Feeding your baby: From breastmilk to solids

A mother holding the feet of her baby

The initiation, duration, and exclusivity of breastfeeding depend greatly on the mother’s perception of 'adequate breastmilk for her baby. Subsequent transition to semi-solids and solids is a decision that mothers take. How do you go about this transition. When do you start ? 

Many mothers fear to practice exclusive breastfeeding due to:

  1. The belief that the child is thirsty
  2. Pressure from family and friends
  3. Perceived insufficiency of breastmilk.
  4. The fear of problems related to the transition from breastmilk to other food.

In contrary to the above views, the production of breastmilk is high and increases over time among mothers who are well supported and follow the recommendations on breastfeeding. Thereby assuring normal infant growth.

6 ways to determine inadequate breastfeeds

1. Frequency of nursing

There is a debate over the ‘normal’ frequency of feeding episodes during the first 24 hours after birth. The more often a baby breastfeeds, the more milk a mother produces. This is applicable when she must pump milk while staying away from the baby.

Ideally, a newborn should be fed 8-12 times/day. i.e The mother may need to nurse her newborn baby every 2-3 hours during the first 24 hours of birth. This schedule would be comfortable for mother and baby as they get enough time to take rest or sleep between the feeds. The frequency can be increased during growth spurts that occur typically at 7-14 days, 1 month, 2 months, 3 months and 6 months based on the infant’s demand.

2.  Length of time

The length of time that a baby feeds varies greatly among infants.  Healthy newborns should be allowed to determine the feeding length. Most babies nurse for 15 to 20 min/feeding. You can assume that length of time taken by your baby to nurse is apt if she gains weight within the normal recommended limits. Most importantly, your baby would the feedings on her own. Experts state that if the infant’s nursing duration is less than 5 minutes per feeding and over 60 minutes per feeding, it could be considered inappropriate.

3. Positioning for nursing

To nurse your baby comfortably, you need to position yourself correctly and follow the correct techniques of breastfeeding. Make sure that your back and feet are well supported during nursing. Your newborn’s body should be aligned in such a way that the ear, shoulder and hip are in a line. When you start feeding your baby from the breast, her tummy should be in contact with yours and her lips should be flanged out while her chin touches your breast.

4. Artificial nipples and formula supplements

Artificial nipples prevent effective suckling at the breast. However, women with a cracked nipple or an inverted nipple may adopt these devices ONLY upon consulting their physician. Formula supplements delay hunger and feeding frequency that is needed in the early weeks of life. Both can lead to the production of less breastmilk. Exclusive breastfeeding is the cost-effective strategy to ensure safe and adequate nutrition for your baby.

5. Mother’s perception of nursing

 A mother’s views and personal beliefs about breastfeeding influence her attitude towards the same. If she considers breastfeeding to be beneficial to her infant and a joyful experience, she is likely to produce more hormones necessary to produce breastmilk. Her positive mindset brings about added stimulation for milk production. Worries, apprehensions and negative attitude towards breastfeeding may interfere with this natural process.

6. Mother's fluid intake

Water constitutes 88 percent of the breastmilk. The water content of breastmilk consumed by an exclusively breastfed baby meets the water requirements for infants. A mother needs to consume approximately 3 litres of fluid per day to meet the baby’s demands. She can have anything ranging from safe drinking water to fresh fruit juices. However, it is better to avoid excessive intake of coffee and carbonated drinks.

The mother produces the maximum quantum of breastmilk within 4 to 6 weeks postpartum.

MEASURES TO ASSESS ADEQUACY OF FEEDS

1.  Number of wet diapers

Within a period of 24-hours, your baby will wet her diaper 3 times or more after the 3rd day of life. Do not give your infant anything other than breastmilk. The diapers that become wet upon the consumption of water, glucose water or other liquids,  given as a supplement, are indeed falsely reassuring.

2. Number of stools

By the 4th day of life, your baby may pass at least 3 soft yellow stools. During the first 6 weeks of life, it is normal for your baby to pass multiple yellow (liquid or soft) stools per day. After a period of six weeks, her stool pattern varies. Many older babies only pass stools once over several days. This is not a problem if the infant is nursing as usual, active and seems comfortable. Do not use laxatives without consulting the doctor. The frequency and consistency of the stools may change with the introduction of formula supplements.

3. Infant body tone

The Infant body tone is a good indicator that helps you to identify the adequacy of feeding that your baby receives. Make note of the infant’s body tone when obtaining weights and lengths of your baby. If she has good strength and supports her body well when held, it implies that she has a good tone. If her body feels floppy or difficult to hold onto, it is a sign of ‘poor’ tone. Poor body tone may indicate ineffective sucking at the breast. This is usually temporary. You should provide optimal infant whole-body support and additional breast stimulation.

4. Infant’s behaviour and Sleep

Babies who are breastfed adequately look satisfied and happy. She may sleep quietly for the next 2 to 3 hours after feeding. Your infant demonstrates appropriate growth and development with a well-nourished look.

TIPS FOR SUCCESSFUL BREASTFEEDING

The following steps are critical to achieve optimal breastfeeding and adequate milk production:

  1. Develop a positive attitude towards breast feeding. This is the most precious gift that you can give your little one during the initial years of life.
  2. Stay tuned to the art of nursing your baby. Spend time with your baby and enjoy listening to her nonverbal cues. Remember that breastfeeding is an acquired skill. Once you master the skill it gives you confidence as ‘mother’.
  3. Correct the latch and positioning problems immediately, especially before the first growth spurt (7 to 14 days).
  4. Establish exclusive frequent nursing during the first 4 weeks to help produce the highest milk volumes possible.
  5. Obtain an appropriate breast pump if your baby is separated from you due to hospitalization or sickness. You may consult your physician before doing so.
  6. Ensure healthy diet habits for yourself. The quality of breast milk depends on your dietary patterns.
  7. Be happy and cheerful. Your emotions play a vital role in breastmilk production. Interact with your baby while feeding. This provides you with a sense of well-being and your baby feels loved and secured.

 Your baby's diet - 6 months later

Appropriate food habits help the baby grow mentally and physically strong. Thus, the baby's diet at various developmental stages of the baby needs to be different.

The World Health Organisation (WHO) clearly states that babies should be fed breastmilk in their first year. However, upon turning six-months-old, babies must consume some solid food and semi-solid food along with breastmilk.

By the time the baby turns a-year-old, he or she should be accustomed to a diet that is similar to that of his or her parents. The reason behind the shift in dietary patterns is the rapidly developing body of the baby.

Breastfeeding a premature baby

Breastfeeding a baby who was born prematurely is more difficult than feeding a term baby. This is because the baby could be quite small and is unable to latch his or her mouth around the mother’s nipple.

In such circumstances, it is suggested that the baby is fed breastmilk that has been expressed. This can be continued until the baby is big enough to consume breastmilk directly, by suckling at the breast.

Only upon consultation - Formula feeds

Some mothers resort to formula feeds for several reasons. These include - the inability to breastfeed their baby or the lack of breastmilk. However, this method should be adopted only upon consulting the physician.

Formula feeds are ideal for few situations like:

  1. During the first few days of life, the baby is said to have low blood sugar levels, excessive weight loss, or dehydration. The mother can give her baby formula feeds if she is unable to breastfeed her baby successfully.
  2. The mother is experiencing a state of inadequate breastmilk production. This is a rare health condition. In such cases, the baby can be fed a combination of breastmilk and formula feeds.

Bottle feeds - CONSULT YOUR DOCTOR

The use of feeding bottle is more convenient as opposed to the former feeding technique. Despite its ease, many doctors say that mothers must consult their physicians before initiating bottle feeds.

Mothers must take care and play it safe while feeding breastmilk to their babies by means of a feeding bottle. After all, your baby must receive sufficient breastmilk that is nutritious and not contaminated.

 Also read: Breastfeeding techniques- lessons for first time mothers – Part 2

Breastfeeding techniques- lessons for first time mothers – Part 1

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This article has been written by Dr. Namitha Subrahmanyam. She has been working as a nurse for over 13 years and holds an M.Sc in OBG Nursing. Recently, Namitha Subrahmanyam has been awarded a PhD. She is also working as an Associate Professor at the Department of Obstetrical and Gynaecological Nursing of the MOSC College of Nursing, Kochi, Kerala, India.

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