Besides meeting an infant's nutrition needs, feeding is a time for a parent to nurture and bond with the baby. Whether breastfeeding or bottle-feeding, there are several issues for parents to think about.
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Feeding can be a special time for parent and baby. Both breastfeeding and bottle-feeding allow for bonding and soothing. This is a great time to communicate with a baby. While feeding the baby, parents can make eye-to-eye contact and massage the baby's hands and feet. They can stroke the baby's hair and face and talk to the baby in a soft, sweet voice. The skin-to-skin contact can be very soothing to a baby.
Parents need to decide whether to bottle-feed or breastfeed, or both. Mothers should be made aware of the benefits of breastfeeding. Public health officials and most healthcare professionals recommend that, if possible, babies be fed from the breast through at least age 6 months. Nevertheless, the type of feeding is a ultimately the mother's personal choice. Whatever decision is made, others should be as supportive as possible.
Positioning an infant during breastfeeding is a learned technique. The main positions in which to hold a baby while nursing are:
Cradle hold. Sitting in an armchair, the mother holds the infant in the bend of her arm. The arm is supported by a pillow beneath it. The baby is held on the lap, with the baby's face, tummy, and knees directly facing the mother's body. The baby's nose should be at the level of the mother's nipple. The baby's lower arm is tucked under the mother's arm.
Clutch or football hold. The mother holds the baby under her arm on the side the baby will nurse on, with baby's feet behind her. She supports the baby's head and shoulders with her arm and hand. She may want to rest her arm on a pillow. The mother then aligns the baby's nose with her nipple, and guides her nipple into the baby's mouth. This position is often recommended after a Cesarean birth because it keeps the baby's weight off the incision.
Side lying. In this position, the mother is lying on her side in bed. The baby is supported in the bend of the mother's arm. It may be helpful for the mother to have a few pillows behind her back. The mother should try to keep her back and neck in a straight line and bring the baby to her nipple.
Getting the correct, comfortable position takes practice and patience. When breastfeeding, it's important for the baby's tummy to face the mother's body and for the baby is able to latch on to the nipple and the areola. The areola is the pigmented area around the nipple. The baby's mouth squeezes the glands inside the areola to make milk come out.
The mother should hold her breast in her hand and touch the baby's lower lip or cheek with her nipple. This stimulates the rooting reflex, which means that the baby instinctively turns toward the breast and searches for the nipple. When the baby's mouth opens, the mother should then gently pull the baby toward her breast and guide the nipple and areola into the baby's mouth.
A baby also needs to sense that the mother is calm, relaxed, and comfortable with breast-feeding. Breast-feeding and bonding time can be quite pleasurable for mother and baby.
Bottle-feedingBottle-feeding is similar in many ways to breastfeeding. Positioning is important, so the baby can relax enough to drink from the bottle. The parent should hold the baby in his or her arm against the chest. He or she should look at the baby and talk softly to him or her. This is an essential time in the baby's development. The baby needs to feel security and closeness from the parent.
The parent should support the baby's head in the cradle of his or her arm. The nipple of the bottle is gently put straight into the baby's mouth. The bottle should be tipped up so that no air gets through the nipple, just formula. Propping the bottle for feeding is not a good idea because it can lead to dental problems in the future.
Buying equipment for bottle-feeding involves a number of decisions. Nipples and bottles come in a wide choice of shapes and sizes. There are traditional, flat-tipped, and orthodontic nipples. Some babies seem to prefer some nipple shapes to others, so parents may need to try different ones.
Formula should drip out of the nipple steadily. If it comes out in a stream, the holes are too big, and the nipple should be discarded. Check nipples periodically for signs of wear, such as discoloration or thinning. Worn nipples should be replaced, because they could break and become a choking hazard.
Bottles also come in different sizes and shapes. They usually hold either 4 ounces or 8 ounces. For most newborns, a 4-ounce bottle may be more useful than an 8-ounce bottle. Babies this age may not drink more than 4 ounces at one sitting. A fresh bottle of formula or breast milk should be used for each feeding.
For storing, heating, or feeding, the safest bottles are those made of glass. Plastic bottles made of polypropylene are also considered safe. Plastic bottles made from polycarbonates or polyvinyl chlorides are unsafe, because they contain "plasticizers" that can be released during sterilization and contaminate the contents of the bottle.
The infant should be burped halfway through the feeding, and again at the end of the feeding to rid the stomach of air bubbles. The mother can hold the baby on her shoulder, across her knees, or sitting up on her lap. The baby's back is gently rubbed or patted. Sometimes a small amount of milk will come up with the burp, which is normal. But if the baby vomits hard, parents should call the healthcare professional.
Most infants are fed every 3 to 4 hours. A breastfed baby may need to be fed more often during the first few weeks to help increase the mother's milk supply. The newborn who is fed when hungry (known as "feeding on demand") will soon adjust to a flexible schedule. It is important to fulfill the baby's needs promptly to assure him or her that the world is a good place in which to live.
Feeding an infant is a learning experience for both a baby and a parent. At first, there are challenges, and every infant is different. There are no absolute rules for feeding every infant. With support and knowledge, feeding can be a very pleasurable experience for both parent and baby.
Mayo Clinic Family Health Book, DE Larson, 1996.
Introduction to Maternity and Pediatric Nursing, E Thompson, 1995.