northpoint pediatrics infant feeding information page

North Point Pediatrics

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INFANT FEEDINGS

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Breast Feeding

Bottle Feeding

Solid Foods

Vitamins and Minerals

Fluoride

In regards to which type of feedings you choose, breast or bottle, we will support whatever decision you make. We do encourage, along with the American Academy of Pediatrics, breast feeding your baby even if it is only for a short period of time.

Breast Feeding:
Usually your milk supply will become adequate between the second and sixth day after delivery. Before this your child will get his or her nourishment from colostrum. Colostrum will provide not only the calories needed but also provide important elements that will help prevent infections. Feeding your baby soon and often after delivery will help encourage your milk supply. Your baby should suckle for 15-20 minutes on the first side. Stop at this point to burp and change your baby's diaper. This will help the infant to stay awake to complete the breastfeeding session. Then let them suckle for another 15-20 minutes. With each feeding you should alternate the starting breast.

Breast fed infants should be fed every 2 hours initially in the first few weeks, then every2-4 hours thereafter. They should go no longer than 4 hours at night without being fed. There are several indications that your baby is getting enough milk:

Your baby is gaining weight
Your baby is having six to ten wet diapers a day
Your baby is active and alert
Your baby is having frequent bowel movements, usually 2-5 each day, or with every feeding.

If you choose not to breast feed or when you have decided to stop, you may have a problem with engorgement of your breast. You may need to use an ace wrap or a tight fitting bra for comfort until the milk production has stopped. The application of ice packs may also be of benefit. This may take up to approximately two weeks to subside.

For those women returning to work there are many commercially available breast pumps that you can use. You can pick up a list of these in our office. Of all the breast pumps the electric pumps are the quickest and easiest way of expressing your milk.

Bottle Feeding:
Your baby will require an infant formula for the first year of life. There are three types of infant formula: lactose, soy and elemental. We usually recommend a 20 caloric/ounce lactose (milk) formula in either a ready to feed, concentrate or powdered form. This should provide all the nutrients and calories your child will need for normal growth. You will not need to sterilize the bottles or nipples if they are washed thoroughly. Using a dishwasher is good enough. There is also no need to boil city water. Recommended bottle feedings by age are listed below:

AGE	NO. OF FEEDINGS	VOLUME (OUNCES)
Birth - 1 wk	6 - 10	1 - 3
1 wk - 1 mo	7 - 8	2 - 4
1 mo - 3 mo	6 - 7	4 - 6
3 mo - 6 mo	4 - 5	6 -7
6 mo - 9 mo	3 - 4	7 - 8
10 mo - 12 mo	3	7 - 8

Solid Foods:
The bulk of nutrition during an infants first year of life comes from either breast milk or formula. Solid foods are intended to supplement formula, not take the place of it. You may introduce solid food when your baby weighs 12 pounds and is at least 4 months old. These instructions should be used as a guideline rather than a hard and steadfast rule. It is not necessary to start foods at this time and some infants can wait until later. Introduce single ingredient foods one at a time and continue for 5 days before introducing another food. This will help isolate food sensitivity and prevent food allergies.

It is common practice to introduce rice cereal first, then fruits, yellow and orange vegetables, green vegetables and finally meats. Start with rice cereal diluted with formula or breast milk. Feed your infant 2-3 tablespoons twice daily. You will gradually increase feedings to three times daily when your infant is ready.

RECOMMENDED SOLID FOOD FEEDINGS
4 months	1-2 teaspoons twice daily
5 months	1/2-1 jar daily stage 1-2
6 months	2-3 jars daily stage 2, yogurt can be added to diet
7 months	3 jars daily, stage 2-3
8 months	4 jars daily, stage 2-3
9 months	Start junior foods and table foods if they can chew and swallow adequately

FOOD AVOIDANCES
Honey should never be used. Avoid using added salt or sugar, or excessive spices.

Until after 12 months of age avoid:
egg whites
strawberries
chocolate
kiwi fruit
acidic foods and juices
shell fish

Until 2 years of age avoid:
nut products
nuts
popcorn

Vitamins and Minerals:
Breast milk and infant formula contain the vitamins and minerals that your child will need, although sometimes iron may need to be supplemented. We will check your child for iron-deficiency anemia at 12 months.

Fluoride:
Fluoride helps reduce the incidence of dental caries in children. Sources of fluoride include infant formula, tap water, juices, and toothpaste. If you will be mixing your infant formula with bottled water you will need to check with the distributor about the fluoride content. It should contain at least 0.6 ppm of fluoride. If you live in Fulton County your tap water supply contains 1 ppm of fluoride which is more than adequate. Your child will not need fluoride until six months of age. After this age, depending on how much fluoride is in the water supply you are using, a supplement may be required. However, a fluorinated toothpaste should not be used until your child is able to refrain from swallowing it. A specifically formulated "children's" toothpaste is our preference.

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