Feed that baby
Feeding Your Newborn (for Parents)
How you feed your newborn is the first nutrition decision you make for your child. These guidelines on breastfeeding and bottle feeding can help you know what's right for you and your baby.
Breast or Bottle?
The American Academy of Pediatrics (AAP) recommends that babies be breastfed exclusively for about the first 6 months. After they start on solid foods, babies should breastfeed through the first year of life and even beyond, if desired.
But breastfeeding isn't possible or preferable for all new moms. Deciding to breastfeed or bottle feed a baby is usually based on the mother's comfort level with breastfeeding and her lifestyle. In some cases, breastfeeding may not be recommended for a mom and her baby. If you have any questions about whether to breastfeed or formula feed, talk to your pediatrician.
Remember, your baby's nutritional and emotional needs will be met whether you choose to breastfeed or formula feed.
Benefits of Breastfeeding
Breastfeeding your newborn has many benefits. Perhaps most important, breast milk is the perfect food for a baby's digestive system. It has the nutrients that a newborn needs, and it’s easily digested. Commercial formulas try to imitate breast milk, and come close, but can't match it exactly.
Breast milk has
antibodiesthat help protect babies from many infections, including diarrhea and ear and lung infections. Breastfed babies are less likely to develop medical problems such as diabetes, high cholesterol, asthma, and allergies. Breastfeeding also might make a child less likely to become overweight.
Breastfeeding is great for moms too. It burns calories, so can help nursing moms lose the weight gained during pregnancy. Breastfeeding also may offer protection from breast cancer and ovarian cancer.
Some moms find breastfeeding easier and quicker than formula feeding — it needs no preparation, and you don't run out of breast milk in the middle of the night. Also, breastfeeding costs little. Nursing mothers do need to eat more and may want to buy nursing bras and pads, a breast pump, or other equipment. But these expenses are generally less than the cost of formula.
Breastfeeding meets a variety of emotional needs for both moms and babies. The skin-to-skin contact can enhance the emotional connection, and providing complete nourishment can help new moms feel confident in their ability to care for their newborn.
Limitations of Breastfeeding
With all the good things known about breastfeeding, why doesn't every mother choose to breastfeed?
Breastfeeding requires a big commitment from a mother. Some new moms feel tied down by the demands of a nursing newborn. Because breast milk is easily digested, breastfed babies tend to eat more often than babies who are fed formula. This means moms can be in demand as often as every 2 or 3 hours in the first few weeks. This can be tiring, but it's not long before babies feed less often and sleep longer at night.
Some new mothers need to get back to work outside the home or separate from their babies from time to time for other reasons. Some opt for formula feeding so other caregivers can give the baby a bottle. Mothers who want to continue breastfeeding can use a breast pump to collect breast milk to be given in a bottle, so their babies still get its benefits even when mom isn't there to breastfeed.
Fathers and other family members may want to share in feeding the baby. When mom is breastfeeding, dad or siblings may want to stay close by. Helping mom get comfortable, or providing a burp cloth when needed, will let them be part of the experience.
When breastfeeding is going well, other family members can help by giving the baby pumped breast milk in a bottle when mom needs a break.
Some moms may feel embarrassed or worried about breastfeeding. These feelings usually end after a successful breastfeeding process is set. It can help to get advice from those who've gone through the experience. Most hospitals and birthing centers offer in-depth instruction on breastfeeding to new moms. Your pediatrician, nurse practitioner, or nurse can answer questions or put you in touch with a lactation consultant or a breastfeeding support group.
In some cases, a mother's health may affect her ability to breastfeed. Moms getting chemotherapy for cancer and those who have HIV should not breastfeed, for example.
If you have a medical condition or take any medicines regularly, talk with your doctor about whether it's OK to breastfeed. If you have to stop nursing temporarily, continue to pump breast milk to maintain milk production. If you or your baby are sick, continue to breastfeed if you can. Talk to the doctor if you have any concerns.
In some situations, it may not possible to breastfeed, such as when a baby is very sick or born early. Mothers should talk with their baby's doctor about expressing and storing milk. Often, a baby who can't breastfeed can get breast milk through a feeding tube or bottle.
Some moms who have inverted nipples may have trouble breastfeeding, but a lactation consultant usually can help them overcome this. Likewise, women who have had plastic surgery on their breasts should be able to successfully breastfeed. Talk with your doctor if you have any concerns.
Hold off on pacifiers or bottles until your baby has gotten used to and is good at breastfeeding. Lactation professionals recommend waiting until a baby is about 3–4 weeks old before offering artificial nipples of any kind (including pacifiers).
Benefits of Formula Feeding
Commercially prepared infant formula is a nutritious alternative to breast milk. Bottle feeding can offer more freedom and flexibility for moms, and make it easier to know how much the baby is getting.
Because babies digest formula more slowly than breast milk, a baby who is getting formula may need fewer feedings than one who breastfeeds. Formula feeding also can make it easier to feed the baby in public, and lets the father and other family members help feed the baby, which can enhance bonding.
Limitations of Formula Feeding
Just as breastfeeding has its unique demands, so does bottle feeding. Bottle feeding takes organization and preparation, especially if you want to take your baby out. Store-bought formula can be pretty expensive, but do not try to make your own formula at home.
It's important to make sure that you have enough formula on hand, and bottles that are clean and ready to be used.
Here are a few guidelines for formula feeding:
- Carefully follow directions on the label when preparing formula. Do not add more water than directed.
- Bottles left out of the refrigerator longer than 1 hour and any formula left in the bottle that a baby doesn't finish should be discarded.
- Prepared bottles of formula can be stored in the refrigerator up to 24 hours and carefully warmed just before feeding. You don't have to warm formula, but most babies prefer it.
- A bottle of formula can be warmed by holding it in running warm water or setting it in a pan of warm water. A bottle of formula (or breast milk) should never be warmed in a microwave. The bottle can heat unevenly and leave "hot spots" that can burn a baby's mouth.
How Often Do Newborns Eat?
Your newborn will nurse about 8 to 12 times per day during the first weeks of life. In the beginning, mothers may want to try nursing 10–15 minutes on each breast, then adjust the time as needed.
Breastfeeding should be on demand (when your baby is hungry), which is generally every 1–3 hours. As newborns get older, they'll nurse less often and have longer stretches between feedings. Newborn babies who are getting formula will likely take about 2–3 ounces every 2–4 hours. Newborns should not go more than about 4–5 hours without feeding.
Signs that babies are hungry include:
- moving their heads from side to side
- opening their mouths
- sticking out their tongues
- placing their hands and fists to their mouths
- puckering their lips as if to suck
- nuzzling against their mothers' breasts
A feeding schedule is not necessary — you and your baby will get into a routine. Babies know (and will let their parents know) when they're hungry and when they've had enough. Watch for signs that your baby is full (slowing down, spitting out the bottle or unlatching from breast, closing the mouth, turning away from the breast or bottle) and stop the feeding when these signs appear.
As babies grow, they begin to eat more at each feeding and can go longer between feedings. There may be other times when your infant seems hungrier than usual. Continue to nurse or feed on demand. Nursing mothers need not worry — breastfeeding stimulates milk production, and your supply of breast milk will adjust to your baby's demand for it.
Is My Newborn Getting Enough to Eat?
New parents often worry about whether their babies are getting enough to eat.
Babies are getting enough to eat if they:
- seem satisfied
- have about 6–8 wet diapers a day
- have regular bowel movements (poops)
- sleep well
- are alert when awake
- are gaining weight
A baby who is fussing, crying, seems hungry, does not appear satisfied after feeding, and has fewer wet diapers may not be getting enough to eat. If you're concerned that your baby isn't getting enough to eat, call your doctor.
Most infants "spit up" a small amount after eating or during burping, but a baby should not vomit after feeding. Vomiting after every feeding might be a sign of an allergy, digestive problem, or other problem that needs medical care. If you have concerns that your baby is spitting up too much, call your doctor.
Should Newborns Get Nutritional Supplements?
Breast milk has the right combination of vitamins and easily absorbed iron for newborns. A healthy infant being nursed by a healthy mother doesn't need extra vitamins or nutritional supplements, with the exception of vitamin D. Breastfed babies should begin vitamin D supplements within the first few days of life, continuing until they get enough vitamin D-fortified formula or milk (after 1 year of age).
Breastfeeding mothers who follow vegetarian diets that do not include animal products need vitamin B12 supplements.
Iron-fortified formula has the right blend of vitamins and minerals for a baby, so supplements usually aren't needed. Infants drinking less than 1 liter, or about a quart, of formula a day may need a vitamin D supplement.
Water, juice, and other foods usually aren't necessary during a baby's first 6 months. Breast milk and formula provide everything babies need nutritionally until they start eating solid foods. Talk to your doctor if you have any questions about feeding your newborn.
Reviewed by: Mary L. Gavin, MD
Date reviewed: February 2021
Feeding Your 4- to 7-Month-Old (for Parents)
Most babies this age are ready to try solid foods. Experts recommend starting solid foods when a baby is about 6 months old, depending on the baby's readiness and nutritional needs.
Be sure to check with your doctor before giving any solid foods.
Is My Baby Ready to Eat Solid Foods?
How can you tell if your baby is ready for solids? Here are a few hints:
- Does your baby swallow food or push it out of their mouth? Babies have a natural tongue-thrust reflex that pushes food back out. Wait until this reflex disappears (typically when babies are 4–6 months old).
- Can your baby support their own head? To eat solid food, an infant needs good head and neck control and should be able to sit up.
- Is your baby interested in food? Babies who stare, reach and grab, and open their mouths for food are ready to try solid foods.
If your doctor gives the go-ahead but your baby seems frustrated or uninterested in solid foods, try waiting a few days before trying again. Breast milk and formula will still meet nutritional needs as your baby learns to eat solid foods. But after 6 months, babies need the added nutrition — like iron and zinc — that solid foods provide.
Do not add cereal or other food to your baby's bottle because it can lead to too much weight gain.
Watch for signs that your child is hungry or full. Respond to these cues and let your child stop when full. A child who is full may suck with less enthusiasm, stop, or turn away from the breast or the bottle. With solid foods, they may turn away, refuse to open their mouth, or spit the food out.
How Should I Start Feeding My Baby Solid Foods?
When your baby is ready and the doctor says it’s OK to try solid foods, pick a time of day when your baby is not tired or cranky. You want your baby to be a little hungry, but not so hungry that they’re upset. So you might want to give your baby a little breast milk or formula first.
Have your baby sit supported in your lap or in a high chair with a safety strap.
Most babies' first food is iron-fortified infant single-grain cereal mixed with breast milk or formula. Place the spoon near your baby's lips, and let the baby smell and taste it. Don't be surprised if this first spoonful is rejected. Wait a minute and try again. Most food offered to your baby at this age will end up on the baby's chin, bib, or high-chair tray. Again, this is just an introduction.
When your little one gets the hang of eating cereal off a spoon, it may be time to try single-ingredient puréed meat, vegetables, or fruit. The order in which you give them doesn't matter, but go slow. Offer foods that are high in iron and zinc — such as meat, poultry, eggs, and beans — especially if your baby is breastfeeding. Try one food at a time and wait several days before trying something else new. This will let you identify any foods that your baby may be allergic to.
Which Foods Should I Avoid?
Foods that are more likely to cause allergies can be among the foods you introduce to your baby. These include peanuts, eggs, cow’s milk, seafood, nuts, wheat, and soy. Waiting to start these foods does not prevent food allergies. Talk to your doctor if you’re concerned about food allergies, especially if any close family members have allergies, food allergies, or allergy-related conditions, like eczema or asthma.
Infants with severe eczema or egg allergies are more likely to have allergies to peanuts. Talk to your doctor about how and when to introduce these foods to your child.
Possible signs of food allergy or allergic reactions include:
- bloating or an increase in gassiness
Get medical care right away if your baby has a more severe allergic reaction, like hives, drooling, wheezing, or trouble breathing.
If your child has any type of reaction to a food, don't offer that food again until you talk with your doctor.
Babies shouldn't have:
- foods with added sugars and no-calorie sweeteners
- high-sodium foods
- honey, until after the first birthday. It can cause botulism in babies.
- unpasteurized juice, milk, yogurt, or cheese
- regular cow's milk or soy beverages before 12 months instead of breast milk or formula. It’s OK to offer pasteurized yogurt and cheese.
- foods that may cause choking, such as hot dogs, raw carrots, grapes, popcorn, and nuts
Tips for Feeding Your Baby Solid Foods
With the hectic pace of family life, most parents try commercially prepared baby foods at first. They come in small, convenient containers, and manufacturers must meet strict safety and nutrition guidelines.
If you prepare your own baby foods at home, here are some things to keep in mind:
- Follow the rules for food safety, including washing your hands well and often.
- To preserve the nutrients in your baby's food, cook it in ways that keep the most vitamins and minerals. Try steaming or baking fruits and vegetables instead of boiling, which washes away the nutrients.
- Freeze portions that you aren't going to use right away.
- Whether you buy the baby food or make it yourself, texture and consistency are important. At first, babies should have finely puréed single-ingredient foods. (Just applesauce, for example, not apples and pears mixed together.)
- After your baby is eating individual foods, it's OK to offer a puréed mix of two foods. As babies get older, they will learn to eat a greater variety of tastes and textures.
- If you use prepared baby food in jars, spoon some of the food into a bowl to feed your baby. Do not feed your baby right from the jar — bacteria from the baby's mouth can contaminate the remaining food. If you refrigerate opened jars of baby food, it's best to throw away anything not eaten within a day or two.
- Around 6 months of age is a good time for your baby to try a cup. You might need to try a few cups to find one that works for your child. Use water at first to avoid messy clean-ups. Do not give juice to infants younger than 12 months.
Over the next few months, introduce a variety of foods from all the food groups. If your baby doesn't seem to like something, don’t give up. It can take 8 to 10 tries or more before babies learn to like new foods.
Breastfeeding a newborn | What to Expect in the First Week
The first week of a baby's life is a wonderful but hectic time, especially if you haven't breastfed before. Our breastfeeding tips will help you settle in as quickly as possible
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The first time after childbirth, mothers are often confused. The body is still recovering, and you are already starting to get to know your newborn baby. The emotional state during this period can be unstable, especially between the second and fifth day, when many women have milk 1 and at the same time postpartum depression begins 2 . In addition, people around often expect (and demand) that a woman come to her senses as soon as possible and become a “super mom”. But the best thing to do this first week is just to be with your baby and get breastfeeding going.
When should I start breastfeeding my newborn?
Try to breastfeed your baby within the first hour after birth. When the baby latch onto the breast and begins sucking rhythmically, it stimulates the mammary gland cells and starts milk production. nine0009 1 It is not for nothing that this time is called the “magic hour”!
“Ideally, the baby should be placed on the mother's stomach immediately after birth so that it can immediately attach to the breast. He won't necessarily eat, but he should be able to,” explains Cathy Garbin, an internationally recognized expert on breastfeeding.
“Hold your baby and let him find the breast on his own and put the nipple in his mouth. This is called the breast-seeking reflex. On the Internet you can watch videos that show what this process looks like. If the baby does not latch onto the nipple on its own, the midwife will help to properly attach it to the breast. But for starters, it’s good to give the baby the opportunity to do it on their own. In this case, the optimal position for the mother is reclining. ” nine0003
Don't spend that special first hour of your baby's life weighing and swaddling—or at least wait until he's suckling for the first time. Enjoy hugs and close skin-to-skin contact. This promotes the production of oxytocin, the hormone of love, in you and your baby, and oxytocin plays a key role in the supply of the first breast milk - colostrum. 3
“As soon as the obstetricians were convinced that our son was healthy, the three of us — me, my husband and our baby — were left to give us the opportunity to get to know each other. It was a very special hour - an hour of awkwardness, turbulent emotions and bliss. During this time, I breastfed my son twice, ”recalls Ellie, a mother of two from the UK. nine0003
Did you know that breastfeeding helps to recover after childbirth? This is because oxytocin stimulates uterine contractions. In the first hours after childbirth, this contributes to the natural release of the placenta and reduces blood loss. 4
What if the birth did not go according to plan?
If you had a cesarean section or other complications during childbirth,
You can still make skin-to-skin contact with your baby and breastfeed him in the first hours after birth. nine0003
“If you can't hold your baby, have your partner do it for you and make skin-to-skin contact with the baby. This will give the baby a sense of security, care and warmth so that he can hold on until you recover, ”Katie advises.
If the baby is unable to breastfeed, it is advisable to start expressing milk as early as possible and do so as often as possible until the baby is able to feed on its own. “While breastfeeding in the first hours after birth lays an excellent foundation for the future, it is not so important,” Cathy reassures. “It is much more important to start lactation so that in the future, if necessary, you can start breastfeeding.” nine0003
To start milk production, you can express milk manually or use a breast pump that can be given to you at the hospital. 5 And with expressed precious colostrum, it will be possible to feed the child. This is especially important if the baby was born premature or weak, since breast milk is extremely healthy.
If a baby was born prematurely or has a medical condition and cannot be breastfed immediately, this is no reason not to continue breastfeeding. “I have worked with many new mothers who were unable to breastfeed their baby for the first six weeks due to preterm labor or other reasons. Nevertheless, all of them later successfully switched to breastfeeding,” says Kathy. nine0003
Does the baby latch on correctly?
Correct breastfeeding is essential for successful breastfeeding 6 , as it determines how effectively the baby will suckle milk and hence grow and develop. Latching on the breast incorrectly can cause sore or damaged nipples, so don't hesitate to ask your doctor to check that your baby is properly attached to the breast, even if you are told that everything is fine and you do not see obvious problems - especially while you are in the hospital. nine0003
“While I was in the hospital, I called the doctor at every feed and asked me to check if I was breastfeeding correctly,” says Emma, mother of two from Australia. - There were several cases when it seemed to me that everything seemed to be right, but it was painful to feed, and the doctor helped me take the baby off the breast and attach it correctly. By the time I was discharged, I had already learned to do it confidently.”
When applying to the breast, point the nipple towards the palate. This will allow the baby to take the nipple and part of the areola under it into their mouth. It will be easier for him to suck if he has both the nipple and part of the areola around in his mouth. nine0009 6
“When a baby latch on properly, it doesn't cause discomfort and it causes a pulling sensation, not pain,” Cathy explains. - The baby's mouth is wide open, the lower lip may be slightly turned outward, and the upper one lies comfortably on the chest. The body language of the child indicates that he is comfortable. There isn't much milk at this early stage, so you probably won't notice your baby swallowing, but he will suckle a lot and nurse frequently."
How often should a newborn be fed? nine0015
The frequency and duration of breastfeeding in the first week can vary greatly. “The first 24 hours of life are completely different for different children. Someone sleeps a lot (after all, childbirth is tiring!), And someone often eats, says Katie. - Such a variety greatly confuses young mothers. Everyone gives different advice, so it's important to remember that every mother and child is different."
“Colostrum is thicker than mature breast milk and is produced in smaller amounts, but has many benefits. When the baby eats colostrum, he learns to suck, swallow and breathe until milk begins to flow in more volume, ”explains Cathy. nine0003
Milk usually arrives on the second or fourth day after delivery. Until this time, the baby is applied to the breast 8-12 times a day (and sometimes more often!), including at night. 7 Feeding may last 10-15 minutes at this stage, or 45 minutes or even an hour, as the baby is just beginning to develop the muscles and coordination needed to suckle effectively.
“At first, the intensity of feeding is very high, often higher than many people realize, and this is shocking to most new mothers,” says Cathy. - Sometimes mom has no time to go to the toilet, take a shower and have a snack. It usually comes as a surprise." nine0003
Camille, a mother from Australia, experienced this. “The first week, Frankie ate every two hours, day and night, and each time it took half an hour to an hour to feed,” she recalls. “My husband and I were completely exhausted!”
Do I need to feed my newborn on a schedule?
The good news is that frequent feeding promotes lactation and stimulates milk production. 7 The more your baby eats, the more milk you will have. Therefore, forget about feeding your newborn on a schedule - this way he will have less chance of feeding. Try to feed your baby when he signals that he is hungry 8 :
- tossing and turning in her sleep;
- opens eyes;
- turns his head if he feels a touch on his cheek;
- sticks out tongue;
- licks lips;
- sucks fingers;
- is naughty;
- is crying.
Crying is the last sign of hunger, so when in doubt, just offer your baby the breast. If he bursts into tears, it will be more difficult to feed him, especially at first, when both of you are just learning how to do it. As your baby grows, he will likely eat less frequently and take less time to feed, so breastfeeding will seem more predictable. nine0003
Does breastfeeding hurt?
You may have heard that breastfeeding is not painful at all, but in fact, in the first days, many new mothers experience discomfort. And this is not at all surprising, given that the nipples are not used to such frequent and strong sucking.
“Breastfeeding can be uncomfortable for the first couple of days – your body and your baby are just getting used to it. If a baby eats too long and does not latch well, the sensations are almost the same as from unworn new shoes, Cathy compares. Just as tight shoes can rub your feet, improper suckling can damage your nipples. Prevention is always better than cure, so if the pain persists after a few days of feeding, contact a lactation consultant or healthcare professional.” nine0003
Maria, a mother from Canada, agrees: “Although my son seemed to latch onto the breast well, he damaged his nipples while feeding, and I was in pain. As it turned out, the reason was a shortened frenulum of the tongue. The breastfeeding specialists at our city clinic have been of great help in diagnosis and treatment.”
In addition, you may experience period cramps during the first few days after breastfeeding, especially if this is not your first baby. This is the so-called postpartum pain. The fact is that oxytocin, which is released during breastfeeding, contributes to further contraction of the uterus to restore its normal size. nine0009 4
When milk arrives, the breasts usually become fuller, firmer and larger than before delivery. In some women, the breasts swell, harden and become very sensitive - swelling of the mammary glands occurs. 10 Frequent breastfeeding relieves these symptoms. For more breast care tips, read our article What is Breast Swelling?
How often does the newborn urinate and defecate?
What goes into the body must go back out. Colostrum
has a laxative effect, helping to eliminate meconium - the original feces. It looks a little scary - black and sticky, like tar. 11 But don't worry, it won't always be like this. Breastfed babies usually have a slightly sweet smell of stool.
How many times a day you will need to change diapers and how the contents should look like, see below.
- Frequency: once or more.
- Colour: greenish black. nine0087
- Texture: sticky like tar.
- Frequency: twice or more.
- Colour: dark greenish brown.
- Texture: less sticky.
- Frequency: twice or more.
- Colour: greenish brown to brownish yellow.
- Texture: non-sticky.
Fourth day and then the entire first month
- Frequency: twice or more.
- Color: yellow (feces should turn yellow no later than by the end of the fourth day).
- Texture: grainy (like mustard with grains interspersed). Leaky and watery.
The baby's urine should be light yellow. On average, babies urinate once a day for the first two days. Starting around the third day, the number of wet diapers increases to three, and from the fifth day onwards, diapers have to be changed five times a day or more often. In addition, during the first few days, the weight of wet diapers increases. nine0009 11
Is the baby getting enough breast milk?
Since very little milk is produced at first,
You may feel that your baby is not getting enough milk. But if you feed your baby on demand, you will produce exactly as much milk as he needs. If you want to keep the process under control, be guided by the frequency of diaper changes given above. If your baby soils less diapers, check with your doctor.
“For the first three or four weeks, most babies just eat and sleep. If the child is worried and constantly asks for a breast, you should consult with your doctor, ”recommends Katie. nine0003
Sometimes the baby may vomit after feeding. If the vomit is the color of milk, this is not a cause for concern. But if there are orange, red, green, brown or black blotches in it, or the child vomits with a "fountain", consult a doctor. You should also consult a doctor if the baby has a high temperature, the fontanel (soft spot on the head) has sunk, blood is found in the stool, and also if the weight recorded at birth has not recovered within two weeks. 11
But if there are no frightening symptoms and the baby is growing at a normal pace, it means that he has enough milk. Soon you will both get used to breastfeeding and establish a more stable routine.
For the next step in breastfeeding, see Breastfeeding in the First Month: What to Expect.
1 Pang WW, Hartmann PE. Initiation of human lactation: secretory differentiation and secretory activation. J Mammary Gland Biol Neoplasia 2007;12(4):211-221. - Pang, W.W., Hartmann, P.I., "Lactation initiation in the lactating mother: secretory differentiation and secretory activation." G Mammary Gland Biol Neoplasia. 2007;12(4):211-221.
2 Shashi R et al. Postpartum psychiatric disorders: Early diagnosis and management. Indian J Psychiatry . 2015; 57( Suppl 2): S 216– S 221. - Shashi R. et al., Postnatal mental disorders: early diagnosis and treatment. Indian J Saikiatri. 2015; 57(App 2): S216-S221.
3 Moberg KU, Prime DK. Oxytocin effects in mothers and infants during breastfeeding. Infant . 2013;9(6):201-206. - Moberg K, Prime DK, "The effects of oxytocin on mother and child during breastfeeding." nine0201 Infant. 2013;9(6):201-206.
4 Sobhy SI, Mohame NA. The effect of early initiation of breast feeding on the amount of vaginal blood loss during the fourth stage of labor. J Egypt Public Health Assoc . 2004;79(1-2):1-12. - Sobhi SI, Moham NA, "Early initiation of breastfeeding and its effect on vaginal bleeding in the fourth stage of labor." nine0201 G Egypt Public Health Assoc. 2004;79(1-2):1-2.
5 Meier PP et al. Which breast pump for which mother: an evidence-based approach to individualizing breast pump technology. J Perinatol . 2016;36(7):493. - Meyer P.P. et al., Breastpump Selection: A Scientific Approach to Customizing Pumping Technology. J Perinatol (Journal of Perinatology). 2016;36(7):493-499.
6 Cadwell K. Latching - On and Suckling of the Healthy Term Neonate: Breastfeeding Assessment. J Midwifery & Women ’ s 2007;52(6):638-642. — Cadwell, K., "Latching and sucking in healthy newborns: evaluation of breastfeeding." W Midwifery Women Health. 2007;52(6):638-642.
7 Kent JC et al. Principles for maintaining or increasing breast milk production. 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.
8 Australian Breastfeeding Association [ Internet ]. Feeding cues ; 2017 Sep [ cited 2018 Feb ]. - Australian Breastfeeding Association [Internet], Feed Ready Signals; September 2017 [cited February 2018]
9 Jacobs A et al. S3-guidelines for the treatment of inflammatory breast disease during the lactation period. Geburtshilfe Frauenheilkd . 2013;73(12):1202-1208. - Jacobs A. et al., "Guidelines S -3 for the management of inflammatory breast disease during breastfeeding." Geburtskhilfe und Frauenheilkünde. 2013;73(12):1202-1208.
10 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.
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 Recommendations
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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 breast 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 since the child 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. nine0009 4
What is a "milk flush"?
At the beginning of each feeding, 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,” Cathy explains. “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 feeding,” Katie 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 suck on 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 can you tell if your 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 eaten, 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. nine0009 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. nine0009 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. nine0009 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
“No one 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? nine0015
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 immunity 14 and reducing your risk of developing certain types of cancer. 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 After the First Month: What to Expect
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. 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. nine0201
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]. nine0201
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]. nine0201
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." nine0201 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 .