When do babies start feeding every 4 hours


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.

Tips for the First Year

Every baby may get hungry on their own unique schedule. That said, most infants in the first months of life will eat every 2-4 hours, depending if they are nursing or drinking formula. Once they eat solids, they’ll gradually drink less.

Eat, sleep, pee, poop, repeat. Those are the highlights of a day of the life of a brand-new baby.

And if you’re a new parent, it’s the eating part that may be the source of many of your questions and worries. How many ounces should your baby take? Do you wake a sleeping baby to eat? Why do they seem hungry all the time? When can your child start solids?

Questions abound — despite Grandma’s insistence, the answers have changed since you were a tot. It’s now recommended that newborns, even formula-fed ones, eat on demand (consider it good preparation for the teenage years) and that babies wait to start solid foods until they’re 4 to 6 months old.

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

It’s hard (or impossible, really) to know how much milk your baby is taking in while breastfeeding. But if you’re bottle feeding due to any number of valid reasons, it’s a bit easier to measure.

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

AgeOunces per feedingSolid foods
Up to 2 weeks of life.5 oz. in the first days, then 1–3 oz.No
2 weeks to 2 months2–4 oz. No
2–4 months4-6 oz.No
4–6 months4–8 oz.Possibly, if your baby can hold their head up and is at least 13 pounds. But you don’t need to introduce solid foods yet.
6–12 months8 oz.Yes. Start with soft foods, like one-grain cereals and pureed vegetables, meats, and fruits, progressing to mashed and well-chopped finger foods. Give your baby one new food at a time. Continue supplementing with breast or formula feedings.

Every baby is unique — but one thing that’s pretty consistent is that breastfed babies eat more frequently than bottle-fed ones. That’s because breast milk is easily digested and empties from the stomach a lot quicker than formula.

Breastfed babies

There’s no rest for the weary. According to La Leche League International, you should begin nursing your baby within 1 hour of birth and provide about 8 to 12 feedings daily in the first few weeks of life (yeah, we’re exhausted for you).

At first, it’s important not to let your baby go more than 4 hours without feeding. You’ll likely need to wake them up if necessary, at least until breastfeeding is well established and they’re gaining weight appropriately.

As your baby grows and your milk supply amps up, your baby will be able to take in more milk in less time at one feeding. That’s when you might start to notice a more predictable pattern.

  • 1 to 3 months: Your baby will feed 7 to 9 times per 24 hours.
  • 3 months: Feedings take place 6 to 8 times in 24 hours.
  • 6 months: Your baby will feed around 6 times a day.
  • 12 months: Nursing may drop to about 4 times a day. The introduction of solids at about 6 months helps to fuel your baby’s additional nutritional needs.

Keep in mind that this pattern is just one example. Different babies have different paces and preferences, along with other factors that influence the frequency of feedings.

Bottle-fed babies

Like breastfed babies, bottle-fed newborns should eat on demand. On average, that’s about every 2 to 3 hours. A typical feeding schedule may look like this:

  • Newborn: every 2 to 3 hours
  • At 2 months: every 3 to 4 hours
  • At 4 to 6 months: every 4 to 5 hours
  • At 6+ months: every 4 to 5 hours

For both breastfed and bottle-fed babies

  • Don’t give liquids other than formula or breast milk to babies under a year old. That includes juices and cow’s milk. They don’t provide the right (if any) nutrients and can be upsetting to your baby’s tummy. Water can be introduced around 6 months when you start offering a cup.
  • Don’t add baby cereal to a bottle.
    • It can create a choking hazard.
    • A baby’s digestive system isn’t mature enough to handle cereal until about 4 to 6 months of age.
    • You could overfeed your baby.
  • Don’t give your baby any form of honey until after their first birthday. Honey can be dangerous for a baby, occasionally causing what’s called infant botulism.
  • Do adjust your expectations based on your baby and their unique needs. Premature babies are likely to follow feeding patterns according to their adjusted age. If your baby has challenges like reflux or failure to thrive, you may need to work with your doctor on the appropriate feeding schedule and amount they should be eating.

Schedules are the holy grail of every parent. Your child will naturally start to fall into a feeding pattern as their tummy grows and they can take in more breast milk or formula at one sitting. This may begin to happen between 2 and 4 months of age.

For now, though, focus on learning your baby’s hunger cues, such as:

  • rooting around your chest, looking for a nipple.
  • putting their fist in their mouth
  • smacking or licking their lips
  • fussing that can escalate quickly (don’t wait until your baby’s hangry to feed them)

Once your baby is a few months old, you may be able to introduce a sleep/feed schedule that works for you.

Let’s say, for example, your 4-month-old wakes every 5 hours for a feeding. That means if you feed at 9 p.m., your baby wakes around 2 a.m. But if you wake and feed the baby at 11 p.m., just before you go to bed, they may not rouse until 4 a.m., giving you a decent chunk of nighttime winks.

In general, if your baby seems hungry, feed them. Your baby will naturally eat more frequently during growth spurts, which typically occur around 3 weeks, 3 months, and 6 months of age.

Some babies will also “cluster feed,” meaning they’ll feed more frequently during certain periods and less at others. For example, your baby may cluster feed during the late afternoon and evening and then sleep longer at night (yay!). This is more common in breastfed babies than bottle fed babies.

Worried about overfeeding? While this isn’t really possible to do with an exclusively breastfed baby, you can overfeed a baby who’s taking a bottle — especially if they’re sucking on the bottle for comfort. Follow their hunger cues, but talk to your pediatrician if you’re worried your little one may be overeating.

Your baby is probably ready for solids if they’re 4 to 6 months old and:

  • have good head control
  • seem interested in what you’re eating
  • reach for food
  • weigh 13 or more pounds

Which food to start with? The AAP now says it doesn’t really matter much in what order you introduce foods. The only real rule: Stick with one food for 3 to 5 days before offering another. If there’s an allergic reaction (rash, diarrhea, vomiting are common first signs), you’ll know which food is causing it.

As your baby grows, move from pureed baby food to ones that have more texture (for example, mashed banana, scrambled egg, or well-cooked, chopped pasta). This generally happens around 8 to 10 months of age.

Your supermarket offers a variety of baby food products, but if you want to make your own, keep it sugar and salt free. Additionally, at this stage, don’t feed your baby anything that could be a choking hazard, including:

  • hard foods, such as popcorn or nuts
  • hard, fresh fruits, like apples; cook to soften or chop into very small pieces
  • any meat that isn’t well cooked and very well chopped (this includes hot dogs)
  • cheese cubes
  • peanut butter (though talk to your pediatrician about this one — and the benefits of introducing diluted peanut butter before the age of 1)

As your baby nears their first birthday, they should be eating a variety of foods and taking in about 4 ounces of solids at each meal. Continue to offer breast milk or formula. By 8 months, babies are drinking about 30 ounces a day.

Oh yeah, and buy some stock in a company that makes stain-fighting laundry detergent. It’ll pay for college.

Babies aren’t cookie cutter. Some will gain weight easily, while others will have problems. Things that can affect a baby’s weight gain include:

  • having a birth defect like a cleft lip or palate, which creates problems feeding
  • having a milk protein intolerance
  • being premature
  • being fed with a bottle versus the breast

A 2012 study of more than 1,800 babies found that the infants who were fed with a bottle — regardless of whether the bottle contained breast milk or formula — gained more weight in the first year than babies who nursed exclusively.

Your baby’s doctor is the best one to advise you on a healthy weight range for your baby.

How, when, and what to feed a baby are top worries of every parent — but there’s good news: Most babies are pretty good judges of when they’re hungry and when they’re full — and they’ll let you know it.

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

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.

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?

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?

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.

This whole process is biologically justified. 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.

Feeding in the first month

Baby falls asleep with breast in 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.

The daytime naps of a one-month-old infant 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.

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?”

The modern woman who gives a pacifier and pumps a stroller is not a bad person deliberately harming 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.

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.
  • 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, attachments as well as in the fourth month of life, are organized around dreams - the baby eats when going to bed and some babies suck during awakening.
  • At six months, the feeding regimen changes. 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.
  • At seven months, the frequency of application 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.
  • 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.
  • 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.
  • 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 dummy or finger to fall asleep or calm down, or falls asleep just like that, without calming down.
  • 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 pleasure. 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.

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.

Moms who don't think about breastfeeding without looking at the clock may get the impression that when breastfeeding on demand, the mother can do nothing but feed the baby. This is wrong. 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.

For a mother who can't imagine breastfeeding without looking back 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.

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 I advise 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.

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.

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. These are changes with a minus sign. It would be better if they were not, these changes.

Breastfeeding is important not only for the baby, it is also important for the mother. During on-demand feeding, the woman's feelings change, a stronger attachment to the baby is formed, the woman becomes more sensitive to the needs of the baby. Deeper affection and understanding are not only preserved in infancy. They persist for life. For clarity, imagine what happens to a woman’s feelings if she tries to “withstand” a child, endures his crying, anxiety. What happens to a woman if she uses the recommendation from one very popular parenting book: "Go to the child if he cries for more than 15 minutes"? Speaking in abstract terms, humanity is interested in reviving the practice of breastfeeding. The revival of this practice is impossible without mothers realizing the true reasons for the child's need for attachment to the breast.

Lilia Kazakova, pediatrician,
Head of Breastfeeding and Child Care Counselors

Breastfeeding regimens - what to choose

— Polina Aleksandrovna, what is the difference between breastfeeding, mixed and artificial feeding?

- The differences between breastfeeding from artificial and mixed clearly explain why feeding regimens differ.

- Normally, by what month should the feeding regimen be established?

- The diet is constantly changing. The older the child becomes, the larger portion of milk he eats, the smaller the frequency of feeding.

After childbirth, when the mother is lactating, the child also develops its own diet. In the first weeks, everything is quite chaotic and there is no regimen as such, and the mother makes sure that the interval between breastfeedings is not more than 2.5 hours (it can be half an hour or two hours) and the child does not remain hungry. From about the second or third week, the baby has more or less regular intervals between feedings. We can say that the regime has been established. But this mode gradually changes as the baby gets older.

- What is the benefit - and what harm can be from feeding by the clock?

pros

  • The child knows when it's time to eat - the body adapts initially. It's no secret: certain enzymes are needed to digest food. When food enters the child's body regularly, his enzyme system and gastrointestinal tract adjust to the regime, and it is much easier for the child to digest food.
  • The mode of wakefulness and sleep is being formed - at every minute of time the child understands what will happen to him.
  • Parents are not "hostage" to the baby, they have the opportunity to plan their free time - especially mothers, who always do not have enough time. The feeding regime and the regime of wakefulness and sleep make the situation very easy - at every moment the mother knows what awaits her.

Minuses

  • Mom keeps a feeding schedule, but doesn't stick to a sleep schedule - and sets herself a trap. She can get into a situation where the baby is sleeping, and it's time to feed him. And it is not clear whether to wake the baby or let him sleep. If you choose a regimen, then it must be observed both in feeding and in laying down.
  • There are situations when it is difficult to feed the baby on time (for example, you are far from home and you do not have formula). But it is worth foreseeing everything, and there will be no problems. You just need to be able to plan everything correctly.

— How to painlessly accustom a child to an hourly feeding schedule?

For a child, the regimen is not something painful, and if we build a clear daily routine, then, believe me, it becomes comfortable not only for the mother, but also for the baby. This is absolutely normal. But in order to build a regimen, you need to understand what it should ideally be - you must plan what intervals between feedings you want to come to.

The next step is to evaluate where you are right now. For example, you would like to make the interval between feedings three hours, but the baby eats every hour and a half. Of course, if you just suddenly start to pause between feedings at three hours, nothing good will come of it - it will be very stressful for the child.

Therefore, you need to act smoothly:

  • determine point A, from which you are going, and point B, which you must come to;
  • gradually adjust to the mode that we would like to have ideally.

Transition diagram

Now the breaks between feedings are 1.5 hours, and we want 3 hours. We add five minutes each time so as not to injure the child, and at some point we take a break not at 1.5 hours, but at 1 hour 35 minutes, then at 1 hour 40 minutes and so on. The amount of food will also change a little.

- If we talk about night feeding with an hourly schedule, is it necessary to wake the baby when it's time to eat?

- Night feedings are normal for a child up to a year old.

Newborn has no division of the day into day and night - there are approximate three-hour cycles. He woke up - ate - slept, woke up - ate - slept. And so every day. For a newborn baby, night feedings are the absolute norm.

For 1 year old child feeding 1-2 times per night will be normal. But a child of a year may not eat at night.

In order to understand whether it is worth waking up and feeding the baby, you need to know how much he eats per day. Each child at each age has a certain norm - the amount of food that he should eat per day (we always count not per day, but per day).

  • If a child has eaten his norm during the day and sleeps at night, then he does not need to be awakened.
  • If child for day ate about 70% of his norm , then at night it is advisable to wake him up and feed him.

We always evaluate nutritional adequacy by weight gain.

  • If a child in one month has gained weight and height within the norm for his age, then he receives enough nutrition.
  • If a child does not gain weight and height , then he needs to be offered food more often at night so that he fits into the norm.

- If there are too many nighttime feeds on an hourly or on-demand basis, what should I do about it?

- Night "snacks" do not always indicate the child's need for food. When a child asks for a breast at night, mothers mistakenly think that this is only hunger and nothing more. In fact, a child may worry at night due to a violation of the regime or the so-called negative association for sleep (when he can only fall asleep with a breast).

When there is no regimen, the child "does not get enough sleep" of the daily norm and there is a so-called accumulated fatigue, his nervous system is in a very strong excitation. In such a situation, nightly feedings every hour often indicate that the baby has a violation of the regime - it is difficult for him to get up, his nervous system is overexcited, he physically cannot fall asleep without his mother's breast.

Such night feedings can be identified easily:

  • the child wakes up every 40 minutes - 1 hour at night and asks for food, and during the day he usually eats every 3-4 hours - which means that he is unlikely to experience hunger;
  • the child eats very little at night - he kissed the breast or a bottle, ate 10-20 g and fell asleep. This means that the baby performed a certain ritual: he waited for his mother, satisfied the sucking reflex, and thanks to this he fell asleep - in such a case, he did not have a goal to eat.

With these night feeds, you need to pay attention to two factors:

  1. Sufficiency of nutrition - it is worth making sure that the child receives the required amount of food during the day, does not starve during the day and does not get at night the amount of food that should have been received in the daytime .
  2. Correct regimen - you need to make sure that the child is all right with the regimen, there is no accumulated fatigue and a negative association with sleep.

— Is it normal for a child not to eat at night or to eat very little?

“This reverse situation may or may not be the norm. It all depends on the age of the baby and on whether he receives enough food during the day.

Newborn

It is not normal for a newborn child not to eat at night, he must eat every 2.5-3 hours. When breastfeeding, this is critically important - for the mother to establish lactation, and for the baby to replenish the reserves that he needs.

An unpleasant situation can happen in the first couple of months - the mother is glad that the baby sleeps well and does not wake up at night, and on weighing it is clear that the child not only gained a little, but did not add at all in one month, that is, he is clearly starving.

Newborn babies have this feature: if they receive very little food, they do not have the strength to ask. Therefore, it is extremely important to ensure that a newborn baby eats both day and night!

Infant

A child older than 1. 5-2 months adds weight and height within the normal range, eats all the amount of food he needs during the day, feels great, is not crying or irritated, and at the same time sleeps at night - let him sleep to his health. The most important thing is that he gains weight and height - these are the main indicators by which we can assess that the child has enough nutrition.

— If a mother prefers on-demand feeding, what is the most gentle way for her to organize it?

It is important to understand that one should not go to extremes.

First extreme:

the child sleeps for a very long time, the intervals between feedings are 5-6 hours. It seems to mom that everything is fine, but weighing shows that the child is underweight. Mom waited too long and missed the moment when the child simply stopped asking for food due to exhaustion.

Second extreme:

A 7-month-old baby eats every hour, that is, about 20 times a day. This is, of course, an abnormal situation.

When we talk about feeding on demand, we mean that there is a certain interval between feedings. It varies depending on age:

  • for a newborn baby it is about 2 hours;
  • for a child older than 1 month - approximately 3 hours;
  • closer to 4 months - 3-3.5 or 3.5-4 hours, each baby individually.

NORM - from 2 to 4 hours during the first year of a child's life, and you can deviate from this norm +/- for half an hour. If the intervals between feedings become very short (every hour) or very long (5-6 hours), we adjust them in order to stick to the norm and not go to extremes.

— If a child eats little, but often enough, then what regimen is more relevant for him?

- Little, but often - this is not quite normal. It is important to observe the daily amount of food. If a child consumes a daily norm that he needs by age, and at the same time eats little, but often, it means that either the mother does not have enough milk for the child to eat more and, accordingly, withstand long intervals, or the child is simply already used to it - He can't eat more at one time. In both cases, you need to try to slightly increase the intervals.

We can feed both on demand and on schedule - there is no fundamental difference here. But most likely, if we stay on demand, the baby will continue to feed every hour and his amount of food at a time will be quite small for his age. Therefore, you need to try to maintain a slightly longer interval between feedings and watch how much he will eat.

- There are situations when a child's regime is disturbed for some reason - an allergy, an upset gastrointestinal tract. How soon can you return to your normal routine?

- By and large, the sooner you return to normal mode, the better. Do not worry too much if the child does not eat for several days according to the regimen, this will not affect your condition or the physical condition of the baby in any way. The most important thing is not through force and not aggressively, but very gently to return the child to the regime that he had. The clearer and longer the regime was, the easier it is to return to it.

— Why is it important to observe the feeding regimen?

— It is important to observe the feeding schedule:

  1. For parents — so that the mother is not a “hostage” of the child and understands what will happen in the near future, could plan something or leave the house. This, it would seem, is not so important for the child, but it is important for the general climate in the family, so that the mother feels relatively free, not “tied hand and foot” to her baby.
  2. For a baby - I am always for the regime and always urge parents to comply with it, because for a child everything should be predictable - he gets used to the order, gets involved in the regime and feels as comfortable as possible. Parents are comfortable when they know what will happen to them - and the baby is much easier when he knows that food or sleep is on schedule - his body begins to adjust accordingly.

— In what cases is it possible to move away from the usual feeding regimen?

— If it is possible not to deviate from the regime, then it is better not to deviate. But if this happened, do not worry, do not blame and do not reproach yourself, nothing critical will happen, even if the child does not eat according to the regimen for a couple of days. Just get back to your routine as quickly as possible and you'll be fine.

- Polina Alexandrovna, please give examples of the feeding regimen and daily diet for babies of different ages.

— There are a few things to consider when planning your baby's feeding schedule and diet.

  • The amount of food that the child should receive per day.

    Many mothers, unfortunately, mistakenly believe that the daily volume depends only on the age of the baby. But there is no universal portion, it is more in line with the weight of the baby. So, two children of the same age, but of different weights, will need different amounts of food per day. Therefore, it is quite difficult to find clear instructions on how many milliliters at a time a child should eat in each case.

  • Feeding frequency.

    In order to calculate the amount of food at one time, you need to know how much food you need per day and how many times the mother will feed the baby - that is, the frequency of his feedings. In this case, you should always focus on children's weight. I recommend scheduling meals with your pediatrician so that everything is tailored to your child's specific needs.

    • for a 2-month-old baby - 6-7 times a day and +/- 120-150 ml of breast milk eaten per feeding,
    • for a child 5-6 months - 5-6 times a day +/- 180-210 ml of breast milk eaten per feeding,

For babies who are on complementary foods, servings are larger, but it all depends on weight and frequency of feedings. And you need to remember: complementary foods are not an additional amount of nutrition, it must fit into the daily norm, which corresponds to age and is redistributed between complementary foods and breast milk and / or mixture in different percentages.


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