Infant Feeding FAQs
Moms asks thoughtful and caring questions about feeding their baby. Ask away, momma! I encourage moms to feel comfortable asking as many questions as they want!
So here are five questions that come up a lot in my role as doula and lactation counselor. A few important notes - one of my doula mantras to families is that every baby and every family is special and unique. There are many great ways to parent and each family has the blessing to make their own decisions. So, while I am presenting research supported, evidence-based answers, you as parents get to decide. Within the scope of “normal” there are several variations.
Do we wake our baby up to feed?
Newborns need to eat between 10-12x/day and have tiny stomachs. The longest it is recommended that they sleep (and thus not eat) is 3-4 hours, and only one 4-hour sleep per 24 hours. Babies are also very communicative and smart and will tell you when they are hungry. They will show several feeding cues such as rooting, sticking tongue out and smacking lips (crying is a late cue, and it’s harder to feed a crying baby). One of the best times to feed a baby is during their light sleep, or rapid eye movement (REM) sleep. This is when the baby appears asleep, but their eye balls are moving, or they look like they are dreaming. If ever you feel the need to wake a baby, this is the sleep stage that would definitely work best as babies can absolutely feed during this light sleep. As long as the baby is gaining healthy weight, you can use responsive feeding and feed the baby when they cue, rather than wake them up. See my blog of feeding cues for more info https://www.earlycaredoula.com/blog-1/how-do-we-know-when-baby-is-hungry-12
How often do we plan to feed our baby? Schedule?
There are mixed opinions for sure about this question, but my training and the research asserts that babies need to eat 10-12x/day and that the time in between feedings varies. I use the snack (apple) versus meal (cheeseburger) example - we adults eat varying sized meals. So can babies. Breastmilk metabolizes quicker than formula, and a mother’s milk changes in fat content throughout the day (higher fat at nighttime). So this too impacts time between feedings. Therefore, most lactation professionals recommend that you watch the baby for cues, rather than the clock.
If breastfeeding, it is also very important to nurse 10-12x/day starting day 1 in order to build your milk supply. Keep in mind that the newborn milk, called colostrum (liquid gold), is yellow and your breasts produce small amounts. This is normal, and baby only needs a small amount, but often. By day 3-4, your mature milk will start and baby will receive more at each feeding 10-12x/day. Research also suggests that the more a baby eats during the day, the less they may eat at night. But they do need to eat during the night!
Do you need to use hot water when making formula?
Yes. Super important to follow the exact instructions on the formula packaging. There is a misconception that we heat water (158 degrees Fahrenheit, short of boiling) to improve the quality of the water. While clean water is certainly important, we boil the water to be certain that there are no germs/bacteria in the formula because powdered formula is not sterile. Certainly, after mixing the formula (always measure water first, then add powder), let it warm or cool to a safe temperature for baby. Here are the CDC recommendations - https://www.cdc.gov/nutrition/downloads/prepare-store-powered-infant-formula-508.pdf
How do we know if baby is getting enough milk or formula?
A common concern I hear from parents is that baby may not be getting enough food. There are three ways to measure that your newborn is getting enough nutrition. The first is to track weight gain. By the 12-14th day of life, the infant should be back to birth weight. At that point, the ideal growth is 1 - 1.5 ounces per day. The second best way is to measure pees and poops. Newborns need to poop 4x/day starting on day 4 along with 6 wet diapers. Urine is harder to measure sometimes because they may poop and pee in one diaper, so focus on the poopy diapers. Research is unclear about when these 4 poops/day transitions to less poops per day. The best conclusion is around 6 weeks - 12 weeks. Formula fed babies tend to poop less than breastfed babies.
Finally, back to the baby being communicative and smart. A baby will tell you when they feel hungry and they also communicate when they are full. Their little fists will open up and their hands will appear relaxed, their body tone will soften, or they will move their mouth away from the breast or bottle. Sometimes they will fall asleep. This is not always a sign that they are full. If the baby had been hungry and crying, they are more likely to fall asleep while eating because crying tires them out. Sometimes when this happens, they fall asleep before their tummy feels full, so they may cue hunger again sooner.
Is it normal for breastfeeding to hurt at the beginning?
Short answer - No. With an ideal latch and/or position, breastfeeding will not hurt. And this is certainly our goal as lactation professionals. That being said, many women experience pain. Please, please, please reach out to lactation for support because 9 times out of 10, the pain will subside after a slight adjustment of the latch. There are a few keys to a pain-free, successful latch. The baby’s mouth needs to be open very wide (140 degrees) in order to take in the nipple, and much of the areola and breast tissue. We want the the nipple to be in the top of the baby’s mouth so that it can fully expand and release milk. Baby’s nose and chin up against the breast while baby’s shoulder and hips aligned, tummy to mummy. There are several more details to observe in a lactation session, and I would be super happy to use my Lactation Assessment Tool (LAT) to help you feel comfortable and help your baby transfer milk quickly. With an efficient latch, breastfeeding may be completed within 6 - 8 minutes per side.
This is perhaps my favorite topic to discuss and support families with. Please reach out if you have questions or concerns!
Becky@earlycaredoula.com
