Breastfeeding newborns with breast milk
As the World Health Organization and Unicef recall on the occasion of the 40th anniversary of the International Code of Marketing of Breastmilk Substitutes (source 1), “breastfeeding is crucial for nutrition, health and the well-being of the child throughout his life. It reduces costs for families, healthcare institutions and governments, protects children from infections and saves lives. Along with other mental health benefits, it stimulates emotional bonding between mother and baby. »
The health organization advocates exclusive breastfeeding during the first 6 months of baby’s life.
The first days of motherhood
Once baby has pointed his nose, the ideal is to offer her the breast as soon as possible. “As soon as he lifts an eyelid, it’s a sign that we can feed him,” says Carole Hervé. We often hear that you have to wait until the baby is awake to put him to the breast, but he is quite capable of nursing while drowsy !
Carole Hervé, lactation consultant “In the maternity ward, mothers are advised to breastfeed their baby as soon as she wants to kiss it: by doing so, she will improve her lactation”
the breast milk is very quickly digested by the babyin particular the colostrum produced the first days after childbirth: the mother should not hesitate to put baby to the breast as often as possible !
The volumes of milk drunk by the infant the first two to three days of life are small: he takes about 25 to 56 ml of colostrum during the first 24 hours.
Then, on average 72 hours after birth, the mother has her milk flow, which corresponds to the transition between colostrum and transitional milk. “The more regularly the mother puts the baby to the breast from birth, the faster this rise in milk will take place,” explains Carole Hervé. The milk becomes more abundant and richer in lactose : the baby starts complaining much more often. The night before the milk comes in is called the “ java night », the baby asks to suckle almost continuously and it is important to accede to his request to limit the risk of engorgement.
Leaving the maternity ward
On leaving the maternity ward, the baby begins to gain weight steadily. We can now talk about breastfeeding on demand. “The signals of hunger in the baby, which must be triggers for breastfeeding, are: the baby passes his tongue over his lips, he passes his hands over his mouth, if an adult takes him in his arms, he tries to suckle her arm or grab her nose,” describes the lactation consultant. Contrary to what we often hear: we must not wait for the baby to vocalize. The crying of the baby are a sign that hunger is already too much established “We do not create a bad habit by feeding the baby as soon as he shows the need for it: on the contrary, the more he suckles and the better he suckles, the more milk the mother will produce and more quickly they will space the feedings naturally” insists the lactation consultant.
Feeding the baby at the breast: how long to feed?
Each child has their own needs, with higher or lower caloric needs depending on their metabolism. In addition, they do not all have the same suction efficiency and while some need little time to absorb the milk they need, others will have to suckle longer without having to worry about it.
A breastfeed can last between 12 and 67 minutes, and it is estimated the average duration of a feeding at around 29 minutes. “What is certain is that the effectiveness of a breastfeed is not measured by its duration,” insists the lactation consultant.
Should two breasts be given per feed or only one? It’s a question that divides but has no universal answer “some babies suckle only one breast, others always two, still others sometimes one or sometimes two: there is no rule” assures Carole Herve.
How many feedings per day?
From the moment breastfeeding is established and has taken on a regular rhythm, feedings are generally spaced 2 to 3 hours apart with 8 to 12 feedings per day on average. But here again, there is no rule. Breast milk is extremely digestible and gastric emptying of breast milk takes barely 40 minutes to be digested by baby: there is therefore no problem in bringing feedings closer together when baby is crying. “This is often the case at the end of the day, when the feedings tend to get closer, unlike in the morning when the child generally nurses less often” explains the lactation consultant.
How much should a baby drink at the breast, between 1 month and 3 months?
From 15 days of life until 6 months, the breastfed child drinks on average 800 ml of breast milk per 24 hour period. He does this naturally and instinctively and there is usually nothing to worry about as long as his growth curve is progressing normally.
How do you know if he is suckling enough?
If in doubt, if the baby is not gaining enough weight, it is possible to check that he is drinking enough breast milk. “When a baby is breastfed and we cannot therefore quantify what he absorbs, we can however check what he rejects, through stool and urine,” explains Carole Hervé. The content of the diaper is therefore a good indicator of the quantities of milk that he absorbs while suckling.
During the first month, the baby will produce an average of 3 large stools – the size of an adult palm – and fill 6 heavy layers of urine.
After this first month, some babies have infrequent bowel movements and go several days – up to 10 and sometimes even longer – without a bowel movement. “You shouldn’t worry about this as long as: the baby looks healthy, has unrestricted access to the breast, sucks well (he can be heard swallowing regularly), is gaining weight, passing gas and producing well 6 heavy layers of urine a day” insists the lactation consultant.
Artificial feeding of the newborn
One in three women in France opts for the bottle rather than breastfeeding, whether by choice, lack of desire or for medical reasons. Whatever the reason, it must be respected and accompanied in its approach. As we often hear it said “Better a bottle given with love than a breast given reluctantly”.
1st age milk: to cover the needs of the infant
During its first three months of life, the infant only needs milk. From birth to 5 months of age, bottle-fed babies are offered an infant formula perfectly suited to their needs: infant milk. “This 1st age milk is made to be as close as possible to breast milk and to perfectly cover all the nutrients, vitamins and minerals essential for its proper development” indicates Aurélia Bardot (Source 2).
The toddler needs about 350 calories per 24 hours during his 1er month of lifeand these needs increase to approximately 500 calories during the 2th and 3th month.
How many bottles per day and how much milk for the newborn?
The quantities of milk what the newborn needs evolve day by day during its 1time week of life. During these first days, if it is possible to give quantities of milk as an indication, it is recommended to give the child bottle on demand, as one would if he were breastfed. “It is important not to make him wait too long, because if he is hungry, he risks drinking too quickly, which can cause him digestive problems of the colic” insists the nutritionist.
As for the number of meals, it is variable: some babies will be satisfied with 6 bottles per day when others will require much more. It is essential to adapt to him and respect his needs.
At D1 : we can offer him 6 bottles of 10 ml milkor up to 10 bottles of 6 ml,
D2 : 6 bottles of 20 mlor up to 10 of 12 ml,
D3 : 6 bottles of 30 mlor up to 10 of 18 ml,
D4 : 6 bottles of 40 mlor up to 10 of 24 ml,
D5 : 6 bottles of 50 mlor up to 10 of 30 ml,
D6 : 6 bottles of 60 mlor up to 10 of 36 ml,
D7 : 6 bottles of 70 mlor up to 10 of 42 ml.
Then, between the 8th day of life and the end of the 1st monththe baby drinks on average between 500 to 600ml of infant milk per day, always divided into 6 to 10 baby bottles 60 to 90ml on average.
Between 2 and 3 months of lifethe baby drinks on average 700 to 800ml of infant milk per day. It can usually be increased to 5 bottles per day of 150 ml each. However, some babies stay at 6 feeds a day.
Between 3 and 4 months of lifethe child needs on average 800 to 850ml of milk. When some stay at 5 bottles of 150 ml, others go to 4 of 180 ml.
How long between each bottle?
From the age of 1 month, it is recommended to space meals at least 2 hours 30 minutes apart, in order to give the baby time to digest. “The crying of the baby does not necessarily mean that he is hungry” recalls Aurélia Bardot. The signs of hunger in the baby are varied: he sticks out his tongue, passes his hand over his mouth, waves his arms and legs, tries to suckle when an adult takes him in his arms.
How to reconstitute the bottle?
The bottle must first be carefully washed and dried, then handled with very clean hands. The vast majority of baby milks are powdered to be reconstituted: a scoop is then provided with the box, which must be filled and leveled, before being diluted in 30 ml of water. “It is important to use the scoop from the box and not another: each box of milk has a scoop adapted to its formulation” insists the nutritionist.
We recommend, for toddlers, the use of mineral water with a low mineral content, opened for less than 24 hours.
“You can occasionally use tap water, but then you should let it run for a few seconds and not use filtered or softened water” recommends Aurélia Bardot.
The bottle can be reconstituted with water at room temperature – or slightly heated in a bottle warmer or bain-marie – and must be consumed a maximum of one hour after its preparation. It is therefore forbidden to keep the end of a bottle from one feed to the next!
In case of intolerances: what milk to give to baby?
In case of suspicion ofintolerance orallergyIt is essential to refer to a professional. Pediatrician, allergist or nutritionist will be able to identify lactose intolerance or an allergy to cow’s milk proteins, and will be able to give appropriate advice. “Whatever happens, be careful to always choose a milk adapted to the child and not never offer him a lambda vegetable milk“warns Aurélia Bardot. Regularly, infants die of malnutrition or dehydration because they have been fed with milk that is not adapted to their needs.
Fortunately there are infant milks with rice or soy proteins for intolerant or allergic children.