Newborn Feeding

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​How does newborn feeding work?

Newborn feeding is one of the most time consuming aspects of having a newborn. Babies need to feed, at maximum, every three hours (from the beginning of one feed to the beginning of the next feed). It is ok if they want to feed more often than every 3 hours. Feeds will gradually space out as the baby gets older and is taking larger volumes. Below are a few helpful tips to aid in your breast or bottle feeding journey.

​Breastfeeding

Positioning baby to feed

  • Undress baby to only a diaper: feeding skin to skin promotes bonding between birthing parent and baby
  • Align baby’s ear shoulder and hip: ensures baby’s neck is not at a strange angle
  • Tummy to Mummy: keeps baby in good position
  • Nipple to Nose: allows the nipple to fall deeply into the baby’s mouth promoting a good latch
  • There are many positions which can be used to feed a baby, the most common for the first few days is the cross-cradle hold

 

Good latch

  • A good latch is generally as deep as possible and should not hurt.
  • There is an initial 10-second pinching sensation when the baby first latches on as the milk lets down. This is normal and should go away as the feed continues.
  • Aiming the nipple at the baby’s nose, allows the nipple to fall to the back of the baby’s mouth when latched on.

 

Colostrum vs. Milk

  • Colostrum is the first milk and is a golden yellow colour. Colostrum is very nutrient-dense and is a golden yellow colour. Babies only require a small amount of colostrum at a time but may want to feed frequently.
  • Mature Milk will usually ‘come in’ on day 3 or day 4 after the baby is born. Mature milk is more white in colour. Babies will consume larger volumes of mature milk at each feed. As a result, babies will start to extend their feed spacing gradually after the mature milk comes in.
  • Babies should only consume breastmilk or formula for the first few months of life. No water or other substitutions need to be given.

Milk Supply

  • Milk supply will gradually increase as your baby grows. If you find that your supply is low, fenugreek and blessed thistle are herbs which improve milk supply (found at any pharmacy).
  • Other galactagogues (stimulate milk supply) include fennel, goat’s rue, asparagus, anise and milk thistle, oatmeal, dark greens, garlic, ginger, almonds, and chickpeas.
  • The more you stimulate the breasts the more milk will come in. Stimulating the breasts can be baby feeding, hand expression or pumping.

How do I know my baby is getting enough?

You will know your baby is getting enough breastmilk or formula, based on how many diapers the baby has (urine and stool), if the baby seems satisfied, and weight gain. Your midwife will see you many times in the first few weeks of your baby’s life to ensure your baby is growing appropriately.

Hand Expression and Pumping

  • Hand expression is especially useful in the first few postpartum days when colostrum is being produced. Hand expression is the manual extraction of colostrum/milk from the breasts.
    • Steps: place hands as close to the chest wall as possible grasping the breast, compress the breast tissue trying to get your thumb and fingers to meet, and slide hands down the breast towards the nipple. You can collect the colostrum/milk with a syringe, spoon or cup. The expressed milk can then be given to your baby at the next feed. To help with hand expression view the Global Health Media: Hand Expression Video.
  • Pumping with either a hand pump or electric pump can be very helpful for dealing with engorgement or simply reserving a supply of breastmilk to be used at a later date. There is a large selection of breast pumps available to purchase. Many breast pumps are, at least partially, covered by most insurance companies. Your midwife can help you set up and teach you how to use your breast pump at your postpartum home visits.

Your midwife will discuss breastfeeding more in-depth at one of your antenatal visits and will help with the first feed immediately after birth. She will also continue to assist with breastfeeding during all postpartum visits.

Bottle Feeding

Milk types

  • Two types of milk are acceptable for newborn infant feeding, expressed breast milk (EBM) and ready-to-feed liquid infant formula. See the above information on hand expression and pumping for tips and techniques on how to best express EBM.
  • With regards to formula, it does not matter what brand you decide to use, all must contain the same basic nutritional components to be called infant formula. Infant formula is highly regulated in Canada to ensure adequate growth of newborns (see Government of Canada resources below for more specific information). It is recommended that babies receive ready-to-feed liquid formula for the first three months of life, after which time it is safe to switch to powder formula.

Positioning Baby to Bottle Feed

The most effective bottle-feeding position is to have your baby sitting mostly upright in your lap. This can be accomplished by placing your less dominant hand around the back of your baby’s neck, supporting their jaw with your thumb and middle finger. The bottle can then be held in your dominant hand, horizontally to the baby’s mouth, tilted up at a slight angle. Ensure the nipple is inserted far enough into the baby’s mouth to reach the soft palate (back of the baby’s mouth). It is important to have the nipple full with milk, to prevent your baby from taking in too much air which can lead to gas discomfort.

Burping Baby

Babies who receive milk from bottles tend to ingest more air. This means that they have more gas to bring up during burping. To burp your baby after feeding you can use a few positions. You can put your baby over your shoulder and pat them gently on the back.

If you are bottle feeding, you can keep your baby in the same seated position on your lap and simply switch hands. You can place your baby’s chin on your dominant hand that was previously used for feeding. Holding your baby securely, you can then pat your baby on the back using your non-dominant hand. In either position, continue to burp your baby for 5-10 minutes. Most of the time you will hear an audible burp, sometimes you won’t, and that’s ok.

Bottle Sterilization

If you are using bottles to feed your baby, they must be kept clean, regardless of what type of milk you are using. After every feed, bottles should be cleaned with hot water and soap. Always ensure to wash your hands before handling clean/sterilized bottles. For babies younger than 2 months, it is recommended by the CDC, that bottles be sterilized daily (CDC 2023).

Different methods of sterilization include:

  • Boil: place disassembled bottles in a pot of boiling water, and boil for 5-10 minutes, ensuring all items are fully submerged in the water.
  • Steam: many microwave and countertop steam sterilizers are available. Please follow the manufacturer’s directions for use.
  • Bleach: only to be used if you can’t use a dishwasher, boil or steam bottles. Mix 2 teaspoons of unscented bleach per 16 cups of water in a clean wash basin. Fully submerge all disassembled bottle parts for 2 minutes in the mixture. Remove and do not rinse.

Regardless of how you choose to feed your baby, your midwife will support you in your feeding journey. Remember, the most important thing is that your baby is fed and growing appropriately. You will figure out what combination of feeding methods works best for you and your baby.