What to Feed

Breast milk is the best food for babies during the first year of life.  The American Academy of Pediatrics encourages breastfeeding until one year of age.  If one year seems excessive, pick an alternative goal that is more realistic for you, such as six months.  Breast milk provides just the right balance and amount of nutrients that babies need for good growth and development.  It also contains substances that help protect babies from certain illnesses and maybe even allergies and asthma.  If you choose not to breastfeed, cannot breastfeed, or if you stop nursing before your baby’s first birthday, infant formula provides an excellent alternative to breast milk.  Do not worry or feel guilty if you need to use formula.  Many of the Blue Fish doctors were exclusively formula-fed infants and we are not all that weird! (In our opinion ☺)

What not to Feed

The American Academy of Pediatrics advises that babies drink breast milk or formula until their first birthday.  Whole cow’s milk should not be given until one year of age and reduced fat cow’s milk is not recommended until after the second birthday.  Cow’s milk does not supply the balanced nutrition your baby needs and it can be hard on your baby’s sensitive digestive system.

Breast milk and formula normally provide all the water your baby needs.  Additional water or juice is not necessary and could prove harmful due to the immaturity of your newborn baby’s kidneys.  A baby who is urinating at least six times per twenty-four hours is not in need of additional fluids.  If you decide to feed your baby water or juice, limit the total amount to 4 ounces per day (a safe time to start is between four and eight months of age).

The American Academy of Pediatrics recommends that no solid foods (e.g. rice cereal) be given before four months of age.  Many parents are eager for the day their baby begins to take solid foods.  There are several reasons to wait until at least four months.  If solids are introduced too early, the risk of food allergies and maybe even type two diabetes could be increased (however, studies are limited regarding this fact).  The extra calories may also make your baby too fat.  Most babies are not able to swallow foods well during the first few months of life posing a choking hazard.  In addition, from a nutritional standpoint, solid foods are not necessary during the first four to six months of life.  Breast milk and formula provide all the nutrients a baby needs.

When to Feed

Feed your baby when they are hungry.  This plan sounds simple, but there is little more to it than that. There is a tension in our culture concerning feeding on demand versus feeding on a schedule.  It is generally more practical to feed on a schedule, filling your baby with each feed and allowing for play and sleep time (for mom as well as baby) in between feeds.  However, it must be emphasized that many babies cannot easily be put on a schedule in the first few months of life.  Milk supply constraints and baby feeding abilities sometime require a feed on demand style.  Almost all babies will adopt a schedule eventually.

It is generally thought that almost all babies respond well to feeding on demand, particularly in the first few weeks of life.  However, this approach can become quite a drain on mom and quite a strain on her nipples as babies tend to “demand” feed quite often.  Some moms cannot tolerate feeding on demand.  Both methods have their advantages and disadvantages, so discuss and explore each option to determine which is best for you and your baby.  During the day, you can aim to have your baby eat every three hours even if this means waking your baby up to feed.  (For the first one to two months, your child might require more frequent feeds).  During the night, do not wake a sleeping baby to feed.  The child will awaken on their own when they are hungry.  Babies should be trained to sleep at night and to feed during the day (despite their tendency sometimes to do just the opposite).  In general, babies are very reliable at asking for as many calories as they need to grow.  Do not worry that you are not giving enough food, as long as your baby is awakening to feed, having good wet diapers, and being satisfied for 2-3 hours after each feed.

Your new baby may cry as often as every hour.  However, keep in mind that babies don’t need to be fed every time they cry (unless they are truly hungry).  Instead, your baby may be protesting that their diaper is wet or that they need a nap (sleep is discussed later in this booklet).  Before you offer the breast or bottle, be sure your baby is not crying for some reason other than hunger.  If you see a pattern of hunger soon after feeds, encourage your baby to eat more each time you feed them (Supplementing Feeds is discussed under Decreasing Milk Supply).  In addition, you might try to buy a little more time between feeds using a pacifier as a distraction.  Babies have a “non-nutritive” sucking need that is very soothing for them. Often times they act hungry ~ 1 hour after feeds, but may just have the need to suck – so offer a pacifier at that time.  If breastfeeding has been well established for >2 weeks, you do not have to worry about nipple confusion.  When your child cannot be distracted anymore, they will be hungry enough to eat more than before.  Usually, the more a baby takes during a feed, the more time they will be content between feeds.  It is best not to get into the habit of offering frequent small feedings to please a fussy baby.  The offerings might encourage a pattern of frequent, unpredictable snacks instead of filling feeds that fully satisfy your baby and move them closer to a more practical schedule. These too-frequent feedings may also lead to partial naps where your baby wakes up hungry and then develops a pattern of snack-nap-snack-nap instead of finishing a meal and completing a good nap (at least > 45 minutes).

Babies differ in their feeding needs and preferences, but by one month, most breast-fed babies will feed every two to three hours, nursing ten to twenty minutes on each breast.  Formula-fed babies will usually feed every three to four hours and finish a bottle in thirty minutes or less.  Bottle-fed infants drink about one and a half to three ounces at first.  By the time they’re a month old, a baby’s formula consumption can double.  Between birth and one month of age, gradually move toward these goals.  Some babies will come home and fall into an every three hour schedule almost right away.  However, most babies will need a good bit of parenting when it comes to simplifying the feeding process.

How Much to Feed

How can you tell whether your baby is getting enough breast milk or formula?  The best confirmation of good nourishment is good growth.  When your baby comes in for a check-up, we will weigh and measure them.  Also, please feel free to call the office and ask for a weight check on our scales if you need confirmation of your baby’s growth.  The following chart approximates how much each child needs to feed (remember these are just estimates!).  Rely on your baby’s cues more than the chart.

Your baby may be eating too much if you notice large amounts of spitting up or fussiness after feeds.  Usually a baby will stop eating when they are full, but sometimes they will eat a little more than they should.  Try smaller volumes more frequently if you suspect over-feeding.

Age # of Feedings Breastfeeding Formula Total 24 hr minimum
1st week 8 – 12 15 – 45 minutes 1 ½ – 3 oz. 10 – 14 oz.
1 month 5 – 8 15 – 30 minutes 2 – 3 oz. 18 – 22 oz.
2 month 5 – 8 15 – 30 minutes 3 – 4 oz. 20 – 28 oz.
3 month 5 – 6 15 – 30 minutes 4 – 6 oz. 25 – 35 oz.
4 month 5 – 6 15 – 30 minutes 5 – 7 oz. 30 – 35 oz.

Signs of a well-fed baby:

  • Happy and satisfied after feedings
  • Wets six or more diapers daily (after five days of age)
  • Sleeps well between feedings
  • Gains weight of ½ – 1 ounce per day

Most newborns weigh between five and ten pounds. The average is about seven and a half pounds. During the first days of life, infants generally lose four to ten ounces of weight. Breast-fed babies may lose a little more. This weight loss is no cause for concern. It is all part of the baby’s adjustment to the outside world. Most of the weight loss is water, and by fourteen days of age, most babies gain back what they have lost. Healthy, well-fed babies generally double their weight by four to five months of age and triple their weight by one year.