• Feeding Your Infant: Ages 0 to 4 Months

    IMAGE Congratulations! You’re the proud (and nervous) parent of the world’s most beautiful baby! Giving your baby love and nurturing comes so naturally to you. So does showing him off to your family, friends, and even perfect strangers! But when it comes to feeding, you may feel a little unsure of what to do. Here are some guidelines.

    What Foods Are Best?

    Breast milk is the only food recommended for the first six months of life. A breast-fed baby should be fed on demand. If you cannot breastfeed or express milk, your infant should be fed iron-fortified formula. A bottle-fed baby should drink every 2-3 hours at first.

    How Much Breast Milk or Formula Should I Give?

    A newborn baby that is breastfed may feed 8-12 times a day or more. You should breastfeed your baby whenever he is showing signs of hunger.
    In the first few weeks, infants should be awoken to feed if four hours have passed since the beginning of the last feeding. As your baby gets older, he will develop a more regular feeding schedule, which may occur about eight times a day. However, your infant may need more than this with growth spurts.
    Newborns that are formula fed may drink 1-½ to 3 ounces every 2-3 hours. The amount per feeding will increase as your baby grows. For example, by two months, he may drink 4-5 ounces every 3-4 hours.

    Growth Spurts

    When babies go through growth spurts, they will want to eat more. Growth spurts may occur around the ages of:
    • 7-14 days
    • 3-6 weeks
    • 4 months

    Important Tips

    Do Not Give Solid Foods Until Your Baby Is Ready
    According to the American Academy of Pediatrics, in the first six months, water and juice are unnecessary. Some babies may be ready to add solid foods after 4 months.
    Look for the following signs that your baby is ready for solid foods:
    • Holds neck steady
    • Can sit
    • Opens mouth when food is offered
    • Draws in lower lip when spoon is removed from mouth
    • Keeps food in mouth and swallows it
    • Reaches for food, showing he wants some
    Do Not Give Cow’s Milk, Honey, Syrup, Kool-Aid, or Soda to Your Baby
    Breast milk or iron-fortified formula is best.

    What Are My Choices?

    Benefits of Breastfeeding Benefits of Iron-Fortified Formula
    • It is easy to digest.
    • It contains disease-fighting compounds.
    • It is less likely to cause allergies.
    • It helps mother and baby develop a special closeness.
    • It helps baby’s jaw develop.
    • It is always ready to go and cheaper than buying formula.
    • It has been found to help reduce infant obesity, respiratory infections, and diarrhea.
    • It provides adequate nutrition and is a suitable substitute when breast milk is not available.
    • It helps to prevent anemia (low iron in the blood).
    Why not cow’s milk? Why not low-iron formula?
    • It has too much protein.
    • It is hard for baby to digest.
    • It has too many minerals and can be hard on baby’s kidneys.
    • It is low in vitamin C, vitamin E, iron, and copper, which are important for your baby’s growth.
    • It does not contain enough iron to prevent anemia.
    • It is not a treatment for constipation.

    What Can I Expect?

    Breastfeeding Iron-fortified formula
    • Breastfeeding is a supply and demand way to feed. The more often the baby nurses, the more milk your breasts will produce.
    • A newborn breast-fed baby will nurse an average of 8-12 times in 24 hours.
    • Your baby may need a vitamin D supplement starting in the first few days after birth. Premature babies may need an iron supplement.
    • A breast-fed baby will nurse an average of 20-30 minutes. The length of time will decrease as the baby gets older.
    • During growth spurts, your baby may need to breastfeed more often. This does not mean your milk supply has decreased.
    • A breast-fed baby should have 6-8 wet diapers in 24 hours.
    • A breast-fed baby may have a bowel movement once per day or once with each feeding. Each baby will have their own schedule. During times of growth, your baby may go several days to a week without having a bowel movement. This is not constipation if the stool is soft.
    • Breast milk should not be heated in the microwave, because it destroys nutrients and can cause hot spots that may burn your baby.
    • Everything must be kept clean. Wash the top of the formula container before opening. Wash bottles and nipples in hot, sudsy water. Rinse well with hot water.
    • Mix formula carefully, following the directions on the label.
    • Use one can of formula before opening another. An opened can of ready-made liquid formula is safe for up to 48 hours when tightly covered and refrigerated.
    • Formula prepared for feeding should be refrigerated and used within 24 hours.
    • Formula should not be heated in the microwave because it can cause hot spots that may burn your baby.
    • Formula should not be frozen.
    • If not able to keep formula cold, use powdered formula and mix when needed.
    • Your baby should have 6-8 wet diapers in 24 hours.
    • Formula-fed babies will develop their own pattern of soiled diapers. Watch for your baby’s pattern.
    • During growth spurts, your baby may need to eat more often.
    • If your baby is not eating enough vitamin D fortified formula, he may need a supplement.

    Tips on Bottles and Storage

    Bisphenol A (BPA) is a chemical found in a many products, including plastic containers or bottles (with recycling number 7), as well as canned goods. While BPA's effects in humans is still being studied, some experts recommend that you limit your baby's exposure to this chemical. To learn more, read the article BPA Raising Concerns.

    RESOURCES

    American Academy of Pediatrics http://www.aap.org

    Infant NutritionFood and Nutrition Information Center http://www.nal.usda.gov

    CANADIAN RESOURCES

    About Kids Health http://www.aboutkidshealth.ca

    The Society of Obstetricians and Gynaecologists of Canada http://www.sogc.org

    References

    Bite-sized milestones: signs of solid food readiness. American Academy of Pediatrics Healthy Children.org website. Available at: http://www.healthychildren.org/English/ages-stages/baby/feeding-nutrition/pages/Bite-Sized-Milestones-Signs-of-Solid-Food-Readiness-.aspx. Updated May 1, 2012. Accessed September 12, 2012.

    Bottle feeding basics. American Academy of Pediatrics Healthy Children.org website. Available at: http://www.healthychildren.org/English/ages-stages/baby/feeding-nutrition/pages/Bottle-Feeding-How-It's-Done.aspx. Updated June 29, 2012. Accessed September 12, 2012.

    Breastfeeding and the use of human milk. Pediatrics. 2005;115(2): 496-506. American Academy of Pediatrics website. Available at: http://aappolicy.aappublications.org/cgi/content/full/pediatrics;115/2/496. Accessed September 12, 2012.

    Breastfeeding FAQs: how much and how often. Kids Health website. Available at: http://kidshealth.org/parent/pregnancy%5Fnewborn/breastfeed/breastfeed%5Foften.html. Updated January 2012. Accessed September 12, 2012.

    Formula feeding FAQs: how much and how often. Kids Health website. Available at: http://kidshealth.org/parent/pregnancy%5Fnewborn/formulafeed/formulafeed%5Foften.html. Updated January 2012. Accessed September 12, 2012.

    Formula feeding FAQs: preparation and storage. Kids Health website. Available at: http://kidshealth.org/parent/pregnancy%5Fcenter/newborn%5Fcare/formulafeed%5Fstoring.html. Updated February 2012. Accessed September 12, 2012.

    How to protect your baby from BPA. Bureau of Environmental Health Massachusetts Department of Public Health website. http://www.mass.gov/eohhs/docs/dph/environmental/exposure/bisphenol-a-brochure.pdf. Updated July 2009. Accessed September 12, 2012.

    Jones P. BPA raising concerns. EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary/. Updated October 2011. Accessed September 12, 2012.

    Wagner CL, Greer FR, American Academy of Pediatrics Section on Breastfeeding, American Academy of Pediatrics Committee on Nutrition. Prevention of rickets and vitamin D deficiency in infants, children, and adolescents. Pediatrics. 2008;122:1142-1152.

    Why formula instead of cow's milk? American Academy of Pediatrics Healthy Children.org website. Available at: http://www.healthychildren.org/English/ages-stages/baby/feeding-nutrition/Pages/Why-Formula-Instead-of-Cows-Milk.aspx. Updated July 30, 2012. Accessed September 12, 2012.

    10/12/2010 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance: Baker R, Greer F, the Committee on Nutrition. Clinical report—diagnosis and prevention of iron deficiency and iron-deficiency anemia in infants and young children (0-3 years of age). American Academy of Pediatrics website. Available at: http://pediatrics.aappublications.org/cgi/reprint/peds.2010-2576v1. Published October 5, 2010. Accessed October 12, 2010.

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