Schedules, nipple confusion, & more
My friend feeds her newborn on a schedule, but I prefer to feed my baby whenever she's hungry. Should I be more organized about this?
If your baby's satisfied and growing and you're happy too, there's no reason to change. In the first few weeks of your baby's life, it makes more sense to feed her "on demand" until you understand her needs. Some babies need to be fed every one to two hours, while others can go longer in between; nursing babies eat more frequently than formula-fed ones.
After a month or two, some moms do prefer to schedule feedings. As long as the baby's content and is eating 8 to 12 times a day, that's okay, says Dr. Stern. Keep in mind that a baby's feeding needs can change, so you may have to readjust her schedule over time. If you listen to your child's signals, you'll do just fine.
I'd like to occasionally give my breastfed baby a bottle, but I'm worried about nipple confusion. What can I do to prevent it?
Most infants move from breast to bottle without much trouble, says Hopkinson. But bottle-feeding is easier for most infants -- the liquid comes out with less effort -- so your baby may start to prefer it over breastfeeding (even if there's expressed milk in the bottle). Since a young baby is most prone to nipple confusion, try to wait until she's been nursing successfully for a month or more before giving her a bottle.
Even when nipple confusion does occur, it can be overcome fairly easily. When a baby drinks from a bottle, she doesn't need to open her mouth very wide, but when she nurses, she must open it enough to take in a large circumference of areola so that the nipple and milk can reach the upper palate of her mouth. If she tries to nurse the way she'd drink from a bottle, she won't be able to latch on properly to draw in milk. So when you're nursing, be sure that your baby's mouth is open wide and taking in a good amount of your breast. If she starts to refuse it, brush your nipple against her cheek to stimulate her suckling reflex, and shift positions until she has a good latch-on.
I'm thinking about using a breast pump. What do I need to know?
When you use a pump, someone else -- your partner in the middle of the night or a babysitter if you go back to work -- can give your baby breast milk from a bottle. Breast milk also freezes well, so you can pump when you have time and defrost it when needed.
If you're thinking of pumping, try to breastfeed exclusively for as long as you can in order to build up a decent supply of milk before you begin, suggests Anne Merewood, director of lactation services at the Breastfeeding Center at Boston Medical Center.
Which pump you choose depends on how you'll use it: If you're going to be returning to work full-time, you may want to buy (or rent) a double set-up electric pump, with adjustable speed and suction levels; pumping both breasts stimulates them to produce more milk. But if you just need a break at home or have more flexibility at work, a hand pump may be fine. Good brands include Medela and Hollister, says Merewood, who also likes the Avent Isis hand pump. If one doesn't work, try another. "Too many moms blame themselves instead of the pump," she says.
What's the best formula for my baby? Is it okay to switch brands?
All formulas on the market, including generics, must meet strict Food and Drug Administration (FDA) guidelines for content and quality. So switching from one brand to another shouldn't cause a problem, says Dr. Stern, although it may take a little while for your baby to get used to the new taste.
What you shouldn't do is switch from one kind of formula to another unless you have a good reason to do so. For most babies, a cow's-milk-based, iron-fortified formula is best.
The exceptions: If your baby is lactose-intolerant, try a soy-based formula; if you have a family history of allergies, you can lessen the risk of your baby's developing them by using a hypoallergenic (or elemental) formula. Since these variations may have drawbacks -- and because they are almost certainly more expensive -- schedule a time to talk to your pediatrician first so he can help you choose one that's appropriate for your baby.
Avoid low-iron formulas -- they were developed years ago when people believed iron caused constipation in babies. Since then, research has disproven this myth and experts agree that babies need iron to avoid anemia.