The creation and production of breast milk is an amazing feature of the female human body. The ability to feed our own young is thought to have contributed to the human race's continued adaptation to the world's climactic changes. In developing countries, where food is scarce and disease and illness is more prevalent, breast milk contributes to the survival of many newborn babies.
Breastfeeding (like giving birth) is essentially a natural process. However, it is also very complex, dynamic biological practice that is intertwined with many social, cultural and emotional issues. Breast milk is the natural first food for babies and can:
• Exclusively nourish a newborn baby to support healthy development for them to thrive, providing all their energy and nutrient requirements for the first 6 months of life, without the need for extra solid foods, water or formula. Some scientists refer to this as being 'species specific'. Human milk (like the milk of other mammals) adapts to meet the exact nutritional requirements of the human baby.
• Continue to provide up to 50% or more of a baby's nutritional needs from 6 months to 1 year.
• Provide up to 30% of a child's nutritional needs during the second year of life (if continuing to breastfeed for this long).
It is universally recognised that "breast is best' for both baby and mother. Breastfeeding is regarded as a cheap, effective way to support the health of young babies, as well as providing health benefits for the mother. Breast milk cannot be replicated. It changes in composition during each feed and adapts over time to accommodate each baby's changing nutritional needs. However, it is breast milk's 'antiinfective' and 'antiallergenic' properties that make it far superior to artificial formula.
The following lists some of the benefits of breastfeeding (or expressing to provide your baby breast milk) for:
There are many recognised advantages for babies having breast milk (obtained through breastfeeding or as expressed breast milk).
• Contains enzymes that are essential for the baby's brain growth, enhancing their nervous system development and promoting their sensory and cognitive development
• Increases a baby's resistance to infection, providing extra immunity against illnesses in the early weeks of life by having immune substances passed from mother to baby.
• Helps protect the baby from developing ear infections, lung infections, gastric diarrhoea and bowel infections.
• Aids faster recovery from illnesses the baby may experience.
• Is recognised as a protective factor against sudden infant death syndrome (or SIDS).
• Reduces the baby's chances of developing allergic illnesses (such as asthma), food allergies and skin disorders (such as eczema) and diabetes later in life.
• May possibly lessen a baby's chances of becoming obese and having high cholesterol later in life.
• Helps prevent life-threatening complications for premature babies, such as Necrotising enterocolitis (or NEC).
• Keeps a baby's poos soft and prevents constipation. A breastfed baby's poos and vomits have a more pleasant odour.
• Provides a unique intimacy between mother and baby, with frequent skin to skin contact.
Overall, a breastfed baby is more likely to be well and healthy. Therefore, they are less likely to need visits to the doctor or experience sleepless nights due to feeling unwell. The action of breastfeeding has also been shown to encourage normal mouth, jaw and facial muscle development, meaning breastfed babies are less likely to experience orthodontic problems.
The advantages of breastfeeding for the mother (or establishing a breast milk supply through expressing breast milk) can include:
• Minimising bleeding after the birth and accelerating the natural shrinking (or 'involution') of the uterus.
• Aiding weight loss after the birth for many women.
• Providing contraceptive benefits by delaying the return of the menstrual cycle. If your baby is less than 6 months old, is being fully breastfed day and night without having any other food or fluids, the chances of conceiving during this time are thought to be about 2 to 3 %. Women who breastfeed may not have a normal menstrual period until their baby is fully weaned off the breast (perhaps 9 to12 months or more).
• Reducing the risks of ovarian cancer and breast cancer later in life.
• Providing economic benefits, because the cost of artificial formula can be a significant expense for many families .Being portable, convenient, always warm and ready to serve. Breastfeeding reduces the workload because bottles do not need to be washed and sterilised, formula does not need to be made daily and milk does not need to be heated.
Many women express a sense of emotional satisfaction when they breastfeed and the act of breastfeeding has been shown to play a large role in shaping the experiences of early motherhood. Breastfeeding women often comment on how they feel they are "doing something positive for their baby', having a sense of "I did that', "My baby is thriving because of me' or "I feel needed'. It can be very rewarding to feel your baby needs you for food as well as comfort. The hormones released during breast-feeding are also related to increased feelings of calm and a positive mood.
This article contains general information only and is not intended to replace advice from a qualified health professional.
Tips for successful breastfeeding
There are a few things you can plan for to help make breastfeeding a positive experience for you and your baby. You may want to include some of these requests in your birth plan. They can include:
• Try to minimise using medicated pain relief during the labour and birth, especially narcotic injections and epidurals. These have the potential to make the baby lethargic and reluctant to want to feed in the days following the birth.
• Try to breastfeed within the first hour after your baby is born (even if you have a Caesarean). Babies who feed soon after the birth tend to have fewer problems with latching and feeding in the days following.
• Try to breastfeed your baby unassisted and only ask for help if you have difficulty. In many cases, if you hold your baby near the breast soon after birth they will eventually find their own way to latch on instinctively.
• Room in with your baby in hospital. This allows you to wake up naturally when your baby wakes for feeding, and helps you to get to know your baby's hunger signs.
• Breastfeed on demand, as often and as long as your baby wants to feed (day and night). This stimulates your milk supply, avoids engorgementand helps your baby to get into a favourable sleeping pattern sooner.
• Practice attaching your baby to the breast without assistance. Getting your baby to latch on well is the key to successful breastfeeding. Make sure you can tell when your baby is latched correctly before you leave hospital. If you have very sore nipples, seek help immediately. Remember that pain is not a natural part of breastfeeding. It is an indication that something is not right and needs rectifying. (Although it is normal in the early days to feel some discomfort when the baby first latches on, this pain should not continue for the whole feed.)
• Avoid using dummies, pacifiers or bottles (at least for the early weeks) so your baby does not experience 'nipple confusion'.
• Get as much rest as possible. Taking care of yourself is important for breastfeeding to succeed. Make sure that you have help at home, especially during the first few weeks and try to let someone else take care of all the household duties.
• Exclusively breastfeed for 4 to 6 months. Babies thrive on just breast milk and do not need additional food or water, even in heatwave conditions. As soon as you start introducing supplements, you start depleting your milk supply.
Remember that breastfeeding is a new experience for both you and your baby. You may need assistance to master this new skill. This is normal. .
This article contains general information only and is not intended to replace advice from a qualified health professional.
How long and how often?
Breastfeeding is a very individual matter, and no two babies, or mothers, are alike. Some babies feed quickly, others feed slowly. The length of time an individual baby takes to feed will also vary from one feed to the next. The time a baby takes to breastfeed can range from 10 to 20 minutes, up to 45 minutes to an hour on one breast, with feeds ranging from 6 to 12 times in a 24 hour period in the early weeks.
Newborn babies often fluctuate with 'spacing' or 'bunching up' the frequency of their feeds at different times of the day and night.
If your baby is attached correctly to the breast, it should not matter how long they feed for. The only factor that contributes to damaging the nipples is incorrect latching, not the length of time the baby is on the breast. Ideally, babies should be allowed to feed for as long as they want to.
However, while it is not recommended that you stop a baby from feeding before they are ready, it is important to be aware of some factors that can contribute to a breastfeed being prolonged more than is actually needed. The more you get to know your baby and their feeding patterns, the more recognisable these situations will become. These can include:
If the baby is not latched correctly, they will not be able to milk the breast efficiently. This usually means that the baby may need to feed for longer, and/or more frequently. However, incorrect latching usually makes breastfeeding quite painful, and usually causes some damage to the nipples. Therefore, hopefully this problem will be recognised and corrected before long. As the baby becomes more 'instinctual' at knowing how to latch correctly, they will usually become more efficient at emptying the breast, and often the feeds will become comparatively shorter.
The baby falling asleep at the breast.
Many babies will fall asleep on the breast while feeding (usually as they become full of milk), however, they may rouse frequently to have a few sucks, in between dozing. This type of feeding can damage the nipples, because the baby often becomes 'lazy' with their latching as they doze. If they are not fully alert, they can 'slip off' the nipple slightly, as well as prolong the feed more than necessary. If you want to stop the feed, because you can see that your baby is dozing, gently place your little finger into the corner of their mouth (between the breast and their lips), and press down on their lower gum, to gently break the seal. Don't just pull your nipple out, as this will often hurt and can damage the nipple.
Babies may also want to feed more frequently, if they fall asleep before their feed is totally completed. Many women will leave nappy changing for the 'middle of the feed' (when the baby starts to doze), so that they rouse their baby enough to complete the feed after changing. If the baby is really 'full' they will usually sleep through (or settle again soon after) the nappy changing process. (Make sure you wash your hands after changing your baby and before handling your breasts again and feeding.)
Some babies will continue to suck on the breast for comfort (rather than hunger). This can be similar to them falling asleep on the breast, because the baby only sucks occasionally (and can also slip off the breast to latch incorrectly). Again, you may want to take your baby off the breast, if you think they are just comfort sucking (or mucking around!) If your nipples feel comfortable, you may choose to let your baby 'comfort suck', if you find it is helping them to settle, or to fall asleep.
NOTE: Take care when feeding at night and dozing with your baby feeding. Many women have experienced waking with a damaged nipple, the morning after they fell asleep with their baby 'munching' on their breast while dozing!
One breast or two?
It may not be necessary to give your baby both breasts. (Mothers of twins hardly ever do!). If your baby is satisfied feeding from one breast, alternating each breast at each feed, will make sure both breasts are drained regularly and your milk supply is stimulated. However, some babies look for both breasts each feed from the start, and others are content to have one breast at each feed in the early weeks, but look for two as they grow older.
If you feel you have fed for a long period of time on one side, and your baby is still looking hungry, you can offer them the other side. If you fed both sides the last feed, start on the 'last breast first' because babies always empty the 'first breast best'. For example, if you fed on the right breast first, and then fed on the left, start on the left breast next feed.
The second side is always regarded as 'just a top up'.
Some women find that their baby has a 'preference' for one breast. Many women even subconsciously foster this 'preference' for their baby. Meaning they could tend to offer one breast more often, if they feel their baby feeds better on one side, or one of their nipples is 'flatter' than the other, or one nipple is damaged and painful.
The more you feed from one breast, the more milk that breast will produce and the less the other breast will produce. This can lead to a cycle where the baby only obtains an adequate feed from one side, and therefore needs to feed from that side more often and so on
If you think that the supply in one breast is dominating the other, you will need to feed your baby from the other side more frequently, offering this breast first, when they are hungry as they are less likely to refuse it. Usually within a day or so, the supply in the 'unfavoured' breast will improve. It has been known for women to exclusively feed from one side (and some women need to because of extensive surgery to one breast). This is possible, however you will need to tolerate being a bit 'lopsided' in breast size, while you are breastfeeding in this way.
Is my baby getting enough?
Many women express concern about their baby 'getting enough' when they breastfeed. Perhaps this stems from not being able to visually see and/or measure the amount of milk the baby drinks (as you can with a bottle). To know if your baby is 'getting enough' and thriving, they should:
• Be having at least 6 wet nappies over each 24 hour period. You may need to swap to cloth nappies for a while, to determine this if you are worried, as it can be difficult to tell with disposables. (Although disposables will feel 'heavy' when wet.) The urine should be pale (not concentrated) and not have a strong offensive odour.
• Look 'bright-eyed' and active when awake, and interested in feeding at least 6 to 12 times in a 24 hour period (and not lethargic and disinterested in feeding).
• Have a gradual increase in their size (length and head circumference) and weight gain over several weeks. (Weighing should not be necessary less than once a week.) Be aware that babies have growth spurts. They may gain large amounts of weight for a few weeks, then level off and gain smaller amounts for a while, this does not indicate that you do not have enough milk, especially if their behaviour and urination are normal.
Expressing breast milk
ıf you are breastfeeding, and/or giving your baby breast milk through a bottle, you will need to know about how to express and store your breast milk. While a few women will never express their milk throughout their whole breastfeeding 'career', most mothers find that they end up needing to express at some stage, for various reasons. These may include:
• Needing to have time away from your baby. This may be to return to work, or to study, or just to go out without your baby for a while (or even a short holiday). Expressing and storing your breast milk before you leave your baby, allows them to have your breast milk with a bottle for their feeds (or at least some of them) while you are not together. Many women will start to store a bottle (or more) in their freezer, once their breast milk is fully established, in case of unexpected emergencies.
• If you are experiencing problems with your feeding, such as sore nipples, engorgement, blocked milk ducts, mastitis, or an undersupply of milk, you may need to express your milk, as one of the strategies to help you overcome these conditions.
• If your baby is unwell and/or premature, or they have a problem with their mouth (such as cleft palate), or they have difficulty feeding (as can be the case sometimes with Downs syndrome), then breastfeeding may be difficult, (or not possible) for a period of time. You may choose to express your breast milk and give it to your baby with a bottle. In some cases, the baby may also need to be complemented with formula milk, if the amount breast milk does not keep up with the baby's feeding requirements.
• To mix with solids. The longer your baby has just breast milk, the less likely they will be to develop allergies to foods. Many mothers will use small amounts of expressed breast milk to mix in with rice cereals, (even pureed vegetables or fruits), once their baby starts solids (somewhere from 4 to 6 months) instead of using adult milks or water.
The aim of expressing breast milk is to mimic the 'milking action' of your baby breastfeeding. This is done by placing gentle pressure on the edge of the darkened skin around the nipple (or the 'areola'). The breast tissue underneath the areola is where the sacs or reservoirs (called 'ampulla') pool and store the breast milk, after it flows down from the breast tissue. When a baby breastfeeds, their tongue gently compress the ampulla against the roof of their mouth to 'milk the breast'. Expressing aims to rhythmically compress this area using your fingers or a breast pump.
Another important component of expressing breast milk is the stimulation of a let-down reflex. This starts the milk flowing more freely. If you are unable to stimulate a let-down reflex, you will be unlikely to express much milk. Using breast massage and stroking, warm compresses and relaxation techniques can help you achieve a let-down.
Once the milk starts flowing, usually swapping from one breast to the other frequently (every 2 to 7 minutes) during an expression session will help you obtain more milk. It may take you 20 to 30 minutes to express in the early weeks, but as your supply establishes, and you become more proficient, it may end up taking around 10 to 15 minutes. Try to avoid spending a long time expressing from just one breast. Once the milk flow slows, swap to the other breast, or come back to expressing at a later time.
Sterilising your equipment
You will need to sterilise all your milk storage bottles or containers (if not using pre-sterilised milk pouches), all your breast pump equipment (that comes in contact with your breast and the milk) and the baby's feeding equipment. This reduces the potential growth of any bacteria in the breast milk. Also, a baby's immune system is immature when born, therefore any of the baby's feeding equipment (whether breast or bottle feeding) and dummies, should be sterilised for at least the first 6 months after birth.
There are 3 main ways you can sterilise bottles and equipment. These are:
No matter which method of sterilisation you choose, you need to prepare the bottles and equipment before they can be sterilised. Even if the sterilisation process is carried out correctly, the bottles and equipment will not be made sterile if they have remnants of milk left on them. Therefore soon after expressing or feeding the milk to your baby, rinse all the equipment in cold water.
Once rinsed, scrub all the equipment in warm to hot soapy water (using dishwashing liquid). Use a bottle brush to clean inside the breast pump receptacles, bottles and inside teats (or use your finger or turn the teats inside out to clean inside them) and squirt water through the teat hole to make sure it is not blocked with milk. After cleaning all the equipment, rinse it all thoroughly in cold water again. Now everything is ready for sterilising.
Boiling is the cheapest way to sterilise bottles and formula preparation equipment. If you want to boil your equipment you will need to have a large saucepan with a lid (ideally, one that is not used to cook food in, used only for sterilising). Make sure all the equipment is able to be boiled (most baby feeding and expressing equipment are designed to tolerate boiling, but you may need to check any directions). Take care with boiling water, especially around siblings and babies.
To sterilise your equipment with boiling:
• Place all your washed bottles, caps and expressing equipment (but not the teats) into a saucepan of clean cold water. Fill the bottles with the water so they are submerged, the saucepan should be deep enough, and filled high enough, with water to cover the bottles. Some parents will use a metal vegetable steamer to keep the equipment submerged while boiling, especially if they do not have a lid for the saucepan to keep the heat in.
• Bring the water to the boil and let the equipment boil for about 7 minutes. Then add the teats (& dummies) to the boiling water replace the lid and leave the lot for another 2 to 3 minutes.
• After about 10 minutes of boiling (all up with bottles & teats), remove the saucepan from the heat and allow it to cool covered, or with the lid on.
• When the equipment is cool, wash your hands and remove the equipment. You can place any bottles or equipment that you do not need to use straight away, in a cleaned, covered plastic container and put it in the fridge. You will need to re-boil any unused equipment every 24 hours, even if stored in the fridge.
NOTE: Be aware that recommended boiling times for bottles and teats might vary from hospital to hospital, and caregiver to caregiver. This can be from 5 to 10 minutes for bottles, and 2 to 5 minutes for teats (after the water starts boiling). Just be aware that teats and dummies can deteriorate rapidly, if boiled daily for long periods of time.
Cold sterilisation (also known as 'chemical sterilisation') uses special antibacterial solution (or tablets) added to a measured amount of water, for the equipment to soak in. It is essentially bleach that is diluted down, so it does not harm your baby, but is capable of killing bacteria. There are a few companies (and 'no name' brands) that produce these types of products, so you can shop around to see what suits. Often the tablets are less messy, and easy to take away with you if you are holidaying. Be careful to keep the concentrated solution, or tablets, out of the reach of children, and store them away from sunlight.
All your feeding and expressing equipment can be sterilised in this way. Many cold sterilisation products also manufacture plastic containers (marked with measurements on the side) with lids and a plastic grid that sits on the equipment, inside the container, to keep all the equipment submerged in the solution. You can purchase one of these, or make up something similar yourself (be aware that it has to be plastic, as metal will corrode in the sterilising solution). You will need to replace the solution every 24 hours and clean the container, lid and grid with warm soapy water and rinse out before making fresh solution.
To cold sterilise your equipment you need to:
• Wash your hands and follow the manufacturer's instructions about the amount of water and solution, or tablets to use.
• Place your cleaned and rinsed equipment, bottles, teats and caps into the freshly prepared solution. Make sure you fill the bottles with the solution, so there are no large air bubbles and squeeze some of the solution through the holes in the teats. The solution will only sterilise what it comes in direct contact with. So if the equipment is not fully submerged, or has large air bubbles in it (don't worry about tiny ones that look like those in carbonated drinks), then the equipment will not be sterile.
• Keep the container out of direct sunlight, and allow the equipment to soak undisturbed for at least one hour, from the time the last piece of equipment is added.
• Wash your hands before removing the equipment. You can shake the solution off, but DO NOT RINSE THEM, otherwise they will need to be sterilised again! You can store any capped bottles (or equipment covered) that you do not need to use straight away in the fridge. Or you can leave it to soak in the solution until needed. You will need to change the solution to re-sterilise any unused equipment every 24 hours (even if stored in the fridge).
NOTE: Be aware that every time you put your hands into the solution, or add another bottle or piece of equipment, you 'contaminate' everything soaking in the solution (meaning it is not sterile). You must wait another hour from adding any piece of equipment (without disturbing the solution) before everything is sterile again. Therefore, if you want to add equipment, you may wish to remove any equipment that is already sterilised, before adding any more.
There are a few steam sterilisers on the market. They are quite expensive, but can make sterilising quick and easy. You will need to clean all your equipment before placing it into the steamer. The ones available are either:
Electric steam sterilisers.
The cleaned and rinsed bottles, teats, caps and equipment are placed into the steamer, with a certain amount of water added (read the instructions). The unit creates steam and raises the temperature quickly, to sterilise the equipment (usually in less than 10 minutes). These are usually automatic, meaning they will turn themselves off when the process is completed.
Microwave steam sterilisers.
These units use the microwave oven to heat the water, and sterilise the equipment. They take about the same length of time as electric steamers and are an option if you prefer them. Always follow the manufacturer's instructions.
Bottle feeding your baby
Some mothers are unable to breastfeed their babies, others choose not to, whatever your reason you can read all about bottle feeding your baby here.
Human babies need to have either their mother's breast milk, or a specially designed milk formula, as their main milk drink for the first 12 months of their life. While breast milk is always the best for babies, and will never be exactly emulated by artificially made formulas (because we cannot 'reproduce' the antiinfective and antiallergenic properties of human milk), companies who manufacture baby formulas have to carefully modify cows milk and soy bean products, so that they come as close as possible to what a baby would drink, if having breast milk.
There are many circumstances, or reasons why, women will choose to bottle feed their baby(s). The formula feeding may start from the time that the baby is born, or after weaning the baby from the breast, before they are 12 months old. Formula milk is usually given to the baby with a bottle, but may be given with a cup if the baby is old enough, (usually after 6 to 9 months). Many women will combine breastfeeding and formula feeding for varying lengths of time, either for personal reasons or to facilitate.
In the last 50 years or so, formula feeding has become a much safer practise in countries with good public health facilities. However, it still remains one of the main causes of infant deaths in under-developed countries. Safe formula feeding for newborn babies is essentially based on:
• Having accurate and understandable information about formula feeding and correct formula preparation.
• Being able to access a continual, clean water supply.
• Being able to prepare formula and sterilise equipment in a clean environment.
• Being able to store prepared formula milk in a refrigerator.
• Being able to afford the cost of purchasing specially designed formula milk for the first 12 months of the baby's life.
History of formula feeding
Attempts were first made to commercially produce infant milk formulas in the late 1800's. Unfortunately, no one knew what the make up of breast milk was at the time, and inappropriate formulas were produced. This combined with many unhygienic practises at the time, often lead to the poor health and death of many babies.
By the mid 1900's, techniques in cleanliness and sterilisation were commonplace, making formula feeding safer. Also formulas were starting to be manufactured, to be more in line with the composition of breast milk. However, it has only been in the last few decades that the complexity of breast milk has been truly realised, and formulas have been modified in ways to try and closely resemble breast milk. For example, it is now known that human milk has a finely balanced combination of amino acids (or the 'building blocks' of protein). This combination is unique to human milk when compared to the milk of all other animals (including cows). Therefore it is not only important for commercial formulas to have a certain amount of protein in their milk, but to balance the different amino acids, (such as glutamic acid and taurine), so that the baby is able to digest and absorb fats in their intestines in the first few weeks of life.
Soy based milks were first introduced into western society the early 1900's. (It is thought they were used to limited degree in some Asian countries prior to this.) Soy based formulas were usually used as an alternative for babies who were thought to be intolerant of cow's milk, but up until the 1990's their use has been very limited. Before the 1960's soy flour (which is high in carbohydrates) was used to make the formula. Babies drinking this early formula often had diarrhoea and colic. By the mid 1960's the carbohydrate was replaced by a soybean protein, which made the milk more digestible. In the last decade, the use of soy-based formulas by women for their babies (mainly as a personal choice) has increased dramatically, despite the fact that most caregivers do not recommend them except in special circumstances (for example, if the baby has a metabolic disorder such asgalactosaemia).
Types of formula
Cow vs Soy formula milk
If you choose to bottle feed your baby from birth, you will need to find out if the hospital will provide your formula. Hospital policies in recent years tend to encourage the woman to supply her own feeding equipment and formula. This is aimed at not promoting a particular brand of formula and facilitating the mother to learn how to prepare the milk correctly and sterilise her equipment, before she goes home (as well as promoting breastfeeding). Regardless of whether your hospital does this or not, you will need to have your formula, bottles teats ready for when you go home.
Don't be concerned if the formula brand your baby is first given in the hospital is not the one you have chosen during the pregnancy. Most hospitals are supplied with a different brand each month (reflecting that one brand is not better than another). Changing brands is not an issue for your baby and changing the type of formula will rarely make a baby unsettled or colicky, nor will it fix this behaviour (unless the change just happens to coincide with your baby growing out of this unsettled phase!)
There are also some 'follow on' formulas available. These are subsequent products developed by formula companies for 'older' babies (for example from 6 to 12 months). You can swap your baby to these after 6 months if you wish, but they are not absolutely necessary and the original formulas 'suitable from birth' are designed to take the baby up to 12 months of age. After 12 months of age babies can have normal cows milk (or soy milk) and a diet similar to the rest of the family.
NOTE: Be aware that normal milk that adults drink, no matter what type - cows, goat or soy substitutes, regular powdered milk or condensed milk- areNOT suitable for babies as their main drink, until they are at least 12 months old. Milk formulas for babies in the their first year of life needs to be designed specifically for newborn babies and labelled as 'suitable from birth'.
There are 4 main categories of baby formulas available. These are:
Cow's milk formulas
Specialised formulas prescribed for babies with nutritional and / or health problems
Goats milk formulas
Cow's milk formulas.
Cows milk formula is the most suitable for newborn babies and the main type of formula recommended by caregivers. The formula milk is made from skimmed cows milk, with most of the Casein protein removed, being replaced by whey protein. Lactose is added, salt is reduced and some of the milk fat is replaced by vegetable fats. Iron and vitamins and minerals are also supplemented.
Soybean formulas are based on protein soy extracts supplemented with specific amino acids to make them close to that of human milk. The fat content is derived from vegetable oils, and carbohydrates are provided by cornstarch and sucrose. Iron and vitamins and minerals are also supplemented.
As a general rule, soy based formulas should only be used on the advice of your caregiver.
Specialised formulas prescribed for babies with nutritional and / or health problems.
These are a few specially designed cow's milk formulas made specifically for very premature babies and babies with metabolic disorders. These types of formulas are usually prescribed by a paediatric doctor.
Goat's milk formulas.
Goat's milk formulas are now recognised as being safe for newborn babies. They may be an alternative for babies who are found to be allergic to cow or soybean formulas.
Once you have chosen your formula, you will now need to know how to prepare it correctly. If your baby has had formula from birth, you were probably shown how to prepare this in the hospital. However, many women will start to use formula after they go home, and may not be aware of the procedures involved.
A tin of formula usually comes in a powdered form. Check the date on the bottom of the formula tin to make sure it is not past its 'use by' date. Once the tin is opened, the formula needs to be used within one month. So, if you are only supplementing your baby occasionally with formula, you are best to only buy small tins.
The formula needs to be prepared exactly as recommended, to give your baby a balanced nutritional diet. Adding extra powder to make the formula 'richer' is dangerous and can constipate and dehydrate the baby, making them sick. It may also make them put on excessive weight. Diluting, or 'watering down', the formula will mean your baby is not getting enough. They get sick and vomit and not put on weight. Therefore, it is important that the correct measure of powder is added to the correct amount of water. Some women will just prepare each bottle as they need it, others will make up about 6 to 8 bottles at any one time, to last them about 24 hours.
Introducing solid foods babies 6 months
In years gone by, many parents and health professionals recommended introducing solids to young babies as early as 3 to 4 months of age. However, it is now recommended by the World Health Organization (WHO) that solids should only be introduced from 6 months of age. If possible, babies should only have breast milk until 6 months. If this is not the case, then a combination of breast milk and infant formula (or formula alone) is all that is required for proper growth and development in the first 6 months.
NOTE: Introducing solids does NOT help your baby sleep through the night, although this is a common myth.
When first introducing solids, be aware that breast milk and/or formula remain the most important part of your baby's diet, especially in the early weeks. Solid foods are initially just an 'extra' for your baby, not their main source of food just yet. If your baby doesn't show much interest at first, wait a week or so before offering solid foods again or try an alternative food if they don't seem to like the one you first offered.
When to start
There are many developmental reasons why giving young babies solid foods should be delayed until 6 months, along with the benefit of helping to reduce the likelihood of allergic reactions, especially in families with a history of allergies or food intolerance.
Babies under 6 months have:
• An immature digestive system which makes it difficult for their bowel to cope with solid foods.
• A natural tongue thrust reflex which causes their tongue to push solid food out of their mouth, rather than swallow it.
Babies from 6 months or older:
• Coordinate chewing and swallowing better, but they don't necessarily need teeth to eat most solid foods .
• Generally have sufficient head control to allow them to swallow safely.
• Start sitting up with assistance (or by themselves), making eating much easier.
Food tastes under 6 months.
Some babies around 4 to 5 months of age show obvious interest in what others around them are eating. Although not necessary, a few parents decide to start giving their baby small 'tastes' of different foods in the weeks before beginning solids in earnest. Take care in what you give your young baby, to help avoid severe food reactions. For example you should not give babies under 12 months honey, peanut butter, strawberries or eggs.
Rice cereals added to a bottle.
It is not recommended to add rice cereal to a baby's bottle of breast milk or formula, unless advised by your paediatrician. Rice cereal is made to be eaten as a solid food separately, not as a milk additive.
Babies are born with self-regulating hunger mechanism that lets them know how much food they need. During the early months, their body takes cues from the volume of milk they drink. Adding rice cereal to their bottles of expressed breast milk or formula interferes with this natural hunger mechanism, making babies ingest a deceptively large amount of calories. This may 'teach' your baby's body to overeat. When starting solids and using a spoon, your baby rests between mouthfuls and then stops when they feel full, allowing them to develop good eating habits to take them into older years.
To prepare for introducing solids to your baby, you will need a teaspoon with smooth edges, an unbreakable dish (some have suction caps on the base to adhere to the table); baby bibs to save food soiling their clothes and some face washers to clean your baby's face and hands when finished. If you don't have something to sit your baby in, you may start with sitting them on your lap or in a baby chair then progressing to a high chair.
Eating food is a new skill and a totally new sensation. Many babies love feeling and playing with different food textures and may initially spit it out (or as they get older throw the food, plate or spoon). This is normal, so be prepared for a mess with food on your baby, in their hair and spillage on the highchair and floor, as well as perhaps on you! You may wish to spread some newspaper or plastic sheeting under your baby's chair or use an area that is easily cleaned when giving your baby solids in the early months.
Which solid foods and how much
Some babies love trying new foods, while others are fussy eaters and not interested at all. Initially small amounts are recommended, so there is no need to prepare a wide variety of different foods or cook large quantities. Often a teaspoon or two is enough and even this may be spat out. Small quantities of cooked foods can be frozen in ice cube trays, stored in airtight plastic bags and thawed as needed.
If giving other foods, these need to be mashed or puréed to get rid of lumps. You can do this with a fork, or you may prefer using a blender or a small hand-held mixer/grinder to make your baby's food texture smooth. Some suggestions include stewed apples or pears, mashed ripe banana or avocado, mashed potato, pumpkin or zucchini. You may choose alternatives to these.
In the beginning, avoid giving a mixture of different foods. Stay with one food for about 4 days (if your baby likes it and is eating it) to see if your baby shows any physical reactions. Going slowly also gives your baby time to get used to the different textures and tastes. If your baby does not like a certain food, try it again in a week or so and/or try an alternative food.
Finger foods can add new tastes and textures to your baby's diet and may be an easy option if your baby loves to feed themselves. These may be well-steamed vegetables (carrots, beans, zucchini), cheese sticks or slices, fruit cut into slices (bananas, peaches, mangoes, pears).
Introducing solid foods and allergies
When you baby is ready to enter the exciting new world of eating solid foods, the key to success is to introduce solids slowly - regardless of whether or not you suspect your baby may suffer from allergies. By introducing first foods individually and over a couple of days, you will be able to easily pinpoint any suspect foods.
As the jury is out on when's best to introduce solids to allergy-prone babies, and all babies do need to start moving onto solid food at around 6 months (as their iron stores are low by this age), there's no need to delay the introduction of solids.
• Begin with rice (usually in the form of cereal), then follow with other low allergy foods such as pumpkin and potato, pear and apple, and then slowly introduce other fruit, vegetables and then chicken
• From 9 months, you can introduce wheat products
• Between 9 and 12 months, introduce soy products
• At 12 months, you can introduce cow's milk and whole eggs from 12 months
• Delay the introduction of fish (tuna, salmon) until 18 months
• Don't introduce peanuts, nuts, shellfish or any other foods that have a known family history until your child is at least 3 years old
*This article contains general information only and is not intended to replace advice from a qualified health professional.
Feeding Your Baby