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Feeding Guide for the First Year

Feeding Guide for the First Year | Johns Hopkins Medicine

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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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.

Baby Feeding Schedule: Tips for the First Year

Contents

Overview

Eat, sleep, pee, pop, repeat. These are the most important events on the day of a brand new baby.

And if you're a new parent, the portion you eat can be the source of many of your questions and concerns. How many ounces should your child take? Do you wake up a sleeping child to eat? Why do they always seem hungry? When can your child get stiff?

There are many questions, and despite your grandmother's insistence, the answers have changed since you were a young man. Nowadays, newborns, even those who are breastfed, are encouraged to eat on demand (consider this good preparation for adolescence) and that babies wait to start complementary foods until they are 4 to 6 months old.

Baby Feeding Schedule by Age

On the first day of life, your baby's stomach is the size of a marble and can hold only 1 to 1.4 teaspoons of liquid at a time. As your baby gets older, their belly stretches and grows.

It is difficult (or almost impossible) to know how much milk your baby is drinking while breastfeeding. But if you're bottle feeding for a number of good reasons, measuring is a little easier.

Here, from the American Academy of Pediatrics (AAP), a typical feeding schedule for bottle-fed babies.

Age Feeding OuncesSolid FoodUd 2 Weeks Life.5 oz. first days, then 1-3 oz. #2 weeks to 2 months 2-4 oz. #2-4 months 4-6 ounces #4-6 months 4-8 ounces Possible if your baby can lift his head and weighs at least 13 kilograms. But you don't need to eat solid food just yet. 6-12 months 8 oz. That. Start with soft foods like whole grains and refined vegetables, meats, and fruits, and work your way up to purees and well-fingered foods. Give your child one new food at a time. Continue supplementing with breast or formula.

How often should your child eat?

Every baby is unique, but one thing that's pretty consistent is that breastfed babies eat more often than formula-fed babies. This is because breast milk is easily digested and empties from the stomach much faster than formula.

Breastfed children

No rest for the weary. According to the International League of La Leche, you should start breastfeeding your baby within an hour of birth and give 1 to 8 feeds a day for the first few weeks of life (yes, we're tired of you).

Initially, it is important not to leave the baby without feeding for more than 4 hours. You will probably have to wake them up if necessary, at least until breastfeeding is established and you have gained proper weight.

As your baby grows and your milk supply increases, your baby will be able to suck more milk in less time per feeding. Then you may begin to notice a more predictable pattern.

  • 1 to 3 months: Your baby will be fed from 7 to 9once within 24 hours.
  • 3 months: Feeding occurs 6 to 8 times a day.
  • 6 months: Your baby will be fed about 6 times a day.
  • 12 months: Treatment can be reduced to about 4 times a day. Eating solid foods at about 6 months helps your baby increase his or her needs for supplemental nutrition.

Please note that this template is just one example. Different babies have different paces and preferences, as well as other factors that affect the frequency of feeding.

Formula-fed babies

Like breast-fed babies, formula-fed babies should be fed on demand. On average, this is about every 2-3 hours. A typical feeding schedule might look like this:

  • Newborn: every 2-3 hours
  • 2 months old: every 3-4 hours
  • 4 to 6 months old: every 4-5 hours
  • 6 months old: every 4-5 hours

Breastfeeding and breastfeeding

  • Do not give liquids other than formula or breast milk to children under one year of age. These include juices and cow's milk. They don't provide enough nutrients (if any) and can cause your baby's stomach to get upset. Water can be taken by mouth for about 6 months when you start offering a cup.
  • Do not put baby cereal in the bottle.
    • May create a choking hazard.
    • The child's digestive system is not mature enough to digest cereals until about 4-6 months of age.
    • You could feed the baby.
  • Do not give your child any form of honey before their first birthday. Honey can be dangerous for a child, sometimes causing what is called infant botulism.
  • Adjust your expectations for your child and their unique needs. Premature babies are likely to follow age-specific feeding patterns. If your child has problems, such as reflux or malnutrition, you may need to work with your doctor on an appropriate feeding schedule and amount of food.

How to get on a feeding schedule

Schedules are every parent's holy grail. Your baby will naturally begin to drop in the form of feeding as their tummy grows and may receive more breast milk or formula in one sitting. This may start to happen between 2 and 4 months of age.

In the meantime, focus on teaching the baby to be hungry, for example:

  • dig into the chest for a nipple.
  • putting fist in mouth
  • biting them or licking their lips
  • swallowing, which can escalate quickly (don't wait for your hungry baby to eat them)

Once your baby is a few months old, you can enter a sleep/feeding schedule that suits you .

Let's say your four year old wakes up every 4 hours to eat. This means that if you feed at 5 o'clock, the baby wakes up around 9 o'clock in the morning, but if he wakes up and feeds the baby at 2 o'clock, just before bedtime, he may not wake up. until 11 a.m., which will give you a decent slice of the night,

What if your child is still hungry?

As a general rule, if your baby looks hungry, feed him. Your baby will naturally eat more of the rasta bursts over time, which usually occur at 3 weeks, 3 months, and 6 months of age.

Some children will also be "fed", meaning they will be fed more frequently for a certain period of time, while others will be fed less frequently. For example, your child may collect food in the late afternoon and evening, and then sleep longer at night (hooray!). It is more common in breastfed babies than formula-fed babies.

Worried about overfeeding? While this is not really possible with an exclusively breastfed baby, you can feed a baby who is taking a bottle, especially if she vacuums the bottle for comfort. Watch for their signs of hunger, but talk to your pediatrician if you're worried your child will overeat.

How to start solids

Your baby is probably ready for animals if he is 4 to 6 months old and:

  • have good head control
  • you seem to be curious about what you eat
  • reaches for food
  • weighs 13 pounds or more

What food to start with? The AAP is now saying that it doesn't really matter what order you introduce the food in. The only correct rule is to stick to one food for 3 to 5 days before offering another. If there is an allergic reaction (rash, diarrhea, vomiting are the most common first signs), you will know which food is causing it.

As your child grows, switch from refined baby foods to more textured foods (such as banana puree, scrambled eggs, or well-cooked, chopped pasta). It mostly happens around 8 to 10 months.

Your supermarket sells a variety of baby food, but if you want to make your own, keep it without sugar or salt. Also, at this stage, do not give your child anything that can cause choking, including:

  • solid food such as popcorn or nuts
  • solid fresh fruit such as apples; boiled to tenderize or cut into very small pieces
  • any meat that is poorly cooked and very well cut (including hot dogs)
  • cheese cubes
  • peanut butter (although discuss this with your pediatrician and the benefits of introducing diluted peanut butter under 1 year of age)

When the little girl approached her first birthday, she needed to eat a variety of foods and take them. 4 ounces of solid food at each meal. Continue to offer breast milk or formula. Children under 8 months drink 30 ounces than.

Oh yeah, and buy supplies from a company that makes laundry detergent. He will pay for college.

Other concerns

Children are not cookies. Some people gain weight easily, while others have problems. Things that can affect a baby's weight gain include:

  • who have a birth defect such as a cleft lip or palate that makes feeding difficult
  • have an intolerance to milk proteins
  • be premature
  • bottle feeding versus breastfeeding

A 2012 study of more than 1,800 babies they found that bottle fed babies, whether the bottle contained breast milk or formula, gained their first weight in the first year compared to infants who were exclusively breastfed.

Your child's doctor will best advise you on a healthy weight range.

Takeaway meals

How, when, and what to feed your baby is every parent's top concern, but the good news is that most babies are pretty good at feeling hungry and full—and they'll let you know.

You just need to present them with the right solutions at the right time and pay attention to their signs. If you have any questions or concerns, your pediatrician is here to help you along the way.

🎖▷ Why You Don't Have to Worry About Weight Gain with Lamictal

Psychology

1,943 2 minutes read

If you're worried that taking Lamictal (lamotrigine) might cause weight gain, there's good news. It probably won't affect your weight much. If anything, you're more likely to lose weight due to Lamictal than gain weight, but either way, the changes are likely to be pretty small.
The effect of Lamictal on weight has been little studied, and various clinical trials have found minimal effect. In fact, some researchers even considered the drug as a possible remedy for obesity and as a remedy for overeating. This information should be reassuring for people with bipolar disorder, as many of the medications used to treat this condition can cause weight gain.

Lamictal findings and weight gain or loss
Lamictal is an anticonvulsant drug that can be used to treat seizures such as epilepsy. It is also used as a mood stabilizer for bipolar disorder.
In the first clinical trials with the drug, 5 percent of adults with epilepsy lost weight while taking Lamictal, while 1 to 5 percent of patients with bipolar I disorder gained weight while taking the drug. The researchers do not disclose how much weight patients have gained or lost.
Meanwhile, a 2006 study comparing the effects on weight of Lamictal, lithium, and placebo found that some Lamictal-treated patients gained weight, some lost weight, and most remained about the same weight. Weight changes are usually not many pounds anyway. Obese patients taking Lamictal lost an average of four pounds, while the weight of non-obese patients remained virtually unchanged.
Relationship between weight gain and other bipolar drugs
Weight gain from medications used to treat bipolar disorder is unfortunately quite common. Some mood stabilizers commonly used for bipolar disorder, especially lithium and Depakote (valproate), carry a high risk of weight gain.
In addition, the atypical antipsychotics Clozaril (clozapine) and Zyprexa (olanzapine) tend to cause significant weight gain in people who take them. Finally, some antidepressants, notably Paxil (paroxetine) and Remeron (mirtazapine), have been associated with weight gain.
Therefore, if you are already overweight, you and your psychiatrist may want to consider additional weight gain when determining your bipolar medication regimen. Based on this, Lamictal may be a good choice.
Lamictal as a possible treatment for obesity
Lamictal has also been studied as a possible treatment for obesity in people without epilepsy or bipolar disorder.
In a small 40-person clinical trial conducted in 2006, investigators randomly assigned participants to receive either lamiktal or placebo for up to 26 weeks. Each participant in the study had a body mass index (BMI) between 30 and 40, placing them in the obese group to the level of severe obesity.

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