Newborn Feeding

Newborn feeding — that first latch to mom’s breast is heart warming!  It’s ideal to have your infant to your breast within the first hour after birth. There are a number of reasons for this. First of all, breastfeeding causes uterine contractions and this can slow down mom’s bleeding after birth. Secondly, bonding is so important and holding your infant skin to skin and providing that first feeding right after birth improves maternal infant bonding. The nursery care (weighing, Vitamin K shot, etc) can all be safely delayed until after that first feeding — the newborn feeding is more important.

Newborns if placed on mom’s belly after birth will smell mom’s milk, see the darkened aerola, and have the inborn ability to “crawl” up to mom’s breast.  This is called the stepping reflex.  Watch this video of a newly born infant latching all by herself to mom’s breast for that important first newborn feeding!newborn feeding — breast crawl

For most infants that first hour or two after birth is a very alert time. That first feeding will be much more successful if your infant is wide awake. If for some reason your infant must be taken to the nursery for monitoring or is born prematurely, then ask for a breast pump within that first hour. Pumping can give you a positive task to assist your newborn at a time when you are feeling helpless. Pumping regularly will bring in your milk supply and help collect all that wonderful colostrum which can be given to your newborn to help boost her immune system when she’s ready to eat.

Newborn feeding is easiest when rooming-in at the hospital

Rooming-in is the preferred hospital situation for a breastfed infant. Expect your baby to breastfeed 8-12 times every 24 hours for the first few days. This is crucial for milk production, transfer of important colostrum, and so that your infant does not lose too much weight. Close contact with your newborn in the first few days of life is also associated with a higher rate of continued breastfeeding at 3 months of age. Expect to feed your infant frequently those first few days and nights! It is normal for breast fed infants to feed frequently, so it’s so important to have your little one in the room with you so you can respond to his feeding cues — your newborn feeding well is most important those first few days to 2 weeks of life.

What to expect for weight loss in the hospital

Normally infants born vaginally will lose about 5-6% of their birth weight within the first 48 hours. If your baby is born by C-section, if a mom’s labor is induced, or if mom has an epidural, then about 7-8% weight loss may be expected. If your infant is losing more weight than expected, you may be asked to supplement with formula. Weight loss greater than 10% with significant dehydration can put your infant’s health at risk.

A better option to supplementing with formula is to ask for a hospital breast pump in the first few days in the hospital.  Use the hospital pump to help stimulate the milk supply especially if you’ve had a c-section, your labor is induced, or if you used an epidural.  When we intervene medically, then we’ve slowed the natural process — which means we need to intervene medically with the breast pump.  You’ll be pleasantly surprised at how well this works!  Don’t be discouraged if you don’t see lots of milk when you pump — a teaspoon of thick, yellow colostrum is a typical feeding in the hospital.  You’re using the pump for about 10-15 minutes at a time to help stimulate your supply — so you may pump and get just a few drops but it worthwhile to bring the mature milk in more quickly.

Newborn Feeding — Will the circumcision procedure affect breast feedings?

One of the decisions the parents of newborn boys need to make is whether to circumcise or not.  The next decision is whether to have the procedure done in the hospital or wait until feedings are well established and have the procedure done in 1-2 weeks.  Consider these things when making this decision —

  • after the procedure your infant will be very tired and may not feed well for 5-8 hours afterwards.  This means mom will need to pump her milk every 2-3 hours until the infant is actively nursing again.  This pumped milk can be syringe fed to your baby during this sleepy time — be sure to get instructions on how to do this safely before you leave the hospital.
  •  if your infant has lost more weight than expected, you may want to delay the procedure for 1-2 weeks.  This will help avoid the need for supplements and help your infant focus on breast feeding and gaining weight.
  • if you choose to have the procedure done after hospital discharge — be sure to check on cost of the procedure and insurance coverage.  Some insurance companies only pay for the procedure if done in the hospital, some will pay only if done in a urologist’s office, and some will pay if it’s done in the pediatrician’s office.

Discuss all the options with your child’s pediatrician and choose what’s best for your child.  The procedure itself is the same whether it’s done in the hospital or in the office setting.

Newborn feeding — differing advice

You will get a lot of advice on ways to latch and hold your infant and opinions on parenting issues during your hospital stay. The most important breastfeeding in hospitalthing to know is there are many different ways to breastfeed and they can all be correct ways. Take what works best for you and your infant and use that information. Try not to get frustrated with differing advice – it all depends on what works best for you and your little one!

Having your infant with you in your hospital room, even at night, can help bring in your mature milk and make those first few nights at home much easier. It can also prevent your infant from losing too much weight and decreases the possibility of the need for supplemental feedings. Here’s the reasoning – babies are used to noisy environments. The uterus has constant “swooshing” blood flow noise. When an infant goes to the nursery (noisy environment) he will sleep longer periods of time because he’s used to noise, and therefore will not wake for feedings as often. Rooming-in with mom is quieter and your infant will be awake more frequently to breastfeed. This is what you want – frequent breast feedings! If your infant is not breastfeeding 8-12 times every 24 hours for the first few days, your mature milk will be slower coming in. You can also quickly respond to your infant’s hunger cues when your infant is rooming in. Crying is a late hunger cue(click here for information on infant hunger cues) and you don’t want your infant crying to show hunger – this burns more calories, causing more weight loss, and causes your infant to swallow more air making him more gassy.

 


 

 

 

Things to know before leaving the hospital

  • Your infant’s last weight.
  • What color was your infant’s last bowel movement?
  • How many wets and stools your infant has had in the last 24 hours?
  • If your infant is jaundiced, what was the bilirubin level?    For more information  on jaundice and your baby click here.

Take this information with you to your first visit at the pediatric office (usually in 1-2 days after discharge from the hospital).

Newborn feeding is a time for bonding and nutritional intake.  Cuddling your newborn during feeding helps maintain body heat which helps with food digestion and regulating metabolism.  Newborn feeding practices vary from one family to another.

 

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