Baby feeding guidlines
Feeding Guide for the First YearFeeding Guide for the First Year | Johns Hopkins Medicine
Tiffani Hays, M.S., R.D., L.N., Director of the Pediatric Clinical Nutrition Education & Practice
Making appropriate food choices for your baby during the first year of life is very important. More growth occurs during the first year than at any other time. It’s important to feed your baby a variety of healthy foods at the proper time. Starting good eating habits at this early stage will help set healthy eating patterns for life.
Recommended Feeding Guide for the First Year
Breast milk and formula are designed to be the primary sources of nutrition throughout an infant’s first year of life. You should talk with your baby’s health care provider before starting solid foods. Solid foods should not begin before age 4 months because:
- Breast milk or formula provide your baby with all the nutrients that are needed.
- Your baby isn’t physically developed enough to eat solid food from a spoon.
- Feeding your baby solid food too early may result in poor feeding experiences and increased weight gain in both infancy and early childhood.
The American Academy of Pediatrics (AAP) recommends that all infants, children and adolescents take in enough vitamin D through supplements, formula or cow’s milk to prevent complications from deficiency of this vitamin. In November 2008, the AAP updated its recommendations for daily intake of vitamin D for infants, children, and adolescents who are healthy. It is now recommended that the minimum intake of vitamin D for these groups should be 400 IU per day, beginning soon after birth. Your baby’s health care provider can recommend the proper type and amount of vitamin D supplement.
Guide for Breast-feeding (Zero to 12 Months)
- In the early days after a baby’s birth, the mother should plan to breast-feed every two to three hours, including overnight. The mother should respond to the infant’s cues of hunger in a prompt and relaxed manner, providing a quiet and comfortable environment for both herself and the baby. Frustrated or distracted infants may have difficulties latching on.
- It is normal for infants to wake up overnight to feed for the first several months. If you have any concerns about overnight feeding, please discuss them with your health care provider.
- Alternate breasts to feed on, and allow the infant to completely empty the breast before switching to the other. This practice ensures the infant receives hindmilk, which is richer in nutrients.
- Follow your child’s feeding cues and resist forcing a schedule. Instead, rely on keeping track of wet diapers and your child’s growth to judge whether he or she is receiving enough breast milk. A mother’s milk changes as the infant grows, and feeding habits change as well in order to best meet a child’s needs. If you have any questions about whether your child is receiving enough breast milk, ask your health care provider.
- When not able to breast-feed, use a breast pump to extract milk and maintain milk supply. Pumped breast milk should be stored safely, using appropriate temperature guidelines. Pumped breast milk may be offered to infants in bottles, while responding to the same feeding cues to determine how much they take. Forcing bottles to be emptied may result in overfeeding and excess weight gain, even when feeding breast milk.
- With the proper support, a mother can meet the needs of most infants, even twins, so seek out help from your health care provider or lactation consultant for success.
Guide for Formula Feeding (Zero to 12 Months)
- When breast milk is not available, standard infant formula is an appropriate alternative for most healthy full term infants, but there are some differences between brands. Do not hesitate to ask your health care provider for a recommendation if you are unsure which formula to use.
- Bottle-feeding should be interactive, with the caregiver holding both the bottle and the infant. Propping a bottle has been linked to an increased risk of ear infections and tooth decay.
- Formula feeding should be in response to the infant’s needs and not based on a predetermined schedule. Look for cues of hunger and fullness to determine both when to feed and how much. The number of wet diapers per day and your child’s growth will reflect if he or she is getting enough formula. The chart below demonstrates common intakes for infants at various stages. However, ask your health care provider if you have any questions about how much formula your infant is taking.
- The amount of formula an infant takes will decrease as the baby increases intake of solid foods, but formula remains a significant source of calories, protein, calcium and vitamin D for the first year of life.
- Ask your health care provider before switching an infant less than 1 year of age from formula to cow’s milk or a cow’s milk alternative.
|Age||Amount of formula per feeding||Number of feedings per 24 hours|
|1 month||2 to 4 ounces||six to eight|
|2 months||5 to 6 ounces||five to six|
|3 to 5 months||6 to 7 ounces||five to six|
Complementary Feedings (After 6 Months of Age)
- Offer only breast milk or formula in bottles until 1 year of age unless specifically advised by your health care provider.
- Begin offering breast milk and/or formula in a cup starting at 6 months of age. Infants should drink breast milk and/or formula for the first year of life.
- Fruit juice is not recommended under 1 year of age.
- When introducing juice, offer 100% pasteurized juice and limit it to 4–6 ounces per day. Do NOT place juice in a bottle.
- Avoid giving any sugar-sweetened beverages to infants.
- Introduce solid foods when your infant is ready, at around 6 months of age depending on the infant’s development. Infants are ready to start eating solid foods when they can:
- sit up on their own or with a little support
- reach for and put things in their mouth
- open their mouth when seeing something coming
- keep food in their mouth rather than pushing it out onto the chin
- move food to the back of their mouth with their tongue
- turn their head away when they do not want something
- Prepare to introduce solid foods in a calm feeding environment where the infant is sitting upright and is appropriately supported and moderately hungry.
- Start with small amounts of solid food, feeding with a spoon or allowing finger feeding, then gradually increase the amount as the infant eats more and develops. Avoid offering breast milk or formula until after the solid-food experience has wound down.
- Expose infants to a wide variety of flavors and textures of healthy food. Don’t limit your baby’s food choices to the ones you like. Offering a range of foods early will pave the way for healthy eating habits.
- Maintain the division of responsibility when feeding.
- The caregiver is responsible for what to eat (offering appropriate variety and textures).
- The child is responsible for deciding whether to eat and how much.
- Avoid adding salt or sugar to make baby foods more appealing. Many babies and toddlers need to experience a new food multiple times before accepting it, and increased intakes of salt and sugar among children are associated with obesity in adults.
- Observe infants for any signs of intolerance when introducing a new food or texture, and discuss all concerns with your health care provider.
- Although convenient and safe, commercial baby foods are not required. Young children are more likely to eat foods they see others eating, so as long as they are observed to see how they handle new food in their mouths, baby-led weaning using table foods is an appropriate way to introduce solids.
- Avoid honey in any form during your child’s first year, as it can cause infant botulism. Address any concerns about developing food allergies with your health care provider.
- Don’t restrict fat and cholesterol in the diets of very young children, unless advised by your child’s health care provider. Children need calories, fat and cholesterol for the development of their brains and nervous systems, and for general growth.
Updated on July 26, 2019.
Breastfeeding Your Baby
Breastfeeding 101: Q&A with Lactation Expert Nadine Rosenblum
Developmental Milestones: Babies and Toddlers
How Often and How Much Should Your Baby Eat?
By: Sanjeev Jain, MD, FAAP
One of the most common questions new parents have is how often their baby should eat. The best answer is surprisingly simple: in general, babies should be fed whenever they seem hungry.
How do I know when my baby is hungry?
For babies born
prematurely or with certain medical conditions, scheduled feedings advised by your pediatrician are best. But for most healthy, full-term infants, parents can look to their baby rather than the clock for hunger cues. This is called feeding on demand, or
A hungry baby often will cry. But it's best to watch for hunger cues before the baby starts crying, which is a late sign of hunger and can make it hard for them to settle down and eat.
Some other typical hunger cues in babies:
Sticking tongue out
Rooting (moving jaw and mouth or head in search of breast)
Putting his/her hand to mouth repeatedly
Opening her mouth
Sucking on everything around
It is important to realize, however, that every time your baby cries or sucks it is not necessarily because he or she is hungry. Babies suck not only for hunger, but also for comfort; it can be hard at first for parents to tell the difference. Sometimes, your baby just needs to be cuddled or changed.
General guidelines for baby feeding
It is important to remember all babies are different―some like to snack more often, and others drink more at one time and go longer between feedings. However, most babies will drink more and go longer between feedings as they get bigger and their tummies can hold more milk:
Most newborns eat every 2 to 3 hours, or 8 to 12 times every 24 hours. Babies might only take in half ounce per feeding for the first day or two of life, but after that will usually drink 1 to 2 ounces at each feeding. This amount increases to 2 to 3 ounces by 2 weeks of age.
At about 2 months of age, babies usually take 4 to 5 ounces per feeding every 3 to 4 hours.
At 4 months, babies usually take 4 to 6 ounces per feeding.
At 6 months, babies may be taking up to 8 ounces every 4 to 5 hours.
Most babies will increase the amount of formula they drink by an average of 1 ounce each month before leveling off at about 7 to 8 ounces per feeding. Solid foods should be started at about 6 months old.
Concerns about overfeeding or underfeeding your baby
Babies are usually pretty good at eating the right amount, but they can sometimes take in more than they need. Infants who are bottle feeding may be more likely to overfeed, because drinking from a bottle may take less effort than breastfeeding.
Overfed babies can have stomach pains, gas, spit up or vomit and be at higher risk for obesity later in life. It's better to offer less, since you can always give more if your baby wants it. This also gives babies time to realize when they're full.
If you are concerned your baby wants to eat all the time―even when he or she is full―talk with your pediatrician. Pacifiers may be used after feeding to help sooth healthy-weight babies who like to suck for comfort, rather than nutrition. For babies who are breastfed, it's best to wait to offer pacifiers until around 3 to 4 weeks of age, when breastfeeding is well-established.
Trouble gaining weight?
Most babies will double their birth weight by 5 months of age and triple their birth weight by their first birthday. If your baby is having trouble gaining weight, don't wait too long between feeding―even if it means waking your baby. Be sure to talk with your pediatrician about how often and how much to feed your baby.
How do I know if my baby is getting enough to eat?
A newborn's diaper is a good indicator of whether he or she is getting enough to eat. In the first few days after birth, a baby should have 2 to 3 wet diapers each day. After the first 4 to 5 days, a baby should have at least 5 to 6 wet diapers a day. Stool frequency is more variable and depends whether your baby is breastfed or formula fed.
During regular health check-ups, your pediatrician will check your baby's weight and plot it on a growth chart. Your baby's progress on the growth chart is one way to tell whether or not they are getting enough food. Babies who stay in healthy growth percentile ranges are probably getting a healthy amount of food during feedings.
Talk with your pediatrician if you have any questions or concerns about your baby getting the right amount to eat.
- Making Sure Your Baby is Getting Enough Milk
- Amount and Schedule of Formula Feedings
- Is Your Baby Hungry or Full? Responsive Feeding Explained (Video)
- Remedies for Spitty Babies
- Ask the Pediatrician: With the baby formula shortage, what should I do if I can't find any?
- Ask the Pediatrician: How should we feed our baby if we're running low on money?
Airplane Choo Choo: A Feeding Guide for Children (National Dairy Council)
Sanjeev Jain, MD, FAAP, is a Clinical Associate Professor of General Pediatrics and Adolescent Medicine at the University of Wisconsin School of Medicine and Public Health. Within the American Academy of Pediatrics, he is a member of the Section on International Child Health and the Wisconsin State Chapter.
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
WHO recommendations on breastfeeding
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Medela fully supports the World Health Organization's recommendation for breastfeeding duration.
WHO recommends that mothers around the world exclusively breastfeed their babies for the first six months of their lives to ensure optimal growth, development and health. After that, they should be given age-appropriate complementary foods and continue breastfeeding for up to two years or more. nine0010
International health organizations recognize that breastfeeding, as the best way to eat during this period, promotes brain development in children, stimulates their growth, improves their school performance and reduces the risk of diseases such as diabetes and obesity in the future life. 1 Medela fully recognizes this.
The first thousand days of your baby's life—from conception to two years of age—gives you an excellent opportunity to lay the foundation for his future health and well-being. nine0013 2 As soon as pregnancy occurs, your body begins to create a new person. And within a month, the development of a new amazing feeding system also begins. 3 Not only is your breast milk perfectly matched to your baby's protein, mineral, vitamin, and fat needs, it contains thousands of protective substances, growth factors, and cells that fight infection, support baby's brain development, and lay the foundation for future health for babies. you and your child. Breastfeeding gives you protection against breast cancer and may also protect you from ovarian cancer and type 2 diabetes. nine0013 1
At each stage of development from birth to one year, the needs of the baby change daily, and milk changes with them. 4 Your breast milk contains thousands of ingredients, the vast majority of which cannot be replaced with artificial additives.
You don't have to lead a perfect life to breastfeed. In fact, studies around the world show that even with malnourished moms 5 Breastfeeding has many advantages over formula feeding. 1
And that's not all! Breastfeeding is better for the environment than formula feeding because it does not require intensive animal husbandry and excessive water consumption, it does not require fossil fuels and factory emissions, it does not use transportation fuels and there is no exhaust fumes, and it does not require packaging. . In the US alone, 550 million packages of artificial formulas are used each year. nine0013 6
Formula is not recommended in addition to breastfeeding. Your breasts need frequent stimulation through breastfeeding in order to produce enough milk now and in the future. If you want to introduce bottle feeding, it is recommended to wait until milk production and breastfeeding have improved. When bottle-fed, babies become full quickly and do not ask for food as often as when breastfeeding. This, in turn, reduces the breast's ability to produce enough milk. Artificial mixtures should be used only when there is a medical indication for this, which should be discussed with your healthcare provider. nine0003
Rules for breastfeeding
Rules and techniques for breastfeeding.
Every woman can breastfeed her baby.
All troubles arise from ignorance of the rules and techniques of feeding.
The first rule is very important - early contact of the mother with the child in the maternity hospital, in the first minutes after birth.
Psychological benefits of breastfeeding.
Breast milk has a positive effect on the formation of the emotional and intellectual sphere, the development of creative abilities. nine0003
- emotional connection from both mother and child:
- close, loving relationship between mother and child;
- - emotional satisfaction of mother and child;
- - the child cries less, positive emotions are formed;
- - the mother becomes more affectionate, attachment to the child appears, self-confidence; : - less likely that the child will be abandoned or offended; breast milk also protects against the occurrence of neuroses. nine0060
- Development: the child shows the best results of intellectual development and creative abilities at an older age.
No less important is the correct laying of the baby to the breast, because this is a powerful stimulus to provide the right amount of milk - galactopoiesis.
- The position of the mother during feeding should be comfortable. It is better to feed the baby either from a lying or sitting position.
- Take the chest in the palm of your hand with 4 fingers from below and 1 from above. nine0060
- Touch the nipple to the baby's lips so that he opens his mouth.
- The baby should capture not only the nipple, but also the halo.
- If the mother felt pain in her chest while feeding the baby, this means that the baby did not take the breast correctly. In this case, it is necessary to carefully touch the child's lips with a finger so that he opens his mouth, and not pull it by force. Try to apply to the chest again.
- Feed the baby on demand. In the first days up to 10-14 times a day. After the formation of lactation (after approximately 2-3 weeks), the regimen is established independently and is 6-7 feedings per day. nine0060
7, It is not recommended to take night breaks in feeding.
- Frequent feeding, including night feeding, contributes to the development of the prolactin and oxytocin reflex.
Produced BEFORE and DURING breastfeeding causes milk to DROP
Sensory suction impulses
- Promotes uterine contractions
- No additional food other than breast milk should be given to a child under 3-4 months of age. nine0060
- It must be remembered that during the day the baby sucks out different amounts of milk.
- Negative emotions block the oxytocin reflex, spasm occurs and milk is poorly excreted.
- What is important is the positive psychological attitude of the mother, the desire to breastfeed her child and the belief that breast milk is the best food for children.
- It is important to observe the rules of personal hygiene (clean linen, hands, mother's chest).
- The duration of feeding is currently not limited. nine0060
Among the most important factors in the formation of full lactation in the early days are:
- Skin-to-skin contact;
- Early breastfeeding;
- Joint stay of mother and child in a maternity hospital;
- Feeding the baby "on demand";
- Application to both mammary glands;
- Exclusion of pre-lactation feeding and supplementation; • Exclusion of devices imitating mother's breasts (nipples, pacifiers). nine0060
Certain rules must be followed with an infant:
- forbid yourself to take a baby to bed !!!!!!!
- the baby does not belong in a bed with other family members, also do not put him to sleep with each other, in order to avoid harm in a dream;
- do not overheat the baby, there is no need to wrap him in a large amount of clothes; nine0003
- no need to swaddle the baby tightly. He should be able to change the position of the head and body in case of lack of air;
- the surface of the bed should be pretty flat, without extra pillows, duvets, blankets. These items can accidentally cut off the oxygen supply to the baby. But even under the weight of your body, it should not fall through, otherwise there is a high probability that the child will get there on his face and strangulation may occur;
- there is no need to put the child to sleep between yourself and the back of the sofa, even if it is soft, so that he is not sandwiched between the fabric and the body of an adult; nine0003
- consider measures that will protect your baby from an unexpected fall from your bed.
Feeding technique Bottle feeding
Feeding technique Bottle feeding is not really difficult. However, there are a few feeding rules you should remember to avoid baby tears, food spills, and other problems.
The position taken by the feeder should resemble the natural position of the mother during breastfeeding:
- The child's head should rest on the left arm.
- The nipple that enters the baby's mouth must always be full of milk or formula - otherwise the baby will swallow air which can cause colic.
- The appearance of bubbles in the bottle means that the child is eating incorrectly and you need to help him, change the position, tilt the bottle in a different way.
- Do not leave a child alone with a bottle and do not let the baby sleep with a bottle in his mouth - in both cases this can lead to choking. nine0003
- It is best to feed your baby when he is in your arms - babies feel most secure in parental arms.
- Remember that the baby's head should always be slightly higher than his torso.
- Make sure that the baby does not tilt the head too far back or forward - if the head is in the wrong position, it becomes more difficult for the baby to eat, the wrong head position can also cause food to enter the respiratory tract.
- When a baby eats from a bottle, he swallows air with nutrition, so he may feel full, despite the fact that he has eaten little. nine0003
- Take breaks every 5 minutes during feeding so that the baby has the opportunity to burp.
- After he has let out air and some food, he will feel hungry again.
- In order for the baby to burp, you need to change his position: put the baby's head on your shoulder and support his back with your hands.
- The child must be in an upright or semi-upright position. If the baby does not burp between feedings, the accumulated air will lead to the formation of painful gases. nine0003
- The sitting position is the most classic feeding position.