A Schedule with Flexibility
Newborns should be fed when they are hungry. Bottle fed babies typically feed every 3 hours. Breast-feeding infants tend to feed more frequently, between 1.5-2.5 hours. However, it is good practice to watch the baby for hunger cues (lip smacking, tongue thrusting, rooting) instead of watching the clock and begin a feeding at the first sign of those hunger cues. Crying is the latest sign of hunger. Most infants will wake when they are hungry. If your baby sleeps more than 4 hours at night, be thankful!
How Long to Feed
Most bottle fed babies will consume their feedings comfortably within 20 to 30 minutes. The same applies to breast fed babies. Nursing babies get about 80% of the mother’s milk in the first 5 minutes of nursing. By 10 minutes, 85% and by 15 minutes 86%. Anything more than 15 minutes per side is probably not giving the baby any extra milk. All babies need to suck more than they need to eat.
Breast-feeding provides many advantages to the newborn as well as to the nursing mother. However, occasional misconceptions about the nursing process may make it a bit harder to get started.
The Baby Regulates the Supply
Nursing babies eat frequently, usually about 10 to 12 times per day (every 2 to 3 hours). The more frequent a baby nurses, the more milk the mother produces. In this fashion, a growing infant can get more milk to grow and develop.
The Nursing Mother Must Have Adequate Rest
Nursing a baby every 2 to 3 hours, especially after the rigors of labor and delivery, can become exhausting. If you can’t get enough rest, your milk supply may suffer. Nap when your baby naps. This is not the time for gourmet cooking and house beautification projects. Arrange for some help to deal with the routine household chores. Your job is to nurse and nap. Factors that tend to increase a mother’s milk supply are:
- feeding more frequently
- getting enough rest
- good nutrition and fluid intake
Factors that will diminish milk supply are:
- infrequent feedings
- fatigue and anxiety
- poor nutrition
Establishing Breastfeeding as the Primary Mode of Feeding
Once you and your baby leave the hospital, you should nurse exclusively. Avoid the temptation to supplement each breast feeding with formula. Sucking from a breast and from a bottle are mechanically very different and can possibly lead to “nipple confusion” in the newborn. This can possibly decrease your milk supply and cause the baby to struggle nursing.
How to Tell Your Baby is Getting Enough
A breastfeeding mother often wonders if her baby is getting enough milk, since she can’t see how many ounces the baby takes. Your baby is doing fine if he or she eats every 2 to 3 hours, appears satisfied after feedings, wets frequently, and has 4 or more soft stools per day. Normal breast feeding stools look like watery mustard, can be quite “explosive”, and frequently are confused with diarrhea.
Just to upset you, many breastfed infants will suddenly “stop” stooling at about 6-8 weeks of age. They may stool only 1-2 times per week. This is normal, and unless the baby’s abdomen is distended or the stools are very hard, there is little to worry about.
Every baby goes through growth spurts, usually 3 to 4 days at a time, every 3 to 4 weeks. During these spurts the baby will want to eat more frequently. This is normal and expected and does not mean your milk is drying up. After a few days of more frequent feedings your milk supply will increase to match your baby’s new needs and the feeding schedule will normalize.
Seated comfortably and holding your baby, hold the bottle so that the neck of the bottle and the nipple are always filled with formula. This helps your baby get formula instead of sucking and swallowing air. If he doesn’t waste energy sucking air, he’s more likely to take enough formula. Air in the stomach may give a false sense of being full and may also cause discomfort.
Your baby has a strong, natural desire to suck. For him, sucking is part of the pleasure of feeding time. Babies will keep sucking on nipples even after they have collapsed. So take the nipple out of the baby’s mouth occasionally to keep the nipple from collapsing. This makes it easier for him suck, and lets him rest a bit.
Never prop the bottle and leave the baby to feed himself. The bottle can easily slip into the wrong position. Remember too, your baby needs the security and pleasure it gives him to be held at feeding time. It’s a time for your baby and you to relax and enjoy each other.
What the infant drinks is the most important source of nutrients for the first year. We recommend breast-feeding or infant formula, because either will provide balanced nutrition for optimal growth and development.
It is important that you never feed the baby the concentrated formula directly from the can. It must always be diluted according to the recipe on the can, because the concentrate is too rich and contains too many substances, such as salts, which might harm the baby if fed in the wrong concentration.
How Much Formula
The amount of formula your baby takes will vary. Most babies feed for about 15 to 20 minutes. You will likely find that sometimes your baby will take all his bottle and sometimes he won’t. Don’t worry. This is normal. As your baby grows and gains weight, he will need more formula. When your baby takes all of his bottle pretty regularly – and sometimes cries for more – it may be time to increase the amount of his daily formula.
Cow’s milk should NOT be given until the infant is 12 months old. When it is introduced, the total amount given should not exceed 24-32 ounces per day. Cow’s milk given too early or too much is associated with anemia and gastrointestinal problems.
Most infants do not need water.
Formula can be fed, straight from the refrigerator, at room temperature, or warmed. If warming is desired, remove a bottle from the refrigerator and warm it in a pan of hot (not boiling) water for a few minutes, or you may also use a bottle warmer.
Test the temperature of the formula by shaking a few drops onto the inside of your wrist. It should feel warm but not hot.
NEVER USE A MICROWAVE OVEN TO WARM A BOTTLE! Severe throat burns have resulted due to the uneven heating that may occur.
Test Nipples Regularly
Testing nipples regularly will save time when you are ready to feed your baby.
Nipple hole should be the right size to help baby suck easily. When the nipple holes are the right size, warm milk should drip as rapidly as possible without forming a stream.
If nipple holes are too small, baby may tire of sucking before he gets all the formula he needs. If holes are too large, baby gets too much formula too fast, and may not get enough sucking to satisfy his needs.
To enlarge holes that are too small, use a white-hot needle. An easy way to prepare the needle is to put the blunt end in a cork and heat it in the flame of a match or a cigarette lighter.
Burping helps remove swallowed air. Burp or bubble him by holding him up right over your shoulder, and patting or rubbing his back gently. Or place him face down over your lap and gently rub his back. Baby can also be burped by holding him in a sitting position (baby leaning slightly forward) on your lap, with your hand supporting his stomach.
The size of the burp is determined by how much air the baby swallows, therefore a baby may burp very little or not at all. If he is happy do not be concerned if he did not burp.
After you have fed and burped your baby, place him in his crib. After bottle feeding, rinse bottles and nipples with cool water. Squeeze water through the holes of the nipples. Washing can be done later.