Infant Feeding - 0 - 4 months
Breast milk is the ideal food for your baby. The baby till 4-5 months of age requires no other food. You may have heard of women who didn’t seem to have enough milk or who had other serious problems in nursing. This mostly happens because the mothers don’t really understand breastfeeding. This is not surprising since most of us don’t have a chance to learn about breastfeeding. Indian mothers secrete 450-600 ml of milk daily with 1.2gm protein content. The energy value is 70 Kcals per 100ml.
Advantages of breastfeeding:
- Safe, hygienic, cheap and available to infant at correct temperature.
- Fully meets the nutritional requirements of the infant in the first few months of life.
- Contains antimicrobial factors such as macrophages, lymphocytes, secretory IgA, anti-streptococcal factor, lysozyme and lactoferrin that provide protection against diarrhoeal diseases, necrotising enterocolitis respiratory infections in first months of life.
- Easily digested and utilized by both normal and premature babies.
- Promotes bonding between mother and infant.
- Helps development of jaws and teeth of baby due to suckling.
- Protects babies from tendency to obesity.
- Prevents malnutrition and reduces infant deaths.
- Natural family planning by prolonging period of infertility
Stomach capacity has never been given much importance while telling a mother how to feed her baby. This results in mothers either force feeding or getting unnecessarily worried about baby not taking enough.
Stomach capacity(0 – 4 months): 30 – 86 ml (6-14 tsp.)
No top feeding / Supplementary foods at all as:
- Breast milk alone can supply all requirements
- Solids given close to breast feed can reduce the absorption of nutrients from milk
- Ability to move food and chew does not develop before 3 – 4 months
- Poor head control and cannot hold neck up for swallowing
- Food digestion is poor as stomach is small (30 – 86 ml)
The current recommendations are to exclusively breastfeed your baby until around 6 months of age- this means that they do not require any substitute milks, water, juices, or foods until around 6 months when you would continue to breastfeed your baby alongside the introduction of complementary foods, for up to 2 years or beyond if it suits both mother and child.
Some may start weaning at 4 months of age
Simplifying it ï¿½ till six months breast milk as the only source of milk; no milk from out provided mother has enough lactation
Breast fed babies will often continue having night feeds for more months- not all, but many will and this is completely normal. Some babies may not give up breast feed at night for 2-3 yrs. When breast milk is regularly consumed the rate of milk production remains what the baby needs to grow; so moms need not worry about ï¿½is the baby getting enough?ï¿½.
Because all our babies and breasts are unique, the pattern of milk consumption and frequency or duration of feeds are never the same between mother/child pairs.
Some babies would very much still need night feeding after 3 months from a nutritional perspective, and since one of the several advantages of breast-feeding is that promotes bonding between mother and infant. Infant learns to depend on/ enjoy the comfort / calming effect the period of breast-feeding provides; many babies would require the closeness of their mother in the nights for many months, which again is totally normal.
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Though no milk can be a real substitute for mother’s milk, sometimes it is needed to give artificial feeding to the baby even in the first few months of life.
Circumstances under which artificial feedings maybe essential are:
- Breast milk has completely stopped or is insufficient to the child.
- Mother is suffering from any serious illness, fever or infection.
- Another pregnancy intervenes during lactation
- If the child is too weak to nurse or cannot because of harelip or cleft palate.
- Mother is not available to feed the child.
Factors like lack of suitable information, disinterest, inappropriate health practices may lead to mothers milk being unnecessarily substituted with a milk formula in the early months of life. This should be avoided and the help of a qualified person should be sought before attempting to switch from exclusive breastfeeding to artificial feeding. Also, see common problems during first weeks of breastfeeding
Modification of the formula
Cow’s milk is diluted to provide a concentration of protein similar to that of human milk. And also reduces tension and leads to the formation of a softer, more flocculant curd that can be more easily digested by the infant’s enzymes. The dilution of milk has the advantage of creating a calcium concentration more nearly to human milk but reduces caloric concentration. Sucrose can be added to increase the calories.
During the first two weeks about 15g. sugar is added to the day’s formula. Thereafter, 30 g. is sufficient. Sugar is discontinued at the time the baby is taking appreciable amounts of other foods.
Liquid: At two months the infants takes about 120 ml of formula. This is increased about 30 ml. each month until the infant is taking a maximum of 240 ml. at approximately 6 months of age.
The steps of sterilization are,
- Pour measured amount of milk into thoroughly washed bottle.
- Put nipple on the bottle and test the flow of the milk
- Cover loosely with nipple cover.
- Place bottle in a container and add water to halfway level of bottle
- Cover it, bring water to boiling, and maintain boiling for 15 – 20 minutes.
- Remove bottle as soon as they can be handled, and cool slightly.
- Store in refrigerator.
Intervals of feeding
Formula – fed babies should not, as a rule be fed at less than 3 hour intervals since the cow’s milk remains for a longer time in the stomach.
Technique of feeding
The feeding is usually warmed to body temperature or can be fed cold. As with breast feeding the baby should be held in a semireclining position. The hole in the nipple should not be large or too small. The nipple should be filled with fluid and not air. The baby should not be expected to finish the entire amount of formula in the bottle at each feeding. Proprietary formulas are available in dry form. Specified quantity of water is added to make up the volume.
Growth failure due to repeated infections or over diluting the formula, infantile obesity, iron deficiency anaemia, hypernatremia, neonatal hypocalcaemia, amino acidaemais in premature infants and acrodermatitis and enteropathica have all been reported. There is a higher prevalence of allergic disorders, infective morbidity, emotional instability and sudden death syndrome in bottle fed than breast fed infants.
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