Breastfeeding & feeding

Your baby grows more during their first year of life than at any other time, so making the right food choices is very important. Learn what to feed your baby and when – because starting good eating habits now can last a lifetime.

A feeding guide for your baby’s first year

Getting proper nutrition is essential to your baby’s healthy growth and development, especially during their first year of life. Feeding your baby is an exciting but also challenging process for many parents, who often have many questions.

How long should a newborn nurse? How many ounces should a newborn eat? How do you bottle feed a newborn? Every baby is different, which means there’s no one “right” way to approach feeding your baby in the first year. Instead, the medical community offers general guidelines based on what is safe and recommended for most babies.

Babies typically get all their nutrition from breast milk and/or infant formula for their first 6 months of life. At 6 months, you can begin to introduce solid foods. Learning what to do and what to avoid during this time can help you become more comfortable with feeding your baby.

Whenever you have breastfeeding or feeding questions, the experts at MD Kids Pediatrics are here to offer advice tailored to your baby’s unique needs. The infant feeding guidelines below should give you a good idea of what to expect for your baby’s first year, from breastfeeding and bottle feeding to the introduction of solid foods.

How to prepare for breastfeeding

It’s common to focus all your time and attention on caring for your baby – but if you are a breastfeeding mother, you need to take care of yourself as well. Here’s how to increase your breast milk supply and ensure that it’s as healthy for your baby as possible.

Eat well

Breastfeeding mothers need about 350-400 extra calories per day to create an adequate milk supply. Most breastfeeding mothers are able to eat a regular diet without avoiding “gas-inducing” foods like broccoli or cabbage. Focus on whole foods that are rich in vitamins, minerals, and proteins like leafy greens, lean meats, fish, eggs, legumes, whole grains, fruits, and nuts. 

Continue taking prenatal vitamins

Continue taking prenatal vitamins that contain iron, calcium, and vitamin D to support your nutritional needs.

Stay hydrated

Breast milk is more than 80% water, so staying hydrated is crucial for effective milk production. Aim for at least 8-10 glasses of water daily.

Limit caffeine and alcohol

It’s safe for breastfeeding mothers to consume moderate amounts of caffeinated beverages. The American Academy of Pediatrics recommends limiting your caffeine intake to 300 milligrams per day – the equivalent of 2-3 cups of coffee.

Breastfeeding mothers may also consume small amounts of alcohol (one standard drink), but should wait at least two hours before breastfeeding. You may pump and discard breast milk during this time. If you are concerned about the effects of alcohol on your baby, it’s best to avoid alcohol altogether.

Ask about medications

Many medications are safe to take while breastfeeding, including certain over-the-counter pain relievers, decongestants, and antihistamines. Always ask your doctor before taking medications while breastfeeding.

How to breastfeed

It’s normal to have some mild discomfort when you begin a breastfeeding session. If your baby does not latch properly, they may pinch or bite your nipple. Any pain that continues after the feeding begins could indicate a poor latch.

What a good breastfeeding latch looks like

When latched properly, your baby’s mouth will be open wide and latched onto most or all of your areola (not just your nipple). Your baby’s chin should be pressed against your breast, leaving their nose unobstructed so they can breathe. A good latch is comfortable and pain-free after the first few minutes, and you can often see and hear your baby swallowing.

Choose a breastfeeding position

The laid-back breastfeeding position allows your baby to self-latch and initiate feeding while reducing pressure on your shoulders and arms. It may be helpful if you delivered your baby via cesarean section or have postpartum discomfort.

• Recline on a bed, chair, or couch at a comfortable angle.

• Place your baby on your chest, stomach-to-stomach, with their head near your breast.

• Use your arms or a breastfeeding pillow to support your baby’s head and body.

• Let your baby attempt to find your nipple latch on naturally.

• If your baby is having difficulty latching, gently guide their head toward your breast.

When does cluster feeding start?

Cluster feeding, or frequent breastfeeding sessions in a short period of time (typically every 1-2 hours), is very common during the first few weeks of your baby’s life. 

Yes, cluster feeding can be exhausting, especially during postpartum recovery. But it has many important benefits, from stimulating milk production to teaching your baby how to breastfeed effectively. Newborns experience growth spurts in the first few weeks and months that increase their appetite, so these skills will quickly come in handy.

What your breast milk contains

Breastfeeding mothers do not usually produce a large volume of milk at first. And that’s okay – your baby’s stomach cannot hold very much anyway.

The first fluid your breast produces is called colostrum, which is thicker and more yellow than breast milk. Colostrum is nutrient-dense and rich in antibodies, including lactoferrin, that prevent infection and help strengthen your baby’s immune system.

After a few days, the colostrum transitions to breast milk, which also has vitamins, minerals, and proteins to help your baby grow and thrive. The content of your breast milk varies from the beginning to the end of a breastfeeding session, with more fat content present at the end of the feeding. Therefore, try to fully empty one breast before switching to the next. 

Add vitamin D and iron supplements

Because breast milk alone does not provide enough vitamin D, all breast-fed babies should be given 400IU of vitamin D each day. Exclusively breast-fed babies should also begin taking iron supplements at 4-6 months of age.

Any amount of breastfeeding helps

Any amount of breastfeeding that you can do is beneficial for nutrition and bonding with your baby. Remember, it does not have to be all or nothing. Needing to supplement with infant formula does not mean that you are failing at breastfeeding. There are some mothers who cannot breastfeed at all for a number of legitimate reasons.

Can you breastfeed with implants? Generally, yes. Some mothers experience difficulty with latching, but there is no evidence that breast implants can harm your milk supply.

If you are struggling with breastfeeding for any reason, ask MD Kids Pediatrics about scheduling a lactation consultation. Many mothers need extra support to be able to breastfeed successfully.

Formula feeding tips

For parents who choose to supplement breastfeeding with formula or feed formula exclusively, most babies can tolerate a standard, cow’s milk-based infant formula. Your pediatrician can suggest alternate options if your baby does not tolerate the formula well. 

Frequency of feedings

Newborns have small stomachs and need to eat frequently. Breast-fed babies may eat every 1-3 hours, while formula-fed babies may eat every 2-3 hours. You should wake your newborn if it has been more than 3 hours since their last feeding.

Over time, your newborn will progress from 1-2 ounces per feeding to 2-3 ounces, 3-4 ounces, and so on.

Avoid overfeeding

When bottle feeding, begin by offering your newborn 1-2 ounces per feeding. You don’t want to overfeed your baby and give them more formula than their stomach can comfortably hold and digest.

Overfeeding is one of the most common causes of crying and fussiness in infants. Other  overfeeding infant symptoms include frequent spitting up, vomiting, gas, diarrhea, and bloating.

Pay attention to feeding cues

When your baby stops actively sucking on the bottle’s nipple, they are done. You should never “prop” the bottle or force your baby to finish a feeding.

As your baby grows, their appetite will grow as well. Continue to pay attention to your baby’s cues and increase the volume of feedings as needed.

Use the position your baby likes best

Typical bottle feeding positions include: 

• Cradle hold – Hold your baby in the crook of your arm to support their head, and tilt your baby slightly so their head is higher than their hips.

• Football hold – Hold your baby tucked under your arm, as if carrying a football.

• Side-lying – Lay your baby on their side on a lap or pillow, or lie on your side with the baby next to you.

• Sitting up – Sit on a bed, chair, or couch and place your baby on your lap. Put your baby’s feet against your stomach so they are facing you if you wish. (This position is helpful for babies who are prone to spitting up.)

How to sterilize feeding bottles

Sterilizing is a step beyond traditional bottle cleaning that provides extra protection against germs – a plus for your newborn’s developing immune system. Sterilizing bottles daily until your child is 3 months old is recommended.

If you use a dishwasher with hot water and a heated drying cycle, it’s not necessary to sanitize your baby’s feeding bottles by hand. But if you prefer to, follow these steps:

• With boiling water – Fill a large pot with enough water to cover the bottles, submerging them upside down. Bring the water to a boil, then boil the bottles for 5 minutes. Remove the bottles using tongs and air dry.

• By microwave – Fill the bottles halfway with water, and microwave on high for 1-2 minutes. Remove the bottles using mitts, empty the remaining water, and air dry.

Or you may opt to invest in a countertop sterilizer, which uses electric steam to sanitize feeding bottles and other baby items.

When do babies stop drinking formula?

By the time your baby reaches 6-8 ounces per feeding, they are usually ready for solid foods. Most babies stop drinking formula around 12 months, when their nutritional needs can be met with the combination of solid foods and whole cow’s milk.

Start by replacing 1-2 formula feedings with whole cow’s milk per day. If your baby experiences gas or diarrhea after switching to milk or refuses milk and is not gaining adequate weight, consult with your pediatrician. It may be necessary to continue with formula for a while longer.

Starting your baby on solid foods

You can offer your baby solid foods for the first time around 6 months of age. It is not recommended to introduce solid foods before 4 months.

Does your baby open their mouth when food is offered? Are they showing interest in watching others eat? Your baby is likely ready to start eating solid foods, as long as they can support their head and sit with minimal support.

If your baby “thrusts” the food out with their tongue, they are not ready. Wait a week or two and then reintroduce solid foods again.

What solid foods to try

You should always feed your baby with a spoon – never put food into a bottle. Start with soft, pureed, or mashed foods like iron-fortified infant cereals, fruits, vegetables, and proteins. You can gradually move to finely chopped finger foods as your baby develops.

It’s generally recommended to wait 3-5 days between trying new foods, so you can easily identify the cause if your baby has a negative reaction. You do not need to avoid allergenic foods (such as peanut butter, shellfish, eggs, wheat, and soy) when feeding your baby. Introducing these foods in very small amounts at this age can actually prevent food allergies from developing later in life.

When you prepare food for your baby, do not add additional sugar or salt. Your baby should also not consume honey until they are over 12 months of age. Honey can contain a type of bacteria that causes infant botulism – a dangerous, life-threatening infection – so avoid honey in any form, including raw honey and honey-flavored foods.

Introducing water

As children and adults, drinking water is an excellent way to care for our health – but that’s not the case for babies.

Newborns under 6 months of age should never be given water as it can lead to water intoxication, which is an imbalance of electrolytes that puts pressure on the brain and other organs. Like breast milk, infant formula is more than 80% water – both provide plenty of water to keep your baby healthy.

After 6 months of age

When you start feeding your baby solid foods, you can offer small sips of water to help with swallowing and digestion – no more than 4-8 ounces per day. Using an open or straw cup can help your baby develop oral motor skills. Juice is generally not recommended at this age due to its high sugar content. 

Good eating habits start early

It’s important for your baby to get used to the process of eating, including taking food from a spoon, resting between bites, and stopping when full. These early experiences will teach your child good eating habits that can last a lifetime.

Breastfeeding and feeding your baby can be stressful, whether you’re an experienced parent or a first-time parent – but it doesn’t have to be! Contact MD Kids Pediatrics for more information and support.