Breast-feeding is certainly best for your baby. You have probably heard or read about the advantages of breast-feeding. • Its constituents are best suited to meet the nutrition for the baby and is easily digested • Infections are less because milk comes directly from mother to the baby and therefore there is no chance of any germs entering it as it would from a bottle (even if you sterilize the bottles some germ contamination can still occur) • It contains many substances that help the baby’s body to resist the germs (viral and bacterial) • Besides these, there are many other advantages including stronger bonding between the mother and the baby Most of the mothers that I come across in my practice do want to breast feed their babies, but some mothers do not succeed. The main reason is wrong advice from relatives and friends. Some mothers do want to breast feed, but cannot breast-feed their babies because they have to go out to work. In this chapter, I will be discussing about breast-feeding as well as about formula feeding. 2.1 Breast-feeding A baby should be put on breast as soon as she is born and is crying vigorously. In case of caesarian section, the baby can suck from the breast as soon as the mother wakes up from the effect of anesthesia, i.e. about 4 to 6 hours after birth. She can keep on lying down, while someone else holds the baby and let the baby suck from the breast. You should tell the nurses 15 CHAPTER 2. FEEDING YOUR NEW BORN BABY 16 in the nursing home or hospital that you want this to be done. Ask them not to give the baby a bottle at all. Only exception is when the mother is too ill and not able to feed the baby. For the first 1 or 2 days, milk secretion is very little in quantity and yellowish in color. This is known as colostrum. If the baby sucks well on the breast, then this amount of milk is enough for her. Initially she will probably demand it frequently, but very soon, you will find that enough milk will be secreted and your baby will sleep well in between the feeds. Actually the more the baby sucks on the breast, more milk will be secreted, as when the baby sucks, mother’s body gets the signal that milk is needed and therefore more milk will be produced. At times, there is a problem initially in making the baby latch on the breast and thus she is not able to suck. This usually occurs if the baby has been given bottle feed before putting on the breast, but it may occur otherwise also. It may be because the way you are holding the baby, you and your baby are not comfortable or it may be due to flat nipple. You can try giving baby breastfeed while lying down. Flat or inverted nipple is one of the commonest reasons for difficulty in making the baby latch on to the breast. The treatment for this should start when the mother is pregnant. She should pull the nipple out a few times a day after applying some cream. When the mother, who has flat nipple, is having difficulty in trying to feed the baby in spite of all the attempt of pulling out the nipple, she can use nipple shield for a while. After a few days, she will find that the baby will be able to suck without the nipple shield. Once the baby latches and sucks well on the breast, there is no reason why she will not succeed in breast-feeding. If your baby is born prematurely then the baby may not be able to suck well on the breast. In such a case, you may have to express the breast milk and give it to the baby with a bottle or a spoon. However if the baby is very premature the baby will have to be given expressed breast milk with a feeding tube. This is always done in a hospital or nursing home and by the nurses, who are experts in feeding these babies. When the baby sucks over the breast, see that the areola (the dark portion around the nipple) is in the baby’s mouth. Sucking directly over the nipple alone causes cracked nipples. Also too much cleaning the skin over the nipple also causes dryness of the skin which causes cracked nipple. It is not advisable to clean the nipple before each feed. Cleaning once a day while taking bath is enough. Once cracked nipples occur, as this is very painful, it becomes very difficult to feed the baby. You can apply some lubricating cream over the nipple, after feeding, to ease the pain and help in healing. If the cracking is very severe, then you may have to stop feeding the baby for a day or two and give the baby expressed breast milk with a spoon or bottle. Do ask someone, who has experience in breastfeeding to help you. 2.2 How often to feed the baby and at what interval? Nowadays, we tell the mothers that the baby should be fed whenever the baby is hungry i.e. cries for feed and wants to suck. We call this demand feeding. You will find that after the first week of life your baby will usually set up her own routine. Some babies will finish their feed
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FEEDING YOUR NEW BORN BABY 17 within 10 to 20 minutes at one go, while others will take a longer time. Some babies will have a set pattern of feeding; that is they will feed for 10 minutes, rest for 10 minutes, again feed for another 10 minutes, and then rest for 30 minutes. During this 30 minutes they may sleep (light sleep) and then wake up and feed for a short interval and then sleep for 3 to 4 hours. I observed this pattern with my baby and many other mothers have told me that their baby have had a similar pattern of feeding. When babies keep on demanding feeds again and again at short intervals, some mothers think that the milk secreted by breast is not enough and therefore they supplement breastreast milk with bottle feeds. This is one of the reasons because of which many mothers do not succeed in fully b feeding. If your baby is passing urine frequently, and gaining weight after the first week of life, your baby is getting enough milk. Usually by 3 months of age, babies drink milk at interval of 3 to 4 hours. They will probably sleep for 3 hours, stay awake for 3 hours, and then again sleep for 3 hours. At night, many babies do sleep for 6 to 7 hours. During this time, they may wake up only once for feed and then sleep again after that. In 24 hours, a 3-month-old baby will sleep for about 15 hours. However not all babies follow the same pattern and if your baby follows a different pattern you do not need to worry about that.