How to properly feed a newborn with formula

What do pediatricians around the world agree on?

Pediatricians around the world agree that breast milk is the ideal nutrition for newborns from 0 to 6 months. Tatyana Eduardovna Borovik, Doctor of Medical Sciences, Head of the Department of Nutrition of Healthy and Sick Children of the Scientific Center for Children's Health, Professor of the Department of Pediatrics and Pediatric Rheumatology of the Pediatric Faculty of the First Moscow State Medical University (First Moscow State Medical University) named after. I.M. Sechenov in an interview to the question “What are the dangers of violations in the organization of feeding children in the first year of life?” answers: “First of all, this is one of the reasons for the development of nutrition-dependent diseases. Thus, the nutrition of an infant “programs” the body’s metabolism in such a way that any negative changes in its usual diet can increase the risk of developing allergic diseases, overweight, malnutrition, iron deficiency anemia and a number of other diseases.”

Professor Borovik T.E. together with an expert group of leading pediatric nutritionists and pediatricians in Russia, we developed the “National Program for Optimizing Feeding of Children in the First Year of Life,” which lists all the advantages of breastfeeding for newborns. In our country, since 2008, all local pediatricians have been guided by this program.

The daily amount of food is:

• at the age of 10 days to 2 months - 1/5 of the actual body weight (on average 600-900 ml);
• at the age of 2-4 months - 1/6 of the actual body weight (on average 800-1000 ml);
• at the age of 4-6 months - 1/7 of the actual body weight (on average 900-1000 ml);
• at the age of over 6 months to one year - 1/8 of the actual body weight (on average 1000-1200 ml).

Carefully follow formula preparation instructions and serving sizes to ensure your baby receives the optimal amount of food.

It is important!

Even if a child has a genetic predisposition to a disease, breast milk, by influencing gene expression, can change the undesirable phenotype, increasing the child’s health potential throughout his life. The composition of breast milk provides protection to the baby from surrounding infections. In addition, milk “evolves” and adapts to the ever-changing needs of the baby in the first year of life. The “National Program” regulates not only the nutrition of newborns, but also the diets of pregnant women and nursing mothers.

Breast-feeding

So, we figured out what nutrition is optimal for newborns. Of course, mother's breast milk. To properly “switch on” the lactation process, pediatricians recommend early breastfeeding and skin-to-skin contact with the mother immediately after birth. The first food received from the mother is colostrum. Despite the fact that it is produced in small quantities, it contains a concentrate of beneficial nutrients: amino acids, fats, easily digestible proteins and vitamins.

Feed on demand or on time?

You need to understand that a child’s crying is not always caused by hunger. The reasons for crying may be the need for contact with the mother, infant colic, a change in environment, overheating or hypothermia of the child, the need to change a diaper, pain, etc. The child’s behavior will tell the mother that he is hungry. He will make characteristic movements, turn his head in search of the chest, and smack his lips. It’s easy to understand that it’s time to give him the breast. Feeding on demand can only be used during breastfeeding and in the first month of life; in the future, it is advisable to formulate a diet for the baby.

Feeding a newborn with formula according to WHO

Smoking while breastfeeding - consequences for the child

WHO has developed its recommendations for mothers on how to feed their babies formula, containing information about the number of feedings required for babies and the volumes of artificial formula fed, depending on age.

The volume of formula on artificial nutrition according to the child’s age

To provide the child with the necessary substances, it is necessary to determine the optimal volume of the mixture

If you don’t have such a table at hand, or the parents don’t trust it, you can use the following formulas to calculate how much formula a newborn should be given per day:

1. Filatova-Zaitseva or Tura (applicable for babies from the first week to 10 days of age): 2 percent of body weight at birth multiplied by the number of days of life;
2. “Volume” formulas (after 10 days of life) - the volume of the mixture is determined by the current weight of the baby:

• up to 2 months – one fifth of the weight;
• from 2 to 4 months – one sixth of the weight;
• from 4 to 6 – one seventh of the mass;
• over six months - one eighth of the weight.

Additional Information. At certain periods of life, the child’s needs may deviate from the recommended norm in one direction or another; this also needs to be taken into account by mothers who practice artificial or mixed feeding. Also, the child may not be able to cope with the prescribed amount of formula in one feeding, then you should feed him in smaller portions, but more often.

Mixed feeding

Feeding a newborn baby is considered mixed if breast milk is combined with an adapted infant formula (supplementary feeding). This type of feeding can be used in cases where:

• the mother produces insufficient milk;

• Mom combines child care and work.

If a mother is worried that she does not have enough milk, she needs to consult a specialist on how to improve and restore lactation. If methods to improve lactation do not work, it is worth discussing with your pediatrician the introduction of supplementary feeding into the newborn’s diet and choosing the appropriate one. It is very important to give your baby breastfeeding until the last moment, even if there is very little milk. The mixture should be given after breastfeeding.

Approximate feeding regimen for 1-3 months

Hypoallergenic formulas for newborns

If a mother is thinking about how to properly feed her newborn with formula, first of all, she must adhere to her child’s diet. In the first 30 days of life, an infant mainly sleeps and eats, so feedings alternate with 2.5-3 hour breaks throughout the day, and the baby must also be accustomed to a night break (after a month, a 6-hour rest for the small ventricle is recommended).

It is recommended to take a short break from feeding at night.

Starting at 2 months of age, the baby has 18 hours for 6 meals, approximately every 3 hours. It is not necessary to follow a precise schedule down to the minute; you should not allow the baby to cry from hunger for too long while waiting for the next feeding, but you should stretch out the time until this moment as much as possible. Gradually the little person adapts to the regime.

When creating a formula feeding schedule, you should not focus on the frequency of breastfeeding of breastfed babies - infant formula and human milk have different rates of absorption by the baby's digestive tract. An artificial product is more filling, so babies are breastfeeding much more often than bottle feeding.

Also, drinking diluted formula from a hole in the nipple is much faster than sucking milk from the breast: the bottle will end in 10 minutes, and you can “hang” on the breast for hours.

Additional Information. When artificially feeding babies, it is advisable to supplement their diet with clean water; its volume is not counted as nutrition.

Artificial feeding

If more than 4/5 of a newborn’s diet consists of infant formula, they speak of artificial feeding. Frequent reasons for switching to completely artificial feeding are a significant decrease or absence of lactation, or the mother being forced to take medications that are incompatible with lactation. When choosing the right formula, pay attention to Nutrilak Premium infant formulas. They contain most of the components that bring infant formula closer in composition to breast milk:

• Omega-3 and Omega-6 fatty acids
• pre- and probiotics to improve intestinal microflora;
• lutein, necessary for the formation and protection of the organ of vision;
• nucleotides that are beneficial for the immune system and the digestive system;
• Milk fat is a special substance that the child’s body uses as a source of energy and also for brain development.

Nutrilak Premium baby formulas do not contain rapeseed or palm oil, which makes them as comfortable as possible for babies' digestion with high-quality milk protein, mineral components, vitamins, milk fat and other substances important for the baby's health.

Regime and norms of nutrition for newborns

At his first meal, a newborn eats about 8 ml. In the first days and weeks of life, the mother puts the baby to the breast on demand (when the baby’s crying or any restlessness should be assessed as a possible feeling of hunger) approximately every 2 hours. Normally this comes out about 10-12 times. The baby eats only about 100 ml of milk per day. These first feedings are quite long - about 20-40 minutes. In the future, the baby's sucking reflex will improve. The baby will be able to eat more in a shorter period of time at the breast. It is believed that with each day of life, the volume of milk consumed at a time increases by 10 ml. Both the amount eaten and the intervals between feedings will gradually increase. A more convenient feeding interval will develop, since breast milk has a beneficial effect on the baby's circadian rhythms of sleep and wakefulness.

Feeding regimen for a bottle-fed baby

The frequency of meals and its volumes for children growing up on formula differ from the nutrition of infants. The feeding regimen of a bottle-fed baby should be clearly planned in time. It is worth finding out in advance how many times a day to feed a newborn, what is the optimal break between meals, and how to soothe the child at night, except for formula.

How to calculate your diet

Unlike infants, artificial babies do not need to be fed on demand. On average, at 1 month a newborn should eat 8 times a day. Plus or minus one feeding. At 2 months, the number of meals can be reduced to 7.

Upon reaching 3 - 4 months, feed the baby 6 times a day. At 5 months, transfer him to 5 meals a day. He will eat this way for up to a year.

The feeding routine should be established from the birth of the baby. Then try to strictly adhere to it. Systematic violation of the schedule is fraught with overfeeding.

In this case, frequent regurgitation, excess weight gain, impaired metabolism and related problems are ensured.

If a child gets used to eating at night, none of the family members will be able to get enough sleep.

Optimal break between feedings

The pause between meals depends on the age of the baby. Due to the abundance of protein in artificial formulas, they take longer to digest than when breastfeeding.

When a newborn is fed too often, a new portion of food is added to the undigested food, complicating the work of the stomach and intestines. Don't let this happen.

Up to a month, the minimum interval is at least 2.5 hours. Then - at least 3 hours. From 5 months, the pause in feeding reaches 4-4.5 hours.

The night break in nutrition in the first weeks of life is at least 6 hours.

Eating at night

The digestive system and intestines need rest. Night is the best time for this. Up to a month, the child may not be able to withstand a night break of more than 6 hours.

From 3 months the interval should be increased to 8-10 hours. Moms know that babies sleep differently at night. For some, the regime is set up quickly and without much effort, for others, up to a year, they have to regularly stand guard at the crib, convincing the baby to sleep.

It is wrong to give your child food every time he wakes up. Hunger is not the only reason to wake up.

Perhaps the baby is experiencing discomfort from cold, stuffiness, a wet diaper or diaper, and is thirsty. Or the baby wanted to make sure that his mother was nearby and just hug and rock him enough to make him fall asleep again.

Another common cause is the sucking reflex.

Knowing for sure that the baby is not hungry, replace the bottle with a pacifier or give the baby something to drink. If the baby has not eaten his daily allowance, the feeling of hunger really interferes with sleep.

Then feed him and he will sleep soundly.

How to create a routine when transitioning from breastfeeding

If the newborn was initially fed breast milk on demand, it may be difficult to organize a regimen when switching to formula.

Be patient. If your baby clearly shows that he is hungry and it is not feeding time yet, feed him.

Increase the interval gradually. Distract your child with toys, entertainment, a pacifier, and walks. Offer him a drink. Every 10 minutes gained will help bring your routine back to normal within a few days.

At each feeding, give your baby the right amount of nutrition, then he will most likely withstand the necessary break.

Pros of eating by the hour

It is important not only to maintain a sufficient break, but also the timing of feeding. Pediatricians note that this way the baby’s body adjusts to stable functioning, and nutrition is better absorbed.

Positive aspects of nutrition by the hour:

• Benefits for digestion. The body quickly gets used to receiving food at the same time and copes well with its processing.

• Comfort for the child. The sequential mode gives him a feeling of stability and correctness of what is happening.

• Convenience for parents. By feeding your baby at a certain time, you won’t have to calculate each time how much time has passed since the last feeding. Plus, it makes it easier to plan your day.

• Children who are accustomed to a certain regime adapt better to kindergarten. And in the future, the little person will have to live according to the regime.

The routine may sometimes change depending on the circumstances and wishes of the child. If he woke up an hour earlier, it means he will want to eat without waiting for the usual time.

Make concessions, do not turn into a despot. Deviations of half an hour are quite acceptable.

Individual characteristics

Don't be surprised if your baby eats different amounts of formula at different feedings. Adults also prefer a light breakfast and a heartier lunch.

Likewise, a child may eat less in the morning and ask for more next time. The amount of food children need is also somewhat different.

For some, 100 ml at a time is enough, for others – at least 200.

Useful tips for mothers: NUTRITION UP TO 3 YEARS OLD

All standards are averaged, and it is worth taking into account the individual characteristics of your child. This will also help establish a correct and stable feeding regimen.

Can't set up a routine? Do not give up!

It is not always easy for a child to agree to live according to the regime. Be patient and don't give up. Ultimately, everyone benefits from a good routine. Does your baby insistently demand a bottle every hour?

Turn on your imagination, keep him busy, give him something to drink. If you follow the lead once, you won’t see the long-awaited regime. By gradually bringing the routine back to normal, you will stabilize the life of the whole family.

The child will get used to eating over time, the functioning of his body will improve, and there will be fewer night rises.

The emotional side of the regime

It is important not only to feed the baby on time and to the full, but also to create an atmosphere of love and care.

Babies, having drunk their mother's milk, may not let go of the breast in order to satisfy their sucking reflex. Artificial children sometimes lack one bottle.

You can offer your toddler a pacifier. Children with a highly developed sucking reflex replace it with their own fingers. Agree, it would be better to be a dummy.

Feeding should take place in a calm, warm atmosphere. The baby should feel that he is close to people who love him.

After feeding your baby, do not rush to put him in the crib. Pet him and rock him so that he feels calm and safe.

How to understand that the regime is suitable for a child

Once the feeding schedule is established, you can easily determine whether your baby likes it. The following signs will indicate this:

• the child waits for the next feeding without whims;
• sleeps well;
• eats with appetite;
• urinates at least 12 times a day;
• has stool at least once a day;
• is in a good mood.

If your baby is not gaining weight well, despite regular and nutritious meals, sleeps restlessly and is constantly naughty, consult your doctor.

Dr. Komarovsky about diet

The pediatrician is confident that a healthy child can be raised both with regular feeding and with free feeding. Mom herself must decide which method is more convenient for her.

It’s easier to endure the whims for a while, but develop a normal regime, than to suffer for many more months. If the mother is happy, the husband and child will be happy.

The normal interval between meals for a newborn is from 2 to 3.5 hours. If the baby is gaining weight normally, the interval can be increased.

There is no need to wake up the baby to feed. Only if these are premature babies or children who are underweight.

A child who has eaten well may not want to eat before 2 hours later. But wanting attention or satisfying the sucking reflex is fine.

Setting up a routine is not always easy. But after surviving for several days, you will gain stability in the daily routine and functioning of the child’s body.

It is important to strictly observe the minimum intervals between feedings, not to encourage night awakenings, and not to give food as soon as the baby cries.

Besides hunger, there are many other reasons for whims.

Make sure your child is comfortable and not thirsty, cold or hot. By establishing an hourly routine, you will appreciate numerous benefits.

Whether the regime is suitable for the baby can be determined by several signs. Attract your baby more, play, walk, give him your warmth.

Arina Nagovitsyna

JOURNALIST Higher education: Faculty of Journalism and Mass Communications

Formation of metabolism

In the first months of life, the digestive system develops and the peculiarities of metabolic processes are laid down. The correct diet of a newborn favors the colonization of the intestines with beneficial microorganisms. Healthy intestinal microflora determines the formation of stable local and systemic immunity of the child.

To ensure proper growth and development of the child, the European Society of Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) advises maintaining breastfeeding for at least 6 months of life.

It is recommended to introduce complementary foods no earlier than the 17th and no later than the 26th week of a child’s life.