Feeding your newborn: Tips for new parents

A newborn's feeding schedule can be unpredictable. Here's what, when and how to feed your
baby.

By Mayo Clinic Staf

Feeding a newborn is a round-the-clock commitment. It's also an opportunity to begin forming

a bond with the newest member of your family. Consider these tips for feeding a newborn.

1. Stick with breast milk or formula

Breast milk is the ideal food for babies with rare exceptions. If breast-feeding isn't possible,
use infant formula. Healthy newborns don't need water, juice or other fluids.

2. Feed your newborn on demand

Most newborns need eight to 12 feedings a day about one feeding every two to three hours.

Look for early signs of hunger, such as stirring and stretching, sucking motions and lip
movements. Fussing and crying are later cues. The sooner you begin each feeding, the less likely
you'll need to soothe a frantic baby.

When your baby stops sucking, closes his or her mouth, or turns away from the nipple or bottle,
he or she might be full or simply taking a break. Try burping your baby or waiting a minute
before ofering your breast or the bottle again.

As your baby gets older, he or she will take in more milk in less time at each feeding.

3. Consider vitamin D supplements

Ask your baby's doctor about vitamin D supplements for the baby, especially if you're breast-
feeding. Breast milk might not provide enough vitamin D, which helps your baby absorb calcium
and phosphorus nutrients necessary for strong bones.

4. Expect variations in your newborn's eating patterns

Your newborn won't necessarily eat the same amount every day. During growth spurts often
at two to three weeks after birth and again at six weeks after birth your newborn might take
more at each feeding or want to be fed more often. Respond to early signs of hunger, rather
than keeping a strict eye on the clock.

5. Trust your instincts and your newborn's

You might worry that your newborn isn't eating enough, but babies usually know just how much
they need. Don't focus on how much, how often or how regularly your newborn eats. Instead,
look for:

Steady weight gain

Contentment between feedings

By the fifth day after birth, at least six wet diapers and three or more bowel movements a day

Contact the doctor if your newborn isn't gaining weight, wets fewer than six diapers a day or
shows little interest in feedings.

6. Consider each feeding a time to bond with your newborn

Hold your newborn close during each feeding. Look him or her in the eye. Speak with a gentle
voice. Use each feeding as an opportunity to build your newborn's sense of security, trust and
comfort.
7. Know when to ask for help

If you're having trouble breast-feeding, ask a lactation consultant or your baby's doctor for help
especially if every feeding is painful or your baby isn't gaining weight. If you haven't worked
with a lactation consultant, ask your baby's doctor for a referral or check with the obstetrics
department at a local hospital.

Should I Try to Breastfeed?

Breastfeeding is a natural process, so you might feel that it should come easily. The truth is, it
takes practice for both Mom and Baby. "It really is something that Mom and Baby both have to
learn. It gets simple, but it's a new experience," says Alan Greene, M.D., pediatrician and author
of Feeding Baby Green. But the work is worth it. Not only does breastfeeding secure a strong
bond between parent and child, breast milk has the perfect combination of nutrients your baby
needs to grow to be strong and healthy -- such as antioxidants to build the immune system --
and breast milk is easier for Baby to digest. It also benefits the mother by burning calories,
shrinking down the uterus, and reducing the risk of ovarian and breast cancer, according to the
American Academy of Pediatrics (AAP).

Is There a Right Way to Breastfeed?

Like many other aspects of pregnancy, birth, and child rearing, everyone is diferent. The first
step is to get comfortable -- the more relaxed you are the better. La Leche League International
also recommends to position Baby so his mouth and nose face the nipple and that you support
your breast to avoid pressing it into Baby's chin. Once Baby has latched on successfully, there
are several common positions for nursing that you can experiment with to see what makes the
best fit for you.

How Do I Know I Have a Good Latch?

The key to successful breastfeeding is the latch, which means getting Baby's mouth positioned
over the nipple. Remember, you're not the only one who is new to this. It's also your baby's first
time having to latch to get food. It takes practice and efort from both of you to get it down
smoothly.

Babies are born with a rooting reflex, which means that they instinctively know how to suck.
When you are ready to nurse, touch your nipple or finger along Baby's check, and notice how
your baby will automatically turn his face toward the sensation and open his mouth. The baby's
nose and chin should lightly touch the breast.

When Baby's mouth is open, draw him to your breast. (Bring your baby to the breast, not the
breast to baby.)

You should see little or no areola, which is the pigmented skin around the nipple.

It is normal for the breasts to be tender, but with proper latching you should not be
experiencing shooting pains or pinching. If it hurts, you should seek the advice of a lactation
consultation.

Cross-Cradle Position

The cross-cradle position is great for newborns who need the most support.

How to do it: Get in a comfortable chair and securely hold your baby crosswise with the arm
opposite from the breast you are nursing with. If nursing from your right breast, hold your baby
with your left arm. Your forearm will support his body and your hand will support and steer his
head. With your right hand you can support your breast by placing your thumb above your
breast and your other fingers beneath.

Football Clutch

The clutch hold is particularly useful for women who have had Cesarean section, as the pressure
of the baby will not be on the abdomen. Women with large breasts or flat nipples also prefer
this hold.

How to do it: As the name suggests, you will be holding your baby at your side. Position a few
pillows next to you and hold your baby under your arm on the same side you will be nursing
from. He will be facing you with his legs pointing behind you, and the pillows will help bring his
mouth to nipple level. Support your baby's head with the palm of your hand.

Do I Need a Lactation Consultant?

Bertie Bregman, M.D., specializing in family practice in New York City, says, "Latching on is an
acquired skill. Lactation consultants are really great resources." Dr. Bergman recommends
moms work with lactation consultants early on. Most hospitals have lactation consultants on
staf or can refer an outside consultant to help answer questions after the baby is born and
assist with breastfeeding techniques. With knowledge of the basics of securing a proper latch,
nursing will become easier.

How Do I Know If I Have Sufficient Milk Supply?

Often new mothers think their milk supply is low and wonder if they are supplying enough milk
to Baby. As long as you monitor the number of wet and dirty diapers your pediatrician
recommends and your baby is gaining weight properly, you are likely supplying sufficient
amounts of breast milk. It's also important to be persistent and consistent to allow the baby's
sucking to signal the breast to make milk. "Most of the time, the most important thing is
patience. Most people expect that the baby should feel satisfied or full in the first three to four
days. It's normal for them to be hungry. It is how they regulate how much milk you are going to
make. Good rest and lots of fluids can help, but patience is the single most important thing," Dr.
Greene says.

Ouch! How Do I Relieve Breast Pain?

Engorgement is the swelling of the breasts caused by the expansion veins and the pressure of
the milk. Most moms experience this common discomfort three to six days after giving birth. Dr.
Greene recommends warm or cool compresses and showers. Using a breast pump a little after
feeding can take the edge of, as well. Dr. Greene also suggests refrigerating cabbage leafs,
breaking the spine and then placing them on the breasts. The leaves have antibiotic and anti-
irritant properties that help reduce swelling. Sore nipples result from the baby stretching breast
tissue. It often occurs because of a poor latch, so the very best thing to do is to go to a lactation
consultant early on. To get immediate relief, certified lactation consultant Gina Ciagne
recommends applying lanolin or gel pads on the nipples.

What If I Formula Feed?

Despite much efort, there are some moms who cannot breastfeed, must supplement
breastfeeding with formula, or simply choose to formula feed. "If the human milk isn't going to
be used, generally an iron-fortified infants formula based on cows milk should be used," Dr.
Greene says. Jodi Greebel, registered dietitian and cofounder of DinDins organic toddler food,
says, "All the major brands of formula and even the generic brands are excellent and held to a
very high standard." Talk to your pediatrician about choosing the best formula option for your
baby.

What Is BPA-Free & Do I Have to Use It?

If you're going to be using a bottle for breast milk or formula, be sure it's a bottle free of
Bisphenol A (or BPA). BPA is a chemical that mimics estrogen. Researchers have found even
small amounts are harmful to animals and people, especially babies. It has been found to cause
cancers, diabetes, and even early puberty. Dr. Greene suggests using BPA-free pumps, pacifiers,
and bottles.

First 24 hours: newborn feeding

Will my baby feed much on her first day?

Because her stomach is so tiny, only the size of a marble, your newborn will need to feed often.
You'll probably find your baby wants between eight and 15 feeds for the first one or two days.

Keep practising latching your baby on to your breast in the way your midwife has shown you.
Try diferent positions for feeding until you feel comfortable.

If breastfeeding seems tricky at first, there's no need to feel downhearted. Many new mums
take a while to get the hang of it. You and your baby will get better at breastfeeding with time.
Just remember to bring your baby to your breast, rather than the other way round. Your baby
needs a wide open mouth, called a gape, to take in a good mouthful of your breast.

Feed your baby as often as he seems to want it. Keep him close to you, snuggled against your
skin if possible. That way you will both get plenty of feeding practice. Try to feed your baby
before he starts yelling loudly for it! Your baby will find it hard to get a good mouthful of breast
if he is crying, because his tongue will be too far back in his mouth.

Soothe and calm your baby before trying to feed him in these early days. Never try to force him
on to your breast. If this seems a lot to take in, try not to worry. You and your baby will get to
know each other in the coming days and weeks. Keep your baby close to you, so you can start to
learn his cues. You'll probably find telling when your baby's hungry gets easier.
In these first few days, your baby may actually lose weight. This doesn't mean he's not getting
enough milk. Your baby should start to put on weight again by the time he's five days old.

If you're breastfeeding, your baby will gradually become more sleepy after a feed. Once he's
had enough colostrum, he'll be very relaxed and will come of your breast himself.

How should I breastfeed my newborn?

Choose a comfortable place to breastfeed your baby. Atmosphere and comfort are important,
especially in the early days of breastfeeding when you're still trying to get the hang of it.

Many mums find cradling their baby across their chest, raised up on a cushion or pillow, works
well. Spend some time working out what position is right for you, and try to relax and enjoy the
closeness with your baby.

Your baby's first feeds will probably take 40 minutes or longer. Your breasts will be producing
the thick, antibody-rich food called colostrum. After a few days your milk will come in, and your
baby will usually feed for between five minutes and 30 minutes.

Try not to worry if your baby doesn't spend long feeding. Some babies can take their fill in just a
few minutes, while for others it takes far longer. As long as your baby is latched on properly, she
should get all of the goodness she needs.

How should I bottlefeed my newborn?

Bottle-fed babies can't control their milk intake in the way that breastfed babies can. This means
they may take larger amounts of formula milk than a breastfed baby. When you're bottle-
feeding your baby, make eye contact and enjoy this extra opportunity to cuddle her.

Make sure you and your baby are comfortable for her feed. Position her on your lap so that
she's fairly upright, and support her head in line with her body. As you tip the bottle, try to keep
it horizontal so she isn't flooded with milk as she feeds. Aim the teat at the roof of your baby's
mouth to stimulate your baby's sucking reflex.

Look out for signs that your baby has had enough, such as slowing down or resting. These
pauses give your baby time to feel whether or not she's full. Your baby, whether she's breastfed
or formula-fed, won't need any extra fluids.