How you feed your newborn is the first nutrition decision you
will make for your child. Take a closer look at these guidelines
for breastfeeding and bottle-feeding so you can make an informed
decision.
Breast or Bottle?
The American Academy of Pediatrics (AAP) and other professional
groups concerned with the care of newborns advocate breastfeeding
as best for your baby. Specifically, the AAP recommends that babies
be breastfed exclusively for about the first 6 months. Following
the introduction of solid foods, breastfeeding should continue
through the first year of life and beyond, if desired.
Breastfeeding may not be possible or preferable for all women.
Deciding to breastfeed or bottle-feed a baby is usually based on
the mother's comfort level with breastfeeding as well as her
lifestyle, but breastfeeding may not be recommended for some
mothers and babies. If you have any questions about whether to
breastfeed your child, talk to your pediatrician.
Remember, your baby's nutritional and emotional needs will
be met whether you choose to breastfeed or formula-feed.
Breastfeeding Advantages
Breastfeeding your newborn has many advantages. Perhaps most
important, breast milk is the perfect food for a human baby's
digestive system. It contains the vitamins and minerals that a
newborn requires, and all of its components - lactose, protein
(whey and casein), and fat - are easily digested by a newborn's
immature system. Commercial formulas try to imitate breast milk,
and come close, but the exact composition cannot be duplicated.
Also, breast milk contains antibodies that help protect infants
from a wide variety of infectious diseases, including diarrhea.
Studies suggest that breastfed babies are less likely to develop
certain medical problems, including diabetes, high cholesterol,
asthma, and allergies. Breastfeeding may also decrease the chances
that the child will become overweight or obese.
Breastfeeding is great for moms, too. It burns calories and
helps shrink the uterus, so nursing moms get back into shape
quicker. Breastfeeding may also protect mom from breast and ovarian
cancer.
Some moms find breastfeeding easier and quicker than
formula-feeding; it needs no preparation, and you don't run out
of breast milk in the middle of the night. Also, breastfeeding
costs little. Nursing mothers do need to eat more and may want to
buy nursing bras and pads, a breast pump, or other equipment. But
these expenses are generally less than the cost of formula.
Breastfeeding meets a variety of emotional needs for both moms
and babies - the skin-to-skin contact can enhance the emotional
connection, and providing complete nourishment can help a new
mother feel confident in her ability to care for her newborn.
Formula-feeding Advantages
Commercially prepared infant formula is a nutritious alternative
to breast milk. Bottle-feeding can offer more freedom and
flexibility for the mother, and it makes it easier to know how much
the baby is getting.
Because babies digest formula more slowly than breast milk, a
baby who is getting formula may need fewer feedings than one who
breastfeeds. Formula-feeding also can make it easier to feed the
baby in public, and allows the father and other family members to
help feed the baby, which can enhance bonding.
Considering the Limitations
Breastfeeding
With all the good things known about breastfeeding, why
doesn't every mother choose to breastfeed?
Breastfeeding requires a substantial commitment from a mother.
Some mothers feel tied down by the constant demands of a nursing
newborn. Since breast milk is easily digested, breastfed babies
tend to eat more often than babies who are fed formula. This means
mom may find herself in demand as frequently as every 2 or 3 hours
in the first few weeks. This can be tiring, but it's not long
before babies feed less frequently and sleep longer at night.
Some new mothers need to get back to work outside the home or
separate from their babies from time to time for other reasons.
Some of these moms opt for formula-feeding so other caregivers can
give the baby a bottle. Mothers who want to continue breastfeeding
can use a breast pump to collect breast milk to be given in a
bottle so their babies still get its benefits even when mom
isn't available to breastfeed.
Other family members (dads most of all) may want to share in
this most fundamental of baby care routines and participate in
feeding the baby. When mom is breastfeeding, dad or siblings may
want to stay close by. Helping mom get comfortable, or providing a
burp cloth when needed, will let them be part of the experience.
Once breastfeeding is established, other family members can help
out by giving the baby pumped breast milk in a bottle when mom
needs a break.
Sometimes a woman may feel embarrassed or apprehensive about the
prospect of breastfeeding. These feelings usually disappear once a
successful breastfeeding process is set. It's often helpful to
seek advice and perspective from those who've gone through the
experience. Most hospitals and birthing centers can provide
in-depth instruction on breastfeeding techniques to new mothers.
Your pediatrician, nurse practitioner, or nurse can answer
questions or put you in touch with a lactation consultant or a
breastfeeding support group.
In some cases, a mother's health may interfere with her
ability to breastfeed. For example, mothers undergoing chemotherapy
for cancer and moms who are infected with human immunodeficiency
virus (HIV, the virus that causes AIDS) should not breastfeed. If
you have a medical condition or take any medications regularly, or
if you or your baby get sick, talk with your doctor about whether
it's OK to breastfeed. If you have to stop nursing temporarily,
it's important to continue to pump breast milk to maintain milk
production.
In some situations, it may not possible to breastfeed, such as
when a baby is sick or born prematurely. Mothers should speak with
their baby's doctor about expressing and storing milk. Even if
the infant cannot breastfeed, breast milk may be given via a
feeding tube or bottle.
Sometimes mothers who have inverted nipples may have difficulty
breastfeeding, but with the help of a lactation consultant this
usually can be overcome. Likewise, women who have had plastic
surgery on their breasts should be able to successfully breastfeed.
Be sure to speak to your doctor if you have any concerns.
Avoid using pacifiers or bottles until after the first month of
life. Introducing them before breastfeeding is known to cause
"nipple confusion," and can lead to an infant giving up
the breast.
Formula-feeding
Just as breastfeeding has its unique demands, so does
bottle-feeding. Bottle-feeding can require a great deal of
organization and preparation, especially if you want to take your
baby out. Also, formula costs can be considerable.
It's important to make sure that you have enough formula on
hand, and bottles that are clean and ready to be used. Here are a
few key guidelines for formula feeding:
- Be sure to carefully follow directions on the label when
preparing formula.
- Bottles left out of the refrigerator longer than 1 hour and
any formula left in the bottle that a baby doesn't finish
should be discarded.
- Prepared bottles of formula should be stored in the
refrigerator for no longer than 24 hours and should be carefully
warmed just before feeding.
- A bottle of formula (or breast milk) should not be warmed in
a microwave. The bottle can heat unevenly and leave "hot
spots" that can burn a baby's mouth.
Is My Newborn Getting Enough to Eat?
Your newborn should be nursing eight to 12 times per day during
about the first month. In the beginning, mothers may want to try
nursing 10 to 15 minutes on each breast, then vary the time as
necessary.
Once your milk supply is established, breastfeeding should be
"on demand" (when your baby is hungry), which is
generally every 1 to 3 hours. As newborns get older, they'll
need to nurse less frequently - some may feed every hour and a
half, whereas others may go 2 or 3 hours between feedings. For
babies who are getting formula, they'll likely take about 2 to
3 ounces every 2 to 4 hours. Newborns should not go more than about
4 hours without feeding.
Call your baby's doctor if you need to awaken your newborn
frequently or continually urge your baby to suck.
Most experts suggest you nurse or feed your baby whenever he or
she seems hungry. Signs that babies are hungry include:
- moving their heads from side to side
- opening their mouths
- sticking out their tongues
- placing their hands and fists to their mouths
- puckering their lips as if to suck
- nuzzling again their mothers' breasts
- showing the rooting reflex (when a baby moves its mouth in
the direction of something that's stroking or touching its
cheek)
A rigid feeding schedule is not necessary; you and your baby
will eventually establish your unique feeding pattern. Babies know
(and will let their parents know) when they're hungry and when
they've had enough. Watch for signs that your baby is full
(slow, uninterested sucking; turning away from the breast or
bottle) and stop the feeding once these signs appear.
As babies gain weight, they begin to eat more at each feeding
and go longer between feedings. There may be other times when your
infant seems hungrier than usual. Continue to nurse or feed on
demand. Nursing mothers need not worry - breastfeeding stimulates
milk production and your supply of breast milk will automatically
adjust to your baby's demand for it.
New mothers, especially breastfeeding moms, are often concerned
that their infants may not be getting enough to eat. It's
important for breastfed infants to be seen by their pediatrician 48
to 72 hours after a mother and newborn leave the hospital. During
this visit, the baby will be weighed and examined, and the
mother's breastfeeding technique can be evaluated. It's
also an opportunity for nursing mothers to ask questions. If a
breastfed baby is doing well, the doctor will probably schedule
another visit for around 2 weeks of age. Formula-fed babies are
usually checked between 2 and 4 weeks of age, unless parents have
specific concerns.
You can be assured that your baby is getting enough to eat if he
or she seems satisfied, produces about four to six wet diapers a
day, has regular bowel movements, sleeps well, is alert when awake,
and is gaining weight. A baby who is fussing, crying, seems hungry,
and does not appear satisfied after feeding may not be getting
enough to eat. If you're concerned that your baby isn't
getting enough to eat, call your doctor.
Many infants "spit up" a small amount after eating or
during burping, but a baby should not vomit after feeding. This can
be due to overfeeding, but vomiting after every feeding may be a
sign of an allergy, digestive problem, or other problem that needs
medical attention. If you have concerns that your baby is spitting
up too much, call your doctor.
Although your baby will probably start on some solid foods
between 4 and 6 months, breast milk or formula will remain the most
important source of nutrition through the first year of life.
Nutritional Supplements
Breast milk contains the right combination of vitamins and
easily absorbed iron that will be sufficient until your baby begins
eating iron-rich cereals around 6 months of age. A healthy infant
being nursed by a healthy mother does not need any additional
vitamins or nutritional supplements, with the exception of vitamin
D. Breast milk does contain some vitamin D, and vitamin D is
produced by the body when the skin is exposed to sunlight. However,
sun exposure increases the risk of skin damage, so parents are
advised to minimize exposure. The AAP recommends that all breastfed
babies begin receiving vitamin D supplements during the first 2
months and continuing until the infant consumes enough vitamin
D-fortified formula or milk (after 1 year of age).
Formula contains the right blend of vitamins, including vitamin
D, for a baby, so supplements are usually not necessary.
Iron-fortified formula is recommended for a baby's first year
and should contain up to 12 milligrams of iron per liter.
Water, juice, and other foods are usually unnecessary during a
baby's first 6 months. Breast milk or formula provides
everything babies need nutritionally until they start eating solid
foods. Talk to your doctor if you have any questions about feeding
your newborn.
Reviewed by:
Steven Dowshen, MD
Date reviewed: August 2008
Note: All information is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
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