Newborn Feeding: Breastfeeding Basics And Breastfeeding Tips

Newborns usually display strong reflexes for rooting and suckling, right after birth, showing their readiness for feeding. If the mother is breastfeeding, the baby is put to breast as early as possible, even within the first half hour after birth. If the baby is to be fed with formula milk, the first newborn feeding is usually given within the first four hours of life.

Mother’s milk is the ideal diet for the baby, and for the first six months, doctors usually advice feeding the baby exclusively on breast milk. However, there are situations in which breastfeeding is not recommended. Certain disease conditions in the mother as well as certain drugs taken by her may make breastfeeding risky. Babies can be brought up well on formula milk too.

While feeding on milk, babies tend to swallow some air too. Since they cannot bring up the air on their own, they should be helped to burp after every feed. Holding the baby in an upright position by supporting it on the parent’s chest and shoulder, and gently patting them on the back, usually helps in bringing up the gas in audible burps. Babies may bring up some milk along with the burps, but it is quite normal.

Breastfeeding Basics

Breast milk contains all the nourishment a baby needs for its growth and development in the first few months of life. The nutrients in the breast milk are easily digested and readily absorbed by the babies. It also contains antibodies produced in the mother’s body as well as white blood cells which would fight infections they may be exposed to. It has a protective effect against diarrhea of bacterial origin, as it promotes the growth of beneficial bacteria in the baby’s intestines. Consequently, breastfed babies have fewer infections, especially those related to the digestive system, when compared to their bottle-fed counterparts. They are also found to be less prone to allergies and auto immune problems such as Crohn’s disease, celiac sprue, as well as diabetes.

The advantages of breastfeeding include the benefits to the mother too. Faster recovery after delivery is a beneficial side effect of the hormone oxytocin produced when the baby suckles. This hormone triggers the contraction of the uterus, helping it to return to its pre-pregnancy size faster. Also, the mother and the baby develop a close bond through the process of breastfeeding.

There are certain long-term benefits too. The risk of developing breast and ovarian cancers is reduced in women who have breastfed their babies at least for the initial six months. Osteoporosis and obesity are also found to be less common in them. Currently, six out of every ten mothers in the United States choose to breast feed their babies. With the awareness of the benefits of breastfeeding spreading, more people are opting for this natural method of feeding the babies. Colostrum is a yellowish secretion produced in the breasts before the production of milk starts. This fluid is very rich in antibodies and proteins. Babies are greatly benefitted from colostrum as the mother’s antibodies contained in it protect them from many infections. Mothers who may have to return to work soon after delivery can breastfeed during the time they are at home. Breast-milk expressed and kept in sterile bottles in the refrigerator, can be fed to the baby when the mother is not at home. After about 2 months, vitamin D drops are given daily to breastfed babies to avoid deficiency diseases.

Breastfeeding Tips: Correct posture during breastfeeding is important. Mother should be relaxed physically, and mentally, while breastfeeding. Breastfeeding can be done in a comfortable sitting position or when lying down. The mother should hold the baby facing towards her and support the baby’s head in a slightly raised position with one arm. With the other hand, she should hold her breast between her fingers. When the nipple touches the cheek or the lips, the baby will open the mouth and turn towards the breast. The mother should take care to introduce not only the nipple, but the whole of the areola as well, into the open mouth. Baby draws out the milk with a milking motion with its palate and tongue. If the areola is not positioned correctly into the mouth, it may cause soreness of nipple which is very painful and difficult to treat. Even when the baby has fallen asleep at the breast, the mother should not try to pull out the nipple from the baby’s mouth as strong suction force may result in bruises. A finger should be introduced into the mouth to break the suction and then the chin should be gently lowered to open the mouth and release the breast.

When the baby is placed at the breast, very little milk comes out initially. A few minutes of suckling produces a powerful let-down reflex indicated by a sudden rush of copious amounts of milk. For successful breastfeeding, the baby should feed long enough to take advantage of this reflex. The more milk the baby feeds, the more quantity is produced. In the beginning, babies should be made to suck from both the breasts to stimulate milk production. If the baby falls asleep while drinking from the first breast, the next time, it should be fed at the other one. It may take 3 to 4 days for proper milk production to take place in a first-time mother. From the second time onwards, milk production may start earlier. Irrespective of the amount of milk produced, the baby should be allowed to suckle very frequently to stimulate milk production.

One of the most important breastfeeding basics is to avoid a feeding routine in the initial weeks. Whenever the baby demands a feed, it should be fed. There should not be any restriction on the duration of each feed too. Usually babies fall asleep when they are full. In the first few weeks, babies feed every 2 to 3 hours, even during the night.

After the baby is discharged from the hospital, the parents should take it to the doctor within the first week itself, to assess if the growth rate is satisfactory. The first visit is of great importance, especially to a first-time mother, as the doctor will weigh the baby and determine if the breast feeding is proper and sufficient. The doubts of the new mother will be answered by the doctor. Unlike in bottle feeding, the quantity of breast milk consumed by the baby cannot be measured by the mother or the doctor. When sufficient quantity of milk is not produced by the mother, the baby may remain hungry and may need very frequent feedings. The weight gain also may be unsatisfactory. Doctors depend on these parameters to decide whether breast feeding is adequate or supplemental formula feeds are necessary.

Weaning: It is the process of gradually decreasing the frequency and duration of breastfeeding as the baby starts on other forms of feeding. Ideally, the baby should be fed exclusively on breast milk in the first six months, and then for the next six months, a combination of breast milk and solid food should be given. Beyond the first year of life, breastfeeding may not have any significant nutritional benefits, but the mother can continue with it as long as both the mother and the baby want. When the mother decides to wean the baby, a gradual transition is better than abrupt stopping of breastfeeding. A few feedings during the day can be replaced by expressed breast milk or formula milk in bottles, for babies younger than six months.

For those who are six months or older, the replacement can be either formula milk or fruit juice. In the meantime, solid food can replace mealtime feedings. Infants who are sitting up already can be weaned to a sipper cup instead of bottle. Acquiring the ability to drink from a cup is considered a milestone in the developmental journey of an infant. By the age of ten months, most babies acquire sufficient capacity to take all liquid feedings from a cup rather than a bottle. Unless actively weaned, most babies may continue with one or two breast feedings a day, especially at bedtime or during the night till they are one and a half to two years. It is very important to ensure that the nutritional requirement of babies are met by solid foods, and the feedings from the cup, by the time they are one year old, whether they are completely weaned or not.

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Yasser Elnahas

MD, PHD, Professor Of CardioVascular Surgery
Dr. Yasser Elnahas, Is an associate Professor of Cardiovascular Surgery. Dr. Elnahas was trained as a fellow At Texas Heart Institute And Mayo Clinic Foundation.Dr. Elnahas is dedicated to educating the general public about different disease conditions and simplifying the medical knowledge in an easy to understand terminology.

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