When it comes to infants and children, basic nutrition choices have a lifetime impact on overall health and are key for satisfactory growth and avoidance of deficiency states. Adequate nutrition helps in the prevention of acute and chronic illnesses; maximizes physical and mental potential and provides reserves for stress. During infancy, it’s all about milk, whether breast milk, formula or a combination of the two. Breast milk and formulas contain enough nutrients needed by babies in the first year of life. Around 4 -6 months of age, most babies can start consuming solid foods like iron-fortified cereal, mashed fruits and vegetables, and pureed meats. As you introduce more foods, keep in mind that a healthy amount of fat is important for the babies’ brain and nerve developments – unless advised by your doctor for particular health reasons, low-fat options can be avoided.
The feeling of ease between infant and mother is essential to successful infant feeding. When mom can establish a comfortable, satisfying feeding practice, the result is usually emotional well-being of both the mother and infant. Remember that mom’s feelings are readily transmitted to the baby and greatly influence the emotional setting in which feeding takes place. Hence, a tense, anxious, and emotionally labile mother is more likely to develop a difficult feeding relationship with her baby. It’s helpful if she receives appropriate guidance and support from an empathetic family member, friend or physician.
Immediately after birth, the infant can safely tolerate feedings to ensure a smooth transition from fetal to extrauterine life, to promote maternal- infant bonding and prevent hypoglycemia and electrolyte imbalances. It is critical that your infant receives enough fluids so he will not develop dehydration. Moms who wish to initiate breastfeeding in the delivery room are definitely encouraged to do so. Subsequent feedings either by breastfeeding or bottle feeding are given every 3-4 hours a day and at night. That’s a lot of eating! This is based on the time it takes for the infant’s stomach to empty and varies from 1-4 hours. Do not expect your baby’s feeding schedule to be consistent immediately after birth. However, by the end of the first month, 90% of babies will establish a more regular feeding schedule. Majority of healthy formula-fed infants will want 6-9 feedings per day by the end of the first week of life. Some babies are satisfied with every four hour feedings, while others who have a faster gastric emptying time will want to eat every 2-3 hours. Interestingly, most breast-fed babies get hungry quicker and require more frequent feedings with shorter intervals. This just reinforces the fact that individual feeding needs vary and one infants’ feeding would not be expected to fit the pattern of another. The best parameter of successful infant feeding is weight gain by the time the baby reaches the second week of life.
Infants cry for various reasons and babies do not need to be fed every time they cry. Usually, sick babies are not interested in feeding and if an infant refuses food, this should act as a red flag to see your pediatrician. If your baby is constantly waking up every 1-2 hours, he may not be receiving enough milk at each feeding or be suffering from infantile colic. This can be addressed during your doctor’s visit and may involve discussions about formula choice and feeding practices. It is important to know that babies cry for reasons other than hunger. Some may just need to be picked up and held, others may continue to cry even after feeding so it’s important to carefully evaluate your infant’s health and behavior for other potential causes of distress. Try to discourage the habit of frequent small feedings, holding and feeding to pacify crying as he may become too reliant on you to calm him.
The post-partum period is oftentimes a period of much anxiety and insecurity for first-time parents who may be overwhelmed by the responsibilities that comes with having a new baby. The questions are endless: Am I feeding her enough? Is she having diarrhea? Should I switch formulas? The list goes on and on. This is why anticipatory guidance sessions should be scheduled between you and your pediatrician. During each office visit, your doctor is already tracking your baby’s weight gain and monitoring whether her weight is steadily increasing. Normally, babies in the first four months of life gain 1 ½ lbs-2 lbs per month and grow 1-1 ½ inches. By the time he is a year old, he would have tripled his birth weight. Breastfed babies also tend to be chubbier than formula-fed babies in the early months of life however they become leaner by nine months to one year of age.
Parents need to understand the goal of infant’s “self- regulation.” Once the infant establishes a regular feeding schedule, other family members are able to resume their normal daily routine with minimal disruptions. It doesn’t take long to achieve the confidence and calm of an experienced parent. Your baby will give you enough signals and clues as to how she likes to be treated, talked to, held and comforted. This very special bond, once established will guide you through this challenging stage and the next.
All information contained in this blog and on our web site(s) should be independently verified by you by a medical professional of your own choosing and you should always conduct your own research and due diligence before making any decision related to the subject matter of this blog or our web site.
Dr. Pearl Cenon
A pediatrician in private practice in New Jersey for over 15 years, Dr. Cenon (we like to call her Dr. Pearl) also has two children of her own. Dr. Pearl’s husband, Kevin McDonough is also a pediatrician and they work together. She writes basic posts about topics that interest many parents, from skin care and nutrition to seasonal issues, such as allergies and colds. Her kind, approachable tone in each blog post will have you looking forward to the next one.