Baby Care: Feeding Decisions
One of the most important decisions you will make is how to nourish your baby. The following information will be helpful for whatever your feeding choice and for weaning from breast to bottle.
Human breast milk is the perfect food for a baby. It can help prevent disease, provide optimum nutrition, and promote healthy growth and development-even lower the risk of allergy and dental problems. When you decide to breastfeed your baby, our certified lactation consultants and registered nurses are here to support you in your decision--with bedside teaching, a "Warmline" for questions, and classes to give you the information you need. For more information, call Woman's Warmline at 225-924-8239. Breastfeeding supplies available through Woman's Mom & Baby Boutique in Physician Office Building or call 225-231-5578. You can also register online now for classes on Breastfeeding and Baby Care.
Your pediatrician will recommend a formula to feed your baby. Most pediatricians recommend a formula based on cow’s milk with iron for the first year of life. A few babies need a formula without cow’s milk, usually a soybean formula.
Formula comes in 3 forms: ready-to-feed liquid, concentrated liquid, and powder. Ready-to-feed is available in cans or different size bottles that can be thrown away. It requires little time to prepare, but is the most expensive of the 3 types of formula. Opened cans or bottles must be kept in the refrigerator.
The cost of concentrated formula is the lowest of the 3 forms if bought in larger quantities. Be sure to follow the directions for mixing the concentrate with water.
Powdered formula is convenient for travel or home use. It is also economical during the time you are weaning from breast to bottle.
Never add more water to make the formula last longer or add less water to make it stronger. This could be very dangerous to the baby’s health.
Discuss formula preparation and sterilization with your doctor.
Using Tap Water
Tap water is usually safe to use in mixing formula. Discuss sterilization with your doctor, since water quality varies in different areas. If your water comes from a well, it may need to be tested by the local office of the Louisiana Department of Public Health for bacteria and contaminants.
To sterilize water, boil it for five minutes and allow to cool before mixing with formula. Distilled or bottled water does not need to be sterilized.
Sterilizing Bottles and Bottle Nipples
Wash your hands before preparing bottles.
Wash bottles and nipples in hot, soapy water, rinse very well in hot water and allow to air dry. Be sure to clean any dried formula out of the nipple and its opening.
You can sterilize the utensils and bottles by boiling them in water for 5 minutes. Allow to cool before adding formula to the bottles.
How Much to Feed
Most pediatricians believe you should feed babies when they act hungry. Babies demonstrate hunger by crying, sucking on their fists, or turning their heads when their cheeks are touched. Most babies will want to feed every 2 to 4 hours, or 6 to 12 times per day. During the first month, if your baby sleeps longer than 4 hours and starts missing feedings, wake him up and offer a bottle.
Your newborn will take from 2 to 3 ounces of formula per feeding. Feedings will generally last about 20 minutes. As the baby grows and gains weight, he will need more formula. It might mean your baby needs to have more formula in the bottle if the baby regularly takes the whole bottle and sometimes cries for more or if your baby keeps sucking strongly after the bottle is empty. If this happens, begin by placing 1/2 ounce more formula in the bottles. If your baby spits up, it may mean there is too much formula in the bottle. Place 1/2 ounce less formula in the bottle.
Prepare formula bottles so you have enough for that feeding. Prepared formula bottles can be refrigerated for a maximum of 24 hours or used within 1 hour of opening.
Warming the Formula
It is your choice whether to warm your baby’s formula. Many babies will be happy to take their formula directly from the refrigerator, while others may prefer it warmed. No one way is best, nor does one way cause colic or upset stomach more than the other. Babies often like things done the same way each time.
If you choose to warm your baby’s formula, do not heat the bottles in a microwave. The formula may heat unevenly and will burn your baby. Formula can be warmed to room temperature by placing the bottle in a pan of warm water. Temperature of the warmed formula should be tested by shaking a few drops onto the inner aspect of your wrist. If it is too warm to your wrist, it is probably too warm for your baby, too.
Does the Baby Need Water?
Babies usually do not need water. It does not contain any of the calories or nutrients that babies need. It also may make them feel full and not hungry for formula or breastmilk. Some babies do not like water and will refuse to drink it when offered.
Your pediatrician may prescribe vitamins with fluoride to ensure that the baby gets proper nutrition and to protect his emerging teeth.
Formulas with iron are often recommended to ensure your baby has enough iron during the months of rapid growth. Iron in the formula is not the cause of colic, constipation, or spitting up.
Other Types of Milk
Other types of milk (whole, low fat, skim, condensed, raw) do not meet the nutritional needs of young babies and should be given only after your pediatrician says you may stop using formula.
Solid foods are not needed for nutritional or physical reasons until the baby is at least 4 to 6 months old.
Giving a baby solid foods too early can contribute to obesity, may provide more salt than the baby’s system can easily handle, and may cause an early food allergy.
Burping the Baby
During the first few weeks you will need to burp your baby frequently. Your baby should be burped during, and at least once after, the feeding.
Traditional over-the-shoulder burping works well, or you may want to try sitting the baby in your lap and lean him slightly forward, supporting his jawbone and upper chest with your hand. Gently rubbing or patting baby’s back is comforting and may help move the air bubbles up.
Holding the Baby for Feedings
The following suggestions may help you to be more comfortable during feedings:
Place pillows under baby and under mother’s arm.
Sit on furniture with arm rests.
Use a lumbar roll or pillow to support your back.
Cuddle baby with the head bent slightly forward. Keep the baby’s head straight, not bending toward the left or right shoulder. If the head rests forward on the chest, the baby may have trouble breathing. He may try to straighten his head by thrusting it backward to make breathing easier, but if his head is too far back this can make it hard to swallow and breathe. Talk to him as he eats.
Make sure formula fills the nipple during the entire feeding or the baby will swallow air. Swallowing air may lead to spitting up, colic, and upset stomach.
Do not lay an infant flat while taking a bottle. Never prop up the bottle or leave your baby alone to feed.
Babies have a strong sucking reflex. Many are not satisfied by the amount of sucking during a feeding and want to suck more even though they are not hungry. Pacifiers fill this need and may calm your baby if he is fussy.
Pacifiers should never be tied around your baby’s neck. The cord or ribbon used to hold the pacifier could get caught on something, causing it to tighten around the neck and choke him. Use only a commercial pacifier, never a homemade one. Never make a pacifier from a nipple and plastic collar or ring. Some babies can separate the nipple from the collar and choke on it. Pacifiers should fit your baby’s mouth comfortably. A pacifier that is too long might gag the baby. Using a pacifier is not harmful, and babies eventually outgrow the need for them.
The use of a pacifier in the breast-fed infant is discouraged during the first 3 weeks, due to possible nipple confusion while breastfeeding is being established. A pacifier used for a short period to calm a fussy breastfed baby could be used as a last resort.