Feeding new born baby

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 responsive feeding.

Hunger cues

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:

Licking lips
Sticking tongue out
Rooting (moving jaw and mouth or head in search of breast)
Putting his/her hand to mouth repeatedly
Opening her mouth
Fussiness
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

Too full?

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?

Daily diapers

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.

Growth charts

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.

Remember

Talk with your pediatrician if you have any questions or concerns about your baby getting the right amount to eat.

More information:

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)

About Dr.

Jain:

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.

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
crying

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

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. 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. ”

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.

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.

“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. ”

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.

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 healthcare provider 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.

“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. 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?

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.

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."

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;
groans;
licks lips;
sucks fingers;
is naughty;
whimpers;
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.

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 for 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.”

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. 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.

Day one

Frequency: once or more.
Colour: greenish black.
Texture: sticky like tar.

Day two

Frequency: twice or more.
Colour: dark greenish brown.
Texture: less sticky.

Day three

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. ¹¹

Is the baby getting enough breast milk?

Since very little milk is produced at first,
You may feel that this is not enough for your baby. 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 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, ”Katie recommends.

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, then 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.

Literature

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." 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." 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 on demand

You can often hear from a nursing mother: "I feed on demand, my baby requires a breast every 3.5 hours." Or: “I have always fed on demand. In a year, we already had 1 feeding in the evening, and my child calmly refused to breastfeed. Before talking about the demand of the child, it is necessary to find out what modern women mean when they say - "I breastfeed."

Modern mothers consider breastfeeding essential for feeding their baby. Just for feeding. Breast milk is food, the mother supplies the baby with the nutrients necessary for growth and development. When a baby suckles at the breast, he eats. Breastfeeding makes sense only as a process of supplying proteins, fats, carbohydrates, vitamins and microelements.

During suckling, the baby receives the nutrients it needs with mother's milk. This is the absolute truth. There is another unconditional truth, which is not given any importance in modern society, it is not taken into account and is not considered. Breastfeeding for a child is communication with the mother. We need to figure out how the child understands feeding on demand? Can he understand anything at all? Is there any difference for him how he is fed, for 15-20 minutes after 3.5 hours or in some other way?

What is on-demand feeding

On-demand feeding of a newborn baby means putting it to the breast for every squeak or search. Squeak and search movements in newborns, even as early as the second or third day of life, begin to appear much more often than after 3.5 or 2.5 hours. The need for attachments increases rapidly, and by the 10-12th day of life, the need to attach to a child may occur 15-16 or more times a day. Applications vary in duration. The baby can fall asleep and sleep while sucking for, for example, 1.5-2 hours. Can release the breast after 1-2 minutes. And then ask her again. Why does a child need such frequent contact with his mother's breast?

That's why. Being in the mother's belly, in a calm, familiar environment, listening to the noises of the mother's body, being in a warm, cramped, confined space, the baby sucked his fist, fingers, loops of the umbilical cord, swallowed amniotic fluid. Learned to suck and swallow. After birth, experiencing discomfort for any, the most insignificant reason, the baby tries to get rid of it. You can get rid of discomfort by getting into the usual conditions of a comfortable stay. The only place where the baby after birth can feel the sensations familiar to him is in the arms of the mother. The only familiar action is sucking. The only familiar taste and smell is the taste and smell of milk and lube in the areola. Milk and lubricant have an odor and taste similar to the taste and smell of amniotic fluid. Therefore, experiencing discomfort, the baby squeaks, or begins to look for an object to suck with his mouth. Ideally, it is immediately applied to the chest. The baby becomes warm, cramped, he hears the beating of his mother's heart, breathing, grumbling in the intestines, he sucks and feels the familiar taste and smell. If such an action happens constantly, the baby gains confidence, no matter what happens, he will solve all his problems with his mother. The place of comfort is now under the breast, and you can suck on the breast.

This whole process is justified from a biological point of view. A newborn child does not feel the feeling of hunger, this feeling is not formed in him. It will begin to form at about two months of age. How to feed a creature that does not experience hunger ?! How to encourage him to take some action to get food? This can be done only at the expense of some other incentives. This stimulus for the newborn is constant bodily discomfort, thanks to which he wants to suckle all the time! The most intense, frequent and prolonged sucking in infants is observed in the first two or three months of life. It is in these first months that the main weight gain of the baby occurs.

Feeding in the first month

Baby falls asleep with the breast in his mouth, sleeps sucking for a while. Falling asleep deeply, lets go of the chest. After sleeping for a while, he wakes up, and is applied on waking. After sleep, he can stay awake for some time, for example, an hour and a half. During wakefulness, he may feel discomfort 2-3 times, for example, from a completely natural desire to pee, and having called his mother for help, having kissed for a couple of minutes, he will do his deeds. Then he will want to sleep, feel discomfort and, kissing his chest, will again fall asleep sucking. After some time, he will wake up and attach again. Then again a little "walk". And after some time, he will fall asleep at the chest again.

The daytime naps of a one-month-old baby feeding on demand vary in duration and number. There can be 4-6 dreams during the day, and they can last from 5-15 minutes to 2-2.5 sometimes 3 hours. "Around" each dream, the baby is applied to the chest, and applied between dreams several times. At night, the child falls asleep at the breast. Usually in the early morning hours, he begins to fuss and apply. In the morning, he almost never fully wakes up. The baby sleeps, from time to time, sucking on his mother's breast. Waking up in the morning, the baby is again applied to the chest. If you count all the attachments that have happened in a baby of one month of age, then approximately 16-20 attachments are obtained. This is how a newborn human cub behaves if it is given the opportunity to behave in accordance with physiological and psychological needs, which, by the way, are genetically determined. The child of the first months of life does not separate his personality from the personality of the mother and from her breast. Mom and her breasts, and everything connected with them, are the universe of the baby and himself.

In most cases, a modern woman, being afraid to “accustom a child to hands”, strives to limit his requests for sucking. A pacifier and a bottle of tea or water come to her aid in this matter. They, too, can be sucked ... The need for sucking seems to be satisfied. But only the need for communication with the mother during suckling is not satisfied, the peculiar chain of mutual assistance and cooperation between mother and baby is destroyed, the formation of maternal affection and concentration is disrupted. Is the difference in the two actions noticeable to the reader: the baby cried, the mother took him, put him to her chest and started rocking him, or gave him a pacifier and started rocking the stroller, even with the words “Why are you crying, my sun?”

The modern woman who gives a pacifier and pumps a stroller is not a bad person who deliberately harms an infant. She is simply in captivity of prejudices regarding the relationship between mother and baby. She does not know how to behave correctly, does not know what to do in accordance with the natural needs of the child. If you tell her what the child really needs, she will exclaim in horror: “What is it, don’t let him get away with?!” Indeed, the child of the first months of life must not be let off the hook. For a woman who does not know how to comfortably carry a baby, and who does not know how to feed him in various positions (sitting, lying, standing and even moving), this can be very difficult. Especially if she is not sure of the correctness of her actions.

An action that should become automatic for the mother of a newborn: when the baby cries or shows other signs of anxiety, put the baby to the breast.

And then?

The baby is growing. A fairly stable rhythm of daytime sleep begins to form in him, and a 3-4-month-old baby behaves quite differently from a newborn. Feeding on demand at this age looks something like this...

At three months, the baby has 10-12 feeds during the day and 2-4 at night. There are frequent applications for a short time, but their number is reduced. There may be a long night break in feedings, about 5 hours, but this is very rare. Much more often the night break is 2.5-3.5 hours. By this age, the baby's body is noticeably rounded.
At four months, the baby begins to breastfeed much less frequently. The main feedings are associated with sleep: the baby suckles before bedtime, during awakening and during sleep, both daytime and nighttime. In this regard, he has a fairly accurate feeding regimen. And many babies stop breastfeeding when they wake up after daytime sleep, sometimes as early as 2.5-3 months.
At five months, the baby has 8-10 daytime feedings and 2-3 nighttime, attachments as well as in the fourth month of life, they are organized around dreams - the baby eats when going to bed and some babies suck during awakening.
Feeding regimen changes at six months. The most active sucking shifts to the last 2-3 hours before waking up from a night's sleep. The period of daytime wakefulness can be divided into two periods: in the morning, when the baby sucked during the night is rarely applied to the breast, and in the evening, when attachments become very frequent. In total, there can be 7-10 day applications and 3-4 night applications. At this age, the baby begins a period of acquaintance with new food - pedagogical complementary foods. Sometimes there are attachments associated with the introduction of complementary foods, the baby “washes down” samples of new food with mother's milk. But many children do not want to drink complementary foods. When complementary foods are introduced to an on-demand baby, it is never meant to replace feedings with complementary foods. This is practically impossible, because the main feedings of the baby are associated with sleep, and mother's breakfasts, lunches and dinners, during which the baby gets acquainted with new food, are located between the baby's dreams, during his wakefulness.
At seven months, the frequency of applications is about the same.
At eight months, the feeding regimen changes. Since the baby shows high motor activity and is very busy exploring the surrounding space, in the daytime he forgets to breastfeed. In this regard, the number of daily feedings can be reduced to 6-8 times. The baby compensates for the reduction in daytime feedings by increasing the frequency and duration of nighttime feedings up to 6 times.
In the second half of the year, babies who stopped breastfeeding on waking from daytime naps recall this habit again. The baby’s daytime sleep in the second half of life, as well as in the region of a year and older, looks something like this: the baby falls asleep sucking, sleeps quietly for a while, for example 1-1.5 hours, then starts tossing and turning, fiddling, worrying, at this moment the mother lies down next to , gives him a breast and the baby can fill up 10-15-30 minutes sucking. Mom may well use this time for her own rest - lie down, read, while the baby sleeps while sucking. I know my mother, a lover of embroidery, who used this time specifically for embroidery ...
Breastfeeding becomes more frequent at nine to ten months. In the daytime, this is 4-6 full feedings and about the same number of attachments for various reasons. The baby has new reasons for attachment. If, during active actions to master the world, the baby fills a bump or gets scared, he calms down with his mother's breast. There may be situations when you can comfort the baby by sitting next to him and hugging him. At night, 4-6 feedings remain, the baby begins to suckle more actively in the morning between 3 and 8 hours.
At eleven months, a baby can already have 2-3 complete complementary foods. Initiation to adult food in the mind of a child is not associated with breastfeeding: attachment to the mother's breast is something other than the desire to get enough of the product they like. As a rule, after the baby has eaten, he feels the need to attach himself to the breast. The number of daily feedings remains the same in the child, but the number of short-term attachments increases. There are active mid-morning feedings between 4 and 8 o'clock in the morning.
At ten or twelve months, the baby, if he is already walking, can sometimes breastfeed every time he comes to his mother, i.e. about every 15-30 minutes. Attachments around dreams and night sucking persist. Therefore, if a mother says that a child suckles once or twice a day, this means that there is no feeding at the request of the child. There are restrictions imposed by the mother, with which the baby has come to terms. He treats breast sucking like food, sucks on a pacifier or a finger to fall asleep or soothe, or falls asleep just like that, without calming down.
At twelve months, the baby is applied in about the same way.
At the age of one and a half years, there may already be one daytime nap, so there are fewer attachments associated with sleep. Preserved for morning sucking. The baby is very free with his mother's breasts. Sometimes it happens that he comes up to suck just for pleasure. For example, like this: he comes up, climbs on his knees, looks into his mother’s face, smiles, starts to swarm in his shirt, gets breasts, smiles at his breasts, sucks for 30 seconds and leaves.

As for the number of feedings per day when feeding a child on demand, their number is almost never less than 12. A newborn has 12 or more attachments, basically they are all associated with dreams. And a child, say 1.5-2 years old, can also have about 12 attachments, only 3-4 are associated with sleep, and the rest are short-term attachments for various reasons. I suggest to all mothers reading this text - do not count the application, do not notice their duration. Breastfeed your baby as often as he asks, when you feel the need to.

Mothers who do not think about breastfeeding without looking at the clock may get the impression that when feeding on demand, the mother can do nothing but feed the baby. This is wrong. After the birth of a baby, a mother begins another life, she is called life with a baby. That's all. The child is with the mother, not the mother with the child! Feel the difference! You need to be able to organize your life in a different way, in the first months, of course, the help of loved ones is very necessary. In the tradition of many peoples, it was customary for the first 40 days after childbirth to remove a woman from any housework and household chores, she was engaged only in a child. In some nations, objects that the mother of a newborn touched were considered “unclean”, therefore, they preferred to protect the mother from the rest of the household, allocating her a separate “corner” of the house, where no one bothered her and she did not interfere with anyone. Among the Slavs, such a restrictive custom was called a six-week. By 1.5-2 months, the rhythm of daytime dreams begins to form, and the baby has a kind of “regime”, the mother becomes more free.

For a mother who can't imagine breastfeeding without looking at the clock, and who is sure that the “right” baby is the baby lying quietly in her crib all the time, feeding on demand will be a complete hassle. It will be much easier for such a mother if she stops looking at the clock and ties the baby to herself with a large scarf or uses a patchwork holder (sling). It will become easier for her if she stops running between the nursery and the kitchen, but takes the baby with her to the kitchen and carries him around the house with her, doing housework, in a box, a cradle, a special chair, if she tries not to put him off often, and pick up as soon as possible, postponing the baby only in case of emergency and not for long.

Breastfeeding is not the same as house arrest. In the conditions of modern society, it is possible to organize the exit of a nursing mother to work from about 6 months of age of the baby. If necessary, you can start working from the age of 4 months, but, of course, it is better not every day of the week and not full time. It is the responsibility of a breastfeeding consultant to help a mother organize her return to work.

Sometimes, when counseling mothers on breastfeeding, I suggest that they forget for a second that they are already living in the 21st century. I propose to return, for example, to the cave and ask what they will do if the child woke up at night, how to calm him down? If you are walking through the forest and trying not to attract the attention of predators, how to make the baby silent? If the child is thirsty, what will you give him? What is the baby used to, for thousands of years of its existence? To the fact that he sleeps on his mother while she wanders through the forest with a digging stick in search of roots, and wakes up when mother stops. Since mom stopped, then there is time to wake up and suck. Therefore, even now the child sleeps well, tied to the mother with a patchwork holder, wakes up when the mother, having done a few household chores, sits in a chair to take care of the baby.

Some mother, reading about the cave, will be offended, saying that she is a civilized creature. But please think. Man, mother's breast and mother's milk have been created by evolution over millions of years. They are made for each other. Baby food has created progress and more recently. The skills of motherhood and breastfeeding have also been lost by our society quite recently. A person is not physiologically adapted to artificial feeding and a pacifier. The mother's breast will not produce enough milk at 6-7 feedings per day. Nature did not know, when creating man as a mammal, that the time would come when the need for breastfeeding would be satisfied by some kind of pacifiers and nipples.

Changes that occur during the formation of the personality of a child who did not have full contact with the mother during prolonged breastfeeding are noted by modern research by psychologists and sociologists.