John hopkins baby feeding
Feeding Guide for the First Year
Feeding Guide for the First Year | Johns Hopkins MedicineHealth
Reviewed By:
Tiffani Hays, M.S., R.D., L.N., Director of the Pediatric Clinical Nutrition Education & Practice
Making appropriate food choices for your baby during the first year of life is very important. More growth occurs during the first year than at any other time. It’s important to feed your baby a variety of healthy foods at the proper time. Starting good eating habits at this early stage will help set healthy eating patterns for life.
Recommended Feeding Guide for the First Year
Breast milk and formula are designed to be the primary sources of nutrition throughout an infant’s first year of life. You should talk with your baby’s health care provider before starting solid foods. Solid foods should not begin before age 4 months because:
- Breast milk or formula provide your baby with all the nutrients that are needed.
- Your baby isn’t physically developed enough to eat solid food from a spoon.
- Feeding your baby solid food too early may result in poor feeding experiences and increased weight gain in both infancy and early childhood.
The American Academy of Pediatrics (AAP) recommends that all infants, children and adolescents take in enough vitamin D through supplements, formula or cow’s milk to prevent complications from deficiency of this vitamin. In November 2008, the AAP updated its recommendations for daily intake of vitamin D for infants, children, and adolescents who are healthy. It is now recommended that the minimum intake of vitamin D for these groups should be 400 IU per day, beginning soon after birth. Your baby’s health care provider can recommend the proper type and amount of vitamin D supplement.
Guide for Breast-feeding (Zero to 12 Months)
- In the early days after a baby’s birth, the mother should plan to breast-feed every two to three hours, including overnight. The mother should respond to the infant’s cues of hunger in a prompt and relaxed manner, providing a quiet and comfortable environment for both herself and the baby. Frustrated or distracted infants may have difficulties latching on.
- It is normal for infants to wake up overnight to feed for the first several months. If you have any concerns about overnight feeding, please discuss them with your health care provider.
- Alternate breasts to feed on, and allow the infant to completely empty the breast before switching to the other. This practice ensures the infant receives hindmilk, which is richer in nutrients.
- Follow your child’s feeding cues and resist forcing a schedule. Instead, rely on keeping track of wet diapers and your child’s growth to judge whether he or she is receiving enough breast milk.
A mother’s milk changes as the infant grows, and feeding habits change as well in order to best meet a child’s needs. If you have any questions about whether your child is receiving enough breast milk, ask your health care provider. - When not able to breast-feed, use a breast pump to extract milk and maintain milk supply. Pumped breast milk should be stored safely, using appropriate temperature guidelines. Pumped breast milk may be offered to infants in bottles, while responding to the same feeding cues to determine how much they take. Forcing bottles to be emptied may result in overfeeding and excess weight gain, even when feeding breast milk.
- With the proper support, a mother can meet the needs of most infants, even twins, so seek out help from your health care provider or lactation consultant for success.
Guide for Formula Feeding (Zero to 12 Months)
- When breast milk is not available, standard infant formula is an appropriate alternative for most healthy full term infants, but there are some differences between brands.
Do not hesitate to ask your health care provider for a recommendation if you are unsure which formula to use. - Bottle-feeding should be interactive, with the caregiver holding both the bottle and the infant. Propping a bottle has been linked to an increased risk of ear infections and tooth decay.
- Formula feeding should be in response to the infant’s needs and not based on a predetermined schedule. Look for cues of hunger and fullness to determine both when to feed and how much. The number of wet diapers per day and your child’s growth will reflect if he or she is getting enough formula. The chart below demonstrates common intakes for infants at various stages. However, ask your health care provider if you have any questions about how much formula your infant is taking.
- The amount of formula an infant takes will decrease as the baby increases intake of solid foods, but formula remains a significant source of calories, protein, calcium and vitamin D for the first year of life.
- Ask your health care provider before switching an infant less than 1 year of age from formula to cow’s milk or a cow’s milk alternative.
| Age | Amount of formula per feeding | Number of feedings per 24 hours |
|---|---|---|
| 1 month | 2 to 4 ounces | six to eight |
| 2 months | 5 to 6 ounces | five to six |
| 3 to 5 months | 6 to 7 ounces | five to six |
Complementary Feedings (After 6 Months of Age)
Beverages
- Offer only breast milk or formula in bottles until 1 year of age unless specifically advised by your health care provider.
- Begin offering breast milk and/or formula in a cup starting at 6 months of age. Infants should drink breast milk and/or formula for the first year of life.
- Fruit juice is not recommended under 1 year of age.
- When introducing juice, offer 100% pasteurized juice and limit it to 4–6 ounces per day. Do NOT place juice in a bottle.
- Avoid giving any sugar-sweetened beverages to infants.
Solid Foods
- Introduce solid foods when your infant is ready, at around 6 months of age depending on the infant’s development. Infants are ready to start eating solid foods when they can:
- sit up on their own or with a little support
- reach for and put things in their mouth
- open their mouth when seeing something coming
- keep food in their mouth rather than pushing it out onto the chin
- move food to the back of their mouth with their tongue
- turn their head away when they do not want something
- Prepare to introduce solid foods in a calm feeding environment where the infant is sitting upright and is appropriately supported and moderately hungry.
- Start with small amounts of solid food, feeding with a spoon or allowing finger feeding, then gradually increase the amount as the infant eats more and develops. Avoid offering breast milk or formula until after the solid-food experience has wound down.
- Expose infants to a wide variety of flavors and textures of healthy food. Don’t limit your baby’s food choices to the ones you like. Offering a range of foods early will pave the way for healthy eating habits.
- Maintain the division of responsibility when feeding.
- The caregiver is responsible for what to eat (offering appropriate variety and textures).
- The child is responsible for deciding whether to eat and how much.
- Avoid adding salt or sugar to make baby foods more appealing. Many babies and toddlers need to experience a new food multiple times before accepting it, and increased intakes of salt and sugar among children are associated with obesity in adults.
- Observe infants for any signs of intolerance when introducing a new food or texture, and discuss all concerns with your health care provider.
- Although convenient and safe, commercial baby foods are not required. Young children are more likely to eat foods they see others eating, so as long as they are observed to see how they handle new food in their mouths, baby-led weaning using table foods is an appropriate way to introduce solids.
- Avoid honey in any form during your child’s first year, as it can cause infant botulism. Address any concerns about developing food allergies with your health care provider.
- Don’t restrict fat and cholesterol in the diets of very young children, unless advised by your child’s health care provider. Children need calories, fat and cholesterol for the development of their brains and nervous systems, and for general growth.
Updated on July 26, 2019.
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Feeding Your Newborn - Johns Hopkins All Children's Hospital
Home | Patients and Families | Health Library | Feeding Your Newborn
- Carefully follow directions on the label when preparing formula.
- 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 should be stored in the refrigerator up to 24 hours and can be 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.
- 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 again their mothers' breasts
- crying
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. Following the introduction of solid foods, breastfeeding should continue 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.
About Breastfeeding
Breastfeeding your newborn has many advantages. Perhaps most important, breast milk is the perfect food for a baby's digestive system.
It has the nutrients that a newborn needs, and all of its components — lactose, protein (whey and casein), and fat — are easily digested. Commercial formulas try to imitate breast milk, and come close, but cannot match its exact composition.
Also, breast milk has antibodies that help protect babies from many infectious illnesses, including diarrhea and respiratory infections. Studies suggest that breastfed babies are less likely to develop medical problems such as diabetes, high cholesterol, asthma, and allergies. Breastfeeding also may decrease the chances that a child will become overweight or obese.
Breastfeeding is great for moms too. It burns calories, so nursing moms get back in shape quicker. Breastfeeding also may protect mom 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 a new mother feel confident in her ability to care for her 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 mom may find herself 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 frequently 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 of these moms 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 available to breastfeed.
Other family members (dads most of all) 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 established, other family members can help out by giving the baby pumped breast milk in a bottle when mom needs a break.
Sometimes a woman may feel embarrassed or worried about breastfeeding. These feelings usually disappear once a successful breastfeeding process is set. It's often helpful to seek advice from those who've gone through the experience. Most hospitals and birthing centers can provide in-depth instruction on breastfeeding techniques to new mothers.
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. For example, mothers undergoing chemotherapy for cancer and moms who are infected with human immunodeficiency virus (HIV, the virus that causes AIDS) should not breastfeed.
If you have a medical condition or take any medicines regularly, or if you or your baby gets sick, 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.
In some situations, it may not possible to breastfeed, such as when a baby is sick or born prematurely. Mothers should talk with their baby's doctor about expressing and storing milk. Even if the infant cannot breastfeed, breast milk may be given via a feeding tube or bottle.
Sometimes mothers who have inverted nipples may have trouble breastfeeding, but with the help of a lactation consultant this usually can be overcome. 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.
Avoid using pacifiers or bottles until breastfeeding is established, usually after the first month of life. Introducing them before breastfeeding might cause "nipple confusion," and can lead to an infant giving up the breast.
About Formula Feeding
Commercially prepared infant formula is a nutritious alternative to breast milk. Bottle feeding can offer more freedom and flexibility for moms, and it makes 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 requires organization and preparation, especially if you want to take your baby out. Also, formula can be pretty expensive.
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:
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 necessary.
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:
A feeding schedule is not necessary; you and your baby will eventually establish your 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 moms often worry about whether their babies are getting enough to eat. It's important for all infants to be seen by their pediatrician 48 to 72 hours after a mother and newborn leave the hospital. During this visit, the baby will be weighed and examined, and feeding questions and concerns can be addressed.
You can be assured that your baby is getting enough to eat if he or she seems satisfied, produces about six to eight wet diapers a day, has regular bowel movements, sleeps well, is alert when awake, and is gaining weight. A baby who is fussing, crying, seems hungry, and does not appear satisfied after feeding may not be getting enough to eat. If you're concerned that your baby isn't getting enough to eat, call your doctor.
Many 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 attention. 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 does not need any additional vitamins or nutritional supplements, with the exception of vitamin D.
The AAP recommends that all breastfed babies begin getting 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).
Iron-fortified formula contains the right blend of vitamins and minerals for a baby, so supplements usually aren't necessary. 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 or formula provides everything babies need nutritionally until they start eating solid foods. Talk to your doctor if you have any questions about feeding your newborn.
Note: All information is for educational purposes only. For specific medical advice, diagnoses, and treatment, consult your doctor.
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Johns Hopkins University was founded in 1876 and is considered one of the most prestigious universities in the country. Students from all over the world study here. 37 Nobel laureates have studied at Johns Hopkins University, it is considered the best educational institution in such fields as science, engineering, medical research.
The University has always adhered to the principles of equality and humanism, continuing the traditions of its founders. Hopkins was one of the first to give women the opportunity to learn.
The university has a large garden and 4 campuses, as well as a beautiful view of the harbor of Baltimore.
In summer programs, university professors teach academic subjects.
University Preparation, 5 weeks
This program offers academic study and university preparation. Here the children will have the opportunity to choose what they are really interested in from an extensive list of subjects. Students can choose 2 courses per program.
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Person and Institute - Mir - Kommersant
Johns Hopkins University gained worldwide fame in 2020. Prior to that, he was one of dozens of respectable, but not the biggest names in education. With the outbreak of the pandemic, Johns Hopkins University began to publish statistics on the incidence of COVID-19 and became one of the leading sources of such information in the world. The university was founded in 1876 with the money of the American entrepreneur Johns Hopkins, who became one of the first major philanthropists in US history, and historians still argue about his life.
American Entrepreneur Johns Hopkins
Photo: JHU Sheridan Libraries / Gado / Getty Images
American Entrepreneur Johns Hopkins
Photo: JHU Sheridan Libraries / Gado / Getty Images
at the Whites Hall estate in Maryland.
His parents, Samuel Hopkins and Hannah Janney, were wealthy planters: the Jones family owned a 500-acre (200 ha) tobacco plantation. Jones was the second oldest of 11 siblings. The Hopkins were Quakers, quite a lot of the facts of Jones's biography are connected with this - like representatives of some other ascetic movements in Protestantism, Quakers are known as good businessmen and merchants. Related to the religious affiliation of the family is the fact - or rather, the assumption - that in 1778, on the recommendation of the local Quaker community, the Hopkins freed their slaves. According to other sources, this liberation was partial, and they completely freed the slaves in 1807. However, some modern researchers question these data. One way or another, but already at the beginning of the 19th century, which fell on Jones's childhood, family members themselves and several black hired workers were engaged in work on the plantation. In 1812, at the age of 17, Johns Hopkins went to Baltimore, Maryland, to live with his uncle Gerard Hopkins, who was a grocery wholesaler.
Jones also joined this family business. As historians write, there he met his cousin Elizabeth, the daughter of Gerard Hopkins. They fell in love, but Quaker rules strictly forbade marriage between cousins. Neither Jones nor Elizabeth ever married, in his will Jones left her a house, she looked after him before her death.
Pretty soon, Johns Hopkins became manager of his uncle's store, and by 1819 he had his own grocery business. The three Jones brothers soon entered the business, and Hopkins & Brothers Wholesalers was formed. Gradually, the business developed, at the same time, Mr. Hopkins began to invest more and more actively in other companies - he invested in the oldest railroad in the United States, the Baltimore and Ohio (B&O), Merchants` Bank and some other companies. At the B&O, Johns Hopkins served at various times as director and head of the finance committee.
Philanthropist
In 1852, Mr. Hopkins retired from active business. At the time of his death in 1873, his fortune was estimated at $ 8 million.
Johns Hopkins was included in the 1996 ranking of the hundred richest Americans in history - its compilers recalculated the fortunes of American businessmen of different times in 1996 dollars.
A variety of stories circulated about Hopkins' private life - some said that he died of pneumonia because he did not want to spend money on a warm coat. However, there is other information - in 1838, Mr. Hopkins bought the Clifton estate in the suburbs of Baltimore, built a luxurious Italian-style mansion there, around which there was a huge well-groomed park. The owner himself is said to have drunk the finest French champagne at dinner every day, despite strict Quaker rules.
Already in the middle of the 19th century, among American entrepreneurs who did not have direct heirs, there was a fashion to donate their fortune to charity. Mr. Hopkins was prompted by his friend George Peabody, another Quaker entrepreneur from Baltimore, who is often called the father of modern philanthropy.
In 1857, Mr. Hopikins founded the Peabody Institute, a music school and conservatory that is now part of Johns Hopkins University. It was for the foundation of this university, located in Baltimore, as well as for the creation of several medical institutions in the city, that the entrepreneur donated most of his fortune - about $ 7 million, mainly in B&O shares. At the time, it was the largest donation in American history. But Hopkins did not deprive his numerous relatives either - they received a total of more than a million dollars from his inheritance.
Johns Hopkins Hospital in Baltimore
Photo: Detroit Publishing Company / Wikipedia
Johns Hopkins Hospital in Baltimore
Photo: Detroit Publishing Company / Wikipedia
which included 12 trustees. The Board of Trustees of the future university worked closely with rectors of leading American universities and educators. The board elected renowned educator Daniel Gilman as president of the university.
As conceived by the creators, the new university was supposed to be different from other higher educational institutions in the United States - it was planned to be built according to the German model and focus not so much on education as on research activities.
Johns Hopkins is sometimes referred to as the first research university in the United States.
Before establishing the university, Mr. Gilman traveled to Germany and studied the experience of the universities there, at that time one of the best in the world. Three years after the death of Johns Hopkins, in 1876, a new university was announced. “Our simple goal is to create scientists who are strong, bright, useful to society and truthful,” Mr. Gilman said at the time.
Now Johns Hopkins University has more than ten different schools, including the School of Medicine, the School of Public Health, the Institute of Political Science, and others. As of 2018, more than 29,000 undergraduate and graduate students studied there.
The university continues to focus on research, spending more than $3.1 billion on various research in 2020. Its medical research is especially well known. 29 teachers or graduates of the university in different years received the Nobel Prize: it is expected that the largest number of Nobel Prize winners in medicine is 16 people. The university is ranked ninth best American institution of higher learning by U.S. News & World Report.
In addition to the university, Mr. Hopkins bequeathed the creation of a hospital in Baltimore and a school for nursing at this hospital with his money - which were eventually opened in 1889. Also, according to the will of the entrepreneur, a shelter for colored orphans was created.
It was founded in 1875 and is designed for 24 children. The orphanage existed for about fifty years and was closed in 1924. The hospital still exists, and classes at the Johns Hopkins University School of Medicine are held on its basis.
Abolitionist or slave owner?
Johns Hopkins Homewood Campus
Photo: Patrick Semansky / AP
Johns Hopkins Homewood Campus
Photo: Patrick Semansky / AP
It is the Johns Hopkins Orphanage that constantly causes controversy among biographers.
Most of his biographies say that he was a staunch abolitionist - he donated money to the fight against slavery, associated with many famous abolitionists and was a supporter of President Abraham Lincoln. Some books write that in 1807, the father called the 12-year-old Jones from the boarding school where he then studied: the Hopkins freed the slaves, and now family members had to work in the fields.
For many years, Johns Hopkins was considered one of the most respected abolitionists in the United States.
This belief is also based on a book published in 1929 by his great-niece Helena Hopkins. The own papers of Mr. Hopkins or his family, which would confirm these data, have not been preserved. In 2013, Johns Hopkins University launched the Hopkins Retrospective, which aims to delve deeper into the life of the university's founder.
However, in 2020, researchers published not too flattering findings. Census data were found, according to which in 1840 Mr.
