WCC RESOURCE CENTER
Feeding Your Baby
By the time a baby arrives, most parents have made the choice of either breastfeeding or formula feeding their baby. Regardless of which option you have chosen, a comfortable, relaxed atmosphere is an important aspect of the feeding experience. While breast milk has certain nutritional advantages, millions of healthy babies have thrived on formula. The decision to breastfeed or give formula to your baby will depend on many factors, including personal preference. This decision is yours alone.
Breast Feeding
Breast milk is the natural food intended for human babies to consume. It is extremely rich in nutrients, and provides babies with the appropriate ratio of carbohydrates, easy-to-digest proteins, and fats needed for optimal growth. It also contains antibodies that help protect babies from many types of illnesses.
Mechanics of breast feeding
Your baby has natural reflexes that help with breast feeding. You will notice that if you stroke the side of the cheek or mouth, your baby will turn toward that side with mouth open, searching for the food (this is the "rooting" reflex). And, the "sucking" reflex is a baby's natural ability to suck, swallow and breathe in a fairly coordinated manner. Sometimes babies get confused with this sucking reflex and need help coordinating it all.
To prepare your baby to latch on, hold her close to your breast and rub her cheek or lips. This will help her open her mouth nice and big and will enable you to make sure her tongue is down. Remember that your nipple needs to be as far back in your baby's mouth as possible, which will help your baby get as much of the areola in, too (the areola is the darkened area beyond the nipple).
When your baby has finished nursing, break the suck by inserting your finger between her gum and your breast and release the nipple from her mouth. Pulling your baby from your breast without breaking the "vacuum seal" may damage the nipple and cause you pain.
Positions
There are three basic nursing positions (although you may find more that work better for you). With any nursing position, make sure you are very comfortable and have a big glass of water nearby to drink. Turn off the TV and phone to help both you and your baby concentrate. Your baby's head and body should always be in alignment (meaning that your baby should never have to turn his head to reach the nipple). The most common cause of a mother's nursing discomfort (beyond the first minute or two of "let-down") is incorrect positioning.
- Cross cradle hold
This position is very helpful in creating a proper latch and is best achieved by sitting in a chair with a pillow or two in your lap and a footstool under your feet. Hold your baby on top of the pillow with your hand under his head and forearm under his back (left breast, right arm; right breast, left arm). Use your free hand to support your breast in a "C-hold" (your thumb on top of the nipple and the other four fingers under the nipple). When you are ready to help him latch on, you can bring him right up to the breast with the hand/arm supporting him, and use your free hand to guide the breast so he latches on far beyond the nipple. - Football hold
This position is so named because it resembles running with a football tucked under one arm! It can be done sitting in a chair or lying in bed, with pillows at your side. Hold your baby with your hand under his head and your forearm under his back but his time the supporting hand is on the same side as the breast (left breast, left hand; right breast, right hand). Support your breast with your free hand (from the opposite side of your body) in the same C-hold. Your baby's body will be "tucked" under your armpit, with his legs near your back. - Side-lying position
This position is especially helpful the first few day after birth, for nighttime feedings, and for weeks if you delivered by cesarean. Your and your baby are both lying on your sides, facing each other, using pillows for comfort and support. Place your lower arm (the one between the bed and your body) as if you were sleeping on your side, or put your arm under your baby (with his head in the crook of your arm). Use your free hand to help bring your baby closer or support your breast. To switch sides, place your baby on your chest and roll on your back to your other side. Or, roll a little further on the same side (slightly more on your abdomen) and offer your baby the other breast. - Let-down reflex
Many mothers describe this as a tingling sensation or a "pins and needles" feeling in the breast as the milk starts to flow. Several factors can stimulate a let-down response, including a baby's cry (not necessarily your own!). As your baby nurses, a signal is transmitted to your brain which triggers the release of prolactin (a maternal hormone that stimulates milk production). Therefore, the more your baby nurses, the more your body will produce milk. This prolactin also acts on the uterus, causing it to cramp, or "involute" (continue to get smaller, toward pre-pregnancy size).
How long to nurse?
While there are absolutely no specific answers here, generally we recommend trying to nurse about 10-15 minutes a side. Often the hardest part is trying to keep your baby awake long enough to offer both breasts. In time, your baby will communicate how long it takes her to finish a side (some babies are done in 5 minutes, some take 20 minutes). Getting your baby to finish at least one side per feeding, especially in the early weeks of nursing, is important to help her get an adequate amount of both the "fore" and the "hind" milk.
Engorgement
There is usually no doubt in a mother's mind, or body, when her milk comes in. But, that does not mean that everyone goes through uncomfortable engorgement. The best way to prevent becoming engorged yourself is to offer your baby frequent, longer feedings (day and night) from the start, and apply warm compresses to your nipples before feedings (to soften the areola). Engorgement becomes uncomfortable for some because the milk production (the "supply") is greatly exceeding what the baby is initially eating (the "demand," especially in a sleepy baby). If you do get engorged, and you are already trying to nurse frequently, try to pump a little of the milk to relieve the pressure, and apply cool compresses after feedings to decrease the inflammation.
Spitting up
Almost all babies spit up at one time or another. The best way to prevent spitting up is to burp your baby before feeding, between breasts, and again after feeding. Sometimes you may not hear a big belch. If you feel the spitting is getting more frequent, more forceful, or more bothersome to your baby, contact us at the clinic.
How do I know if my nursing baby is getting enough to eat?
This is a common concern among breast feeding parents. If your baby seems satisfied after feedings, has 5 or more wet diapers a day, and is having an increasing number of loose yellow stools (usually several a day), then there's probably enough food going in. If your baby does not seem to be following these guidelines, or if you are concerned, please schedule an appointment to come in a see us. Most babies need to nurse 8-12 times in 24 hours, especially in the first few weeks of life, to re-gain lost birth weight and then start advancing on the growth curve. This usually means nursing every 2-3 hours during the day (from start to start of feedings). Unless your baby is having difficulty gaining weight, and you have been instructed otherwise, it is OK to let him be your alarm clock at night (he may wake you every 4 hours, or every 2 hours; it varies). Remember that the longer a baby sleeps at night, the more feedings he will need during the day.
Keeping parents healthy
It is very important that both the nursing mom and the supporting dad take care of themselves. A nursing mother needs 10-12 glasses of fluids a day and approximately 1000 more calories (a few extra servings within each section of the USDA Food Pyramid usually does it). And, BOTH parents need as much rest as possible!
Pumping
Unless you are having a specific problem with nursing, we usually do not recommend routine pumping and/or bottle feedings until your baby has really established a good nursing routine and skill. This is usually accomplished by age 2 weeks. At that time, many parents start pumping so dad can do some feedings, or so they can start storing milk for a night out or the future.
Supplementing
We usually do not recommend supplementing breast feeding with formula in the first few weeks, as this can result in a diminished milk supply, especially if the nursing is not yet well-established. If you elect to supplement with formula (whether now or in the future), or if formula becomes your baby's main food source, it is recommended to use formula with iron.
When should I plan to wean?
Whenever you or your baby feels it is the right time. The American Academy of Pediatrics recommends nursing through the first year if you are able. For the first 6 months, breast milk is all your baby needs for healthy growth. After that time, the breast milk is still the primary source of protein and nutrients, but solid foods start supplying more of the calories.
What do I do if I have additional concerns or feel my baby isn’t nursing well?
Our clinic has a Certified Lactation Consultant available by appointment. Please call and ask to see Anna Hoffman, CFNP, IBCLC.
Formula Feeding
Formulas today provide babies with all the basic nutrients and calories required for healthy growth. The brand is up to you, but unless there are special dietary considerations, we recommend an iron-fortified cow's milk-based formula through the first year.
How to prepare
There are three types of formula preparations. Be sure to wash the tops of the cans (regardless of which type you buy) and use a clean can opener to avoid any contaminant. It is fine to use your tap water (cold water only), and there is no need to sterilize bottles or nipples (washing in the dishwasher or in hot soapy water is adequate to kill the germs). If you use the liquid forms of formula (ready-to-feed and liquid concentrate), it is recommended that once you open a new can, divide the whole amount right away into bottles (ready-to-feed) or mix the entire can at once and then divide into multiple bottles. Seal the bottles, store them in the refrigerator, and use within 24 hours. Do not store an opened can of the liquid.
Ready-to-feed
This is prepared, pre-bottled formula that does not require any mixing
(only getting it to the temperature your baby likes). It is very convenient for traveling
(especially if you are not sure of the water source), but is also the most expensive form of
formula to use.
Liquid concentrate
This looks like the ready-to-feed formula but needs to be mixed
with an equal amount of water before feeding. Read the labels carefully! Many people
have either given the liquid concentrate without mixing with water, or have given the
ready-to-feed diluted with water.
Powdered
This is the most economical formula on the market. Follow the printed
instructions on the can (usually the mixture is one scoop to two ounces of water). You
can mix up a pitcher and pour into bottles as mentioned above (again, once mixed, use
within 24 hours).
How much does a baby eat?
Most newborns eat 1 to 1-1/2 ounces per feeding at first, and gradually increase the volume. In general, babies should be fed every 2-4 hours during the day, and they should get enough formula to equal 16 or more ounces in 24 hours. But, all babies are different; smaller infants will eat smaller amounts at more frequent intervals. Let your baby let you know how much and how often she wants to eat.
Warming formula
If you have just mixed the formula, or just taken it out of the refrigerator, we recommend warming up the bottle by placing it in a container of warm water. We do not recommend using the microwave to warm formula; heat pockets can easily form which can then lead to burns in the baby's mouth. Shake the bottle after it is warm, and check the temperature of the formula a few times before feeding your baby.
Leftover formula
After each feeding, discard any remaining formula. Formula that has already contacted a baby's mouth and has warmed up is susceptible to growing bacteria.
Bonding
Use feeding times as your chance to be close to your baby and learn how he communicates. Feed him skin-to-skin with you (both mom and dad can do this) so he gets a chance to feel your warmth and your heartbeat.
