Feeding Your Baby

Breast-Feeding—the natural way of feeding your baby, and many women find it simpler and far more satisfying than bottle-feeding. Your own milk is almost always the best food for your baby. So unless you have strong feelings against breast-feeding, you should plan to nurse your baby. It is worth starting even if you know you will have to stop after a few weeks or months. Make a special effort to breast-feed if members of the family have allergies which the baby may inherit.

If you don't wish to nurse or if you aren't able to start or continue, you can be confident that bottle-feeding of modern infant formulas is a convenient and safe substitute.

Advice on a printed page can provide only a little help with breast-feeding. Demonstration and practice are more important. Find someone who is experienced and sympathetic to teach you about breast-feeding. Most obstetric and nursery nurses are good helpers. Other mothers who have breast-fed their babies and enjoyed it can give you excellent help. In many communities such mothers have organized into groups to help new mothers with breast-feeding. The hospital or public health nurse, your doctor, or other mothers will know of such groups. The following practical pointers may help:

• Most women find that a good nursing bra, one with wide straps that provide good uplift and one that opens easily for nursing, makes nursing easier and more comfortable. Many wear such a bra during the last weeks of pregnancy after the breasts have enlarged, and day and night during the months they are nursing. Some mothers have found that rubbing the nipples with a towel each day during the last months of pregnancy toughens the nipples, making them less tender when nursing starts.
• Find a position that is comfortable for you and your baby; a chair with arms, a pillow and a footstool for your feet are often helpful.
• Use the first few days, when there is little milk in the breast, to get your nipples used to your baby's nursing.
• Let your baby suck 3 to 5 minutes at each breast at each feeding the first day. Gradually add a minute or 2 until you are nursing about 10 minutes on each breast at each feeding.
• Touch the baby's cheek with the nipple to start. The baby will turn his or her head to grasp the nipple. (If you try to push the baby to the nipple with a finger, the baby will turn away from the nipple and toward your finger.) You may find it helpful to pinch the tip of the breast slightly with your fingers to project the nipple and make it easier for the baby to grasp.
• Allow the baby to grasp the entire darkly colored part of the breast in its mouth. The baby gets the milk by squeezing it from the nipple as well as by sucking. The grasp on your nipple may hurt for the first few seconds, but the pain should disappear once he or she is nursing in a good rhythm. If the baby's nose is pressed against your breast, use your finger to press the breast away to allow easy breathing. When you want to stop nursing, first break the suction by inserting your finger in the corner of your baby's mouth. This will save sore nipples. If your entire breast becomes sore, you may be able to relieve the discomfort by lifting and supporting the breast with one hand during nursing.
• Keep yourself rested, well nourished and relaxed.
• You will need more fluids, extra protein and some extra calories while you are nursing. Be sure you get at least two servings of lean meat, fish, poultry, eggs, dried beans or peas each day for protein and two glasses of milk or servings of cheese for calcium. Fruits, juices, and green leafy vegetables will provide extra vitamins and minerals. Avoid alcohol, smoking and any medicines that are not absolutely necessary, or that have not been prescribed by a doctor who knows that you are nursing.
• A small amount of milk may come out of your nipples between feedings. A small nursing pad or piece of sanitary napkin inserted in the bra over the nipple will absorb this milk, keeping the bra clean and preventing irritation of the nipple. You may wish to clean your breast with plain water before or after feedings. Otherwise your breasts require no special bathing other than your regular baths or showers.
• If you have less milk than the baby seems to want, nurse more frequently. This will increase the supply of milk.
• If the nipple area becomes swollen with milk, you may have to squeeze some out by hand in order to get the whole nipple area into the baby's mouth.
• If the entire breast becomes swollen and painful, let the baby empty the breast as much as possible. Use comfortably hot towels, a hot water bottle, or a hot shower on the breasts; gently and firmly massage the milk from the edges of the breast toward the nipple; squeeze as much milk as you can out of the nipple area by hand. If you notice a spot of tenderness or redness on your breast or nipple that persists for more than two or three feedings, be sure to seek medical advice promptly.
• Don't blame yourself or let others blame your milk for all the ups and downs of your breast-fed infant. Babies fuss, spit up, cry and have unusual bowel movements no matter how they are fed. Just go right ahead with your breast-feeding and chances are that such minor "problems" will disappear.

Bottle-Feeding—Hold your baby close to you in your arms. Be sure that milk is in the nipple of the bottle. Touch the nipple next to the baby's mouth and the baby will turn and grasp the nipple. Hold the bottle so that it sticks straight out at a right angle to the baby's mouth.

The nipple holes should be large enough so that milk drops slowly from the bottle when it is held with the nipple down. The cap should be loose enough so that air bubbles can enter the bottle to allow the milk to be sucked out of it.

Halfway through the bottle, "burp" your baby on your shoulder by patting gently on the back until the infant burps. Another way is to hold your baby in your lap over your hand or knee, pat the back and gently rub the stomach. The baby will usually burp up some air and often a little of the formula.

Be sure to protect your clothing with a diaper or other covering. It is much easier to clean up a diaper than your clothing.

How Often to Feed—Feed when your baby seems hungry. Most babies will fall into a pattern of 6 to 8 feedings about 3 to 5 hours apart. If your baby is more irregular than this, develop a more regular schedule by waking your infant a little earlier or feeding later when he or she is a bit more hungry. It is easier and better to get to a regular schedule by working from the baby's own schedule than by just deciding to feed at certain times whether the baby is hungry or not.

After a few weeks, most babies will begin to sleep through one feeding. Most parents prefer to skip the night feeding rather than a daytime feeding. If your baby sleeps through a daytime feeding, wake and feed at the usual time so that the baby—hopefully—will give up one of the nighttime feedings.

How Much to Feed—If you are breast-feeding, you don't have to worry about how much to feed—your baby decides. Most mothers who are breast-feeding worry at some time about whether they have enough milk. Actually, too little milk is extremely rare and more frequent feeding automatically increases the supply. The best reassurance is your baby's normal activity and growth.

Most babies, after the first few days, take 2 to 3 ounces of milk each day for each pound of their body weight. Most bottle-fed babies want to have 6 or 7 feedings each day. For a 7-pound baby, this would mean 14 to 21 ounces of formula a day, or 2 1/2 to 3 1/2 ounces in each 6 or 7 feedings. You might begin by offering 3 ounces in each bottle. When your baby begins to empty the bottle completely at 2 or 3 feedings a day, add 1/2 ounce to the bottle at each feeding. Stay a little ahead of the baby and let the baby decide how fast to increase the intake of formula. If your baby takes much more or less than 2 to 3 ounces per pound per day, discuss this with your doctor or nurse. Don't worry about how much is taken at a single feeding; most babies will have times when they just aren't hungry and other times when they take more than you expect.

Spitting Up—Most babies spit up some milk after many of their feedings. The milk seems to overflow from the baby's mouth and is often curdled from the normal action of the stomach. This is really not a health problem—it is just messy. Babies who spit up a lot grow as fast and as strong as those who do not.

There are several tricks to reduce the amount of spitting up. But none of them works all the time, and most babies will continue some spitting up even when all the tricks are used.

• Burp the baby carefully mid-way through the feeding, at the end of the feeding, and a few minutes after the feeding.
• Prop the baby's infant seat or cradle a few inches so the baby's head is tilted forward over the stomach for 10 or 15 minutes after each feeding.
• Try feeding cold formula directly from the refrigerator.