Pediatric Health Information
Feeding Your Infant
One of the first decisions every parent has to make is whether to breast or bottle feed their infant. Breast milk is the ideal source of nutrition for babies. It is easy to digest, filled with antibodies that help fight against infection, and always the right temperature. If you decide not to breast feed, there are many good formulas on the market.
It would seem that since breast feeding is a natural process it would also be easy. But, this is not always the case, especially in the first few days. Most new mothers need help getting started. Certified lactation consultants can assist you in the hospital as well as after you go home. Most babies are very sleepy in the first week of life, and it may be difficult to keep them awake to feed at times. Most babies need to eat at least every 2-3 hours and may only nurse for 5-10 minutes. This should increase to at least 10-15 minutes as the baby demands more milk and your milk supply increases. Initially, your newborn gets colostrum which is high in antibodies and has a thicker, more yellow appearance. It may take 2-5 days for your milk to ‘come in’. Your baby may fall asleep after nursing on one breast. If he or she will not nurse from the other side, simply start on the other side with the next feeding. You will know if your baby is doing well with nursing if he seems satisfied after nursing and is having good wet diapers (6-8 wet diapers in 24 hours) by the 3rd or 4th day of life.
It is best to use formula with iron since iron is not as well absorbed from formula. Most formulas come in three forms: ready-to-feed, concentrate, and powder. Most babies will want to eat every 3-4 hours and will generally start off taking 1-2 ounces per feeding. This will gradually increase as the baby grows. A rough guide for how much an infant should take at a feeding is an ounce per each week of age. NEVER prop the bottle – ALWAYS hold your baby cradled in your arm with the baby almost upright. Hold the bottle so that the nipple is filled with milk so that the baby does not swallow air. You should also avoid warming bottles in the microwave because uneven heating can burn your baby’s mouth and throat. Discard any milk that the baby does not take during a feeding – saliva may break down the milk and it is also a good place for germs to grow.
The number of stools babies have varies. Breast fed infants often stool after every feeding and formula fed babies might stool every two days. Consistency and color also vary-breast fed infants have stools that are usually mustard yellow liquid with curds. They are sometimes green or brown as well. Formula fed infants usually have stools that are firmer and yellowish-brown. All babies will occasionally grunt, strain, grimace, and turn red in the face when having a bowel movement. This is normal unless the stools are very hard, dry, or pellet-like. Stool frequency, consistency, and color change with each change of diet.
It is normal for babies to spit up. Some babies spit up after most feedings! Formula-fed infants spit up more than breast-fed infants. To help with spitting up, try to burp your baby during and after each feeding. For formula fed infants, make sure the hole in the nipple is not too large. This may cause your baby to eat too fast, swallow more air, and spit up more. It is also helpful to place your baby in a carrier to keep him/her upright for approximately 30 minutes after feedings. Please call the office if you feel your baby is spitting up very large amounts frequently or is vomiting after feedings. Vomiting is forceful emptying of the stomach. If your baby has projectile vomiting (very forceful vomiting that shoots out a foot or more), please notify our office.
Crying is a newborn’s only means of communicating that he/she needs something. Do not worry about spoiling your baby by picking him up when he cries. You will learn to distinguish certain cries as hunger, wet/dirty diaper, gas/tummy ache, etc. Some babies will begin an almost daily routine of crying when they are 2-4 weeks of age. This is “colic”. No one knows exactly what causes colic. It tends to occur in the late afternoon or evening hours and is often characterized by inconsolable crying that can last for several hours. The baby’s face may turn dark red; he may draw his legs up then stiffen out; he may pass gas, etc. Although most people have thought colic represents some type of abdominal pain, others have suggested that it may result from immaturity of the nervous system which leads to increased crying. Whatever the cause, it is usually better by 2-3 months of age. Some suggestions to help with a ‘colicky’ infant include: carrying in baby wrap/sling/carrier, gently rocking the baby, putting him in a swing, putting him in a vibrating bouncy seat, or taking him for a car ride. Some babies settle down to the sound of a vacuum cleaner/dishwasher or by placing him on top of the washing machine/dryer (Note: he should be strapped in a seat and accompanied at all times). Other babies respond well to swaddling tightly in a soft, stretchy blanket or by taking them for a walk outside.
Colic can be very stressful to your family. Try letting a family member watch your baby while you take some time alone or with your spouse. Remember, although it may seem like a lifetime away, colic almost always improves by 3 months of age.
One of the biggest threats to your child’s health is accidental injury. To prevent accidents and injury to your baby, be aware of things that may put him in danger:
1. ALWAYS use an approved car seat when traveling with your child. Children should be rear-facing in the backseat for as long as possible, until they outgrow the rear-facing weight and height limitations for your specific seat.
2. NEVER leave your baby unattended on a bed, changing table, sofa, or chair. Use safety straps on the changing table or keep one hand on the baby at all times. It takes one glance behind you with him unattended for him to roll onto the floor!
3. NEVER shake your baby or toss him into the air – it can cause damage to his brain.
4. NEVER put anything on a string around your baby’s neck such as a pacifier or toy, including amber teething necklaces.
5. Avoid drinking hot drinks such as tea or coffee while holding your baby.
6. ALWAYS leave the side rails up on the crib and check to make sure they are in the locked position when leaving the baby in the crib.
7. NEVER smoke or allow anyone to smoke around your baby.
8. Keep your hot water heater on medium or 120 degrees and test the bath water before bathing your baby.
9. Infants should always sleep on their backs in a place made for a baby–crib, pack and play, bassinet, etc. The sleep space should be free of other objects such as pillows, stuffed toys, loose blankets, and crib bumpers.