What a new mother needs to know about breastfeeding

You can often hear from a nursing mother: “I feed on demand, my baby requires breastfeeding every 3.5 hours.” Or: “I have always fed on demand. In a year we already had 1 feeding in the evening, and my child calmly refused to breastfeed.” Before talking about the child’s requirements, we need to find out what modern women mean when they say “I’m breastfeeding.”

Modern mothers consider breastfeeding necessary to feed their baby. Just for feeding. Breast milk is food; the mother provides the baby with the nutrients necessary for growth and development. When a baby suckles, he eats. Breastfeeding is understood only as a process of supplying proteins, fats, carbohydrates, vitamins and microelements.

While suckling, the baby receives the nutrients it needs through mother's milk. This is an absolute truth. There is another unconditional truth, which in modern society is not given any importance, it is not taken into account and is not considered. For a baby, sucking the breast is communication with the mother. We need to figure out how a child understands feeding on demand? Can he understand anything at all? Does it make a difference for him how he is fed, 15-20 minutes every 3.5 hours or something different?

Dear mothers!

We welcome you to the breastfeeding support group, organized on the initiative of the leadership of the Center for Social and Social Responsibility.
For convenience, you can.

Who are breastfeeding consultants and when might their help be relevant?

A lactation consultant provides psychological support, information and practical assistance in any situation related to breastfeeding, nutrition and lifestyle of a nursing mother, introduction of complementary foods, weaning, etc.

Helps mom make the best decision, taking into account her life circumstances and wishes.

If you need advice on breastfeeding, caring for a newborn, ways to calm restless babies (or restless mothers?). If you just want to speak out, to be listened to, understood, accepted and supported, call the numbers listed below!

Is it possible to use formula feeding on demand?

When a child receives an adapted formula instead of breast milk, it is better not to adhere to the rules of feeding on demand and switch to feeding according to the schedule (the same applies to those situations when, for some reason, the mother needs to temporarily switch to IV and then return to breastfeeding). The formula is a rather heavy product for the children's gastrointestinal tract; it takes a long time to digest, so overfeeding should be avoided.

How to properly feed a baby formula by month? Manufacturers of baby food took care of parents, and on almost every package they placed information on how much, at what age and at what intervals their product should be given. By the way, if formula feeding is an addition to breastfeeding, in order not to use pacifiers, it is better to purchase a sippy cup for feeding infants.

Facts about breastfeeding

Breastfeeding is a natural process that follows pregnancy and childbirth. A newborn and his mother have the same need for breastfeeding.

1. Breastfeeding fully satisfies all the basic needs of a child.
2. Breast milk contains an optimal ratio of proteins, fats, carbohydrates, vitamins, more than 15 hormones, lactobacilli, growth and development factors.
3. Mother's milk is rich in antibodies that protect the baby from infections.
4. Breast milk changes composition depending on the needs of the baby at the moment.
5. Breastfeeding helps a woman recover faster after childbirth.
6. Breastfeeding prevents depression and strengthens the maternal instinct.
7. Breast size and shape do not affect the amount of milk or duration of breastfeeding.
8. Flat or inverted nipples are not an obstacle to successful breastfeeding.
9. Any woman is able to give her baby as much milk as he needs and can continue breastfeeding for as long as he likes.
10. Breastfeeding does not require financial costs and allows you to save from 36 to 120 or more thousand rubles per year.

Does a mother need a special diet to breastfeed?

No and no again! The diet of a nursing mother should be varied and balanced, containing all food groups: meat, cereals, vegetables and fruits, dairy products, bread. You can even have coffee (1 cup of a quality drink a day won’t hurt anyone)! And in general, in order to establish breastfeeding for a newborn, you do not need to change your usual diet. While still in the womb, the baby gets used to the mother's taste preferences. Observe your and your child's reaction to what you eat. Great news for those who don't like whole milk: lactation will not be affected if you add it to your tea. Therefore, you should not torture yourself. But any warm drink (compote, tea, coffee, etc.) before feeding promotes better milk supply.

Principles for successful breastfeeding

WHO/UNICEF provide a list of factors on which successful breastfeeding is built. Which, in turn, has a beneficial effect on the health of children and their mothers.

1. Early breastfeeding

   within the first hour after birth.

2. Lack of supplementary feeding for the newborn

   before the mother puts him to the breast.

3. Staying together between mother and child

   after birth.

4. Proper latching of the baby to the breast

   will ensure effective sucking and comfort for the mother.

5. Feeding on demand.

   Put your baby to your breast for any reason. Let him nurse whenever he wants and for as long as he wants. Then he will be full and calm.

6. The duration of feeding is regulated by the child.

   Feeding will end when the baby releases the nipple on his own.

7. Co-sleeping (at the request of the parents).

   With such a sleep arrangement, parents can sleep better, since they do not have to constantly get up to the child, and most children sleep better in close proximity to mom or dad.

   Read also:  First trimester of pregnancy: changes in a woman’s body and fetal development week by week
8. Night breastfeeding is very important

   for good milk production. For a child they are the most complete.

9. An exclusively breastfed baby does not need additional water.

   If the baby is thirsty, he should be put to the breast more often. Breast milk is 87-90% water.

10. Breasts do not require frequent washing.

    This leads to the removal of the protective bactericidal layer of fat from the areola and nipple, which can cause abrasions, irritation and cracks. It is enough to rinse your breasts 1-2 times a day during a general shower, preferably without soap.

11. Frequently weighing a child does not provide objective information about nutritional status

    baby, irritates the mother, leads to decreased lactation and unreasonable introduction of supplementary feeding. It is enough to weigh once a week.

12. No additional pumping is needed.

    With proper organization of feeding, milk is produced exactly as much as the baby needs. Pumping is necessary in case of problems: forced separation of mother and child, mother going to work, etc.

13. Breastfeeding only until 6 months.

    The child does not need additional nutrition and complementary feeding until 6 months. He can be predominantly breastfed for up to 1 year without compromising his health (according to separate studies).

14. Maintaining breastfeeding up to 1.5 – 2 years

    (or longer as desired by mother and child). Breastfeeding up to 1 year is not a physiological period for stopping lactation, so if you need to stop breastfeeding, consult with specialists to make a balanced, informed decision.

15. The use of bottles and pacifiers is undesirable.

    They can cause the following problems: low milk supply, nipple injuries and discomfort under the breasts. If supplementary feeding is necessary, it should be given only from non-sucking objects (cups, spoons, cups, pipettes or syringes without a needle).

What does “feeding on demand” mean?

Memories are still fresh when children in maternity hospitals were separated from their mothers, and feeding took place according to a schedule - every three hours. With the same recommendations, the woman and baby were discharged home. Now, fortunately, the rules have changed. From the first minutes, the child is next to his mother, and the woman gets to know him and learns to understand him.

On-demand feeding of a newborn is a method in which the breast is offered in response to the baby's cues. And it doesn’t matter what breaks there are between feedings - an hour has passed or just 20 minutes. Every day, the young mother gets better at picking up the signals that the baby gives that he needs to be put to the breast: the newborn begins to actively move in his sleep, open his mouth, twist his head, and sometimes he can put his finger in his mouth. The most obvious sign that a baby is hungry is crying, of course. Therefore, to the question of how often to apply, there is only one answer - at the first call of the baby.

There is no need to be afraid that the baby will overeat. Nature has decreed that the baby decides for himself how much he needs to suck at a particular moment. The stomach of newborns is the size of a walnut - physically it cannot accommodate much. In addition, breast milk is digested many times faster than formula. Infant formula is a rather heavy product. Therefore, babies in artificial feeding mode ask to be fed less often.

Only breastfeeding on demand helps to establish lactation! At the very beginning, the production of breast milk occurs according to the “supply and demand” rule: the more often the baby makes sucking movements on the breast, the more the hormone oxytocin is produced, and as a result, more milk arrives. This process is established in some women by the month of the baby’s life, while in others only at 3 months. At the stage of lactation, it is not recommended to replace breastfeeding with sucking a pacifier or bottle: most often, it is because of this that the child asks for the breast less often, and, consequently, less milk is produced.

Attachment and feeding positions

You can feed your baby in any position that will ensure comfort for you and your baby. During breastfeeding, mom has the opportunity to rest, so try to position yourself so as not to feel tension or discomfort.

In a comfortable position for mother and baby:

• Mom is relaxed, comfortable and not in pain
• The baby's body is located close to the mother's body
• The baby faces the breast and does not need to turn his head
• The baby is positioned at the breast so that the nipple is directed towards his nose and he has to tilt his head back slightly
• The child is breathing freely
• The baby is calm

During the month after birth, you may experience increased sensitivity in your nipples while breastfeeding. If discomfort persists for more than 10-15 seconds after the start of feeding, it is recommended to pay attention to the correct attachment.

Infant feeding regimens - what to choose

How much and how often should you feed your baby day and night? What is better - giving breast or bottle on demand or setting feeding hours and strictly observing the time intervals between them? Advice on how to properly organize the feeding regimen of a breastfed and bottle-fed newborn is given by pediatrician, leading expert of the online school for future and established parents “SMART Mama” Polina Aleksandrovna Kizino.

— Polina Aleksandrovna, what is the difference between feeding regimens for breastfed, mixed and bottle-fed children?

— The differences between breastfeeding and artificial and mixed feeding clearly explain why feeding regimes differ.

— Normally, by what month should a feeding regimen be established?

— The feeding schedule changes constantly. The older the child gets, the larger the portion of milk he eats, the lower the frequency of feedings.

After childbirth, when the mother establishes lactation, the baby also develops its own diet. In the first weeks, everything is quite chaotic and there is no routine as such, and the mother makes sure that the interval between breastfeedings is not more than 2.5 hours (it can be half an hour or two hours) and the baby does not remain hungry. From about the second or third week, the baby begins to have more or less regular intervals between feedings. We can say that the regime has been established. But this regime gradually changes as the baby gets older.

- What is the benefit and what harm can come from breastfeeding by the hour?

pros

• The child knows when it’s time to eat - the body adapts from the very beginning. It's no secret: in order to digest food, you need certain enzymes. When food enters the child's body regularly, his enzyme system and gastrointestinal tract adapt to the regime, and it is much easier for the child to digest food.
• A wakefulness and sleep pattern is formed - at every minute the child understands what will happen to him.
• Parents are not “hostage” to the baby; they have the opportunity to plan their free time - especially mothers, who always lack time. The feeding regime and the waking and sleeping regime greatly facilitate the situation - at every moment the mother knows what awaits her.

Minuses

• Mom adheres to the feeding schedule, but does not adhere to the sleep schedule - and sets a trap for herself. She may find herself in a situation where the baby is sleeping and it’s time to feed him. And it’s not clear whether to wake the baby or let him sleep. If you choose a regimen, then you must follow it both in feeding and in bed.
• There are situations when it is difficult to feed your child on time (for example, you find yourself far from home and you don’t have formula). But it’s worth foreseeing everything, and there will be no problems. You just need to be able to plan everything correctly.

— How to painlessly accustom a child to an hourly feeding schedule?

For a child, a routine is not something painful, and if we build a clear daily routine, then, believe me, it becomes comfortable not only for the mother, but also for the baby. This is absolutely normal. But in order to build a regimen, you need to understand what it should ideally be - you must plan what intervals between feedings you want to achieve.

The next step is to evaluate the point where you are now. For example, you would like to have a three-hour interval between feedings, but your baby eats every hour and a half. Of course, if you just suddenly start to wait three hours between feedings, nothing good will happen - it will be very stressful for the baby.

Therefore, you need to act smoothly:

• determine point A from which you are coming and point B to which you must arrive;
• gradually adapt to the regime that you would ideally like to have.

Transition diagram

Now the breaks between feedings are 1.5 hours, but we want 3 hours. We add five minutes each time so as not to injure the child, and at some point we take a break not at 1.5 hours, but at 1 hour 35 minutes, then at 1 hour 40 minutes, and so on. The volume of food will also change slightly.

— If we talk about night feeding with an hourly schedule, is it necessary to wake up the baby when it’s time to eat?

— Night feedings are normal for a child under one year old.

In a newborn

there is no division of the day into day and night - there are approximate three-hour cycles. He woke up - ate - slept, woke up - ate - slept. And so every day. For a newborn baby, night feedings are the absolute norm.

For a child aged 1 year

Feeding 1-2 times per night is normal. But a one-year-old child may not eat at night.

In order to understand whether it is worth waking up and feeding your baby, you need to know how much he eats per day. Each child at each age has a certain norm - the amount of food that he should eat per day (we always count not per day, but per day).

• If a child has eaten his or her quota during the day and sleeps at night,
  then there is no need to wake him up.
• has eaten approximately 70% of his norm
  during the day then it is advisable to wake him up at night and supplement him with food.

We always evaluate nutritional sufficiency by weight gain.

• If a child has gained weight and height within the normal range
  for his age in one month, it means he is receiving enough nutrition.
• If a child does not gain weight and height,
  then he needs to be offered food more often at night so that he fits into the norm.

— If there are too many night feedings with an hourly schedule or with feeding on demand, what to do about it?

— Night snacks do not always indicate a child’s need for food. When a baby asks for the breast at night, mothers mistakenly think that it is just hunger and nothing more. In fact, the child may be restless at night due to a disruption in the routine or the so-called negative sleep association (when he can only fall asleep with the breast).

When there is no routine, the child “does not get enough sleep” and the so-called accumulated fatigue is evident; his nervous system is in very strong excitement. In such a situation, night feedings every hour often indicate that the baby has a violation of the regime - it is difficult for him to get up, his nervous system is overexcited, he physically cannot fall asleep without his mother's breast.

Such night feedings can be easily identified:

• the child wakes up every 40 minutes - 1 hour at night and asks for food, and during the day he usually eats every 3-4 hours - which means he is unlikely to experience hunger;
• the child eats very little at night - he latched onto the breast or bottle, ate 10-20 g and fell asleep. This means that the baby performed a certain ritual: he waited for his mother, satisfied the sucking reflex and thanks to this he fell asleep - in such a case he had no goal of eating.

With such night feedings, you need to pay attention to two factors:

1. Adequacy of nutrition - it is worth making sure that the child receives the required amount of nutrition per day, does not go hungry during the day and does not get at night the amount of food that should have been received during the day.
2. The correct regime - you need to make sure that the child is in order with the regime, there is no accumulated fatigue and negative associations with sleep.

— Is it normal that a child does not eat at night or eats very little?

— Such a reverse situation may or may not be the norm. It all depends on the baby’s age and whether he receives enough nutrition during the daytime feedings.

Newborn

It is not normal for a newborn baby not to eat at night; he should eat every 2.5-3 hours. During breastfeeding, this is critically important - so that the mother’s lactation is established, and the baby replenishes the reserves that he needs.

An unpleasant situation can happen in the first couple of months - the mother is happy that the baby sleeps well and does not wake up at night, but the weighing shows that the child has not only gained little, but has not gained at all in one month, that is, he is clearly starving.

Newborn babies have this peculiarity: if they receive very little food, they do not have the strength to ask for it. Therefore, ensuring that your newborn baby eats both day and night is extremely important!

Baby

A child older than 1.5-2 months gains weight and height within the normal range, eats all the food he needs during daytime feedings, feels great, is not whiny or irritated, and at the same time sleeps at night - let him sleep to his health. The most important thing is that he gains weight and height - these are the main indicators by which we can assess that the child has enough nutrition.

— If a mother prefers on-demand feeding, how can she organize it as gently as possible for her?

“It’s important to understand that you can’t go to extremes.

First extreme:

The baby sleeps for a very long time, the intervals between feedings are 5-6 hours. It seems to the mother that everything is fine, but the weighing shows that the child is underweight. Mom waited too long and missed the moment when the child simply stopped asking for food due to exhaustion.

Second extreme:

A 7-month-old baby eats every hour, that is, about 20 times a day. This is, of course, an abnormal situation.

When we talk about feeding on demand, we mean that there is a certain interval between feedings. It varies depending on age:

• for a newborn baby this is approximately 2 hours;
• for a child over 1 month - approximately 3 hours;
• closer to 4 months - 3-3.5 or 3.5-4 hours, each baby individually.

NORMAL - from 2 to 4 hours during the first year of a child’s life, and you can deviate from this norm by +/- half an hour. If the intervals between feedings become very short (every hour) or very long (5-6 hours), we adjust them in order to adhere to the norm and not go to extremes.

— If a child eats little, but often enough, then which regimen is more relevant for him?

- Little, but often - this is not entirely normal. It is important to observe the daily amount of food. If a child consumes the norm per day that he needs according to his age, and at the same time eats little, but often, it means that either the mother does not have enough milk for the child to eat more and, accordingly, maintain longer intervals, or the child is simply already used to it - He can’t eat more at one time. In both cases, you need to try to increase the intervals a little.

We can feed both on demand and on a schedule - there is no fundamental difference here. But most likely, if we stay on demand feeding, the baby will continue to feed every hour and his amount of food at one time will be quite small for his age. Therefore, you need to try to maintain a slightly longer interval between feedings and watch how much he eats.

— There are situations when a child’s routine is disrupted for some reason — allergies, gastrointestinal disorders. How soon can I return to my usual routine?

— By and large, the sooner you return to normal, the better. Do not worry too much if your child does not eat according to the schedule for several days; this will not affect your condition or the physical condition of the baby in any way. The most important thing is not through force or aggressively, but very gently to return the child to the regime that he had. The clearer and longer the regime was, the easier it is to return to it.

— Why is it important to follow a feeding regime?

— It is important to follow the feeding regimen:

1. For parents - so that the mother is not a “hostage” of the child and understands what will happen in the near future, she can plan something or leave the house. This, it would seem, is not so important for the child, but it is important for the general climate in the family, so that the mother feels relatively free, not “tied hand and foot” to her baby.
2. For a baby - I am always in favor of a routine and always encourage parents to follow it, because for a child everything should be predictable - he gets used to the order, gets involved in the routine and feels as comfortable as possible. Parents are comfortable when they know what will happen to them - and it is much easier for the baby when he knows that food or sleep are on a schedule - his body begins to adjust accordingly.

— In what cases can you move away from the usual feeding regimen?

- If you can not deviate from the regime, then it is better not to deviate. But if this happens, don’t worry, don’t blame or reproach yourself, nothing critical will happen, even if the child doesn’t eat according to the schedule for a couple of days. Just get back to your routine as quickly as possible and everything will be fine.

— Polina Aleksandrovna, please give examples of feeding regimens and daily rations for babies of different ages.

— There are several points that need to be taken into account when building a baby’s feeding regimen and diet.

• The amount of food a child should receive per day.

  Many mothers, unfortunately, mistakenly believe that the daily volume depends only on the age of the baby. But there is no universal portion; it corresponds more to the baby’s weight. So, two children of the same age, but different weights will need different amounts of nutrition per day. Therefore, it is quite difficult to find clear instructions on how many milliliters a child should eat at a time in each specific case.

• Frequency of feedings.

  In order to calculate the amount of food for one time, you need to know how much food is needed per day and how many times the mother will feed the baby - that is, the frequency of feedings. In this case, you should always focus on the child’s weight. I recommend calculating meals with your pediatrician so that everything is selected according to the needs of your specific child.

• for a 2-month-old baby - 6-7 times per day and +/- 120-150 ml of breast milk consumed per feeding,

for a child 5-6 months old - 5-6 times per day +/- 180-210 ml of breast milk consumed per feeding,

For babies receiving complementary foods, the portion size is larger, but it all depends on the weight and frequency of feedings. And you need to remember: complementary feeding is not an additional amount of nutrition, it must fit into the daily norm, which corresponds to age and is redistributed between complementary feeding and breast milk and/or formula in different percentages.

The feeding regimen of a breastfed, mixed or bottle-fed baby is a great help for mother and baby. The regime should not lead to additional difficulties in the family - sitting with a stopwatch near the baby, waking him up at night, when three hours have passed since feeding. If you adhere to the correct diet and sleep, then both the child and you will have an understanding of what will happen next at any given moment. This will make life easier for the whole family.

Pediatrician Polina Aleksandrovna Kizino

*The ideal food for an infant is mother's milk. WHO recommends exclusive breastfeeding for the first 6 months. MAMAKO® supports this recommendation. Before introducing new foods into your baby’s diet, consult a specialist.

Feeding positions

Check out a few of the most common breastfeeding positions.

Cradle

The most common feeding position. The mother sits down and takes the baby so that his head is on the bend of the elbow. She turns him towards him with his tummy and gives him the breast. With the palm of her other hand, the mother supports the baby’s butt and back.

For proper breast latch, it is important that the head is at the same height as the nipple. To do this, at first, you will have to raise your elbow high (you can put a pillow under your arm to avoid tension or discomfort).

Please note that the baby's head is tilted back slightly. This ensures the most effective sucking, in which the baby gets the most milk.

Reverse cradle

This variation of the “cradle” position will help the baby to latch onto the breast correctly in the first days after birth. This position is especially convenient in the case of premature and low birth weight babies.

The mother supports the baby's head not with her elbow, but with the palm of her hand. This provides more secure support and also allows you to control the baby's head if necessary. The hand opposite the nursing breast is used for support. The mother's palm is located under the back and shoulders, and the baby's head is between the thumb and forefinger. With the other hand, the mother supports the breast from below; when the baby has taken the breast well, the hand can be removed.

To prevent your supporting arm from getting tired, you can place a pillow under it. Or, after making sure that the baby has taken the breast well, switch hands and continue feeding in the “traditional cradle” position.

Lying on your side

Most often, this position is used during night feedings, if the baby sleeps with the mother, as well as after a cesarean section or episiotomy, when the mother experiences pain and is limited in movement.

Mom and baby lie on their sides and face each other. In the first days after birth, this position may be uncomfortable due to the difference in height of the nipple and the baby’s mouth.

Relaxed position

This position will help mother and baby relax and rest as much as possible during feeding. Mom lies reclining, with her head and shoulders slightly raised, surrounding herself with comfortable support from pillows and providing herself with complete comfort. The baby lies on the mother, who helps him find the breast and latch on. In addition to the fact that the mother herself is relaxed, the baby himself calms down perfectly in this position: it is especially good for restless children who wave their arms and legs and turn their heads.

We have listed several of the most common feeding positions to help you navigate the first time after the birth of your baby. In fact, the variety of feeding positions is limited only by the comfort of mother and baby, as well as the surrounding circumstances and the availability of aids (pillows, sling, etc.).

About correct application

To breastfeed correctly , first of all, you need to hold the baby correctly . The position can be any, the main thing is that the baby is turned towards you with his whole body, his tummy is pressed tightly against your body, and his knees and nose are facing the same direction. The nipple should be at the level of the baby's upper lip and nose. Next, you need to form a fold from the breast (put your thumb on top, and the rest under the breast along the edges of the areola and squeeze), then tease the child a little (move the lips up and down). When your baby's mouth is wide open, insert your breast as deeply as possible while moving your baby's head with your other hand. It turns out to be counter traffic.

If there is a need to hold the breasts, there is no need to do it with “scissors” (hold between the index and middle fingers), since this is fraught with stagnation (fingers block the flow of milk). It is better to hold your chest in a “C” shape, that is, place your thumb on top and the other four fingers underneath your chest.

Signs of proper attachment

• the child's mouth is wide open, the lower lip is turned outward
• baby's chin is pressed to the chest
• sometimes you can see the baby's tongue above the lower lip
• When sucking, the baby first makes short, quick movements, then changes the rhythm to more constant deep sucking. During feeding, the baby makes pauses, which become longer and longer as he becomes full.
• The baby's cheeks are rounded, sometimes the ears may move when sucking
• the baby does not make any extraneous sounds (no smacking, no slurping - only breathing and swallowing)

The importance of the first attachment for mother and baby

Attachment to the breast is the logical end of the birth process, which gives a powerful impetus to the establishment and establishment of lactation. Ideally, attachment should take place immediately after the baby is born. The baby is born and cries, the midwife lays it “belly to belly” towards the mother, helping to find the nipple.

The mother's body is prepared and adjusted to breastfeeding if the newborn is attached immediately after birth. Sucking the breast gives a signal that labor is over, and the woman’s body’s task is to feed the baby with milk. Baby sucking at the breast activates nerve endings in the mother's body that are responsible for active contractions of the uterus, which leads to a reduced risk of developing postpartum complications.

Attachment is of particular importance for the baby. He receives the first drops of colostrum, which activate protective reserves. They help the child cope with pathogenic bacteria and allergens. Colostrum, containing a large amount of antibodies, protects the baby from diseases. It helps in populating the intestinal microflora with beneficial bifidobacteria.

The psychological role of early attachment is also important. During childbirth, the child is exposed to stress, finds himself in unfamiliar conditions, and the baby needs his mother to feel safe. Mom's touch, physical contact, and breast sucking help reduce postpartum stress and establish a tight emotional “mother-child” connection, which is called “imprinting.”

It has been established that breastfeeding increases the level of pleasure hormone in a woman’s blood -

endorphin, allowing you to relax and unwind even after a difficult birth.

Nutrition of a newborn baby

From the moment of birth until approximately 3-5 days after birth, the baby will receive colostrum as food, which in quantity and composition fully corresponds to the baby’s nutritional needs.

During the first days of life, most babies lose up to 10% of their birth weight. This is due to physiological loss of fluid due to changes in environmental conditions and disposal of original feces (meconium).

With the arrival of “mature milk”, children usually regain their birth weight within 5-10 days. However, for some children, 3 days may be enough for this, while others will need 3 weeks.

Breastfeeding and artificial feeding

Today, many children are given formula instead of breast milk from birth. They help replace mother's milk, but have less benefit and value for the body. Let's look at the features of breastfeeding and artificial feeding.

Features of breastfeeding

Mother's milk is ideal for feeding the baby. It fully meets the requirements of the baby’s body, helps to form a strong immune system and improve digestion. You need to feed your baby milk on demand, not by the hour. It is quickly digested, and the baby begins to feel hungry, becomes moody and restless. The intervals between feedings should be at least 1-1.5 hours.

Immediately after birth, until real milk comes in, the baby feeds on colostrum. It is no less useful and nutritious, but it is more difficult to “obtain”. The baby has to suckle intensively at the breast.

Features of artificial feeding

The quality and benefits of artificial feeding directly depend on the quality of the formulas used. You need to buy them only in specialized stores. Be sure to pay attention to the integrity of the packaging and expiration dates.

If your baby is bottle-fed, you need to remember a few simple rules:

• You can store an opened package of the mixture for no more than three weeks. After this period has expired, it cannot be given to the child.
• Feeding bottles and nipples must be thoroughly sterilized. They should be stored in a place protected from dust.
• The water temperature for preparing the solution should be no higher than 37-40 degrees. This way the baby will not get burned and all the nutrients will remain unchanged.
• Be sure to control the volume of the mixture flowing out. If the fluid leaks out too quickly, your baby may choke. If the formula is poured too slowly, the baby will not have the strength to suck it out.
• Make sure that the child does not swallow air. This can cause problems with the intestines and stomach.

If you are feeding your baby a specific formula, do not change it without consulting your pediatrician. Otherwise, a sudden transition can provoke colic, bloating, allergies and a number of other problems.

Very important! If a child is bottle-fed, he must be supplemented with water. Its amount per day should be 80-100 ml. You should also not feed your baby on demand. It is necessary to maintain clear intervals between feedings. This will avoid problems with the gastrointestinal tract.

Does the baby have enough milk?

After being discharged from the maternity hospital, mothers may doubt whether the baby has enough milk? There are only two objective criteria by which you can determine whether a baby is getting enough milk:

1. Weight gain (at least 500 grams per month or 125 grams per week) *
2. Number of urinations (at least 10-12 times a day, urine is light, transparent, without a strong odor)

* After the baby regains physiological weight loss after birth. If physiological loss is more than 10% or weight restoration is delayed for more than 3 weeks, consult a doctor.

Breast fullness, “feeling of tide,” tingling or lack thereof and other subjective sensations of the mother are not an indicator of the amount of milk.

How long to breastfeed?

It is important to remember that breastfeeding, no matter what its benefits, is a mother's choice. And no one has the right to give her unsolicited advice or impose any decision. Also, each woman decides for herself how long she wants to breastfeed her baby. According to the World Health Organization, it is recommended to exclusively breastfeed until the baby is six months old, and then continue breastfeeding until at least two years of age, along with appropriate complementary foods.

Maternal drug treatment

Many medications are compatible with breastfeeding (including antibiotics). In most cases, it is much more harmful to stop breastfeeding than to continue it while the mother is on medication.

A lactation consultant will help you check your prescribed treatment for compatibility with breastfeeding. If necessary, he will provide information about the availability of analogues that are safe for children, the possibility of using which you can discuss with your doctor.

It is worth noting separately that any local anesthesia does not require a temporary cessation of breastfeeding or additional pumping after the procedure.

What should you pay attention to in the first days after birth?

First breastfeeding after childbirth

The first day after birth is very important, and during this period it is advisable to hold the baby to yourself as often as possible and maintain contact with him, feeding him on demand. All this will help the child calm down and overcome postpartum stress. After birth, the baby sleeps, eats and cries a lot. But crying is not always caused by hunger - most often the child reacts by crying to the stress experienced during childbirth. In order to calm the baby, it is enough to simply take him in your arms and offer the breast.

On the first day, the baby may regurgitate amniotic fluid. In such an uncomfortable situation, he may refuse to breastfeed. Don't worry, the situation usually resolves within 24 hours.

What should breast milk be like?

Colostrum is not milk yet

There is not as much colostrum as milk - sometimes only drops of colostrum are released. Often the mother thinks that this amount may not be enough for the child. However, it is not. On the first day, the baby's stomach is very small - the size of a cherry (volume 5-7 ml). But colostrum covers all the baby’s needs in the first days, because it contains very little water and a lot of calories.

Colostrum can be considered the baby’s “first vaccination”, because it is not so much food as it is an immune defense factor. Therefore, it is very important to frequently put your baby to the breast in the first days after birth: he will be regularly saturated with high-calorie drops and gradually prepare for the transition to breast milk. In addition, colostrum has a laxative effect, as a result of which meconium (original feces) in the baby's intestines changes to normal stool when breastfeeding. Colostrum also helps remove bilirubin, which prevents jaundice.

Pumping

Expressing is a procedure for removing milk from the breast, which is carried out for specific indications. Such as:

• Unpleasant or painful sensations in the breasts caused by excess milk, stagnation, mastitis, etc. – You need to empty your breasts effectively.
• It is necessary to increase the amount of milk
• The baby is unable to latch on to the breast or refuses it
• Mother needs to leave and leave breast milk for baby
• The mother is undergoing treatment with drugs that are not compatible with breastfeeding
• The child and mother are separated. Pumping is necessary to maintain lactation.

You can express milk by hand or with a breast pump, but hand expression is usually more effective.

In the absence of the above difficulties, there is no need to express after feedings. This can provoke hyperlactation (excess milk), which forces the mother to pump regularly, since the baby cannot cope with so much milk. This condition takes a lot of time and effort from the mother and increases the risk of milk stagnation and mastitis.

Contact a lactation consultant to find out if pumping is right for you.

Until what age is it necessary to feed a child on demand?

Many young parents are afraid that the baby will “hang” on the chest for days or demand the breast at the most unexpected moment. How to establish a regime? It will improve on its own: every month, as the child grows older, the intervals between applications will increase. If the baby is not limited in contact with his mother and receives the breast at every call, he does not feel anxiety and feels safe, therefore he does not see the point in frequent latching. In the first months, feeding is most often built around dreams: as a rule, the mother puts the baby to bed with the breast, and after waking up offers it.

Later, when a child's life has a predictable rhythm of the day and complementary feeding, breastfeeding also becomes more predictable. And the line between feeding a newborn on demand or on the clock is blurred, because the baby asks for the breast at approximately the same time every day.

How to express milk?

Handle your breasts gently while pumping. Breast tissue is very sensitive to any physical impact.

When expressing, you should not squeeze, knead, put pressure on the breast, or “break” lumps and lumps with your hands. This may be dangerous to your health!

The process of expressing milk consists of two stages:

1. Breast massage.
   It is done to “warm up” the breast and move the milk forward a little. If you need to express your right breast, then cup your right hand and lift your breast with it. Place your left hand on top so that your fingers hug the axillary lobe too. The right hand goes up, the left hand goes down - clockwise. You gently stroke your breasts. It is enough to make 3-4 movements.
2. Pumping.
   If you have fairly large breasts, it is better to lift them and support them with your palm. Place the pads of your thumb and index finger on the areola, approximately 3 centimeters from the nipple. Press your breasts slightly towards you with these fingers, then connect your fingers together, thereby slightly squeezing the nipple. It shouldn't hurt. If you feel pain, it means that you have placed your fingers too far from the nipple and are grabbing the glandular tissue. Move them a little closer to the nipple. If you did everything correctly, then after several such movements milk will drip or even pour out of your chest - then just continue. You can try placing your fingers a little further or closer and you will find the most comfortable position.

Expressing is not painful. If you feel pain while pumping, it means you are doing something wrong and it may be better to seek advice from a lactation specialist.

Difficulty breastfeeding

The baby does not latch on to the breast

• baby turns his head
• grabs the chest several times and throws

These are manifestations of the search reflex.
What to do:

• pass the nipple over the baby's lips and cheeks
• express a couple of drops of colostrum and apply it to the areola and nipple
• hold the baby's head, help find the nipple.

Baby sucks poorly

• The child is restless due to hunger.
• sucks sluggishly, quickly falls asleep.

Occurs in weakened premature babies, during difficult births, and jaundice.
What to do:

• Wake up the baby for feeding (every 1.5-2 hours during the day, every 3-4 hours at night).
• skin-to-skin contact.
• help the baby find the breast.

If you can’t wake him up, you need to express each breast for 10-15 minutes.

Short bridle

Causes difficulty when sucking, you can hear clicking and smacking sounds.
What to do:

• See your dentist for a frenulum trimming

Tight breasts

Milk is difficult to separate and it is difficult to breastfeed
. What to do:

• increase application frequency.
• Before feeding, stretch your breasts and express some milk.

Nipple shape

Difficulties with inverted or flat nipples
What to do:

• pick a pose
• use nipple formers and silicone nipple covers.

Not enough milk

What to do:

• increase the volume of fluid consumed (2.5-3 l.)
• Drink a warm drink before feeding.
• apply to the breast more often, especially at night. Between 3-4 am, the hormone responsible for the amount of milk, prolactin, is produced.
• Monitor your nutrition and caloric intake. Eat 5-6 times a day in small portions.

A lot of milk

What to do:

• reduce the amount of liquid
• Express your breasts before feeding.
• express breasts after feeding to prevent congestion and mastitis.
• Use breast pads to protect clothing from leaks.

Dummy

Due to pacifier sucking, the baby is less likely to attach to the breast.
Less milk is produced. The child prefers the pacifier to the breast. What to do:

• Limit your child from sucking a pacifier
• offer breasts more often.

Storing and using expressed milk

The main way to store expressed milk is by refrigerating or freezing it.

You can give newly expressed breast milk to your baby for several hours, leaving it at room temperature. During storage, milk may separate into bulk and thick cream rising to the top. If you are sure that the baby will eat the entire portion, carefully mix the milk, and if he often does not eat the entire portion, then it is better, on the contrary, not to mix so that the child is guaranteed to receive the valuable fatty part of breast milk.

If you are going to use milk within the next week, do not freeze it, but store it on the refrigerator shelf:

all this time it remains fresh and does not lose many of its immune properties, which still happens to some extent when frozen.
If you decide to freeze milk, then before placing it in the freezer, cool it in the general compartment of the refrigerator. Be sure to mark your pumping date!
When defrosting, a portion of milk is moved from the freezer first to the general compartment of the refrigerator, and then it is heated under running warm water from the tap. The milk is heated only to body temperature – approximately 36.6°C.

Higher temperatures destroy enzymes and reduce the immune properties of breast milk. The temperature of the milk is usually checked on the wrist - the drop should feel neither cold nor hot.

Milk should not be heated on the stove or in the microwave.

, since it is very easy to overheat, and in a microwave oven most of the valuable anti-infective factors will also be destroyed. In addition, a microwave oven creates so-called super-hot zones that can remain in the milk even after stirring.

Frozen milk often has a somewhat soapy odor and sometimes changes color.

This is completely normal, as some fatty acids in breast milk behave this way when frozen. Most children do not react to changes in smell.

If after storage the milk has a pronounced sour smell, it has spoiled and should not be given to a child.

All about supplementary feeding and breast milk substitutes

Sometimes not enough breast milk is produced and the baby does not get enough to eat. In this case, various mixtures come to the rescue. However, you should not stop breastfeeding completely. When mixed feeding, always give the baby the breast first and only then supplement with formula milk.

Important! If you decide to supplement your baby with formula, be sure to consult your pediatrician about this issue.

Artificial mixtures are made from cow's and goat's milk. They can be sweet, sour milk, milk. The choice of the appropriate option depends on the individual characteristics of the baby’s body. An incorrectly selected diet can provoke the development of gastrointestinal problems or food allergies.

Mixtures are divided according to labeling:

• 1 - these mixtures are intended for feeding babies from birth to six months.
• 2 - intended for feeding children from six months to one year. They have a richer composition, since as the child ages, he needs much more vitamins and minerals.
• 3 - suitable for children from one to three years old. Act as an additional power source.

In order not to harm the baby, young parents should remember a few simple rules:

• You should not change formula milk frequently. This will provoke the development of problems with the gastrointestinal tract.
• If there is a need to transfer the baby from one mixture to another, do it gradually. Usually the transition takes 5-7 days. The child’s digestive tract adapts to an unfamiliar mixture only after 2 weeks.
• If there is any formula left over from a previous feeding, under no circumstances should it be reheated or mixed with freshly prepared food.

Be sure to supplement your baby's food in hot weather or if he is exclusively bottle-fed. As a drink, you can use not only ordinary water, but also various herbal teas. You should not give more than 50 ml of tea per day.

When should supplementary feeding be introduced into a child’s diet?

Supplementary feeding should be introduced no earlier than 4 months and no later than 6 months. Before introducing new products, be sure to consult with your pediatrician. The feeding schedule will depend entirely on the individual characteristics of the baby’s body. Despite the introduction of new products, formula feeding or breastfeeding should not be stopped.

How to properly express breasts after childbirth and when should you express colostrum?

There are circumstances when in the first days of life a baby cannot attach to the breast - during an emergency caesarean section for the mother, in case of prematurity, etc. In such cases, it is necessary to begin breast stimulation - pumping. It is advisable to do this within the first 6 hours after birth in order to maintain lactation at the proper level. Even while in the intensive care unit after a cesarean section, the mother can, without collecting colostrum, make pumping movements, stimulating the breasts. In this way, the brain receives signals that the baby needs milk and supports the lactation process. You can express the colostrum into a clean spoon and feed it to your baby if necessary.

Expressing should be done every three hours 7-8 times a day, including at night. For the first three days, while colostrum is in progress, 15 minutes of pumping is enough for both mammary glands. In the first three days after birth, it is very important not to leave an interval between feedings of more than three hours: even if the baby is sleeping, he must be gently woken up (unswaddled, changed diaper) by offering him the breast.