Sunday, February 10, 2019

How Much Should A Newborn Eat


One very practical question that many mothers ask is how much should a newborn eat when she brings her home from the hospital. Two particular ideas that exist as to the means of determining the time that should elapse between breastfeedings. At one extreme is the school that feels babies should be breastfed by the clock, that is, at carefully regulated intervals. Mothers who are insecure in their new role may like clock feedings because rigid guidelines are provided and they are not required to make decisions.

The second school that of demand feeding recommends breastfeeding whenever the infant wakens and demands to be fed. This latter philosophy, on the surface, might appear to be the more logical way of determining when to breastfeed the baby. To all inexperienced mother, however, this method may prove to be a little more complicated in practice than it sounds in theory, for she may be confused as to what a particular cry means. Does it mean that the baby is hungry and needs to eat, or does it merely indicate that the baby is uncomfortable and needs some assistance and reassurance?

Newborn breastfeeding schedule

how much should a newborn eatFor the average baby and mother, the simplest way of establishing how much breastmilk does a newborn need at each feeding would be to integrate the two schools of thought, using the demand feeding system combined with the clock technique. That is, encouraging the baby toward a somewhat systematic breastfeeding schedule, but allowing some variation according to the particular needs indicated by the crying of the baby. It certainly seems foolish to awaken a sleeping child when the clock says it is time for a meal, but on the other hand, it also is a bit ludicrous to breastfeed a baby who has just finished a meal an hour earlier. Therefore, a mother probably will be most comfortable with a baby if she encourages him toward a breastfeeding schedule of approximately four-hour intervals between feedings. However, premature or tiny babies will need to eat as often as every two or three hours for a few days.

In many instances, the baby will already be established on a time interval of four hours between feedings since this is the approximate breastfeeding schedule of most hospitals. Some babies, however, may need to be gradually encouraged in this direction. Most mothers of first babies find some comfort in an approximate newborn feeding schedule such as this, rather than using demand feeding entirely.

Establishment of a newborn feeding schedule is most easily accomplished by being certain that the baby has had an adequate meal at each feeding. This may mean, for some sleepyheads, that the mother might need to rouse the baby rather than putting him back in bed when he drowses off after consuming only an ounce or two of milk.

In general, it is unwise to get in the practice of giving more food soon after the baby finishes a meal. If a well-fed baby rouses after approximately one hour, it is much more likely to be a gas pain upsetting him than a hunger pain. Therefore breastfeeding is not appropriate at such a time and, after relief of a gas pain by burping, the baby probably will go back to sleep until close to the time for the next breastfeeding.

It is extremely wearing on both mother and baby if frequent breastfeedings become the pattern. Should this situation develop, mothers can gradually extend the time between feedings so that they begin to work back toward the desired breastfeeding schedule. A four-hour newborn feeding schedule (six feedings per day for the young infant) seems to work well for both breast- or bottle-fed babies. It permits the baby time to rest before it is time to commence the next feeding, and it also gives the mother time to do other jobs. Small infants probably will not be able to achieve a four-hour breastfeeding schedule until a weight of approximately eight pounds is reached.

As the baby matures, it will gradually be possible to eliminate the middle of the night feeding. This, from the parental viewpoint, is extremely desirable. One can work toward the routine on how much should a newborn eat by having good breastfeeding at approximately ten o'clock at night and then encouraging the baby at the usual middle of the night feeding to gradually wait just a little longer. With the average size baby, sleeping through_ the night will occur at three to six weeks of age. The baby that is smaller at birth will require a somewhat longer time to reach a weight that will enable him to go through the night without the usual two o'clock feeding.

Is my baby getting enough breast milk?

how much breastmilk should a baby need
Some babies never lose an ounce from the day they're born and put on weight with the greatest of ease. Most newborns drop some pounds during the first week but get back to birth weight by about three weeks of age. In rare instances, perfectly healthy babies take as long as six weeks to recoup their birth weight.

Is my newborn getting enough breast milk? The newborn baby is probably getting enough to eat if the baby nurses every two or three hours.

Checking the number of wet diapers is an easy way to determine whether your baby is getting enough breastmilk. If the baby has six to eight wet diapers a day, he is doing fine. (For this purpose, keep the baby in cloth diapers. It's easier to judge wetness with cloth, rather than disposable, diapers.)

From time to time, you and your doctor will weigh the baby as a way of measuring his physical progress. A pound (453 grams) a month, or four to seven ounces a week is an acceptable gain, although some babies add a pound or more a week. Remember—healthy, happy babies come in all shapes and sizes. Both the quite fat and the very slim baby can be normal and healthy. Neither bigness nor smallness is a reason for concern as long as the baby's food is breast milk and nursing care according to his needs. If you feed your baby in a way that is naturally intended for the human infant, his weight gain will be what is natural for your particular child.

Concerning baby's size and appetite, mothers who give birth to large babies and mothers who give birth to small babies have at least one thing in common: they can expect to have their ability to breastfeed the baby questioned.

How to determine if my baby is getting any breastmilk when nursing?

First be sure that your baby's mouth is positioned correctly over your nipple and areola. Her lips should be turned out on the breast, not in over her gums. She should have your nipple and most, if not all, of the areola in her mouth.

Next, watch the pattern of sucking. At first, the jaw moves very quickly, almost frantically for a few seconds, while she positions the nipple against the roof of her mouth. Then the sucking becomes rhythmical, and you will see and hear a suck, swallow, breathe sequence. This is "nutritive" sucking. Five to ten minutes of this type of sucking will give your baby all the milk needed at a feeding. Toward the end of a nursing, the sucking sequence changes to three or more jaw movements or sucks before swallowing. Some babies' mouths seem to quiver. This is sucking for satisfaction or contentment. It is okay to let baby do this if you do not have any nipple discomfort.

How do I get my baby to let go when he is finished nursing?

To break the suction that your baby has created on your breast, slip your finger into the corner of baby's mouth and between the gums. When the suction is released, or your baby starts sucking on your finger, you can gently withdraw your breast.

When should I baby nurse for the first time?

This will often have a lot to do with your hospital or birthing center's policy. Ideally, you should baby nurse as soon after delivery as possible. Your baby's sucking reflex is most vigorous immediately after delivery, and then it slows down for the next day or two. Nursing soon after birth can be helpful to stimulate milk flow. If that isn't possible, don't worry. Most new mothers baby nurse their newborn for the first time sometime within twenty-four hours after the birth.

How long should my baby nurse at a feeding?

A baby can empty a breast in five to ten minutes, but you should not let the clock decide the length of a feeding. Let baby decide when the meal is over. Sucking is his most pleasurable experience. Sometimes he will be starving and eager to eat and finish quickly. Other times he will be lazy and slow, taking far longer to baby nurse. Still other times, he may enjoy the sucking sensation so much that he will linger after sucking vigorously for a while. All of these patterns are normal, and all babies vary to some degree nursing to nursing. Once you have baby nursed for a short while, you'll be alert to these changing patterns in your baby.

Limiting of Nursing Times

A common precaution given to new mothers is to limit nursing in the first few days to three or five minutes on each side at each feeding and to work up to about ten minutes on the third or fourth day. More than one person may tell you not to let the baby nurse too long or too often for fear of getting sore nipples. Such advice does not take into account the fact that it may take two or three minutes for the milk to let down in any quantity, especially in the early days. Nursing for less than five minutes could mean that the feeding would end almost before it started. And once the milk is flowing, the slight soreness that may be felt subsides when the baby begins to nurse. Keep in mind that, in the beginning, nursing frequently—every two hours or so—is more comfortable on the nipples and at the same time stimulates the production of milk, a primary concern.

Such advice about the drastic limiting of nursing times should be put into perspective. Many nursing moms are never worried about sore nipples at all, no matter how often or how long the breastfeeding takes.  Soreness may never be a problem for you, particularly if you have followed the suggestions for nipple care during pregnancy.

If you do develop tender nipples, there are some tried and true remedies to prevent them from becoming worse and to ease the discomfort. Nipple soreness, like muscle soreness after a workout, is temporary. With continued exercise (or continued breastfeeding) it goes away. Limiting nursing may only prolong the conditioning period and the length of time that the nipples remain sore. It also depresses the milk supply. What an empty accomplishment it would be if a program of restricted nursing kept a mother's nipples from getting sore, but she was then left with insufficient milk for her baby.

Should I use both breasts every time I baby nurse at each feeding?

how much to feed a newborn
You should alternate the breast at which you begin each feeding. To keep track of the breast used first at the last feeding, some mothers put a small safety pin on that side of their bra. If you alternate the first breast used at each feeding, it doesn't matter if the baby nurses from both breasts. Let the newborn baby nurse at least five minutes on the 1st breast.

You can then slide her over to the other breast and let baby nurses as long as she likes. She will get the bulk of her nourishment from the first breast and contentment and extra sucking from the second. If you are nursing for the first time and your nipples are a little tender, using both breasts can help to keep one from getting too sore due to prolonged nursing. Using both breasts in the beginning also helps stimulate milk flow.

Why should you offer both breasts to the newborn baby?

While breastfeeding is being established, we recommend that you offer both breasts to the baby at each feeding. Nursing on one breast only could mean a four- to six-hour lapse before a breast is again baby nursed—too long a period in the beginning. The added stimulation of suckling baby on both breasts is a way of keeping pace with his increasing interest in nursing and his need for more milk. Besides, the breasts will not become painfully overfull, a condition that can develop quickly in the early days.

At each feeding, alternate starting sides. For instance, if at one feeding you start nursing on the right and then switch to the left, reverse the order for the next feeding. You'll be using the last used side first and the first, last. To help remember the starting order, mothers have come up with all kinds of ideas from fastening a small safety pin on the bra on the side used last to transferring a small ring from hand to hand. You'll soon figure out your method. If you do forget, your baby and your full breast will probably soon let you know—oops!—you've offered the "wrong" side. No harm is done if this happens from time to time; there's no need for you to worry about it.

How often should my baby be nursed in a day?

It is a fact that when a baby's tummy is filled often enough, and the mother's breasts are emptied regularly enough, most breastfeeding problems are avoided. But no timetable can tell you how often you should baby nurse. All babies are different, and each has his timetable for eating. Because breast milk is easily digested, most newborns need to be fed every two hours in the beginning. It may stretch out to three hours apart as the baby gets a little larger and his stomach can hold more, and you produce more milk. During the first few months, most babies nurse seven to ten times a day. Some baby nurses more while others get hungry less often. Such an increased need is an indication that the baby is lively and growing and is not a cause for worry. "Ad-lib nursing" can be very relaxing. You should not worry about putting the baby to the breast "too often."

Milk and Milk Composition

Breast milk is a continually changing food that adjusts to the age and needs of your baby. The composition of your breast milk is never constant. The amount of protein, fat, sugar (lactose), and other components changes. The milk you produce if your baby is delivered prematurely is different from milk you would produce after nine months of pregnancy. And that milk is different from the milk you will produce after a few months. Mothers make milk that is suited to the needs of their babies.

The first milk being produced by new mothers is the colostrum, which looks yellowish and creamy. Only a small amount of it is produced, but it is exactly what is needed, and you should not need to supplement with anything else. Colostrum is high in protein and helps your baby resist infection. It also acts as a laxative, helping babies pass the thick, green/ black meconium (the first stool). This is important in avoiding the development of jaundice.

In the first two or three clays, your milk will gradually change from colostrum to mature breast milk. This milk is thinner and sometimes slightly bluish, rather than the yellow color of colostrum. Some women become anxious that their milk is not thick enough now to satisfy their babies. But in fact, it is all your baby needs for the next six months; usually, no artificial formula, water, or juice is needed.

Your body does all of this work for you, and you do not have to think about it or decide what your baby needs. But it is essential to understand that how you feed your baby can affect the composition of the milk that your baby takes.

Getting the Balance Right

Milk composition also changes throughout every breastfeed. The milk your baby takes at the end of a feed is different from the milk at the beginning of a feed. As you start, she will get a lot of milk quickly. This milk (called the foremilk) is high in volume, low in fat. So although your baby gets a lot quickly, this milk is low in calories but high in protein and other good things to help her grow and resist infection.

As your baby feeds, the composition of your milk gradually changes. After the first few minutes, the amount of milk she gets slows down. You will see that her sucking also slows down, with longer pauses between periods of sucking.

As she sucks less frequently, she starts to get milk that is low in quantity and higher in calories; it is called the hindmilk. This is a progressive change that occurs throughout the feed. It is not related to the timing of the letdown.

It is essential that your baby get a good balance of both the foremilk and the hindmilk because this is the only way that the baby will be able to take in enough milk and enough calories.

Your baby is the only person who knows that she has had the right balance of foremilk and hindmilk.

Your baby understands her appetite, and she knows when she is full. To ensure that she gets a good balance, therefore, all you need to do is let her feed when she is hungry and let her stay on each breast until she has had enough and came off herself.

Allow your baby to take the first breast first, then offer her the second side.

When she comes off the first side, sit her up. Let her burp if she needs to. (This is usually easy for breastfed babies.) Then offer her the second side. She will often take the second breast, but sometimes she will have had enough with one.

Problems that might occur in getting the balance right:

• Not positioning your baby well at your breast will result in her often not feeding long enough to get to the hindmilk.

• Limiting feeding time could cause problems for babies. Stopping her from feeding as often as she needs, or taking her off the breast after a set period might result in her not getting enough milk or enough calories.

Don't Impose Rules


how often do newborns eat
There are no rules about the amount of time babies need to stay at the breast.

Some babies take all they need in four or five minutes; others need forty to fifty minutes. This changes over time with each baby too; they may take longer when very young than when they are older. And there are times when they increase their feeding time over a day or two to boost milk production. Like adults, who sometimes eat a small meal and sometimes a three-course dinner, your baby will sometimes feed for a short time, sometimes longer. Don't look at the clock to decide if she has had enough; look at your baby. Women breastfed long before clocks were invented.

Don't worry about trying to balance the foremilk and the hindmilk yourself. Your newborn will let you know what you need to know. The important thing is that you do not interfere with the balance by limiting the frequency or length of breastfeeds.

A tip: Sometimes you will need to interrupt a feed before your baby is finished. For example, you may need to answer the phone or get to the shops before they close. This is okay to do as long as you do not do it regularly. Every now and then is fine. It is essential to keep your life normal.

Here is a summary of what is important about milk and milk composition:

• Let your baby take a good balance of quantity and quality (foremilk and hindmilk). To do this, do not limit the number of times you feed or the length of each feed.

• Offer your newborn the second side if your baby finished taking the first breast. This is to see if she wants to take more.
Things to avoid are as follows:

• Do not give a fixed, small number of feeds in a day.

• Do not take your baby off either the first or second breast before she is finished.

• Do not let your baby feed if she is not well positioned.

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