How often should a four week old baby feed

Do you know when breast milk production stabilizes? And how does the frequency and duration of feedings change as the baby grows? You will find answers to these questions in our recommendations for breastfeeding after the first month.

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Congratulations: You made it through the first month of breastfeeding. Your breast milk has reached full maturity ¹ , its production stabilizes, and it leaks almost or not at all from the chest. Don't worry, it's not getting less milk, it's just that your breasts are better able to produce and store it now. ² At the age of six weeks, your baby will begin to please you with his charming toothless smiles, and by two months you will already have 500-600 feedings behind you. With a favorable development of events, problems with latch on by this point will already be resolved, and you can simply enjoy the convenience and benefits of breastfeeding.

When does breastfeeding decrease?

"Normal" feeding frequency for babies aged one to six months varies considerably, with some needing four feedings a day, others asking to be breastfed 13 times a day. ³

“From the age of one month, the amount of milk a baby consumes per feed increases, so that he can go without food for longer,” explains Cathy Garbin, a recognized international expert on breastfeeding, “A baby’s stomach grows, so he eat more at one time. In addition, mature milk allows him to stay full longer.”

Feeding can last from 12 minutes to one hour -
the habits of babies vary so much! ³ But if the child is gaining weight and falls within this range, there is no cause for concern.

What is most surprising, no matter how often the baby eats, he consumes approximately the same amount of milk per day - both at one month and at six, when it is time to start complementary foods with solid food. ⁴

“However, sometimes the baby eats more and sometimes less, especially when he is unwell. It’s better to just listen to his needs,” Katie explains.

Is breast milk enough for the first six months?

Yes. Breast milk contains everything a baby needs for the first 90,023 six months of life—exclusively breastfed babies don't even need to drink more water! ⁵ Until about six months of age, a child's digestive system is simply not adapted to the digestion of solid food, and he will be able to drink cow's milk only after a year.

In addition, breastfeeding during this period prepares the child for further development. It strengthens the muscles of the mouth, develops the jaw and helps straighten the teeth ^6.7 . All this will come in handy when the baby begins to eat and talk. And because what you eat and drink affects how your breast milk tastes, your baby discovers new tastes even before he starts eating solid foods. ⁸

In addition, when your baby is sick, your body produces breast milk that is
rich in antibodies that help fight infection. ⁹ In other words, milk continues to protect the baby for many months as he grows and becomes more active.

Breastfeeding is also very comfortable once you get used to it. Claudia, a mother of two from the UK, notes: “No need to sterilize a mountain of bottles, prepare formula, carry it all with you, warm it up - in general, breastfeeding turned out to be very convenient, especially when my babies grew up and we began to leave the house more often. ".

At what age does a breastfed baby start sleeping through the night?

Waking up at night is normal for babies. Most babies between the ages of one and six months consume a fifth of their daily milk requirement at night, so nighttime feedings should not be neglected if you want your baby to get the required amount of calories. ³

"It really depends on what you mean by 'sleep through the night'," says Cathy. "And it's better than waking up every two hours anyway! I have met infants who, starting at six weeks old, fell asleep at 19:00 and woke up at 7:00, but most continue to wake up frequently at night after this age. All children are different."

In Wales, a study of more than 700 infants showed that almost 80% of children aged 6 to 12 months wake up at least once a night, and 25% of them wake up three times or more. And it did not depend on what type of feeding the child is on - breastfeeding or artificial. ¹⁰

And if nighttime awakenings are unavoidable anyway, breastfeeding is at least comfortable! Maina, a mother of two from Australia, agrees: “You can even take a nap while feeding in the middle of the night - both the body and the baby do their job on autopilot. No need to plan, measure, sterilize anything - ready-made food at the right temperature is right in your chest. I think it's ideal."

My child wakes up more often. Perhaps he is hungry?

Around four months of age, a baby's sleep patterns change as they develop deep and light sleep phases like an adult. Because of this, he may wake up more often at night. “At four months, sleep is more of a problem than feeding,” Cathy admits. “It can be exhausting, but try to adapt and be patient.”

Some call this " a four-month sleep regression ", but "progress" is more appropriate here. From the outside it may look like a step back, but in fact the child is approaching an important stage of development. He learns quickly, begins to become aware of the world around him, his perception is sharpened and, perhaps, there is anxiety about being separated from his mother. Crying when waking up and being able to eat milk cuddled up to mommy’s chest is a way for a baby to calm down. ^11–13

Resist the urge to “supplement” your baby with formula or start solid foods early
in an attempt to improve his sleep. Breast milk contains
hormones that make you sleepy and help you both relax
. Research shows that breastfeeding mothers actually sleep longer at night than mothers of formula-fed or mixed-fed babies
. ¹⁴

How does teething affect breastfeeding?

Teething usually begins around four months of age. When a baby has gum pain, he becomes restless, throws his chest and cries. All this, of course, is unpleasant.

However, breastfeeding can be an excellent sedative.
Studies have shown that babies who are breastfed
during the vaccination period cry less and forget pain more quickly. ¹⁵ Breastfeeding during teething can have the same calming effect.

An unpleasant side effect may be the child's attempts to try out his new teeth on the mother's breast. “Sometimes children flirt and bite their mother’s nipples. This can be felt in advance by how the behavior of the child changes when feeding: before biting, he removes his tongue, explains Cathy, “Usually this is not a problem and only happens a couple of times. It is enough to stop feeding, affectionately say that biting is not good, and the baby will soon leave this fun.

How to continue feeding if you have to be separated from the baby?

It happens that during the first six months, when the baby is still fully breastfed, the mother needs to be away for several hours - or even longer if she has to go to work or go away on business for a couple of days.

But this does not mean that you should stop breastfeeding. You can still feed your baby healthy breast milk - just express it and have someone give it to your baby when you're away. Here's Katie's advice:

“Start expressing milk a couple of days in advance, in small batches, 40-60 ml at a time. So you will have the necessary supply for the time of your absence, but at the same time the amount of milk produced will remain the same.

If you have to return to work, check with your employer about your daily schedule. Many mothers breastfeed their babies in the morning, evening and night, and pump milk at lunchtime to relieve discomfort and create a reserve for the next day.

This usually turns out to be much easier than one might think, and today many companies are well placed to do this, notes Cathy. “Breast pumps make it easy to solve this problem.”

Natalie, mother from the USA, shares her experience: “I feed Dylan as soon as he wakes up, and sometimes again before leaving for work, in order to maintain milk production and not lose contact with the child. At work, I pump twice the next day (in my absence, he eats two bottles of breast milk), and after work I rush home for the evening feed. I don't pump on the weekends - we resume regular breastfeeding."

Can breastfeeding continue after the introduction of solid foods?

When your baby begins to show interest in food and can sit up on his own - usually around six months of age - it's time to start solid foods. However, it is not necessary to stop breastfeeding, Cathy explains: “A baby’s iron stores during pregnancy are depleted by six months, so he needs additional sources of this element.

Start complementary foods with solid foods, but remember that breast milk remains a more important source of calories and nutrients until the baby is eight to nine months old. By this time, he will be eating much more solid food, but he will still need to breastfeed four to five times a day. By 12 months, the frequency of feeding may be two to six times a day. All babies are different, and many of them at this age are still getting half their daily calorie intake from breast milk.”

Don't forget that breast milk can be added to solid foods, such as cereals and purees, so that the baby can taste the familiar taste. If possible, use milk expressed just before feeding (not thawed) and add just before serving to keep bacteria and nutrients alive. ¹⁶

You may be pressured by others to stop breastfeeding when your baby is six months old, but the longer you breastfeed or pump milk, the better for you and your baby.

How long can I continue breastfeeding?

“The World Health Organization recommends breastfeeding along with solid foods until at least two years of age because it plays an important role in supporting immunity,” says Cathy. feels bad".

At eight months, the baby sometimes breastfeeds four times a day, but by one year old, the frequency of feedings can be reduced to two times a day. You yourself will understand which feeding regimen is more suitable for you and your baby. For example, Jane, a mother of two from the US, breastfed until the age of two: “I breastfed when I was at home - in the evenings and on weekends, when the children wanted to be close to me,” says Jane, “It helped a lot when they were sick . Breastfeeding has become my favorite form of comfort."

“When my son got a little older and bolder, he still often asked me to breastfeed him - as if to calm down and gain strength,” recalls Amy, a mother of two children from Canada, “When he happened to hit or skin his knee , breastfeeding was a wonderful way to comfort him. ”

If your baby is over a year old and you are still breastfeeding, people around you will probably tell you that this way he will never wean. But if children are not pressured, they usually refuse to breastfeed themselves between the ages of two and four. ¹⁷

“I didn’t intend to breastfeed for so long, but as a result, I still breastfeed my four-year-old daughter and 22-month-old son,” says Suzanne, mother of two from the UK, “I breastfeed my youngest before and after work, and in I express milk on business trips. The eldest daughter likes to breastfeed a little before bed or when she is upset - this is a great way to make contact. When I get tired of it, I remind myself what great benefit and comfort it brings them. I now plan to pursue a baby-initiated end breastfeeding strategy — let them decide when to stop.”

For more information on what to expect and lots of tips and tricks, see our guide Breastfeeding Problems After the First Month.

Literature

1 Ballard O, Morrow AL. Human milk composition: nutrients and bioactive factors. Pediatr Clin North Am . 2013;60(1):49-74. - Ballard O., Morrow A.L., "Composition of breast milk: nutrients and biologically active factors." Pediatrician Clean North Am. 2013;60(1):49-74.

2 Kent JC et al. Principles for maintaining or increasing breast milk production. J 2012;41(1):114-21. - Kent J.S. et al., "Principles for Maintaining and Increasing Milk Production". J Obstet Ginecol and Neonatal Nurse. 2012;41(1):114-121.

3 Kent JC 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.

4 Kent JC et al. Longitudinal changes in breastfeeding patterns from 1 to 6 months of lactation. Breast Med . 2013;8(4):401-407. - Kent J.S. et al., Longitudinal changes in breastfeeding patterns from 1 to 6 months of lactation. Brest Med. 2013;8(4):401-407.

5 Almroth S, Bidinger PD. No need for water supplementation for exclusively breast-fed infants under hot and arid conditions. Trans R Soc 1990;84(4):602-604. - Elmroth S., Bidinger P.D., "No need for supplementation of exclusively breastfed infants in hot, dry conditions." Trans R Sots Trop Med Hyg. 1990;84(4):602-604.

6 Victora CG et al . Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet. 2016;387(10017):475-490. - Victor S.J. et al., "Breastfeeding in the 21st century: epidemiology, mechanisms and long-term effects". Lancet 2016;387(10017):475-490.

7 Peres KG et al. Effect of breastfeeding on malocclusions: a systematic review and meta - analysis. Acta Paediatr. 2015;104( S 467):54-61. - Perez K.G. et al., "The impact of breastfeeding on malocclusion: a systematic review and meta-analysis". Akta Pediatr. 2015;104(S467):54-61.

8 Mennella JA, Beauchamp GK. Maternal diet alters the sensory qualities of human milk and the nursling's behavior. Pediatrics. 1991;88(4):737-744. - Mennella, JA, Beauchamp, GK, "Maternal nutrition influences the organoleptic properties of breast milk and infant behavior." Pediatrix (Pediatrics). 1991;88(4):737-744.

9 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." Clean Transl Immunology. 2013;2(4).

10 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.

11 Infant sleep information source. [Internet]. Normal Infant Sleep Development; December 2017 [cited 2018 Feb] - All about baby sleep. [Internet] "The development of normal sleep in a child", December 2017 [cited February 2018].

12 Baby sleep science. [Internet]. The-Four-Month-Sleep-Regression-What-is-it-and-What-can-be-Done-About-it. March 2014 [ cited 2018 Feb ] - The science of baby sleep. [Internet], "Four-month sleep regression: what it is and what to do about it." March 2014 [cited February 2018].

13 The Myth Of Baby Sleep Regressions – What’s Really Happening To Your Baby’s Sleep? [Internet]. Pinky Mckay ; December 2017 [ cited 2018 Feb ] - "The Myth of Baby Sleep Regression - What's Really Happening to Your Baby?" [Internet]. Pinky McKay, December 2017 [cited February 2018].

14 Kendall - Tackett K ET Al . The effect of feeding method on sleep duration, maternal well-being, and postpartum depression. Clinical Lactation . 2011;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.

15) Harrison D et al. Breastfeeding for procedural pain in infants beyond the neonatal period. Cochrane Database Syst Rev . 2014;10. — Harrison D. et al., "Breastfeeding for Relief of Medical Pain in the Neonatal Period." Cochrane Database of System Rev. 2014;10:CD11248

16 Czank C et al. Retention of the immunological proteins of pasteurized human milk in relation to pasteurizer design and practice. Pediatr Res . 2009;66(4):374. - Zhank S. et al., "Retention of immunological proteins in pasteurized milk depending on the technique and practice of pasteurization". Pediatrician Res. 2009;66(4):374.

17 Weaning from the breast. (2004). Paediatr Child Health, 9(4):249–253. - "Weaning from the breast" (2004). Pediatrician Child Health, 9(4):249–253.

Diet for a 4-6 month old baby

Your baby is already 4 months old. He has noticeably grown up, become more active, is interested in objects that fall into his field of vision, carefully examines and reaches for them. The emotional reactions of the child have become much richer: he joyfully smiles at all the people whom he often sees more and more often, makes various sounds.

You are still breastfeeding or have had to switch to formula or formula feeding. The child is actively growing, and only with breast milk or infant formula, he can no longer always get all the necessary nutrients. And that means it's time to think about complementary foods.

The optimal time to start its introduction is between 4 and 6 months, regardless of whether the baby is receiving breast milk or formula. This is the time when children respond best to new foods. Up to 4 months, the child is not yet ready to perceive and digest any other food. And with the late introduction of complementary foods - after 6 months, children already have significant deficiencies of individual nutrients and, first of all, micronutrients (minerals, vitamins, long-chain polyunsaturated fatty acids, etc.). In addition, toddlers at this age often refuse new foods, they have delayed development of chewing skills for thick foods, and inadequate eating habits are formed. It is important to know that, no matter how strange it may seem at first glance, with a delayed appointment of complementary foods, allergic reactions more often occur on them.

When is it advisable to introduce complementary foods as early as 4 months, and when can you wait until 5.5 or even 6 months? To resolve this issue, be sure to consult a pediatrician.

As a rule, at an earlier age (4 - 4.5 months), complementary foods are introduced to children at risk of developing iron deficiency anemia, as well as children with insufficient weight gain and with functional digestive disorders.

The optimal time to start complementary foods for a healthy baby is between 5 and 5.5 months of age.

The World Health Organization recommends that breastfed babies should be introduced to complementary foods from 6 months of age. From the point of view of domestic pediatricians, which is based on extensive practical experience and scientific research, this is possible only in cases where the child was born on time, without malnutrition (since in these cases the mineral reserves are very small), he is healthy, grows well and develops. In addition, the mother should also be healthy, eat well and use either specialized enriched foods for pregnant and lactating women, or vitamin and mineral complexes in courses. Such restrictions are associated with the depletion of iron stores even in a completely healthy child by 5-5.5 months of age and a significant increase in the risk of anemia in the absence of complementary foods rich or fortified with iron. There are other deficits as well.

The first complementary food can be vegetable puree or porridge, fruit puree is better to give the baby later - after tasty sweet fruits, children usually eat vegetable puree and cereals worse, often refuse them altogether.

Where is the best place to start? In cases where the child has a tendency to constipation or he puts on weight too quickly, preference should be given to vegetables. With a high probability of developing anemia, unstable stools and small weight gains - from baby cereals enriched with micronutrients. And if you started introducing complementary foods with cereals, then the second product will be vegetables and vice versa.

If the first complementary food is introduced at 6 months, it must be baby porridge enriched with iron and other minerals and vitamins, the intake of which with breast milk is no longer enough.

Another important complementary food product is mashed meat. It contains iron, which is easily absorbed. And adding meat to vegetables improves the absorption of iron from them. It is advisable to introduce meat puree to a child at the age of 6 months. Only the daily use of children's enriched porridge and meat puree can satisfy the needs of babies in iron, zinc and other micronutrients.

But it is better to introduce juices later, when the child already receives the main complementary foods - vegetables, cereals, meat and fruits. After all, complementary foods are needed so that the baby receives all the substances necessary for growth and development, and there are very few in their juices, including vitamins and minerals.

Juices should not be given between feedings, but after the child has eaten porridge or vegetables with meat puree, as well as for an afternoon snack. The habit of drinking juice between meals leads to frequent snacking in the future, a love of sweets is instilled, children have more tooth decay and an increased risk of obesity.

With the start of the introduction of complementary foods, the child is gradually transferred to a 5-time feeding regimen.

Rules for the introduction of complementary foods:

• Preference should be given to children's products of industrial production, they are made from environmentally friendly raw materials, have a guaranteed composition and degree of grinding
• Complementary foods should be offered to the baby by spoon at the start of feeding, before breastfeeding (formula feeding)
• the volume of the product increases gradually, starting with ½ - 1 spoon, and in 7 - 10 days we bring it to the age norm, subsequent products within the same group (cereals from other cereals or new vegetables)
• can be entered faster, in 5 - 7 days
• start introduction with monocomponent products
• it is undesirable to give a new product in the afternoon, it is important to follow how the child reacts to it
• do not introduce new products in the event of acute illnesses, and before and immediately after prophylactic vaccination (should abstain for several days)

When introducing a new type of complementary food, first try one product, gradually increasing its amount, and then gradually "dilute" this product with a new one. For example, vegetable complementary foods can be started with a teaspoon of zucchini puree. During the week, give the baby only this product, gradually increasing its volume. After a week, add a teaspoon of mashed broccoli or cauliflower to the zucchini puree and continue to increase the total volume every day. Vegetable puree from three types of vegetables will be optimal. The portion should correspond to the age norm. Over time, you can replace the introduced vegetables with others faster.

After the introduction of one vegetable (bringing its volume to the required amount), you can proceed to the intake of porridge, and diversify the vegetable diet later.

If the child did not like the dish, for example, broccoli, do not give up and continue to offer this vegetable in a small amount - 1-2 spoons daily, you can not even once, but 2-3 times before meals, and after 7 - 10, and sometimes 15 days, the baby will get used to the new taste. This diversifies the diet, will help to form the right taste habits in the baby.

Spoon-feeding should be done with patience and care. Forced feeding is unacceptable!

In the diet of healthy children, porridge is usually introduced after vegetables (with the exception of healthy breastfed children, when complementary foods are introduced from 6 months). It is better to start with dairy-free gluten-free cereals - buckwheat, corn, rice. At the same time, it is important to use porridge for baby food of industrial production, which contains a complex of vitamins and minerals. In addition, it is already ready for use, you just need to dilute it with breast milk or the mixture that the baby receives.

Children suffering from food allergies are introduced complementary foods at 5-5.5 months. The rules for the introduction of products are the same as for healthy children, in all cases it is introduced slowly and begins with hypoallergenic products. Be sure to take into account individual tolerance. The difference is only in the correction of the diet, taking into account the identified allergens. From meat products, preference should first be given to mashed turkey and rabbit.

Diets for different age periods

Explain how you can make a diet, it is better to use a few examples that will help you navigate in compiling a menu specifically for your child.

From 5 months, the volume of one feeding is on average 200 ml.

Option 1.

If your baby started receiving complementary foods from 4-5 months, then at 6 months his diet should look like this:

* - infant formula
** - diluted with breast milk or VHI

Option 2.

I feeding
6 hours Breast milk or VHI* 200 ml II feeding
10 hours Dairy-free porridge**
Fruit puree 150 g
20 g III feeding
14 hours Vegetable puree
Meat puree Vegetable oil
Fruit juice 150 g
5 - 30 g
1 tsp
60 ml IV feeding
18 hours Fruit puree
Breast milk or VHI* 40 g
140 ml V feeding
22 hours Breast milk or VHI* 200 ml

* - infant formula
** - diluted with breast milk or VHI