How to time baby feedings for newborns

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 FAQs: How Much and How Often (for Parents)

Breastfeeding is a natural thing to do, but it still comes with its fair share of questions. Here's what you need to know about how often and how long to breastfeed your baby.

How Often Should I Breastfeed?

Newborn babies should breastfeed 8–12 times per day for about the first month. Breast milk is easily digested, so newborns are hungry often. Frequent feedings helps stimulate your milk production during the first few weeks.

By the time your baby is 1–2 months old, he or she probably will nurse 7–9 times a day.

In the first few weeks of life, breastfeeding should be "on demand" (when your baby is hungry), which is about every 1-1/2 to 3 hours. As newborns get older, they'll nurse less often, and may have a more predictable schedule. Some might feed every 90 minutes, whereas others might go 2–3 hours between feedings.

Newborns should not go more than about 4 hours without feeding, even overnight.

How Do I Count the Time Between Feedings?

Count the length of time between feedings from the time your baby begins to nurse (rather than at the end) to when your little one starts nursing again. In other words, when your doctor asks how often your baby is feeding, you can say "about every 2 hours" if your first feeding started at 6 a.m., the next feeding was around 8 a.m., then 10 a.m., and so on.

Especially at first, you might feel like you're nursing around the clock, which is normal. Soon enough, your baby will go longer between feedings.

How Long Does Nursing Take?

Newborns may nurse for up to 20 minutes or longer on one or both breasts. As babies get older and more skilled at breastfeeding, they may take about 5–10 minutes on each side.

How long it takes to breastfeed depends on you, your baby, and other things, such as whether:

your milk supply has come in (this usually happens 2–5 days after birth)
your let-down reflex (which causes milk to flow from the nipple) happens right away or after a few minutes into a feeding
your milk flow is slow or fast
the baby has a good latch, taking in as much as possible of your areola (the dark circle of skin around your nipple)
your baby begins gulping right away or takes it slow
your baby is sleepy or distracted

Call your doctor if you're worried that your baby's feedings seem too short or too long.

When Should I Alternate Breasts?

Alternate breasts and try to give each one the same amount of nursing time throughout the day. This helps to keep up your milk supply in both breasts and prevents painful engorgement (when your breasts overfill with milk).

You may switch breasts in the middle of each feeding and then alternate which breast you offer first for each feeding. Can't remember where your baby last nursed? It can help to attach a reminder — like a safety pin or small ribbon — to your bra strap so you'll know which breast your baby last nursed on. Then, start with that breast at the next feeding. Or, keep a notebook handy or use a breastfeeding app to keep track of how your baby feeds.

Your baby may like switching breasts at each feeding or prefer to nurse just on one side. If so, then offer the other breast at the next feeding. Do whatever works best and is the most comfortable for you and your baby.

How Often Should I Burp My Baby During Feedings?

After your baby finishes on one side, try burping before switching breasts. Sometimes, the movement alone can be enough to cause a baby to burp.

Some infants need more burping, others less, and it can vary from feeding to feeding.

If your baby spits up a lot, try burping more often. While it's normal for infants to "spit up" a small amount after eating or during burping, a baby should not vomit after feeding. If your baby throws up all or most of a feeding, there could be a problem that needs medical care. If you're worried that your baby is spitting up too much, call your doctor.

Why Is My Baby Hungrier Than Usual?

When babies go through a period of rapid growth (called a growth spurt), they want to eat more than usual. These can happen at any time. But in the early months, growth spurts often happen when a baby is:

7–14 days old
2 months old
4 months old
6 months old

During these times and whenever your baby seems extra hungry, follow your little one's hunger cues. You may need to breastfeed more often for a while.

How Long Should I Breastfeed My Baby?

That's a personal choice. Experts recommend that babies be breastfed exclusively (without formula, water, juice, non–breast milk, or food) for the first 6 months. Then, breastfeeding can continue until 12 months (and beyond) if it's working for you and your baby.

Breastfeeding has many benefits for mom and baby both. Studies show that breastfeeding can lessen a baby's chances of diarrhea, ear infections, and bacterial meningitis, or make symptoms less severe. Breastfeeding also may protect children from sudden infant death syndrome (SIDS), diabetes, obesity, and asthma.

For moms, breastfeeding burns calories and helps shrink the uterus. In fact, breastfeeding moms might return to their pre–pregnancy shape and weight quicker. Breastfeeding also helps lower a woman's risk of diseases like:

breast cancer
high blood pressure
diabetes
heart disease

It also might help protect moms from uterine cancer and ovarian cancer.

Introduction of complementary foods to an infant

Breast milk contains enzymes, essential amino acids, antibodies, vitamins and other substances necessary for the growth and development of the baby. However, with age (between 6-24 months, according to WHO), the needs of the child change, and then it is necessary to introduce complementary foods. At the same time, it is not necessary to immediately turn off breastfeeding (WHO recommends breastfeeding until 2 years of age). Anna Aleksandrovna Tsaregorodtseva, a CTA pediatrician, spoke about how to competently introduce new foods into a child's diet.

You can start feeding your baby if:

He is 6 months old or older.
He holds his head well.
Can touch his mouth with his hand and actively "chews" various objects.
If placed in a highchair or on an adult's lap, the child can sit up.
He has a food interest: when adults eat, the baby watches, pulls his hands and wants to try.

Getting Started

The first foods should be puréed to make it easier for the baby to digest them!

As a rule, the child is first introduced to vegetables. If you want to introduce vegetables from jars, then it is better to buy mono-products - so that the puree contains only zucchini or only broccoli, etc. It is best to start with zucchini. After that, you can enter cauliflower, then broccoli, then potatoes, pumpkin and carrots.

Enter at lunchtime (12-15 hours) and no more than one product at a time. Vegetable puree (like any other complementary foods) is given before breastfeeding or formula, 1 teaspoon. The next day, you need to observe the skin and stool of the child and do not give him complementary foods, but only breastfeed! If the body perceives the new product normally, in a day you can give 2 tsp already. zucchini. According to the same scheme - if everything is in order, you can increase the amount to 3 tsp. Gradually give more complementary foods (up to 5 spoons) and less and less often supplement the child with milk. When the volume of vegetables in the diet is approximately 150-200 g per day, you can stop breastfeeding your baby at this meal.

How to enter a new dish

The 2nd dish (cauliflower) must be added to the one already entered. That is, 5 tsp. zucchini and 1 tsp. cauliflower. On the "fasting day" you can give 5 tsp. zucchini, but discard the cabbage and watch. As a result, you will give the baby 5 tsp. zucchini and 5 tsp. cauliflower.

Then you can enter the 3rd dish - broccoli - and then other vegetables. When the child is familiar with different vegetables, vegetable mixtures can be introduced.

If you want to feed your child with home-cooked vegetables, then note that it is best to boil vegetables in a double boiler. So it will be possible to save vitamins and minerals.

Fruits and berries

When the child digests vegetables well, fruits can be added to the diet. It is better to give them from jars. The time for the introduction of fruit is an afternoon snack (16-18 hours).

As the first fruit, it is better to take an apple, then a pear, then a prunes. The scheme is the same: 1 tsp. applesauce before breastfeeding. The next day, you do not give fruit and feed the child vegetables that he is already used to. A day later, the amount of applesauce increases to 2 tsp. and so on.

Liquids

When complementary foods are introduced, the child should be offered bottled or boiled water. Pour water into a cup so that your baby does not get used to a bottle with a pacifier. Children drink well from a cup from birth!

Other products

You can also introduce ground cereals into the diet, gradually adding butter or vegetable oil to them. If this is baby porridge and needs to be diluted with liquid, then it is better to use mother's milk or a mixture, rather than cow's.

From 7-8 months, semi-solid food should be introduced so that the child develops chewing skills (and with them the correct work of the tongue and speech), fine motor skills, and eye work. Products can be kneaded, rubbed or ground. So it will be easier for the child to eat them.

From 8-9 months you can cut food (cooked vegetables and fruits) into small pieces and offer to your baby. He will take food with his hand, put it in his mouth and eat.

By the age of one, the child will be ready to eat solid food.

WHO recommendations for the introduction of complementary foods

08.08.2019

Readiness of the child to complementary foods According to the WHO recommendation, existing for 2018, it is optimal to introduce complementary foods to an infant at 6-8 months. Until six months, the baby's gastrointestinal tract is still not sufficiently formed, all the necessary enzymes are not produced for the assimilation of food other than mother's milk or formula. And by 9-10 months, the child can already form stable stereotypes of eating only liquid food, and overcoming them will be painful and difficult for the baby.

Thus, WHO defines the following signs of a child's readiness for the introduction of complementary foods: the maturity of the digestive system; extinction of the solid food ejection reflex; the appearance of the first teeth, making it possible to chew; the readiness of the baby to be stable in an upright position; emotional readiness for new tastes and sensations.

Complementary feeding system WHO has developed recommendations for three complementary feeding options: cereals, vegetables, and meat.

Fruit complementary foods are not recommended for cereals and vegetables. This is due to the fact that up to 8-9 months the gastrointestinal tract of the baby is not ready for the absorption of raw fruits and fruit juices. It is vegetables and cereals that will populate the intestines with the necessary bacteria for the absorption of fruits.

Kefir, according to the WHO, is not considered complementary foods because it is not a solid food. The WHO complementary feeding scheme includes kefir only as an additional food from 8 months. The introduction of cow's milk is recommended by WHO only from 12 months.

Any complementary feeding scheme assumes that portions of complementary foods will systematically increase from half a teaspoon to 100-200 g. The first dishes for complementary foods are prepared exclusively with one-component. Each next component is introduced only after complete addiction to the previous one (6-7 days).

Product sequence

The following sequence of introduction of complementary foods is proposed.

Vegetables at 6 months.
Porridges on the water (oatmeal, buckwheat, corn) at 6.5 - 7 months.
Fruit puree, yolk at 8 months.
Milk porridge at 8-9 months.
Meat puree at 9 months.
Meat by-products at 9-10 months.
Kefir, cottage cheese, yogurt at 9-10 months.
Fish at 10 months.
Juice at 10-12 months.
Berry puree at 12 months.
Meat broths at 12 months.

The introduction of vegetable oil (olive, sunflower) in puree and porridge is allowed from 6 months: a scheme with 1 drop with a gradual increase to a volume of 1 teaspoon. The introduction of butter begins at 7 months: the scheme is from 1 g to 10 g in porridge.

For formula-fed babies, the first feeding schedule is similar, with a few exceptions. For these babies, it is better to introduce complementary foods from 5 months, because the milk mixture does not give the small body all the “building material”. The introduction of complementary foods differs only in terms: vegetable purees and cereals are introduced a month earlier.

First cereals

If the child's weight is significantly less than normal, WHO recommends starting complementary foods with non-dairy cereals. For babies, cereals are prepared only with non-dairy, unsalted, semi-liquid, absolutely homogeneous in consistency. The first cereals are prepared from cereal flour (the sorted and washed cereals are carefully ground and crushed).

The following sequence of introduction of cereals is proposed: buckwheat, rice, corn, oatmeal, semolina. It is recommended to cook semolina porridge only once a week, because it contains practically no nutrients, but it is rich in gluten, which can cause problems in the intestines. Proportion for the preparation of the first porridge: 5 g of cereal flour per 100 ml of water. After slightly cooling the finished porridge, chop again. In the finished porridge, you can add 1-2 drops of vegetable oil or a little expressed breast milk.

From 9 months, the baby's nutrition system involves multicomponent cereals, from products already well known to the child. You can already add vegetables and fruits familiar to the baby to cereals. At 9 months, it is allowed to cook barley and millet porridge for babies. And by 10-11 months, cereals on the water will be a great addition to meat and fish meatballs and steam cutlets.

Vegetable food

The first purees are made from one vegetable.

The sequence of introducing vegetables into complementary foods for babies suggests the following order: zucchini, cauliflower, pumpkin, potatoes, carrots, green peas, beets. These vegetables are introduced within 6-9baby months. After 1 year, you can give your child cucumbers, eggplants, tomatoes, sweet peppers, white cabbage. After preparing the puree, make sure that the mass is completely homogeneous, there are no fibers and small particles, the consistency is semi-liquid. Don't salt. Add 1-2 drops of vegetable oil or expressed milk.

If the child refuses vegetable complementary foods, cancel this product for 1-2 weeks. Try to temporarily replace it with another and return to it after a while.

Meat supplements

From 9 months old, the first meat purees are recommended for babies. The first courses are recommended to be prepared from lean meats: rabbit; quail; turkey; chicken.

Complementary foods for a 6-month-old baby are recommended to be introduced in the morning. This will allow you to track the child's reaction to an unfamiliar product before a night's sleep: is there a rash, intestinal disorders, anxiety in the baby, profuse regurgitation. It is better to give vegetables or porridge first, and then saturate with breast milk or formula. Gradually, porridge and a vegetable dish will replace one full meal.