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What times should i feed my baby


How Often and How Much Should Your Baby Eat?

By: Sanjeev Jain, MD, FAAP

One of the most common questions new parents have is how often their baby should eat. The best answer is surprisingly simple: in general, babies should be fed whenever they seem hungry.

How do I know when my baby is hungry?

For babies born prematurely or with certain medical conditions, scheduled feedings advised by your pediatrician are best. But for most healthy, full-term infants, parents can look to their baby rather than the clock for hunger cues. This is called feeding on demand, or responsive feeding.

Hunger cues

A hungry baby often will cry. But it's best to watch for hunger cues before the baby starts crying, which is a late sign of hunger and can make it hard for them to settle down and eat.

Some other typical hunger cues in babies:

  • Licking lips

  • Sticking tongue out

  • Rooting (moving jaw and mouth or head in search of breast)

  • Putting his/her hand to mouth repeatedly

  • Opening her mouth

  • Fussiness

  • Sucking on everything around

It is important to realize, however, that every time your baby cries or sucks it is not necessarily because he or she is hungry. Babies suck not only for hunger, but also for comfort; it can be hard at first for parents to tell the difference. Sometimes, your baby just needs to be cuddled or changed.

General guidelines for baby feeding

It is important to remember all babies are different―some like to snack more often, and others drink more at one time and go longer between feedings. However, most babies will drink more and go longer between feedings as they get bigger and their tummies can hold more milk:

  • Most newborns eat every 2 to 3 hours, or 8 to 12 times every 24 hours. Babies might only take in half ounce per feeding for the first day or two of life, but after that will usually drink 1 to 2 ounces at each feeding. This amount increases to 2 to 3 ounces by 2 weeks of age.

  • At about 2 months of age, babies usually take 4 to 5 ounces per feeding every 3 to 4 hours.

  • At 4 months, babies usually take 4 to 6 ounces per feeding.

  • At 6 months, babies may be taking up to 8 ounces every 4 to 5 hours.

Most babies will increase the amount of formula they drink by an average of 1 ounce each month before leveling off at about 7 to 8 ounces per feeding. Solid foods should be started at about 6 months old.

Concerns about overfeeding or underfeeding your baby


Too full?

Babies are usually pretty good at eating the right amount, but they can sometimes take in more than they need. Infants who are bottle feeding may be more likely to overfeed, because drinking from a bottle may take less effort than breastfeeding.

Overfed babies can have stomach pains, gas, spit up or vomit and be at higher risk for obesity later in life. It's better to offer less, since you can always give more if your baby wants it. This also gives babies time to realize when they're full.

If you are concerned your baby wants to eat all the time―even when he or she is full―talk with your pediatrician. Pacifiers may be used after feeding to help sooth healthy-weight babies who like to suck for comfort, rather than nutrition. For babies who are breastfed, it's best to wait to offer pacifiers until around 3 to 4 weeks of age, when breastfeeding is well-established.

Trouble gaining weight?

Most babies will double their birth weight by 5 months of age and triple their birth weight by their first birthday. If your baby is having trouble gaining weight, don't wait too long between feeding―even if it means waking your baby. Be sure to talk with your pediatrician about how often and how much to feed your baby.

How do I know if my baby is getting enough to eat?

Daily diapers

A newborn's diaper is a good indicator of whether he or she is getting enough to eat. In the first few days after birth, a baby should have 2 to 3 wet diapers each day. After the first 4 to 5 days, a baby should have at least 5 to 6 wet diapers a day. Stool frequency is more variable and depends whether your baby is breastfed or formula fed.

Growth charts

During regular health check-ups, your pediatrician will check your baby's weight and plot it on a growth chart. Your baby's progress on the growth chart is one way to tell whether or not they are getting enough food. Babies who stay in healthy growth percentile ranges are probably getting a healthy amount of food during feedings.

Remember

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

More information:

  • Making Sure Your Baby is Getting Enough Milk
  • Amount and Schedule of Formula Feedings
  • Is Your Baby Hungry or Full? Responsive Feeding Explained (Video)
  • Remedies for Spitty Babies
  • Ask the Pediatrician: With the baby formula shortage, what should I do if I can't find any?
  • Ask the Pediatrician: How should we feed our baby if we're running low on money?
  • Airplane Choo Choo: A Feeding Guide for Children (National Dairy Council)

About Dr.

Jain:

Sanjeev Jain, MD, FAAP, is a Clinical Associate Professor of General Pediatrics and Adolescent Medicine at the University of Wisconsin School of Medicine and Public Health. Within the American Academy of Pediatrics, he is a member of the Section on International Child Health and the Wisconsin State Chapter.

The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

With the baby formula shortage, what should I do if I can't find any?

Since the outbreak of COVID-19, there have been significant shortages of infant formulas nationwide. Current shortages have been largely caused by supply chain issues and the recent recall of several baby formula products over contamination concerns.

Here are some tips on finding baby formula during the shortage, and what you may safely consider if you absolutely can't find any.

Keep in mind, this advice is strictly during this current URGENT formula shortage. If you have any concerns about your baby's nutrition, please talk with your pediatrician.

What if baby formula is out of stock everywhere I look?

Call your pediatrician if you can't formula you need for your baby. They may have samples in stock, connections to other local organizations or ideas of other places to call, such as your local WIC clinic. Also consider:

  • If you can afford it, buy formula online until store shortages ease. Purchase from well-recognized distributors, grocers, and pharmacies rather than individually sold or auction sites.
  • Check social media groups. There are groups dedicated to infant feeding and formula, and members may have ideas for where to find formula. Make sure to check any advice with your pediatrician.

This formula crisis is hitting families who are already grappling with stresses of parenting young children in a pandemic. It can be tempting to buy as much formula as possible right now, but the American Academy of Pediatrics (AAP) advises buying no more than a 10-day to 2-week supply of formula to help ease shortages.

I found small amounts of several different baby formulas. What is the best way to switch among the brands?

For most babies, it is OK to switch to any available formula, including store brands. It is likely that your baby will do just fine with different formulas as long as they are the same type. (The exception would be if they are on certain specialty formulas for medical reasons. Read more below.) If your baby does not like the taste or has a hard time tolerating a different formula, you may want to try gradually introducing small amounts of the new formula mixed with the usual formula. Slowly increase the amount of the new formula.

Be patient, since it may take some time for your baby to get used to a new formula. If you have questions about whether your baby is tolerating the new formula, call your pediatrician.

My infant needs a specialty metabolic baby formula, but I can't find any. What should I do?

Abbott is releasing limited quantities of Similac PM 60/40 and other metabolic or amino-acid formulas for babies in urgent need. Your pediatrician's office can fill out a request and, if it is approved, the formula can be shipped to your home. Talk to your pediatrician about safe, comparable specialty formulas for your baby.

Only one brand of baby formula is covered under the WIC program, but I can't find any. What should I do?

Most states are allowing parents who use WIC benefits to buy other brands of baby formula or different sizes and forms like ready-to-feed formula. To find out what your state is allowing, you can check this map.

I have a 3-month-old infant and can't find my usual baby formula.

What should I do?

This is a very difficult problem. If you can find another similar formula, it's OK to make the switch. If you use a special formula for allergies or other special health needs, the North American Society For Pediatric Gastroenterology, Hepatology & Nutrition provides a list of comparable formulas here.

Can I add extra water to formula and give my baby a multivitamin to make up the nutrients?

This should never be done. Adding extra water to formula can dilute the levels of protein and minerals, and lead to low sodium levels in the blood and other electrolyte disorders that may require hospitalization. Always follow label instructions or those given to you by your pediatrician.

Can I make my own baby formula? I've seen a recipe online using evaporated milk that people say was used safely in the 1940s.

Evaporated milk, also known as unsweetened condensed milk, is a form of concentrated milk. Mixing it with water can cause contamination or an incorrect balance of nutrients.

For similar reasons, AAP does not recommend using homemade baby formula. Although homemade formula was used in the past, it also came with many risks to infants. Online recipes for homemade baby formula have significant safety concerns regarding contamination and nutrient concentration. Using homemade baby formula can harm your infant. Some babies have been hospitalized from reported use of homemade formulas.

What is the earliest age I can start giving my baby solid food to stretch my formula supply?

Solid foods should not be used to stretch baby formula supply. Formula contains all of the nutrients young babies need, while solid foods may not. Infants generally are ready to eat solid food when they are about 6 months old, but it depends on their stage of development. Talk with your pediatrician about when your baby may be ready for solid foods.

Is it safe to get breast milk from a friend or online group?

We can't know for sure whether breast milk from a friend or online group is safe. It is better to check with a local milk bank that is accredited through the Human Milk Banking Association of North America. To find an accredited milk bank, check here.

I heard the government is importing baby formula from other countries. Is that safe?

The Food & Drug Administration (FDA) is working to verify safe production standards, labeling and shipping of some imported baby formula brands not previously sold in the United States. European baby formulas are regulated by the European Food Safety Agency similar to how the FDA regulates U.S. formula, and are highly reliable.

The most important safety consideration if using imported formulas is to read the label carefully. Many imported formulas use milliliter (ml) rather than ounce (oz) in the mixing directions. If your baby bottles don’t have ml scale markings, you may have to convert from ounces to milliliters. Too much or too little water used with powder or concentrate is dangerous for your baby.

It is also important to select the right imported formula for your baby’s age. Imported formulas may be labeled as "Stage 1" (for the first six months after birth, but generally can be used throughout the first year), and "Stage 2" (just for babies who are over 6 months of age).

Can toddler "formula" substitute for regular baby formula?


Toddler drinks, often found in the formula aisles, are not recommended for infants. However, if you absolutely have no other choice, these products can be safe for a few days for babies who are close to a year of age.

Can I give my full-term baby premature formula?

Formulas designed for babies who were born premature (and have "catch-up" growth to do) can safely be used for a few weeks to feed full-term babies if nothing else is available.

Is cow's milk a safe alternative to baby formula?


If your child is older than 6 months of age and is usually on regular formula (not a specialty product for allergies or other special health needs), this may be an option. In a pinch, you could feed them whole cow's milk for a brief period of time (no more than a week).

This is not ideal and should not be done for more than one week. One concern with giving cow's milk to a baby who is 7-12 months old on a long-term basis is that it does not contain enough iron. This can lead to anemia. If you have to use cow's milk to feed your infant, ideally do so for as short a time as possible. It's also important to give your baby plenty of iron-containing solid foods, such as baby food made with meat or iron-fortified cereals.

If you need to give your baby whole cow's milk for a week during the shortage, talk with your pediatrician.

What about feeding my baby goat's milk?

Remember that raw goat's milk, like raw cow's milk, is not safe for a baby since it has not been pasteurized to kill harmful bacteria. But some goat milk-based baby formulas made in other countries are among those being imported and distributed in the United States to help ease the national shortage. These are considered safe.

Can I use plant-based milk instead of baby formula if needed?

Plant-based milk alternatives generally are not recommended for babies under a year of age. Soy milk may be an option to give babies who are close a year old during the shortage, but not for more than one week. If you can't find formula and have to use soy milk, be sure to buy the kind that is fortified with calcium and vitamin D. Make sure to change back to formula as soon as some is available. Be especially careful to avoid almond milk or other plant milks as these are often low in protein and minerals. Talk with your pediatrician if you are considering using plant-based milk.

How long can baby formula be used past a "best by" date?

Generally, formula should not be used past the "best by" date because it may no longer be safe or have the required levels of nutrients.

Remember

This is a stressful and scary time for families. Your pediatrician is a resource who can help advise on the best and safest ways to feed formula-fed formula babies during the shortage.

More information

  • Ask the Pediatrician: Why are we seeing baby formula brands on the shelves from companies I haven't heard of before?
  • How to Safely Prepare Formula with Water
  • How Much and How Often Should Your Baby Eat?
  • Choosing a Baby Formula
  • Low Milk Supply: 5 Steps That Can Help
  • North American Society For Pediatric Gastroenterology, Hepatology & Nutrition Tools for Infants and Children Affected by Formula Shortages
  • Helping Families Find Formula During the Infant Formula Shortage (HHS.gov)

Breastfeeding in the first month: what to expect

Not sure how to establish lactation and increase milk production? If you need help, support, or just want to know what to expect, read our first month breastfeeding advice

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The first weeks of breastfeeding are a very stressful period. If at times you feel like you can't handle it, know that you are not alone. Feeding your baby all day long is completely natural and helps produce breast milk, but can be quite tiring at times. Be patient, think about yourself and remember: after the first month, when milk production stabilizes, it will become easier. nine0003

How often should a baby be breastfed?

Babies are born with a small stomach that grows rapidly with increasing milk production: in the first week it is no larger than an apricot, and after two weeks it is already the size of a large chicken egg. 1.2 Let the child eat as much as he wants and when he wants. This will help him quickly regain the weight lost after birth and grow and develop further.

“Be prepared to feed every two to three hours throughout the day. At night, the intervals between feedings can be longer: three to four or even five hours, says Cathy Garbin, a recognized international expert on breastfeeding. Some eat quickly and are satiated in 15 minutes, while others take an entire hour to feed. Do not compare your breastfeeding regimen with that of other mothers - it is very likely that there will be nothing in common between them. nine0003

At each feed, give your baby a full meal from one breast and then offer a second one, but don't worry if the baby doesn't take it. When the baby is full, he lets go of his chest and at the same time looks relaxed and satisfied - so much so that he can immediately fall asleep. The next time you feed, start on the other breast. You can monitor the order of the mammary glands during feeding using a special application.

Why does the child always ask for a breast?

The first month is usually the hardest time to breastfeed. But do not think that because the baby is constantly hungry and asks for a breast almost every 45 minutes, then you do not have enough milk. nine0003

In the first month, the baby needs to eat frequently to start and stimulate the mother's milk production. It lays the foundation for a stable milk supply in the future. 3

In addition, we must not forget that the child needs almost constant contact with the mother. The bright light and noise of the surrounding world at first frighten the baby, and only by clinging to his mother, he can calm down.

Sarah, mother of three from the UK, confirms: “Crying is not always a sign of hunger. Sometimes my kids just wanted me to be around and begged for breasts to calm them down. Use a sling. Place the cradle next to the bed. Don't look at the clock. Take advantage of every opportunity to relax. Forget about cleaning. Let those around you take care of you. And not three days, but six weeks at least! Hug your baby, enjoy the comfort - and trust your body." nine0003

Do I need to feed my baby on a schedule?

Your baby is still too young for a strict daily routine, so
forget about breastfeeding schedules and focus on his needs.

“Volumes have been written about how to feed a baby on a schedule, but babies don't read or understand books,” Cathy says. - All children are different. Some people can eat on a schedule, but most can't. Most often, over time, the child develops his own schedule.

Some mothers report that their babies are fine with scheduled feedings, but they are probably just the few babies who would eat every four hours anyway. Adults rarely eat and drink the same foods at the same time of day - so why do we expect this from toddlers?

Offer your baby the breast at the first sign of hunger. Crying is already the last stage, so be attentive to early signs: the baby licks his lips, opens his mouth, sucks his fist, turns his head with his mouth open - looking for the breast. nine0013 4

What is a "milk flush"?

At the beginning of each feed, a hungry baby actively sucks on the nipple,
thereby stimulating the milk flow reflex - the movement of milk through the milk ducts. 5

“Nipple stimulation triggers the release of the hormone oxytocin,” explains Cathy. “Oxytocin is distributed throughout the body and causes the muscles around the milk-producing glands to contract and the milk ducts to dilate. This stimulates the flow of milk. nine0003

If the flushing reflex fails, milk will not come out. This is a hormonal response, and under stress it may not work at all or work poorly. Therefore, it is so important that you feel comfortable and calm when feeding.

“Studies show that each mother has a different rhythm of hot flashes during one feed,” Kathy continues, “Oxytocin is a short-acting hormone, it breaks down in just 30-40 seconds after formation. Milk begins to flow, the baby eats, the effect of oxytocin ends, but then a new rush of milk occurs, the baby continues to suckle the breast, and this process is repeated cyclically. That is why, during feeding, the child periodically stops and rests - this is how nature intended. nine0003

The flow of milk may be accompanied by a strong sensation of movement or tingling in the chest, although 21% of mothers, according to surveys, do not feel anything at all. 5 Cathy explains: “Many women only feel the first rush of milk. If you do not feel hot flashes, do not worry: since the child eats normally, most likely, you simply do not understand that they are.

How do you know if a baby is getting enough milk?

Since it is impossible to track how much milk a baby eats while breastfeeding, mothers sometimes worry that the baby is malnourished. Trust your child and your body. nine0003

After a rush of milk, the baby usually begins to suckle more slowly. Some mothers clearly hear how the baby swallows, others do not notice it. But one way or another, the child himself will show when he is full - just watch carefully. Many babies make two or three approaches to the breast at one feeding. 6

“When a child has had enough, it is noticeable almost immediately: a kind of “milk intoxication” sets in. The baby is relaxed and makes it clear with his whole body that he is completely full, says Katie, “Diapers are another great way to assess whether the baby is getting enough milk. During this period, a breastfed baby should have at least five wet diapers a day and at least two portions of soft yellow stool, and often more. ” nine0003

From one month until weaning at six months of age, a baby's stool (if exclusively breastfed) should look the same every day: yellow, grainy, loose, and watery.

When is the child's birth weight restored?

Most newborns lose weight in the first few days of life. This is normal and should not be cause for concern. As a rule, weight is reduced by 5-7%, although some may lose up to 10%. One way or another, by 10–14 days, almost all newborns regain their birth weight. In the first three to four months, the minimum expected weight gain is an average of 150 grams per week. But one week the child may gain weight faster, and the next slower, so it is necessary that the attending physician monitor the health and growth of the baby constantly. nine0013 7.8

At the slightest doubt or signs of dehydration, such as
dark urine, no stool for more than 24 hours, retraction of the fontanel (soft spot on the head), yellowing of the skin, drowsiness, lethargy, lack of appetite (ability to four to six hours without feeding), you should immediately consult a doctor. 7

What is "cluster feeding"?

When a baby asks to breastfeed very often for several hours, this is called cluster feeding. nine0013 6 The peak often occurs in the evening between 18:00 and 22:00, just when many babies are especially restless and need close contact with their mother. Most often, mothers complain about this in the period from two to nine weeks after childbirth. This is perfectly normal and common behavior as long as the baby is otherwise healthy, eating well, gaining weight normally, and appears content throughout the day. 9

Cluster feeding can be caused by a sharp jump in the development of the body - during this period the baby especially needs love, comfort and a sense of security. The growing brain of a child is so excited that it can be difficult for him to turn off, or it just scares the baby. nine0013 9 If a child is overworked, it is often difficult for him or her to calm down on his own, and adult help is needed. And breastfeeding is the best way to calm the baby, because breast milk is not only food, but also pain reliever and a source of happiness hormones. 10

“Nobody told me about cluster feeding, so for the first 10 days I just went crazy with worry - I was sure that my milk was not enough for the baby,” recalls Camille, a mother from Australia, “It was a very difficult period . I was advised to pump and supplement until I finally contacted the Australian Breastfeeding Association. There they explained to me what was happening: it turned out that it was not about milk at all. nine0003

Remember, this is temporary. Try to prepare dinner for yourself in the afternoon, when the baby is fast asleep, so that in the evening, when he begins to often breastfeed, you have the opportunity to quickly warm up the food and have a snack. If you are not alone, arrange to carry and rock the baby in turns so that you have the opportunity to rest. If you have no one to turn to for help and you feel that your strength is leaving you, put the baby in the crib and rest for a few minutes, and then pick it up again. nine0003

Ask your partner, family and friends to help you with household chores, cooking and caring for older children if you have any. If possible, hire an au pair. Get as much rest as possible, eat well and drink plenty of water.

“My daughter slept a lot during the day, but from 23:00 to 5:00 the cluster feeding period began, which was very tiring,” recalls Jenal, a mother from the USA, “My husband tried his best to make life easier for me - washed, cleaned, cooked, changed diapers, let me sleep at every opportunity and never tired of assuring me that we were doing well. nine0003

If you are concerned about the frequency of breastfeeding, it is worth contacting a specialist. “Check with a lactation consultant or doctor to see if this is indicative of any problems,” recommends Cathy. “Resist the temptation to supplement your baby with formula (unless recommended by your doctor) until you find the cause. It may not be a matter of limited milk production at all - it may be that the child is inefficiently sucking it.

When will breastfeeding become easier? nine0011

This early stage is very special and does not last long. Although sometimes it seems that there will be no end to it, rest assured: it will get easier soon! By the end of the first month, breast milk production will stabilize, and the baby will become stronger and learn to suckle better. 2.3 Any problems with latch on by this time will most likely be resolved and the body will be able to produce milk more efficiently so inflammation and leakage of milk will begin to subside.

“The first four to six weeks are the hardest, but then things start to get better,” Cathy assures. It just needs to be experienced!” nine0003

The longer breastfeeding continues, the more benefits it brings, from saving on formula and improving sleep quality 11–13 to boosting your baby's immune system 14 and reducing your risk of certain cancers. 15

“When you feel like you're pushing yourself, try to go from feed to feed and day to day,” says Hannah, a UK mom. “I was sure I wouldn’t make it to eight weeks. And now I have been breastfeeding for almost 17 weeks, and I dare say it is very easy.” nine0003

Read the resource Breastfeeding Beyond the First Month: What to Expect

Literature

1 Naveed M et al. An autopsy study of relationship between perinatal stomach capacity and birth weight. Indian J Gastroenterol .1992;11(4):156-158. - Navid M. et al., Association between prenatal gastric volume and birth weight. Autopsy. Indian J Gastroenterol. 1992;11(4):156-158.

2 Neville MC et al. Studies in human lactation: milk volumes in lactating women during the onset of lactation and full lactation .Am J Clinl Nutr . 1988;48(6):1375-1386. at the beginning and at the peak of lactation." Am F Clean Nutr. 1988;48(6):1375-1386.

3 Kent JC et al. Principles for maintaining or increasing breast milk production. J Obstet , Gynecol , & Neonatal Nurs . 2012;41(1):114-121. - Kent J.S. et al., "Principles for Maintaining and Increasing Milk Production". J Obstet Ginecol Neoneutal Nurs. 2012;41(1):114-121. nine0129

4 Australian Breastfeeding Feeding cues ; 2017 Sep [ cited 2018 Feb ]. - Australian Breastfeeding Association [Internet], Feed Ready Signals; September 2017 [cited February 2018]

5 Kent JC et al. Response of breasts to different stimulation patterns of an electric breast pump. J Human Lact . 2003;19(2):179-186. - Kent J.S. et al., Breast Response to Different Types of Electric Breast Pump Stimulation. J Human Lact (Journal of the International Association of Lactation Consultants). 2003;19(2):179-186.

6) Kent JC et al . 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.

7 Lawrence RA, Lawrence RM. Breastfeeding: A guide for the medical profession. 7th ed. Maryland Heights MO, USA: Elsevier Mosby; 2010. 1128 p . - Lawrence R.A., Lawrence R.M., "Breastfeeding: A guide for healthcare professionals." Seventh edition. Publisher Maryland Heights , Missouri, USA: Elsevier Mosby; 2010. P. 1128.

8 World Health Organization. [Internet]. Child growth standards; 2018 [cited 2018 Feb] - World Health Organization. [Internet]. Child Growth Standards 2018 [cited February 2018]. nine0129

9 Australian Breastfeeding Association . [ Internet ]. Cluster feeding and fussing babies ; Dec 2017 [ cited 2018 Feb ] - Australian Breastfeeding Association [Internet], Cluster Feeding and Screaming Babies; December 2017 [cited February 2018]. nine0129

10 Moberg KU, Prime DK. Oxytocin effects in mothers and infants during breastfeeding. Infant . 2013;9(6):201-206.- Moberg K, Prime DK, "Oxytocin effects on mother and child during breastfeeding". Infant. 2013;9(6):201-206.

11 U.S. Department of Health & Human Services [Internet]. Surgeon General Breastfeeding factsheet; 2011 Jan 20 [cited 2017 Feb] - Department of Health and Human Services [Internet], "Breastfeeding Facts from the Chief Medical Officer", Jan 20, 2011 [cited Feb 2017]

12 Kendall-Tackett K et al. The effect of feeding method on sleep duration, maternal well-being, and postpartum depression. clinical lactation. 2011;1;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.

13 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.

14 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." nine0129 Clean Transl Immunology. 2013;2(4):e3.

15 Li DP et al. Breastfeeding and ovarian cancer risk: a systematic review and meta-analysis of 40 epidemiological studies. Asian Pac J Cancer Prev . 2014;15(12):4829-4837. - Lee D.P. et al., "Breastfeeding and the risk of ovarian cancer: a systematic review and meta-analysis of 40 epidemiological studies." Asia Pas J Cancer Prev. 2014;15(12):4829-4837.

Breastfeeding on demand

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

Modern mothers consider breastfeeding necessary for feeding their baby. Just for feeding. Breast milk is food, the mother supplies the baby with the nutrients necessary for growth and development. When a baby suckles at the breast, he eats. Breastfeeding makes sense only as a process of supplying proteins, fats, carbohydrates, vitamins and microelements. nine0003

During suckling, the baby receives the nutrients it needs with mother's milk. This is the absolute truth. There is another unconditional truth, which is not given any importance in modern society, it is not taken into account and is not considered. Breastfeeding for a child is communication with the mother. We need to figure out how the child understands feeding on demand? Can he understand anything at all? Is there any difference for him how he is fed, for 15-20 minutes after 3. 5 hours or in some other way? nine0003

What is on-demand feeding

On-demand feeding of a newborn baby means putting it to the breast for every squeak or search. Squeak and search movements in newborns, even as early as the second or third day of life, begin to appear much more often than after 3.5 or 2.5 hours. The need for attachments increases rapidly, and by the 10-12th day of life, the need to attach to a child may occur 15-16 or more times a day. Applications vary in duration. The baby can fall asleep and sleep while sucking for, for example, 1.5-2 hours. Can release the breast after 1-2 minutes. And then ask her again. Why does a child need such frequent contact with his mother's breast? nine0003

That's why. Being in the mother's belly, in a calm, familiar environment, listening to the noises of the mother's body, being in a warm, cramped, confined space, the baby sucked his fist, fingers, loops of the umbilical cord, swallowed amniotic fluid. Learned to suck and swallow. After birth, experiencing discomfort for any, the most insignificant reason, the baby tries to get rid of it. You can get rid of discomfort by getting into the usual conditions of a comfortable stay. The only place where the baby after birth can feel the sensations familiar to him is in the arms of the mother. The only familiar action is sucking. The only familiar taste and smell is the taste and smell of milk and lube in the areola. Milk and lubricant have an odor and taste similar to the taste and smell of amniotic fluid. Therefore, experiencing discomfort, the baby squeaks, or begins to look for an object to suck with his mouth. Ideally, it is immediately applied to the chest. The baby becomes warm, cramped, he hears the beating of his mother's heart, breathing, grumbling in the intestines, he sucks and feels the familiar taste and smell. If such an action happens constantly, the baby gains confidence, no matter what happens, he will solve all his problems with his mother. The place of comfort is now under the breast, and you can suck on the breast. nine0003

This whole process is justified from a biological point of view. A newborn child does not feel the feeling of hunger, this feeling is not formed in him. It will begin to form at about two months of age. How to feed a creature that does not experience hunger ?! How to encourage him to take some action to get food? This can be done only at the expense of some other incentives. This stimulus for the newborn is constant bodily discomfort, thanks to which he wants to suckle all the time! The most intense, frequent and prolonged sucking in infants is observed in the first two or three months of life. It is in these first months that the main weight gain of the baby occurs. nine0003

Feeding in the first month

Baby falls asleep with the breast in his mouth, sleeps sucking for a while. Falling asleep deeply, lets go of the chest. After sleeping for a while, he wakes up, and is applied on waking. After sleep, he can stay awake for some time, for example, an hour and a half. During wakefulness, he may feel discomfort 2-3 times, for example, from a completely natural desire to pee, and having called his mother for help, having kissed for a couple of minutes, he will do his deeds. Then he will want to sleep, feel discomfort and, kissing his chest, will again fall asleep sucking. After some time, he will wake up and attach again. Then again a little "walk". And after some time, he will fall asleep at the chest again. nine0003

The daytime naps of a one-month-old baby feeding on demand vary in duration and number. There can be 4-6 dreams during the day, and they can last from 5-15 minutes to 2-2.5 sometimes 3 hours. "Around" each dream, the baby is applied to the chest, and applied between dreams several times. At night, the child falls asleep at the breast. Usually in the early morning hours, he begins to fuss and apply. In the morning, he almost never fully wakes up. The baby sleeps, from time to time, sucking on his mother's breast. Waking up in the morning, the baby is again applied to the chest. If you count all the attachments that have happened in a baby of one month of age, then approximately 16-20 attachments are obtained. This is how a newborn human cub behaves if it is given the opportunity to behave in accordance with physiological and psychological needs, which, by the way, are genetically determined. The child of the first months of life does not separate his personality from the personality of the mother and from her breast. Mom and her breasts, and everything connected with them, are the universe of the baby and himself. nine0003

In most cases, a modern woman, being afraid to “accustom a child to hands”, strives to limit his requests for suckling. A pacifier and a bottle of tea or water come to her aid in this matter. They, too, can be sucked ... The need for sucking seems to be satisfied. But only the need for communication with the mother during suckling is not satisfied, the peculiar chain of mutual assistance and cooperation between mother and baby is destroyed, the formation of maternal affection and concentration is disrupted. Is the difference in the two actions noticeable to the reader: the baby cried, the mother took him, put him to her chest and started rocking him, or gave him a pacifier and started rocking the stroller, even with the words “Why are you crying, my sun?” nine0003

The modern woman who gives a pacifier and pumps a stroller is not a bad person who deliberately harms an infant. She is simply in captivity of prejudices regarding the relationship between mother and baby. She does not know how to behave correctly, does not know what to do in accordance with the natural needs of the child. If you tell her what the child really needs, she will exclaim in horror: “What is it, don’t let him get away with?!” Indeed, the child of the first months of life must not be let off the hook. For a woman who does not know how to comfortably carry a baby, and who does not know how to feed him in various positions (sitting, lying, standing and even moving), this can be very difficult. Especially if she is not sure of the correctness of her actions. nine0003

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

What's next?

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

  • At three months, the baby has 10-12 feeds during the day and 2-4 at night. There are frequent applications for a short time, but their number is reduced. There may be a long night break in feedings, about 5 hours, but this is very rare. Much more often the night break is 2.5-3.5 hours. By this age, the baby's body is noticeably rounded. nine0455
  • At four months, the baby begins to breastfeed noticeably less frequently. The main feedings are associated with sleep: the baby suckles before bedtime, during awakening and during sleep, both daytime and nighttime. In this regard, he has a fairly accurate feeding regimen. And many babies stop breastfeeding when they wake up after daytime sleep, sometimes as early as 2.5-3 months.
  • At five months, the baby has 8-10 daytime feedings and 2-3 nighttime feedings, as well as in the fourth month of life, they are organized around dreams - the baby eats when going to bed and some babies suck during awakening. nine0455
  • Feeding regimen changes at six months. The most active sucking shifts to the last 2-3 hours before waking up from a night's sleep. The period of daytime wakefulness can be divided into two periods: in the morning, when the baby sucked during the night is rarely applied to the breast, and in the evening, when attachments become very frequent. In total, there can be 7-10 day applications and 3-4 night applications. At this age, the baby begins a period of acquaintance with new food - pedagogical complementary foods. Sometimes there are attachments associated with the introduction of complementary foods, the baby “washes down” samples of new food with mother's milk. But many children do not want to drink complementary foods. When complementary foods are introduced to an on-demand baby, it is never meant to replace feedings with complementary foods. This is practically impossible, because the main feedings of the baby are associated with sleep, and mother's breakfasts, lunches and dinners, during which the baby gets acquainted with new food, are located between the baby's dreams, during his wakefulness. nine0455
  • At seven months, the frequency of applications is about the same.
  • At eight months, the feeding regimen changes. Since the baby shows high motor activity and is very busy exploring the surrounding space, in the daytime he forgets to breastfeed. In this regard, the number of daily feedings can be reduced to 6-8 times. The baby compensates for the reduction in daytime feedings by increasing the frequency and duration of nighttime feedings up to 6 times.
    • nine0454 In the second half of the year, babies who stopped breastfeeding when waking up after daytime naps recall this habit again. The baby’s daytime sleep in the second half of life, as well as in the region of a year and older, looks something like this: the baby falls asleep sucking, sleeps quietly for a while, for example 1-1.5 hours, then starts tossing and turning, fiddling, worrying, at this moment the mother lies down next to , gives him a breast and the baby can fill up 10-15-30 minutes sucking. Mom may well use this time for her own rest - lie down, read, while the baby sleeps while sucking. I know my mother, a lover of embroidery, who used this time specifically for embroidery ...
  • Breastfeeding becomes more frequent at nine to ten months. In the daytime, this is 4-6 full feedings and about the same number of attachments for various reasons. The baby has new reasons for attachment. If, during active actions to master the world, the baby fills a bump or gets scared, he calms down with his mother's breast. There may be situations when you can comfort the baby by sitting next to him and hugging him. At night, 4-6 feedings remain, the baby begins to suckle more actively in the morning between 3 and 8 hours. nine0455
  • At eleven months, a baby can already have 2-3 complete complementary foods. Initiation to adult food in the mind of a child is not associated with breastfeeding: attachment to the mother's breast is something other than the desire to get enough of the product they like. As a rule, after the baby has eaten, he feels the need to attach himself to the breast. The number of daily feedings remains the same in the child, but the number of short-term attachments increases. There are active mid-morning feedings between 4 and 8 o'clock in the morning. nine0455
  • At ten or twelve months, the baby, if he is already walking, can sometimes breastfeed every time he comes to his mother, i.e. about every 15-30 minutes. Attachments around dreams and night sucking persist. Therefore, if a mother says that a child suckles once or twice a day, this means that there is no feeding at the request of the child. There are restrictions imposed by the mother, with which the baby has come to terms. He treats breast sucking like food, sucks on a pacifier or a finger to fall asleep or soothe, or falls asleep just like that, without calming down. nine0455
  • At twelve months, the baby is applied in about the same way.
  • At the age of one and a half years, there may already be one daytime nap, so there are fewer attachments associated with sleep. Preserved for morning sucking. The baby is very free with his mother's breasts. Sometimes it happens that he comes up to suck just for fun. For example, like this: he comes up, climbs on his knees, looks into his mother’s face, smiles, starts to swarm in his shirt, gets breasts, smiles at his breasts, sucks for 30 seconds and leaves. nine0455

As for the number of feedings per day when feeding a child on demand, their number is almost never less than 12. A newborn has 12 or more attachments, mostly they are all associated with dreams. And a child, say 1.5-2 years old, can also have about 12 attachments, only 3-4 are associated with sleep, and the rest are short-term attachments for various reasons. I suggest to all mothers reading this text - do not count the application, do not notice their duration. Breastfeed your baby as often as he asks, when you feel the need to. nine0003

Mothers who do not think about breastfeeding without looking at the clock may get the impression that when feeding on demand, the mother can do nothing but feed the baby. This is not true. After the birth of a baby, a mother begins another life, she is called life with a baby. That's all. The child is with the mother, not the mother with the child! Feel the difference! You need to be able to organize your life in a different way, in the first months, of course, the help of loved ones is very necessary. In the tradition of many peoples, it was customary for the first 40 days after childbirth to remove a woman from any housework and household chores, she was engaged only in a child. In some nations, objects that the mother of a newborn touched were considered “unclean”, therefore, they preferred to protect the mother from the rest of the household, allocating her a separate “corner” of the house, where no one bothered her and she did not interfere with anyone. Among the Slavs, such a restrictive custom was called a six-week. By 1.5-2 months, the rhythm of daytime dreams begins to form, and the baby has a kind of “regime”, the mother becomes more free. nine0003

For a mother who can't imagine breastfeeding without looking at the clock, and who is sure that the “right” baby is the baby lying quietly in her crib all the time, feeding on demand will be a complete hassle. It will be much easier for such a mother if she stops looking at the clock and ties the baby to herself with a large scarf or uses a patchwork holder (sling). It will become easier for her if she stops running between the nursery and the kitchen, but takes the baby with her to the kitchen and carries him around the house with her, doing housework, in a box, a cradle, a special chair, if she tries not to put him off often, and pick up as soon as possible, postponing the baby only in case of emergency and not for long. nine0003

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

Sometimes, when counseling mothers on breastfeeding, I suggest that they forget for a second that they are already living in the 21st century. I propose to return, for example, to the cave and ask what they will do if the child woke up at night, how to calm him down? If you are walking through the forest and trying not to attract the attention of predators, how to make the baby silent? If the child is thirsty, what will you give him? What is the baby used to, for thousands of years of its existence? To the fact that he sleeps on his mother while she wanders through the forest with a digging stick in search of roots, and wakes up when mother stops. Since mom stopped, then there is time to wake up and suck. Therefore, even now the child sleeps well, tied to the mother with a patchwork holder, wakes up when the mother, having done a few household chores, sits in a chair to take care of the baby. nine0003

Some mother, reading about the cave, will be offended, saying that she is a civilized creature. But please think. Man, mother's breast and mother's milk have been created by evolution over millions of years. They are made for each other. Baby food has created progress and more recently. The skills of motherhood and breastfeeding have also been lost by our society quite recently. A person is not physiologically adapted to artificial feeding and a pacifier. The mother's breast will not produce enough milk at 6-7 feedings per day. Nature did not know, when creating man as a mammal, that the time would come when the need for breastfeeding would be satisfied by some kind of pacifiers and nipples. nine0003

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

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