A Guide To Feeding Your Baby

Feeding is an important way to nurture your baby’s body and mind, so it is worthwhile learning how you can make the most of this special time

Australian guidelines recommend that infants be exclusively breastfed until about 6 months of age. Once solids are introduced, breastfeeding should continue until 12 months or for as long as mum and baby desire.When a baby is not breastfed or is partially breastfed, the only suitable alternative until 12 months is infant formula product.

The World Health Organization (WHO) also recommends exclusive breastfeeding for the first 6 months of life. Thereafter, other foods should complement breast milk until the child is 2 years of age or older.

This brochure aims to help guide you on providing the right nutrition for your baby during their first 6 months. Remember, you can always seek advice from your childhealth nurse, doctor or healthcare professional if you have any questions.

Each baby’s growth is individual and influenced by gender, genetics, environment and their general health.Breastfed babies tend to gain weight in a different pattern to formula-fed babies. This may be because
breastfed babies tend to self-regulate the amount of milk they drink. Formula-fed babies tend to be heavier
than breastfed babies of the same age, because of differences in milk intake and protein content.

Approximate growth rates for babies

Generally, weight is assessed as an average over 4 weeks. Percentile charts are a useful guide to monitor your baby’s overall growth. Australia has adopted the WHO growth charts as a reference source to monitor the growth of babies. The WHO has designed these growth charts specifically for breastfed babies. The WHO charts are different to standard growth charts, which are based on weight gain and growth for formula-fed babies.

Breast is best

Breastfeeding is the natural and best way of feeding babies. It offers significant health benefits for both
mother and baby, and provides a unique opportunity for bonding. For babies, breastfeeding provides a number of positive nutritional, physical and psychological benefits. In addition, breast milk has special antibody properties that help to reduce the incidence of common infections, affecting the respiratory and gastrointestinal systems.

Advantages of breastfeeding

For Baby

• May help to protect against food allergies, eczema, asthma; and helps reduce the number of hospitalisations for ear infections.
• Associated with a decreased risk of becoming overweight or obese later in life.
• Breast milk:
  • is easy to digest
  • contains easily-absorbed iron
  • helps to support gut and nervous system development.

For Mum

• Helps strengthen the emotional and physical bond between mum and baby.
• Helps the uterus to contract after childbirth.
• Assists with losing pregnancy weight and a return to pre-pregnancy weight range.
• May reduce the likelihood of breast and ovarian cancer, heart disease and osteoporosis.
• Is convenient in terms of preparation and storage.
• Is readily available, affordable, and does not require any special equipment (unless
  expressing).

Important considerations

• Breastfeeding can take a few weeks to establish, and requires patience, help and support.
• Most women experience some nipple tenderness for a few weeks until they get used to feeding. However, correct attachment can help to reduce tenderness.
• Breastfeeding relies on a mother’s availability, and feeding can’t easily be shared. However, some women see this as a benefit because it enhances the unique relationship that only a mum can have with her baby.

Although breastfeeding is the natural way to feed your baby, it may not always come easily. For most women
and their babies, breastfeeding is a learned skill, especially in the early days.

The WHO recommends that breastfeeding be initiated within the first hour after birth. Breastfeeding shortly after birth helps to stimulate milk production. It also provides an opportunity for babies to practice sucking before their mother’s milk comes in.

Colostrum is a highly concentrated form of early milk that provides unique nutrients and antibodies for newborn babies. Most women find that their breasts don’t start to transition from producing colostrum to milk until 2–4 days after birth. Colostrum, as well as the newborn’s reserves of energy, is enough to meet their needs during these first few days.

Attachment to the breast

Many women find that they need to be patient as they learn how to attach their baby to the breast and ensure they are sucking effectively. Your baby needs to be attached to the whole areola, rather than just sucking on the nipple. Most babies like to comfort-suck even when they’ve been fed and don’t appear hungry.Sucking is a strong, biological urge and is one way for babies to soothe and calm.

Signs that your baby has good attachment to the breast

• They are turned so their entire face and body are facing your breast.
• They have a wide mouth gape, with their top lip turned upwards and the bottom lip turned out.
• They use rhythmic sucks with a pattern of sucking, swallowing and little pauses; this is a sign that there is good milk transfer from your breast into your baby’s mouth.
• Their ears and jaw are moving rhythmically.

For good attachment to the breast, remember: “chin to breast and chest to chest.”

Successful breastfeeding is based on a supply-anddemand principle. The more frequently your baby feeds, the more your pituitary gland is stimulated and the more milk you produce. Babies who are breastfed when they want it, rather than on a timed schedule, tend to gain weight more quickly. They also feed in shorter, more frequent feeding patterns than when their feeds are regulated. Frequent breastfeeds are beneficial for
mothers as well, and may reduce their chances of breast engorgement and infection.

Newborn babies will often demand to be breastfed 8–12 times a day. This is because their stomachs cannot
hold large volumes of milk. Breastfeeding frequently is often a normal pattern of feeding behaviour in the
newborn period. It is not always a sign of not having enough milk.

It can take a minimum of 6 weeks for breastfeeding to become fully established. Bottles or pacifiers introduced during this time can affect the success of breastfeeding, and aren’t recommended. Supplementary feeding with formula can also negatively affect lactation. Breastfed babies who are fed extra formula may not want to suck as strongly at the breast.

Signs that your baby is probably getting enough breast milk

• They are generally content and alert
• Their skin is firm with good elasticity
• They have 6 or more pale wet nappies a day
• Until about 2 months of age, they have 3 or more bowel motions a day, which are mustard coloured, soft lumps and runny (they are unlikely to be constipated). Between 6 weeks and 3 months, bowel motions may slow down
• They have a steady weight gain, and increase in head circumference and length. They are growing out of their clothes, and you need to buy the next size up if you’re using disposable nappies.

Tips for boosting breast milk supply

• Eat a well balanced diet with on average an extra 2000–2100 kJ a day, to help support your body’s nutritional needs during lactation
• Getting more rest, using relaxation techniques and exercising can help
• Breastfeed more frequently and make sure your baby is sucking effectively
• Offer “top-up” breastfeeds 20–30 minutes after feeding
• Offer each breast alternately, and try switching sides several times through a feed
• Speak with your healthcare professional about medications that may assist in increasing your milk supply.

Fascinating facts about breast milk

• Human breast milk can be pale blue in colour and may also change colour depending on the mother’s diet.
• Breast size is not a good indicator of how much milk a mother will produce.
• Breast milk contains living cells and antibodies, and its composition changes at different times throughout the day.
• Babies obtain 75% of their milk in the first 5-10 minutes of feeding, but only get 50% of the energy (kilojoules). Hind milk, which is produced after the initial 5-10 minutes, is rich in fat and helps meet their energy requirements.
• Breastfeeding exposes babies to different tastes and flavours when their mum eats a variety of foods. This encourages babies to be more accepting of a variety of foods when they start eating solids.

Support for breastfeeding mums

One of the most important factors for successful breastfeeding is having a supportive partner and family. Preparing for breastfeeding actually starts during pregnancy, rather than after birth. Early intervention, with support and guidance from healthcare professionals, can help avoid breastfeeding problems.

Below are some examples of where you can get support:

• In most Australian states and territories, there are early parenting centres that provide free support services to parents and their children. Most also have telephone information services.
• Early childhood nurses who work in community health centres.
• Lactation consultants who work in hospitals, community health centres and in private practice.
• The Australian Breastfeeding Association provides breastfeeding support to mothers. Visit www.breastfeeding.asn.au or call 1800 686 268.
• Breastfeeding support groups, online forums, playgroups and mothers’ groups can also be an excellent source of practical and emotional support for breastfeeding mums.

Although breastfeeding is the ideal way to feed babies, it isn’t always possible for all mothers and babies.When babies are not being breastfed, the only suitable and safe alternative is infant formula product. It is important for mums to know that bottle feeding is not a sign of having failed.

Brands of infant formula sold in Australia need to meet strict standards for quality and nutritional content. Cow’s milk formula is suitable for most healthy, full-term babies, and is recommended over formula made from soy beans or goat’s milk.

Specialty infant formulas are designed for specific medical conditions. These may be based on soy milk,
or may be modified in some way to allow for better tolerance e.g. lactose-free or anti-reflux formulas.
The use of these formulas should be discussed with a healthcare professional before use.

Formulas labelled ‘suitable from birth’ can be fed to a baby from birth up to 12 months.

Formulas stating ‘follow-on’ are designed for babies aged 6–12 months. Follow-on formula may have a higher iron content, which helps to meet growing babies’ increased nutritional needs.

Important considerations

• Formula feeding does not have similar health advantages to breastfeeding.
• It is expensive and requires feeding equipment, a regular supply of formula, and time to prepare.
• It is less convenient and portable than breastfeeding, taking organisation and planning into consideration.

You will need to sterilise all feeding equipment until your baby is 12 months old. There are 3 ways you can do this:

1) Electric steam steriliser which works by creating steam. Temperature rises quickly in the unit to kill
harmful bacteria. Microwave sterilisers work on similar principles and tend to be cheaper than electric steam sterilisers.

2) Chemical sterilising which works by using a special antibacterial chemical solution. This tends to be messier than steam sterilising.

3) Boiling equipment in a saucepan of water on the stove for 5 minutes.

You can store clean, sterilised bottles and teats in a closed container for up to 24 hours, but will need
to sterilise them again after this time.

TOP TIP:

It is recommended that you own at least 6 bottles and several teats. This will minimise the need to be constantly preparing bottles between feeds.

Mixing formula correctly according to the manufacturer’s directions will provide your baby with the nutritional requirements they need. Always read the pack instructions to check you are mixing the correct amount of water and powder, as this varies between formulas. Different formulas may also use different sized scoops, so make sure you only use the enclosed scoop.

Before mixing:

1) Wash your hands and clean the area where you are preparing formula.

2) Wash and sterilise feeding bottles and utensils.

3) Prepare COOL BOILED water (boil fresh tap water for 5 minutes, allow to cool for 30 minutes).

• Adding formula directly to hot boiled water can destroy important vitamins and may cause scalding.
• Bottled water (but not sparkling mineral water or soda water) can be used to prepare formula if unopened, but it is not necessary; it should only be used if there is no access to clean tap water.NOTE: If bottled water is to be used it still needs boiling before use.

Mixing

1) Add the correct volume of cool boiled water to the bottle.

2) Check the expiry date on the can of formula and do not use expired formula.

3) Measure the correct amount of formula powder using the scoop provided, and level it off on the leveller.

• Don’t over-pack the scoop or tap it on the side of the can, as this will make the formula too concentrated, which may cause constipation.
• Don’t add half-scoops or extra scoops

4) Add the formula powder to the bottle.

5) Cap the bottle and shake well until mixed.

Note

Heating formula in a microwave is not recommended, as it can heat unevenly and burn baby’s mouth.

After mixing:

1) Ideally, formula should be prepared just prior to feeding. Otherwise, refrigerate prepared formula and use within 24 hours.

2) Before giving formula to your baby, warm it by standing the bottle in a container of warm water.

3) Test the formula temperature on your wrist before feeding.

4) Discard any formula left in the bottle after feeding.

It is very important to hold your baby during their bottle feeds. Feed times are an opportunity for loving interaction and closeness between parents and their baby. Below is some advice to help make feed time as comfortable and safe as possible for your baby.

• Make sure the neck of the bottle and teat are filled with milk when you tilt the bottle ready for feeding. This will help prevent your baby swallowing excess air and getting wind.
• Give your baby a break halfway through the bottle or when they aren’t sucking as strongly. Try to burp them mid-way through the feed and at the end. Babies will often have a small spill or posset of milk when they bring up their wind.
• Change sides when you feed your baby, and try to not always hold them in the same arm. Switching sides is automatic for breastfeeding babies, but formula-fed babies can benefit from changing positions as well.
• Leaving your baby alone or propping a bottle may mean your baby feeds too quickly or could choke. Babies who are put to sleep while drinking from a bottle are at a greater risk of ear infections and tooth decay than those who are held during feeds.
• If you are going out, keep the formula and water separate until just before feeding your baby. Otherwise, you will need to keep the prepared formula cold.

How long should a feed take?

Feeds should generally take between 15–30 minutes. Any less than 10 minutes can limit your baby’s sucking urge. More than 30 minutes can be tiring and affect the next feed time. A feed should not take any longer than an hour. If your baby is taking too long to feed, slightly loosen the screw cap on the top of the bottle. This will increase the flow of milk to baby’s mouth.

How much does my baby need?

The amount of formula your baby needs depends on their age and stage. Babies aged 6–12 months need to drink about 100 mL/kg/day of formula. Your baby may not always finish all of the milk in their bottle. As long as they are growing and gaining a steady amount of weight, they are getting enough nutrients.

How do I know when my baby has had enough?

Be sensitive to your baby’s signals when they have had enough milk. At the start of feeds, babies look hungry and suck strongly. When they are full, they may pull away, stop sucking, fuss, and move their face and mouth away from the bottle.

For further information about formula feeding, speak to your early childhood health nurse.

Some mums choose to combine breastfeeding with expressed breast milk (EBM) or formula. Returning to work, illness or personal choice are some reasons. Breastfeeding first, followed by EBM or formula, is preferable, as offering formula to a breastfed baby can negatively influence the success of breastfeeding.

If you are changing from breast to bottle feeding, it is best to do so over a couple of weeks if possible. If weaning is done gradually, it may help to reduce breast engorgement. It also allows for a period of adjustment for your baby to become used to sucking on a teat.

You can express breast milk by hand or by using a battery operated or electric pump. EBM can be offered from a bottle, cup or spoon.

NOTE: Seek support and guidance from your healthcare professional before commencing any changes to your baby’s feeding.

Storing expressed breast milk

• Fresh EBM can be stored in a sterile container in the refrigerator for no more than 72 hours. It needs to be stored at the back of the fridge where the temperature is coldest.
• Freeze EBM that has not been used within 48 hours. It can be stored safely for 3 months in the freezer section of a refrigerator (that has a separate door), or 6–12 months in a deep freezer.
• Thaw frozen EBM either outside the refrigerator in warm water and use within 4 hours, or in the refrigerator and use within 24 hours. Discard all unused thawed EBM after each individual feed time.

Preparing expressed breast milk for feeds

EBM is warmed in the same way as formula. Pour into a sterilised feeding bottle and then place the bottle in a jug of warm water. Avoid microwaves for warming, as they heat the milk unevenly and pose a burning risk.

By about 6 months of age, most babies are ready to eat solid foods. You can find out more in the Aspen Nutritionals brochures titled Introducing Solids and Yummy Scrummy Cookbook.

For other information specific to your child’s age, visit staging.mamc2017.flywheelsites.com

Our special thanks to Jane Barry, Registered Nurse, Midwife and Child Health Nurse, for her contribution to this brochure, based on her experience and professional knowledge (March 2015).

Important Statement:

Breastfeeding is the normal method of infant feeding, and is best for babies. It has benefits for the infant, such as reducing infection risk, and for the mother. It is important to have a healthy balanced diet in preparation for, and during breastfeeding. Infant formula is designed to replace breast milk when an infant is not breastfed. Breastfeeding can be negatively affected by introducing partial bottle-feeding, and reversing a decision not to breastfeed is difficult. Infant formula must be prepared and used as directed. Unnecessary or improper use of infant formula, such as not properly boiling water or sterilising feeding equipment, may make your baby ill. Social and financial implications, including preparation time and the cost of formula, should be considered when selecting a method of infant feeding.