Newborn - Feeding

We strongly encourage you to breasted your baby. Breastfeeding provides the best nutrition for your baby along with valuable antibodies that protect your baby from infections. For some women, breast feeding is a very smooth and easy experience, but it may not be for others, especially in those initial 2 weeks after birth. We have two experienced lactation educators in our office who can provide advice and consultations in the office or over the phone if you have any questions after you are discharged from the hospital.

Breast milk does not come in fully until 3-7 days after delivery. In the meantime, your baby will be receiving colostrum and we recommend nursing your baby every 2-3 hours. This will also stimulate milk production. Most babies will nurse for about 10-15 minutes on each breast, but this can vary from baby to baby. Some babies are very efficient and some babies are slow nursers. Some babies also take only one side at a time, or have feeding clusters oat specific times of the day when they are nursing frequently. It is a good idea to burp your baby after feedings to help relieve gas and eliminate discomfort.

After your milk is in, we know that you baby is getting enough if we see 6-8 wet diapers/day and of the baby seems content between feedings. We may recommend supplementation with formula in the first days of life if the baby appears dehydrated or is not gaining weight. Many babies can then transition to exclusive breast feeding. There are also many babies who receive a combination of formula and breast milk throughout the first year of life.

Women can generally eat whatever they wish while they are nursing. Babies can occasionally become more fussy or gassy after a mother has eaten certain foods. If you notice a continuous pattern, it may be useful to eliminate that particular food from your diet. Medications such as Tylenol and Motrin are safe for breast feeding mothers, as are many over the counter cough and cold preparations. Please call our office if you have questions about a certain medicine.

Many babies will "spit up" or regurgitate some milk through the mouth and/or nose after feeding. It may happen after burping your baby or even several hours after a feeding/. If you baby does not appear uncomfortable and is gaining weight well, no specific treatment is necessary. We occasionally see babies who spit up large amounts of fluid or seem excessively gassy or irritable during or after feedings. This may be a sign of milk intolerance or gastroesophageal reflux. We can discuss these issues with you in the office as the need arises.

Formula Feeding

Iron-fortified formulas are an acceptable alternative to breast feeding. Formulas can be divided into several categories:

• Cows milk-based formulas - Similac Advance, Enfamil Lipil
• Cows milk protein, lactose-free formulas - Lactofree
• Soy protein formulas - Prosobee or Isomil
• Protein Hydrolysate formulas - Neutramigin, Alimentum, Carnation Good Start

The choice of formula should be made before leaving the hospital. In the newborn period, most babies will drink anywhere from 1/2 ounce to 2 ounces every 3-4 ours. Formula is not digested as quickly as breast milk, so the stooling frequency can vary from several times a day to one stool every 4-6 days.

Formula comes in several forms: powder, concentrate, and ready to feed. Regular tap water can be used to prepare formula from powder and concentrate. Once prepared, formula may be kept in the refrigerator up to 48 hours. We recommend heating bottles of formula by immersion in warm-hot water. Microwave heating can cause uneven heating and lead to burns. Bottles and nipples can be washed with hot soapy water by hand or through the dishwasher. There are many different types of bottles and nipples on the market. Sometimes it is necessary to try different nipples until your find the one that your baby likes.

We would be happy to discuss any issues regarding possible formula intolerance in the office.

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