relatives. Do the best you can. You have an excellent chance of being successful at breast feeding.
The first week of life can be extra stressful when your baby acts as if you cannot satisfy them. The nursery or floor nurse will help you get comfortable with nursing. If you decide to supplement with formula and are concerned about any confusion from taking the formula from a bottle then do this. Use a medication cup or small syring to drip liquid into baby’s mouth or let them lap it up from a cup. Don’t try to pour it into the mouth. Nurses can show this technique for supplementation.
Parents frequently are concerned their baby is not eating enough.
Last reviewed May 15, 2007
Not eating enough
If you are changing four to five diapers a day the first few days, you can rest assured because your baby is getting enough to eat during the first week. You should be concerned in those first few days when your baby is wetting only one or two diapers every 24 hours. I encourage you to give some water or sugar water by cup or syringe to be sure they are receiving enough fluids.
Traditionally, parents view switching their baby from breast milk or formula to cow’s milk as a major step in their development. This switch may cause serious nutritional consequences if made too early. Cow’s milk does not supply the balanced nutrition that your baby requires during the first 9 to 12 months of life. You should continue to breast feed or feed a cow’s milk formula like Similac™ or a soy formula like Isomil™ until I recommend otherwise. Any formula choices should be dictated by your child’s health and family history of allergy to cow’s milk or soy.
First get into a comfortable position. If you lie down you can feed the baby and rest at the same time. Stroking the baby’s cheek and mouth with the nipple will stimulate the baby to open his or her mouth and turn toward the breast to grasp the nipple. Nurse from both breasts at each feeding time. Let the baby nurse from each breast for three minutes when you first start and increase the time by one minute every few times. Babies are normally sleepy during their first 48 hours of life. Until your nipples have toughened up, it is best not to nurse from the first breast for more than five minutes before changing to the other breast. Alternate the breast you start with at each feeding. Some mothers use a safety pin fastened to the bra side where they finished as a reminder for the next feeding.
Total nursing time to empty your breasts is usually 10 minutes. I recommend you start at three minutes on each breast and gradually work up to 10 minutes. This routine may take several days to a week to do.
To prevent sore nipples, avoid harsh soaps and irritating medications. Dove ™, Nutragena™, or plain water work very well. Keep the nipples dry to prevent cracking. Avoid increased tension in the breasts by starting to nurse early and by nursing day and night. If the dark area around the nipple (areola) is too swollen for the baby to grasp easily, some milk should be manually squeezed out to reduce its size slightly. When nursing time is over, place your finger on the your baby’s chin or press on the base of the nipple to relieve the suction. Now, the baby can be removed from the breast without hurting the nipple.
Last reviewed May 15, 2007
At four to six months of age you may start adding solid foods like cereal. Rice or oat cereals are tolerated the best and are least likely to cause an allergic reaction. At six months you may start adding fruits and vegetables. Avoid corn and wheat, plus citrus like orange or lemon. Add only one new food each week.
You want to avoid allergic reactions like: pain, spitting up, vomiting, diarrhea, rash, runny nose, or cough. Do not force these new foods. If your baby refuses, stop for a few days and then resume. Your fresh, home-cooked foods, put into a blender or mixer, are the best foods for your infant. They taste better, have more nutritive value and cost less. Commercial baby foods are convenient but more expensive. Use plain foods for your baby. Avoid mixed dinners, mixed vegetables, puddings, cobblers, or desserts. They have less food value. To prepare these foods for future use you can blend a larger amount and fill an ice cube tray, freeze and put individual cubes in a freezer bag for future meals.
- 0-4 months Breast milk or Formula
- 4-6 months Cereal - rice or oatmeal preferred
- 6-8 months Vegetables: carrots, squash, sweet potatoes, green vegetables and fruits: applesauce, pears, peaches Your child hold a cup by 6 months so start off with a tippy cup
- At 7 or 8 months, your infant can be introduced to soft table foods.
- 8-12 months eggs, meats, finger foods
From 8 to 12 months, babies eat more from the table. Feed them mashed or pureed foods or small bite sized finger foods that dissolve easily in the mouth (finger foods). Teething biscuits or Jell-O are fine. Avoid rich or seasoned foods. When starting eggs, remember: 2 to 4 eggs per week. Start with the yolks and then in a week, add the cooked white of the egg (This part of the egg is more likely to be a cause of egg allergy).
Water
Offer one to two ounces of unsweetened water between feedings if your baby is fussy and not comforted when picked up or talked to soothingly. In our warm summer months, water may be offered if your infant has been exposed to warmer temperatures. Hiccups may be soothed by nursing, formula or water. Water does not need boiling and the bottle does not need sterilization. Do not add honey as a sweetener at any time during the first year because of the risk of botulism – a life-threatening infection. The risk disappears after this age.
Circumcision
If your baby has been circumcised, apply Vaseline™ to the penis the first day or two only if the foreskin was removed. Notify me if marked bleeding or swelling occurs. Sometimes a Plastibell™ or plastic ring is used so no vasolene would be necessary. If a was used for the circumcision, no special care is needed. The ring will fall off in about one or two weeks.
As long as your baby is nursing, taking formula or receiving supplementary vitamins with fluoride, there is no need for orange juice. Vitamin drops will provide an ample supply of Vitamin C for your baby so orange juice which contains Vitamin C is not needed. O.J. may cause allergies in small infants, so it is preferable to wait until 9 months or longer before starting it. Commercially prepared vitamins with fluoride will be prescribed at your child’s six month visit. I will advise you when to start solid foods. My preference is to leave your infant on breast milk or formula exclusively for the first 4 to 6 months. Do not use cow’s milk becaue of problems with adequate digestion, allergy and intestinal bleeding that can cause anemia. The earlier solid foods are started, the greater your infant’s chances of having difficulties with future allergies or bowel problems.
Vitamins and increased appetite?
Vitamins play an essential role in the body’s machinery and basic chemical reactions. Without vitamins, individual human cells would stop functioning. When severe and prolonged deficiencies occur, many obvious and subtle changes can be all detected. These include rashes and skin changes, personality changes, disorders of organ functions, blood pressure variations, vision problems and many other symptoms.
One question that often arises during office visits or phone calls – my two or five year old’s appetite isn’t what it used to be; can this be improved with vitamins and minerals?
The human body is very efficient about how it uses these vitamins. It only requires small amounts of vitamins and minerals each day. The body grows at a certain rate, rapidly during the first 9 to 18 months. Substantial amounts of foods are required to meet growth needs. When the rate of growth slows, the need for food decreases in the same proportion. Taking additional minerals and vitamins, will not increase growth beyond what has been determined by the baby’s genetics. Vitamins don’t control the body’s rate of growth, and your child’s natural appetite for foods won’t increase with mineral and vitamin supplements. This does not apply to children with severe deficiencies of these essential elements, but these children are very rare in the normal population.