12 13 2 Feeding Your Baby

The vast majority of women are physically capable of nursing their babies, and nature has seen to it that the production of ’s is closely related to a newborn’s needs. However, some women choose to bottle-feed their , which is also a healthy option. The following is what you need to know about feeding your newborn in the first weeks of his or her life.

The Newborn Manual UCLAHEALTH.ORG | 1-800-UCLA-MD1 : DAY THREE DAY FIVE Days 2 to 6

Milk comes in between days two and six of the newborn’s life. As this happens, the increases in volume and becomes milky-white DAY SIX DAY 25 transitional milk. Signs that your milk is coming in include: full and tender , leaking of milk, seeing milk around your baby’s mouth, and hear- Breastfeeding: ing your baby swallow when feeding. As this occurs, you may be aware Days 1 to 3 of only mild changes or your breasts may become engorged, which For the first few days of life, a new- means they will be swollen, hot, lumpy born sleeps much of the time and is and painful. The best treatment for content with a precursor engorgement is frequent feeds every 14 found in the mother’s breasts, called two to three hours for at least 10 15 colostrum. minutes per breast. Colostrum is a thick, yellow- Don’t be surprised if you have a lot orange fluid that is rich in protein. It of middle-of-the-night feedings during benefits the baby by giving him or the first weeks of your baby’s life. her immediate protection against These 2 a.m. feedings help bring in Breastfeeding Basics disease and infection. Colostrum also your milk and build up your milk sup- has a laxative effect and readies your ply. The more frequently you nurse, baby’s digestive tract for the milk she the less swelling you will have. Breast milk is a natural food for babies that comes with will be getting in a few days. For a few days, warm compresses, many advantages for both mother and child. While there During the first few days of life, it warm showers, breast massage or are other healthy options, we encourage breastfeeding is normal for babies to lose weight. It hand-expressing a few drops of milk may take at least 10 days for a baby to prior to the feeding may help soften whenever it is possible. regain her . Offering the the and the dark area sur- breast frequently during the early days rounding the nipple, called the . n Breastfeeding develops a special n Breastfeeding benefits your baby by helps to bring milk in sooner and may Applying ice packs to the breast after closeness between a mother and her providing added protection against help prevent severe engorgement. a feeding can also be soothing. baby that is beneficial to both. disease and infection.

n Breast milk is the perfect food for your baby, ideally suited to his or her nutritional needs and bodily BIRTH DAY 2 DAY 3 DAY 4 DAY 5 DAY 6 development.

The Newborn Manual UCLAHEALTH.ORG | 1-800-UCLA-MD1 Breastfeeding: General Guidelines and Information While Feeding

Before You Breastfeed Breastfeeding Positions n Many newborns don’t nurse vigor- n Be sure your baby takes as much of ously the first few days of life. Help the areola as possible into her mouth n Wash your hands. This helps protect your baby get started nursing by and not just the nipple. You can help your baby from infections. holding her close so that her lips your baby by holding the top touch your breast. This will prompt of your breast with your thumb and n Make yourself comfortable in a her to open her mouth and search keeping your fingers out of the way. relaxed and quiet atmosphere. for your nipple. Give her time to find it, as she is learning too. If your n Never pull the nipple from your baby’s n Before you start nursing, you may breast is very full and firm, press it mouth, as this can hurt the nipple. experience what is known as “the let- away from your baby’s nose so that down.” This is the reflex that creates she can breathe easily. n To break your baby’s suction, insert the flow of milk from the back of the a clean finger into the corner of her breast to the nipple. The let-down n The rooting reflex is initiated by mouth. occurs each time the baby suckles. touching your nipple to the center Signs of the let-down are different for of your baby’s lower lip. This causes n Nursing time ranges from five to 30 16 each woman and may include cramp- the baby to latch onto the nipple and minutes per breast. Try to alternate 17 ing in the uterus, a tingle or even areola. the side you begin with before slight pain in the breast, a sudden each feeding. feeling that the breasts are heavier, or milk dripping from the breast that’s not being used. Breastfeeding: the second breast entirely. This is normal. Gradually increasing feedings up to 10 to 15 minutes per breast will Common help your milk supply develop and n When your baby is ready to nurse, contribute to a good feeding routine. hold him so that his head is a little Questions higher than his tummy. This applies How can I tell that How much milk does my whether you nurse lying on your side my baby is hungry? baby need? or sitting up. If you sit up to nurse, Early signs of hunger may include small Your baby needs less than 1 tablespoon it helps to put a pillow on your lap movements as your baby wakes up, (15cc or ½ oz) per feeding on the first day such as whimpering or lip smacking; under your baby and position your of life and about 2 tablespoons (30cc or 1 pulling up her arms or legs toward her baby with his entire body facing you. oz) per feeding on the second day of life. middle; stretching or yawning; waking and looking alert; putting her hands n Try different positions to breastfeed. How long should my baby nurse? toward her mouth; making sucking Have a nurse or consultant In the first day or two of life, some motions; moving her fists to her mouth; at the hospital help you with the newborns are sleepy and only nurse for becoming more active, and nuzzling a few minutes at each breast or refuse proper positioning and latching of against your breast. your baby.

The Newborn Manual UCLAHEALTH.ORG | 1-800-UCLA-MD1 After and Between Feedings

n If your baby is not latching correctly or is not positioned properly, you may end up with cracked or sore . To prevent this, try chang- ing your baby’s position at each feeding so that you are not applying pressure to the same area each time. Also, you may apply ointments containing pure lanolin to the nipples after you allow your nipples to air-dry. You do not need to clean Formula-Feeding Basics off the lanolin prior to the next 18 feeding. If nipple soreness is severe, Some women aren’t able to breastfeed or decide that they 19 you may need to see a lactation prefer to use formula to feed their baby. It is important to n Make sure to burp your baby after specialist. feedings. It is sometimes helpful to remember that formula-fed babies grow up healthy and burp him or her during the feeding n Wearing a nursing will provide strong. Let us know if you have questions about using formula. too. Either hold him upright over support while allowing you to nurse your shoulder or sit him on your lap easily. Place nursing pads inside by supporting him with one hand in your bra to prevent your nipples There are three standard front, and gently pat or rub his back from sticking to the bra. Always types of formula: More formula with your other hand. air-dry your nipples after nursing, information: before you replace the bra flap. n Uterine cramps frequently occur 1. Milk-based: made from n Baby formula comes in three forms: during breastfeeding as hormones cow’s milk protein powder, liquid concentrate and are released in response to your ready-to-feed. baby’s suckling. One hormone, n Iron-fortified is the called , causes you to recommended substitute for the first 2. Soy-based: made from year of life. Cow’s milk, goat’s milk, produce milk, and the other, called soybean protein soy drinks (not ) and low , causes you to release milk iron formulas should not be used. and also causes uterine contrac- n Your baby does not need any tions. These contractions are 3. Simple protein formula: additional water, as formula nature’s way of returning your intended for with supplies adequate calories and uterus to its normal size and gastrointestinal issues fluids simultaneously. controlling bleeding.

The Newborn Manual UCLAHEALTH.ORG | 1-800-UCLA-MD1 While feeding Safety Information n You should be comfortable and relaxed, and cradle your baby in a Published guidelines on the semi-reclined position. As your handling and storage of infant newborn is feeding, you can look formula state that it is unsafe into his or her eyes and sense to feed an infant prepared behavioral cues of hunger, satiation, formula that: comfort or distress. n Has been stored at room temperature longer than one hour or longer than recommended by the manufacturer. n Has been stored in the refrigerator longer than 48 hours for concentrated or ready-to-feed formula, or 24 hours for powdered formula. 20 21 Formula Feeding: n Remains in a bottle one hour n The holes in the nipples should be after the start of feeding and/or large enough to allow a steady drip remains in a bottle from an earlier General Guidelines but not a full stream of formula. The feeding. and Information nipple and neck of the bottle should always be filled with milk so that air is not swallowed. Before you feed your baby n Some babies will empty a bottle in n Always wash your hands with soap n If you do decide to boil the water five minutes while other babies will and water before handling the items when preparing your baby’s formula, take half an hour. required for formula preparation. the U.S. Food and Drug Administra- tion recommends that you bring it to n Burp your baby about halfway n When preparing formula, always use a bubbly boil for a minute or two and through the feeding and again at clean drinking water. There is a lot of then let it cool. Once it has cooled, the end of the feeding. discussion about the type of water you will be ready to add it to your that should be used when mixing baby’s formula. n Avoid propping the bottle or letting powder formulas. The American n When the baby sucks, there should your baby feed alone. This will Academy of suggests boil- n Boiling, hot or warm water should be a steady stream of air bubbles minimize the risk of choking, ear ing water for the first month or two not be used directly when reconsti- entering the bottle. If there is not a infections and insufficient intake. of life, and in most cases, tap water tuting infant formula because it can steady stream of bubbles, the cap is acceptable. lead to clumping or separation, or may be on too tightly or the holes in n Do not put your baby to bed with cause nutrient degradation. the nipple may be too small. a bottle.

The Newborn Manual UCLAHEALTH.ORG | 1-800-UCLA-MD1