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Which Formula is Better? – Forbes Health

Stroll the aisles of any grocery store and you’re bound to see multiple baby formula options from Similac and Enfamil, two of the biggest brand names on the shelves. From one company’s standard formula to the other’s specialized option for spit up-prone babies, which will serve your family best?

Below, we examine the standard milk-based, gentle and spit-up formulations from both brands to help you decide which makes most sense for your baby. (Note: Costs for all products are sourced from Amazon, and are accurate as of date of publication.)

Enfamil vs. Similac: The Main Differences

While both Enfamil and Similac share many similarities, the two baby formula brands do have a number of key differences. We dive deeply into their differences later in this article, but here’s a summary of the main ways they differ. 

  • Standard milk-based baby formulas: Enfamil NeuroPro (Enfamil’s standard milk-based formula) contains milk fat globule membrane, which more closely mimics breast milk, and slightly higher levels of certain fatty acids.
  • Gentle baby formulas: The Similac and Enfamil formulas that are specifically designed for fussy babies rely on different protein sources—Similac’s Pro-Total Comfort contains 100% whey protein while Enfamil’s Gentlease uses 60% whey and 40% casein.
  • Spit-up baby formulas: Similac claims its spit-up formula reduces spit-up episodes by 54% while Emfamil claims a reduction of 50% with its spit-up formula.

No matter which brand you go with, all baby formulas marketed in the U.S. are required to meet certain nutrient specifications outlined by the U.S. Food and Drug Administration (FDA) that ensure your infant receives the nutrients they need to grow and thrive.

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Standard Milk-Based Formula: Enfamil NeuroPro vs. Similac Advance

When not breastfeeding or otherwise using human milk, most parents in the U.S. rely on standard milk-based infant formulas for nourishing their little ones. Indeed, the American Academy of Pediatrics (AAP) recommends formula-fed babies receive iron-fortified, milk-based formulas.

Health care providers will look to alternatives if a baby has an intolerance to a milk-based formula, but standard milk-based formulas are most often their starting point, explains Dyan Hes, M. D., a pediatrician in New York City.

“We always start with cow’s milk formula because all of the sugar is lactose, which is the same as [in] breast milk,” she says. The closer infant formulas can replicate the makeup of breast milk, the better for babies.

Similac Advance

Similac Advance is an iron-fortified, milk-based formula that includes docosahexaenoic acid (DHA)—an omega-3 fatty acid—lutein and vitamin E to better support infant neurodevelopment. The brand boasts it omits palm olein oil in an effort to increase calcium absorption, though it’s worth noting studies show the substance naturally occurs in breast milk and has no adverse effects on developing babies.

Cost: $1.41 per ounce

Key ingredients:

  • Nonfat milk
  • Lactose
  • Whey protein concentrate
  • High oleic safflower oil
  • Soy oil
  • Coconut oil
  • Galactooligosaccharides (prebiotics)

Enfamil NeuroPro

What sets Enfamil NeuroPro apart is its emphasis on brain and eye-boosting fatty acids. The World Health Organization recommends infant formulas contain between .3% and .5% DHA for brain health. This formulation from Enfamil contains .32%.

Cost: $1.57 per ounce

Key ingredients: 

  • Nonfat milk
  • Lactose
  • Vegetable oil (palm olein, coconut, soy and high oleic sunflower oils)
  • Whey protein concentrate
  • Whey protein-lipid concentrate

The Winner: Enfamil NeuroPro

While the Advance and NeuroPro formulas appear to share a similar ingredient list, the Enfamil NeuroPro has a winning advantage: something called milk fat globule membrane (MFGM).

MFGM is a substance that occurs naturally in human milk fat, which helps this formula more closely mimic the properties of breast milk, says Delene P. Musielak, M.D., a pediatrician in St. Louis. One study in the Journal of Pediatrics found consuming formula with added bovine MFGM and bovine lactoferrin gave babies a boost in their language, cognitive and motor development.

Dr. Musielak also notes the Enfamil NeuroPro contains slightly higher levels of both DHA and arachidonic acid (ARA), an omega-6 fatty acid. These fatty acids are essential to the development of babies’ eyes and brains, though she also notes studies have been inconclusive about the long-term benefits of consuming higher levels of these fatty acids in infancy.

“Parents should use the formula that their baby tolerates best and is most affordable for the family,” Dr. Musielak says, noting that one formula isn’t necessarily better than the other. However, if finding an option that most closely resembles breast milk is important to you, then the Enfamil NeuroPro has the advantage in this comparison.

Gentle Baby Formula: Similac Pro Total Comfort vs. Enfamil Gentlease

While most pediatricians start babies on standard milk-based formulas, Dr. Musielak says they may recommend a switch to gentle varieties if parents report any of the following symptoms:

  • Gas
  • Digestive issues
  • Colic and excessive fussiness
  • Sensitivity to lactose

Gentle—or partially hydrolyzed—formulas are easier for tiny stomachs to digest as they have already broken down the protein molecules found in milk. In fact, gentle formulas may better mimic breast milk in terms of protein size, according to Bridget Young, M.D., an assistant professor of pediatrics at the University of Rochester School of Medicine in Rochester, New York.

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“On average, human breast milk proteins are smaller in size than cow’s milk proteins,” says Dr. Young. “So partially hydrolyzed formulas provide proteins that are closer in size to breast milk proteins than standard formula proteins.”

Because they contain casein and whey, however, even gentle formulas are not suitable for babies with true milk allergies.

Similac Pro-Total Comfort

The Pro-Total Comfort formula from Similac uses 100% partially hydrolyzed whey protein that may be gentler on some stomachs. When it comes to this option, Dr. Hes is impressed by Similac’s inclusion of human milk oligosaccharides (HMOs), which are prebiotics naturally present in breast milk that provide immune, gastrointestinal and cognitive support.

Cost: $1.50 per ounce (at CVS)

Key ingredients: 

  • Corn maltodextrin
  • Whey protein hydrolysate
  • High oleic safflower oil
  • Sugar
  • Soy oil
  • Coconut oil

Enfamil Gentlease

Intended to be easier on little stomachs, Gentlease provides partially hydrolyzed nonfat milk and whey proteins. This formula is geared toward infants struggling with digestive discomfort, and aims to ease gas and the fussiness that often goes along with it.

Cost: $1.45 per ounce

Key ingredients: 

  • Corn syrup solids
  • Partially hydrolyzed nonfat milk and whey protein concentrate solids (soy)
  • Vegetable oil (palm olein, coconut, soy, and high oleic sunflower oils)
  • Calcium phosphate

The Winner: Similac Pro-Total Comfort

When it comes to comparing Pro-Total Comfort and Gentlease, one isn’t necessarily better than the other—it’s all about testing and choosing the option that your baby tolerates more easily, says Dr. Young.

The two formulas have different protein sources, which may affect your baby’s comfort: Gentlease uses a partially hydrolyzed mix of 60% whey and 40% casein while the Pro-Total Comfort makes use of 100% whey protein that’s been partially hydrolyzed. Dr. Young also notes differences in the carbohydrate and fat sources, explaining, again, that a parent’s decision should all come down to the baby’s preference.

If you’re dealing with an infant with lactose intolerance, however, Dr. Hes leans toward the Pro-Total Comfort formula. In addition to valuable HMOs, this variety also contains just 2% lactose versus the 20% found in Gentlease.

Baby Formula for Spit Up: Enfamil AR vs. Similac Spit-Up

Spit up is simply part of new parenthood. Tiny developing digestive systems are to blame, but with proper weight gain and adequate wet diapers (about six to eight a day), pediatricians often find no cause for concern.

“If spit up is affecting the baby’s quality of life and/or disrupting sleep, we may consider switching formulas,” says Dr. Hes. “Many babies are happy spitters and they do not need a formula change…if a baby is not growing or gaining weight well, we may change to a formula that protects against spit up.”

Similac for Spit-Up

Similac claims its spit-up formula reduces spit-up episodes by 54% in healthy, 2-month-old babies compared to infants fed standard milk-based formulas. This formula uses additional rice starch to ease spit up and contains a blend of DHA, lutein and vitamin E to support infant neurodevelopment.

Cost: Previously $1.28 per ounce (currently unavailable on Amazon)

Key ingredients: 

  • Corn syrup
  • Modified rice starch
  • Milk protein isolate
  • High oleic safflower oil
  • Sugar
  • Soy oil
  • Coconut oil
  • Galactooligosaccharides (prebiotics)

Enfamil A.R.

Enfamil A.R. is a rice-starch thickened formula aimed at reducing instances of spit up in babies by as much as 50%. This option includes the same recommended amount of DHA and ARA present in the brand’s other formulations.

Cost: $1.35 per ounce

Key ingredients: 

  • Non-fat milk
  • Vegetable oil (palm olein, coconut, soy and high oleic sunflower oils)
  • Rice starch
  • Lactose
  • Maltodextrin
  • Galactooligosaccharides (prebiotics)
  • Polydextrose (prebiotics)

The Winner: Similac for Spit-Up

First, a word of warning: Dr. Musielak says both formula options contain a thickening agent called rice starch that helps infants keep liquids down. Because these varieties are thicker than standard formulas and can clog bottles during feedings, Dr. Musielak advises parents to use a bottle with a larger nipple size. She cautions against cutting or modifying bottle tops on your own, as you want to ensure they don’t become choking hazards while feeding.

While the formulas are fairly similar—especially in their method of reducing spit-up—the increased efficacy of Similac, coupled with its lower price, pushes it into first place.

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Enfamil vs. Similac: Other Infant Formulas

In addition to the formulas noted above, both Enfamil and Similac offer formulas designed for babies with a sensitivity to cow’s milk protein or other allergies.  

Specifically, Enfamil offers: 

  • Nutramigen with Enflora LGG Powder. Crafted from extensively hydrolyzed proteins, this hypoallergenic formula is lactose-free and contains DHA and ARA for brain and eye development. Enfamil also offers this formula in liquid form.
  • PurAmino Hypoallergenic Infant Formula Powder. Enfamil notes this formula is designed for babies with severe food allergies, as it’s crafted with free amino acids. 

Meanwhile, Similac offers the following for food allergies: 

  • Similac Alimentum. This hypoallergenic formula contains 2’-FL HMO—an ingredient for immune support—and features a broken-down protein that’s easier for babies to digest. This formula also comes in ready-to-feed bottles. 

For those interested in organic formulas, both Similac and Enfamil have options, too. Enfamil’s Simply Organic formula contains USDA-certified organic milk, and Similac Organic is non-GMO and features organic milk and other ingredients.

Picking the Best Formula for Your Baby

No matter which baby formula you choose, rest assured that the FDA has a strict set of nutritional requirements each approved product must meet. Ultimately, formula choice comes down to preference—both yours and your baby’s.

A good rule of thumb: “Make your decision based on the first few ingredients in the list,” says Dr. Young. “These make up 98% of the formula and will have the biggest impact on your baby’s comfort.” She recommends ignoring the marketing claims and heading straight for the ingredient list, discussing with your pediatrician which options make the best choice for your baby’s digestive comfort.

Frequently Asked Questions (FAQs)

Is it okay to switch from Similac to Enfamil?

If you’re interested in switching to a different baby formula brand, consult your pediatrician. With the recent baby formula shortage partially driven by a voluntary recall of some Similac baby formulas, Enfamil has identified products on its website that might be a suitable swap. Experts note that in cases where your infant doesn’t require specialized formula, you should be able to switch brands safely. Check with your pediatrician first, though.

Why is there corn syrup in baby formula?

Enfamil notes that corn syrup is derived from corn and consists of long chains of glucose. Not to be confused with high-fructose corn syrup, corn syrup solids provide energy for babies.

Can I use a microwave to prepare baby formula?

The FDA does not recommend heating infant formula or breast milk in the microwave, as it can heat the liquid unevenly, creating hotspots that can scald your baby’s mouth or throat.

What if my baby does not like formula?

Speak with your pediatrician if your baby is vomiting (but keep in mind a little spit-up is normal). If your baby is experiencing belly pain, they may have a sensitivity or allergy to the protein present in cow’s milk. Reach out to your pediatrician, who can help determine the root cause of your infant’s discomfort.

References

Berg J, Tymoczko J, Stryer L. Biochemistry, 5th edition, 2002.

Industry Presented Blog: What to Eat Before and After a Workout. American College of Sports Medicine. Accessed 5/24/2021.

Gustafson C, Rakhmatullaeva N, Beckford S, Ammachathram A, Cristobal A, Koehler K. Exercise and the Timing of Snack Choice: Healthy Snack Choice Is Reduced in the Post-Exercise State. Nutrients. 2018;10(12):1941.

The Top 4 Protein Sources May Surprise You. Cleveland Clinic. Accessed 5/24/2021.

James L, Stevenson E, Rumbold P, Hulston C. Cow’s milk as a post-exercise recovery drink: implications for performance and health. European Journal of Sport Science. 2019;19(1):40-48.

Nieman DC, Zwetsloot KA, Simonson AJ, Hoyle AT, Wang X, Nelson HK, Lefranc-Millot C, Guérin-Deremaux L. Effects of Whey and Pea Protein Supplementation on Post-Eccentric Exercise Muscle Damage: A Randomized Trial. Nutrients. 2020;12(8):2382.

Bowtell JL, Sumners DP, Dyer A, Fox P, Mileva KN. Montmorency cherry juice reduces muscle damage caused by intensive strength exercise. Medicine and Science in Sports and Exercise. 2011;43(8):1544-51.

Vitale KC, Hueglin S, Broad E. Tart Cherry Juice in Athletes: A Literature Review and Commentary. Current Sports Medicine Reports. 2017;16(4):230-239.

The Worst Foods to Eat After a Workout. American Council on Exercise. Accessed 5/24/2021.

Nutrient Timing: Pre and Post-Workout Questions Answered. National Academy of Sports Medicine. Accessed 5/24/2021.

American Dietetic Association, Dietitians of Canada, and American College of Sports Medicine. Nutrition and Athletic Performance. Medicine & Science in Sports & Exercise. 2009;41(3):709-731.

Rossen L, Simon A, Herrick, K. Types of Infant Formulas Consumed in the United States. Clinical Pediatrics.(2015):278–85.

Eidelman A, Schanler R. Breastfeeding and the Use of Human Milk. Pediatrics. 2012;129(3)e827-e841.

Infant Formula: Evaluating the Safety of New Ingredients. National Academies Press. 2004. Accessed 5/14/2021.

Di Genova L, Cerquiglini L, Penta L, et al. Pediatric Age Palm Oil Consumption. Int J Environ Res Public Health. 2018;15(4):651.

Dha Ara One-Pager. Munich: European Foundation for the Care of Newborn Infants. Accessed 5/13/2021.

Li F, Wu S, Berseth C L, et al. Improved Neurodevelopmental Outcomes Associated With Bovine Milk Fat Globule Membrane and Lactoferrin in Infant formula: A Randomized, Controlled Trial. The Journal of Pediatrics. 2019.

Questions & Answers for Consumers Concerning Infant Formula. Food and Drug Administration. Accessed 5/13/2021.

Salem N. What is the Right Level of DHA in the Infant Diet? Pediatr Res, 2007;61,518–519.

Formula Options for Infants and Toddlers with Food Allergies. Kids With Food Allergies. Accessed 5/13/2021.

Spitting Up in Babies. Familydoctor.org. Accessed 5/13/2021.

Spitting Up–Self-Care. Medlineplus. Accessed 5/27/2021.

Your Newborn’s Growth. KidsHealth. Accessed 5/27/2021.

Similac. Abbott. Accessed 5/27/2021.

Enfamil. Mead Johnson. Accessed 5/27/2021.

Baby formula: Abbott announces another recall but claims it affects small fraction of total US supply

Amid formula shortage, moms donate their milk to others

02:30 - Source: CNN

CNN  — 

Abbott Labs said Friday that it is recalling certain lots of 2 fluid ounce/59 milliliter bottles of Ready-to-Feed liquid formula for infants and children due to a problem with the bottle caps on some bottles that may not have sealed completely and could result in spoilage.

If a child were to consume spoiled formula, the company said, it could cause stomach problems such as vomiting or diarrhea.

Similac and Enfamil products are seen on largely empty shelves in the baby formula section of a Target store, amid continuing nationwide shortages in infant and toddler formula, in San Diego, California, U.S., May 25, 2022. REUTERS/Bing Guan/File Photo

Bing Guan/Reuters

FDA report details agency fumbles during infant formula investigation that hampered response

A company spokesperson told CNN that the recall involves “less than a day’s worth” of the total infant formula used in the US and should not affect the overall supply.

This formula was manufactured in Columbus, Ohio, not at Abbott’s plant in Sturgis, Michigan, that was the focus of a large recall in February that exacerbated a shortage of baby formula, leading to ongoing problems.

The recalled brands include Similac, Pro-Total Comfort, Similac 360 Total Care, Similac 360 Total Care Sensitive, Similac Special Care 24, Similac Stage 1, Similac NeoSure, Similac Water (Sterilized) and Pedialyte Electrolyte Solution.

A customer stands waiting for assistance to receive baby formula in a Walmart Supercenter on July 08, 2022 in Houston, Texas. Consumer goods continue seeing shortages as the country grapples with ongoing supply chain issues stemming from the pandemic.

Brandon Bell/Getty Images

Baby formula waivers, rebates extended to allow WIC families more flexibility to buy different brands

Most of these products are distributed primarily to hospitals and doctors’ offices.

The recall does not include any other liquid or powder formula brands or other nutrition products produced at Abbott’s Ohio facility or any other manufacturing location.

Affected lot numbers are listed on the website similacrecall. com. If a consumer has one of the recalled products, they should not feed it to their child, the company said.

“We take our responsibility to deliver high-quality products very seriously,” Joe Manning, Abbott’s executive vice president of nutritional products, said in a news release. “We internally identified the issue, are addressing it, and will work with our customers to minimize inconvenience and get them the products they need.”

Fort Lauderdale Fl July 6: Baby Formula shortages hit Florida Super Markets ( Publix) on July 6 2022

hoo-me/MediaPunch/AP

Baby formula shortage is easing for many, but it still isn't over

Abbott’s Sturgis plant was shuttered for months after an FDA inspection found Cronobacter sakazakii bacteria, which can be deadly to infants, in several areas. Similac, Alimentum and EleCare powdered infant formulas made at the plant were recalled, and the closure exacerbated shortages caused by supply chain disruptions. Families across the United States have struggled for months to find formula for infants and for people with specific nutrition needs.

Production had been underway for less than two weeks before a storm and flooding in July prompted officials to close the plant again. It was restarted in August.

The Biden administration’s Operation Fly Formula efforts have brought in millions of pounds of imported formula to help with the shortage.

Stock rates for formula have gotten much better, but they are still not back to typical levels before the shortage, according to market research firm IRI.

Breastfeeding in the first month: what to expect

Not sure how to establish lactation and increase milk production? If you need help, support, or just want to know what to expect, read our first month breastfeeding advice

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The first weeks of breastfeeding are a very stressful period. If at times you feel like you can't handle it, know that you are not alone. Feeding your baby all day long is completely natural and helps produce breast milk, but can be quite tiring at times. Be patient, think about yourself and remember: after the first month, when milk production stabilizes, it will become easier. nine0003

How often should a baby be breastfed?

Babies are born with a small stomach that grows rapidly with increasing milk production: in the first week it is no larger than an apricot, and after two weeks it is already the size of a large chicken egg. 1.2 Let the child eat as much as he wants and when he wants. This will help him quickly regain the weight lost after birth and grow and develop further.

“Be prepared to feed every two to three hours throughout the day. At night, the intervals between feedings can be longer: three to four or even five hours, says Cathy Garbin, a recognized international expert on breastfeeding. Some eat quickly and are satiated in 15 minutes, while others take an entire hour to feed. Do not compare your breastfeeding regimen with that of other mothers - it is very likely that there will be nothing in common between them. nine0003

At each feed, give your baby a full meal from one breast and then offer a second one, but don't worry if the baby doesn't take it. When the baby is full, he lets go of his chest and at the same time looks relaxed and satisfied - so much so that he can immediately fall asleep. The next time you feed, start on the other breast. You can monitor the order of the mammary glands during feeding using a special application.

Why does the child always ask for a breast?

The first month is usually the hardest time to breastfeed. But do not think that because the baby is constantly hungry and asks for a breast almost every 45 minutes, then you do not have enough milk. nine0003

In the first month, the baby needs to eat frequently to start and stimulate the mother's milk production. It lays the foundation for a stable milk supply in the future. 3

In addition, we must not forget that the child needs almost constant contact with the mother. The bright light and noise of the surrounding world at first frighten the baby, and only by clinging to his mother, he can calm down.

Sarah, mother of three from the UK, confirms: “Crying is not always a sign of hunger. Sometimes my kids just wanted me to be around and begged for breasts to calm them down. Use a sling. Place the cradle next to the bed. Don't look at the clock. Take advantage of every opportunity to relax. Forget about cleaning. Let those around you take care of you. And not three days, but six weeks at least! Hug your baby, enjoy the comfort - and trust your body." nine0003

Do I need to feed my baby on a schedule?

Your baby is still too young for a strict daily routine, so
forget about breastfeeding schedules and focus on his needs.

“Volumes have been written about how to feed a baby on a schedule, but babies don't read or understand books,” Cathy says. - All children are different. Some people can eat on a schedule, but most can't. Most often, over time, the child develops his own schedule.

Some mothers report that their babies are fine with scheduled feedings, but they are probably just the few babies who would eat every four hours anyway. Adults rarely eat and drink the same foods at the same time of day - so why do we expect this from toddlers?

Offer your baby the breast at the first sign of hunger. Crying is already the last stage, so be attentive to early signs: the baby licks his lips, opens his mouth, sucks his fist, turns his head with his mouth open - looking for the breast. nine0013 4

What is a "milk flush"?

At the beginning of each feed, a hungry baby actively sucks on the nipple,
thereby stimulating the milk flow reflex - the movement of milk through the milk ducts. 5

“Nipple stimulation triggers the release of the hormone oxytocin,” explains Cathy. “Oxytocin is distributed throughout the body and causes the muscles around the milk-producing glands to contract and the milk ducts to dilate. This stimulates the flow of milk. nine0003

If the flushing reflex fails, milk will not come out. This is a hormonal response, and under stress it may not work at all or work poorly. Therefore, it is so important that you feel comfortable and calm when feeding.

“Studies show that each mother has a different rhythm of hot flashes during one feed,” Kathy continues, “Oxytocin is a short-acting hormone, it breaks down in just 30-40 seconds after formation. Milk begins to flow, the baby eats, the effect of oxytocin ends, but then a new rush of milk occurs, the baby continues to suckle the breast, and this process is repeated cyclically. That is why, during feeding, the child periodically stops and rests - this is how nature intended. nine0003

The flow of milk may be accompanied by a strong sensation of movement or tingling in the chest, although 21% of mothers, according to surveys, do not feel anything at all. 5 Cathy explains: “Many women only feel the first rush of milk. If you do not feel hot flashes, do not worry: since the child eats normally, most likely, you simply do not understand that they are.

How do you know if a baby is getting enough milk?

Since it is impossible to track how much milk a baby eats while breastfeeding, mothers sometimes worry that the baby is malnourished. Trust your child and your body. nine0003

After a rush of milk, the baby usually begins to suckle more slowly. Some mothers clearly hear how the baby swallows, others do not notice it. But one way or another, the child himself will show when he is full - just watch carefully. Many babies make two or three approaches to the breast at one feeding. 6

“When a child has had enough, it is noticeable almost immediately: a kind of “milk intoxication” sets in. The baby is relaxed and makes it clear with his whole body that he is completely full, says Katie, “Diapers are another great way to assess whether the baby is getting enough milk. During this period, a breastfed baby should have at least five wet diapers a day and at least two portions of soft yellow stool, and often more.” nine0003

From one month until weaning at six months of age, a baby's stool (if exclusively breastfed) should look the same every day: yellow, grainy, loose, and watery.

When is the child's birth weight restored?

Most newborns lose weight in the first few days of life. This is normal and should not be cause for concern. As a rule, weight is reduced by 5-7%, although some may lose up to 10%. One way or another, by 10–14 days, almost all newborns regain their birth weight. In the first three to four months, the minimum expected weight gain is an average of 150 grams per week. But one week the child may gain weight faster, and the next slower, so it is necessary that the attending physician monitor the health and growth of the baby constantly. nine0013 7.8

At the slightest doubt or signs of dehydration, such as
dark urine, no stool for more than 24 hours, retraction of the fontanel (soft spot on the head), yellowing of the skin, drowsiness, lethargy, lack of appetite (ability to four to six hours without feeding), you should immediately consult a doctor. 7

What is "cluster feeding"?

When a baby asks to breastfeed very often for several hours, this is called cluster feeding. nine0013 6 The peak often occurs in the evening between 18:00 and 22:00, just when many babies are especially restless and need close contact with their mother. Most often, mothers complain about this in the period from two to nine weeks after childbirth. This is perfectly normal and common behavior as long as the baby is otherwise healthy, eating well, gaining weight normally, and appears content throughout the day. 9

Cluster feeding can be caused by a sharp jump in the development of the body - during this period the baby especially needs love, comfort and a sense of security. The growing brain of a child is so excited that it can be difficult for him to turn off, or it just scares the baby. nine0013 9 If a child is overworked, it is often difficult for him or her to calm down on his own, and adult help is needed. And breastfeeding is the best way to calm the baby, because breast milk is not only food, but also pain reliever and a source of happiness hormones. 10

“Nobody told me about cluster feeding, so for the first 10 days I just went crazy with worry - I was sure that my milk was not enough for the baby,” recalls Camille, a mother from Australia, “It was a very difficult period . I was advised to pump and supplement until I finally contacted the Australian Breastfeeding Association. There they explained to me what was happening: it turned out that it was not about milk at all. nine0003

Remember, this is temporary. Try to prepare dinner for yourself in the afternoon, when the baby is fast asleep, so that in the evening, when he begins to often breastfeed, you have the opportunity to quickly warm up the food and have a snack. If you are not alone, arrange to carry and rock the baby in turns so that you have the opportunity to rest. If you have no one to turn to for help and you feel that your strength is leaving you, put the baby in the crib and rest for a few minutes, and then pick it up again. nine0003

Ask your partner, family and friends to help you with household chores, cooking and caring for older children if you have any. If possible, hire an au pair. Get as much rest as possible, eat well and drink plenty of water.

“My daughter slept a lot during the day, but from 23:00 to 5:00 the cluster feeding period began, which was very tiring,” recalls Jenal, a mother from the USA, “My husband tried his best to make life easier for me - washed, cleaned, cooked, changed diapers, let me sleep at every opportunity and never tired of assuring me that we were doing well. nine0003

If you are concerned about the frequency of breastfeeding, it is worth contacting a specialist. “Check with a lactation consultant or doctor to see if this is indicative of any problems,” recommends Cathy. “Resist the temptation to supplement your baby with formula (unless recommended by your doctor) until you find the cause. It may not be a matter of limited milk production at all - it may be that the child is inefficiently sucking it.

When will breastfeeding become easier? nine0011

This early stage is very special and does not last long. Although sometimes it seems that there will be no end to it, rest assured: it will get easier soon! By the end of the first month, breast milk production will stabilize, and the baby will become stronger and learn to suckle better. 2.3 Any problems with latch on by this time will most likely be resolved and the body will be able to produce milk more efficiently so inflammation and leakage of milk will begin to subside.

“The first four to six weeks are the hardest, but then things start to get better,” Cathy assures. It just needs to be experienced!” nine0003

The longer breastfeeding continues, the more benefits it brings, from saving on formula and improving sleep quality 11–13 to boosting your baby's immune system 14 and reducing your risk of certain cancers. 15

“When you feel like you're pushing yourself, try to go from feed to feed and day to day,” says Hannah, a UK mom. “I was sure I wouldn’t make it to eight weeks. And now I have been breastfeeding for almost 17 weeks, and I dare say it is very easy.” nine0003

Read the resource Breastfeeding Beyond the First Month: What to Expect

Literature

1 Naveed M et al. An autopsy study of relationship between perinatal stomach capacity and birth weight. Indian J Gastroenterol .1992;11(4):156-158. - Navid M. et al., Association between prenatal gastric volume and birth weight. Autopsy. Indian J Gastroenterol. 1992;11(4):156-158.

2 Neville MC et al. Studies in human lactation: milk volumes in lactating women during the onset of lactation and full lactation .Am J Clinl Nutr . 1988;48(6):1375-1386. at the beginning and at the peak of lactation." Am F Clean Nutr. 1988;48(6):1375-1386.

3 Kent JC et al. Principles for maintaining or increasing breast milk production. J Obstet , Gynecol , & Neonatal Nurs . 2012;41(1):114-121. - Kent J.S. et al., "Principles for Maintaining and Increasing Milk Production". J Obstet Ginecol Neoneutal Nurs. 2012;41(1):114-121. nine0129

4 Australian Breastfeeding Feeding cues ; 2017 Sep [ cited 2018 Feb ]. - Australian Breastfeeding Association [Internet], Feed Ready Signals; September 2017 [cited February 2018]

5 Kent JC et al. Response of breasts to different stimulation patterns of an electric breast pump. J Human Lact . 2003;19(2):179-186. - Kent J.S. et al., Breast Response to Different Types of Electric Breast Pump Stimulation. J Human Lact (Journal of the International Association of Lactation Consultants). 2003;19(2):179-186.

6) Kent JC et al . Volume and frequency of breastfeedings and fat content of breast milk throughout the day. Pediatrics. 2006;117(3): e 387-395. - Kent J.S. et al., "Amount and frequency of breastfeeding and fat content of breast milk during the day." Pediatrix (Pediatrics). 2006;117(3):e387-95.

7 Lawrence RA, Lawrence RM. Breastfeeding: A guide for the medical profession. 7th ed. Maryland Heights MO, USA: Elsevier Mosby; 2010. 1128 p . - Lawrence R.A., Lawrence R.M., "Breastfeeding: A guide for healthcare professionals." Seventh edition. Publisher Maryland Heights , Missouri, USA: Elsevier Mosby; 2010. P. 1128.

8 World Health Organization. [Internet]. Child growth standards; 2018 [cited 2018 Feb] - World Health Organization. [Internet]. Child Growth Standards 2018 [cited February 2018]. nine0129

9 Australian Breastfeeding Association . [ Internet ]. Cluster feeding and fussing babies ; Dec 2017 [ cited 2018 Feb ] - Australian Breastfeeding Association [Internet], Cluster Feeding and Screaming Babies; December 2017 [cited February 2018]. nine0129

10 Moberg KU, Prime DK. Oxytocin effects in mothers and infants during breastfeeding. Infant . 2013;9(6):201-206.- Moberg K, Prime DK, "Oxytocin effects on mother and child during breastfeeding". Infant. 2013;9(6):201-206.

11 U.S. Department of Health & Human Services [Internet]. Surgeon General Breastfeeding factsheet; 2011 Jan 20 [cited 2017 Feb] - Department of Health and Human Services [Internet], "Breastfeeding Facts from the Chief Medical Officer", Jan 20, 2011 [cited Feb 2017]

12 Kendall-Tackett K et al. The effect of feeding method on sleep duration, maternal well-being, and postpartum depression. clinical lactation. 2011;1;2(2):22-26. - Kendall-Tuckett, K. et al., "Influence of feeding pattern on sleep duration, maternal well-being and the development of postpartum depression." Clinical Lactation. 2011;2(2):22-26.

13 Brown A, Harries V. Infant sleep and night feeding patterns during later infancy: Association with breastfeeding frequency, daytime complementary food intake, and infant weight. Breast Med . 2015;10(5):246-252. - Brown A., Harris W., "Night feedings and infant sleep in the first year of life and their association with feeding frequency, daytime supplementation, and infant weight." Brest Med (Breastfeeding Medicine). 2015;10(5):246-252.

14 Hassiotou F et al. Maternal and infant infections stimulate a rapid leukocyte response in breastmilk. Clin Transl immunology. 2013;2(4). - Hassiot F. et al., "Infectious diseases of the mother and child stimulate a rapid leukocyte reaction in breast milk." nine0129 Clean Transl Immunology. 2013;2(4):e3.

15 Li DP et al. Breastfeeding and ovarian cancer risk: a systematic review and meta-analysis of 40 epidemiological studies. Asian Pac J Cancer Prev . 2014;15(12):4829-4837. - Lee D.P. et al., "Breastfeeding and the risk of ovarian cancer: a systematic review and meta-analysis of 40 epidemiological studies." Asia Pas J Cancer Prev. 2014;15(12):4829-4837.

What is normal breastfeeding? | Interview with Dr. Jacqueline Kent

It can be difficult for new mothers to understand if breastfeeding is going well, so we decided to ask the expert if it is possible to talk about the norms when it comes to breastfeeding.

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Dr Jacqueline Kent, Research Fellow, Hartmann Human Lactation Research Group:
Jacqueline joined the University of Western Australia research group in 1986 and received her PhD in 1999. She is currently researching the biochemical and physiological aspects of breast milk synthesis and release in search of scientific information to help mothers breastfeed longer.

Dr. Jacqueline Kent and her colleagues have been studying breastfeeding for many years. As it turned out, for all mothers and babies, this process occurs in its own way. nine0003

What were the most surprising results of your research?

Variety. It turns out that the limits of the norm are extremely wide.
We are used to textbooks that say that an infant should eat 8-12 times a day and gain 150 grams per week. But babies don't read textbooks and do things their own way! Some gain weight more slowly, others very quickly.

We followed exclusively breastfed infants aged one to six months. As our studies have shown, on average, a child is breastfed 4 to 13 times a day, and the duration of one feeding varies from 12 minutes to 1 hour. nine0013 1

How much milk do breastfed babies usually consume?

According to our research, the amount of milk consumed by baby
ranges from 54 to 234 ml per feeding. 1

Sometimes it seems to the mother that the baby ate well, but when weighed, it turns out that he ate very little milk. And it happens the other way around: the child is distracted, breastfeeds for only a few minutes and still eats 100 ml of milk. Even if the baby is restless, this does not mean at all that he is malnourished. nine0003

All babies are different, but they all get as much milk as they need in one way or another. One needs 500 ml of milk per day, while others eat up to 1356 ml!

By the way, boys on average eat 76 ml more milk per day than girls. The main thing is that you have enough milk, and the baby will decide when and how much he will eat.

Should I offer my baby a second breast?

I advise offering the second breast to the baby after the first has been completely emptied. If he accepts it, then he hasn't finished eating. If not, don't worry. Let the baby decide for himself - only he knows when he is full. According to our research, 30% of babies get enough milk from one breast, 13% eat from two breasts at each feed, and 57% from time to time. nine0013 1

How do you know if a baby is getting enough milk?

In my experience, mothers often blame themselves for not producing enough milk. Ask yourself: Is my child growing? Is he putting on weight? Is he cheerful? Is his skin healthy? How often does he get diapers dirty? If the answer is “yes”, then the baby is getting enough milk, no matter if he eats a lot or a little.

What is the most common misconception about breastfeeding? nine0011

Mothers usually think that the older the child gets, the more often
he needs to be fed and the more milk he will eat. They are often surprised to learn that between the 4th and 26th weeks, total milk production normally does not change. 2

In the first few months, the baby grows very fast and his metabolism is accelerated. The milk that the child consumes during this period is almost completely used for growth and maintenance of metabolism.

Between the ages of three and six months, metabolism slows down and growth slows, so the same amount of milk is sufficient for the baby. In other words, the baby does not have to consume more and more milk as they grow older. On the contrary, feedings become shorter and less frequent, but at the same time the child receives the same amount of milk, because he suckles better.

Do studies say anything about the age at which breastfed babies start sleeping through the night? nine0011

Most babies need to be fed at night.
The baby's stomach is not large enough to go all night without feeding, and breast milk is digested very quickly. Therefore, it is natural for the baby to wake up at night - and this usually continues for at least the first six months. Feeding at night is normal. When you feed your baby at night, do not even hesitate - all over the world at this moment other mothers of babies of the same age are doing the same. Be patient - it usually only lasts a few months. nine0013 1

What worries new mothers the most during the first few weeks of breastfeeding?

The most common concern is whether the baby latch on correctly, sucks well, and is full during feeding. Often mothers also worry about sore nipples. The main thing is to find the right position for feeding from the very beginning and ensure that the baby is latching on correctly. Practice shows that this significantly affects the flow of milk and the convenience of feeding. nine0003

What breastfeeding symptoms should be of concern?

Milk production usually returns to normal levels two weeks after birth. If the child does not begin to gain weight on the fifth or sixth day of life, it's time to sound the alarm. You should contact your doctor to make sure that milk is being produced and that its composition is changing from colostrum to mature breast milk.

What advice would you give to a new breastfeeding mother?

Try to ensure skin-to-skin contact with the baby as soon as possible after delivery. If possible, feed your baby within the first hour of life, or at least breastfeed. As soon as possible, contact a specialist to correct the position and grip of the breast during feeding and thus avoid damage to the nipples. nine0003

Feed frequently. Young mothers do not immediately succeed in correctly recognizing the signals that the child gives. Be sure to feed your baby on demand, and not at set intervals. Offer the breast as soon as you notice any signs of hunger - as a rule, the baby suckles better when he is calm. If he cries, it is more difficult for him to take the breast. If you are not sure what the child wants, offer him the breast. He decides whether he wants to eat or not.

To learn more about Dr. Kent's research, download infographic "How to determine the limits of normal when it comes to breastfeeding" or see it below.

Literature

1 Kent JC et al. Volume and frequency of breastfeedings and fat content of breast milk throughout the day. Pediatrics . 2006;117(3): e 387-395. - Kent J.S. et al., "Amount and frequency of breastfeeding and fat content of breast milk during the day." Pediatrix (Pediatrics).


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