Infant Feeding By: Claire Tran and Kenimer Highsmith for CTAE Resource Network Timeline for Feeding • • • • 0-3 months – The baby should be eating breast milk at least 8 times a day or 18-40 ounces of iron fortified formula a day. 4-5 months – The baby should be eating breast milk every 2-4 hours or 24-45 ounces of iron fortified formula. Your baby may also need 1-4 Tbsp. of dry cereal mixed with breast milk or formula. You can tell if your baby is ready for cereal if she's between 4-6 months old, holds her head up, can sit with support, acts interested in foods you're eating, doesn't push food out with her tongue, and can give you satiety cues. 6-8 months – The baby should be eating breast milk at least 5 times a day or 24-37 ounces of iron fortified formula a day. Also included in their diet should be iron fortified infant cereal, fruit juices, vegetables and fruits, and small servings of finger foods. 9-12 months – The baby should be eating breast milk at least 4 times a day or 24-31 ounces of iron fortified infant formula. The baby should also experience a number of other foods such as: iron fortified infant cereal, fruit juices, vegetables and fruits, finger foods, legumes, egg yolks, meat, dairy foods. Foods Not Allowed • • • • • • • • • • Low iron formulas Enzymes, herbs, spices, or botanicals Oral dehydration fluids or electrolyte solutions Flavoring or thickening agents Sports or breakfast drinks Infant cereal with added infant formula, milk, fruit, or other noncereal ingredients Peanuts Fruit-nut mixtures Sodas, salt, sugar, honey, fish, raw eggs. Goats' and sheep's milk (under a year old) How to Feed a Baby • Hold the baby close while feeding. • Hold the baby's head higher than the body keeping it supported, to make swallowing easier. • Hold the bottle so that most of the artificial nipple is in your baby's mouth and the formula fills the nipple. This will prevent the baby from swallowing air. • The baby will not be able to support the bottle alone during the first year. • Let the baby set the pace. Do not rush feeding. • Burp the baby after each feeding. If the baby has a lot of gas, burp halfway through the feeding. • Never prop the bottle in baby's mouth. This could cause choking or tooth decay. Weaning • The process of gradually introducing infants to an adult diet and withdrawing the supply of their mother's milk. • Weaning should start when the baby is 6 months old. • Never put solids food in the baby's bottle. • The first recommended solid food is fortified rice cereal. • Infant rice cereal is easy to digest and unlikely to trigger an allergic reaction. • Introduce fruits after the baby gets used to vegetables. • At 10-12 months, the baby's diet will begin to resemble that of the rest of the family’s, with 3 meals and 2 snacks a day along with 3-4 feedings of breast milk or formula. Breast Milk • Colostrum: thin, watery and yellowish fluid that contains antibiotics. • Nutrients: – Vitamins and minerals: calcium, iron, phosphorous – High quality protein – High quality fatty acids: linoleic and linolenic – Hormones and enzymes Advantages of Breastfeeding – Antibodies passed from a nursing mother to her baby can help lower the occurrence of many conditions such as infections and allergies. – Breast milk is easily digested by a newborn's immature system. – Breast milk also naturally contains many of the vitamins and minerals that a newborn requires. – Free – Convenient – May help prevent obesity. – Lowers the risk of breast cancer, high blood pressure, diabetes, cardiovascular disease, and may also decrease the risk of uterine and ovarian cancer. Disadvantages of Breastfeeding – Breastfed babies need to eat more often. – Requires a substantial time commitment from mothers. – Women who are breastfeeding need to be careful about what they eat and drink, since things can be passed to the baby through the breast milk. – Medical conditions such as HIV or AIDS or those that involve chemotherapy or treatment with certain medications may make breastfeeding unsafe. How to Breastfeed – Position the baby on her side so she is directly facing you, with her belly touching yours. Next, prop up the baby with a pillow if necessary, and hold her up to your breast; don't lean over toward her. – Place your thumb and fingers around your areola. – Tilt your baby's head back slightly and tickle her lips with your nipple until she opens her mouth wide. – Help her "scoop" the breast into her mouth by placing her lower jaw on first, well below the nipple. – Tilt her head forward, placing her upper jaw deeply on the breast. Make sure she takes the entire nipple and at least 1 1/2 inches of the areola in her mouth. Formula Types • Different types of formulas: – Regular iron fortified infant formulas are made with lactose and cow's milk based proteins. Most infants who are not breastfeeding exclusively should be given a cow's milk based iron fortified formula. • Examples: Similac Advance, Enfamil Lipil, and Nestle Good Start Supreme – Soy formulas are made with soy protein and are lactose free. They are good for children who don't tolerate lactose or milk proteins. • Examples: Enfamil ProSobee, Similac Isomil, and Nestle Good Start Supreme Soy – Elemental formulas are also lactose free and are made with hydrolysate proteins which are easy to digest for infants with protein allergies. • Examples: Nutramigen, Pregestamil and Alimentum. Why not low-iron: – The infant suffers an increased risk of iron deficiency anemia. Anemia, or reduction of oxygen-transporting red blood cells, reduces the delivery of oxygen to the developing infant, especially the brain and nervous system. Iron-deficiency anemia is associated with problems in cognitive, behavioral, and physical development in infants and children. Advantages and Disadvantages of Formula Advantages: – Commercially prepared infant formulas are a nutritious alternative to breast milk, and contain some vitamins and nutrients that are not found in breast milk. – Allows the mother to share the feeding duties and helps her partner to feel more involved in the crucial feeding process and the bonding that often comes with it. – Women who opt for formula don't have to worry about what they eat or drink and how it could affect their babies. Disadvantages: – Lack of antibodies – Formula can be costly – Possibility of producing gas and constipation How to Mix Formula 1) Pour the desired amount of water into a bottle. Only use purified, distilled water. 2) Add unpacked, level scoops of powder to the water in the bottle; 1 scoop for every 2 ounces of water 3) Place a finger over the nipple of the bottle and shake it until all the powder has dissolved. Nursing Bottle Syndrome • Caused when children, generally under the age of 3, are put to bed with a baby bottle filled with fruit juice or sweetened milk. • The result is severe decay of the front top teeth.