Newborn to Six Months: Breastfeeding

Excerpted from
The Baby's Table
By Brenda Bradshaw, Lauren Bramley

For the first 6 months your baby will be led only breast milk or breast milk substitute. The first 6 months is a time of peak growth and bonding, when your baby will double or triple his birth weight, will learn to smile and laugh and will rely on you entirely for healthy nutrition. It has been proven that breast milk is the optimum nutrition for young babies. It is not always possible to breastfeed, however. Regardless of whether it is breast or bottle, a loving and caring approach to feeding will ensure your baby thrives.

According to the Canadian Pediatric Society, the Dietitians of Canada, Health Canada and the American Academy of Pediatrics, breastfeeding is the optimum method of feeding for all infants with very few exceptions. Research continues to prove the vast benefits of breastfeeding for your baby:

Reduced rates of infection: Breastfeeding has been shown to reduce the rates of respirator)', ear, gastrointestinal, urinary tract and other infections in both infancy and childhood by at least 30 to 50 percent. Antibodies and other proteins from the mother prevent infection and strengthen the immune system.

Possible prevention of Sudden Infant Death Syndrome (SIDS): In addition to placing an infant on his or her back for sleep, recent studies show a reduced risk of SIDS among breastfed infants.

Enhanced cognitive development: Breastfeeding has been shown to improve childhood intelligence quotient (IQ), standardized tests of reading, mathematics and scholastic ability. These improvements arc thought in part to be due to the specific fatty acids found only in breast milk.

Prevention of allergies: There is evidence to suggest that exclusive breastfeeding for at least the first 3 to 4 months of life is protective against eczema, cows milk allergy and wheezing in the early years.

Prevention of iron deficiency: Breast milk is associated with lower rates of iron deficiency, provided iron-fortified cereals are not postponed much beyond 6 months.

Other benefits: There is a possible reduction in asthma, diabetes, bowel diseases and some childhood cancers in breastfed children. And then there are the health benefits of breast feeding; for mothers:

Decreased osteoporosis in later life: During pregnancy, calcium is lost from the mother's bones as a source for the developing baby. The hormones produced by breastfeeding replace the skeletal calcium lost during pregnancy, which leads to a decrease in osteoporosis.

Decreased cancer risk: Breastfeeding is associated with a reduced risk of ovarian and breast cancer. This is thought to be due to the reduced levels of estrogen caused by breastfeeding.

Entranced weight loss: Breastfeeding is related to increased weight loss following birth and a faster return to pre-pregnancy weight and body shape. This process begins immediately, as hormones released during breastfeeding promote faster shrinkage of the uterus and mobilization of fat from the lower body. These effects occur without dieting or excessive exercise and arc more evident with prolonged breastfeeding.

Other benefits: New parents are often overwhelmed by the time commitment of breastfeeding a newborn baby. However, breastfeeding is an excellent way to escape the demands of cleaning, sterilizing and preparing bottles, particularly in the early weeks of baby's life. Furthermore, breast milk is a dynamic substance, which alters its consistency depending on both climate and your baby's needs.

How Long? Many benefits can be achieved with 6 months of exclusive breastfeeding. For this reason Health Canada recommends at least 6 months of exclusive breastfeeding followed by the introduction of nutrient rich complementary foods, with particular attention to iron. It is ideal to continue breastfeeding for the first 2 years and beyond, if possible, as many of the benefits are more marked with prolonged breastfeeding. However, should extended breastfeeding not be possible, the benefits of even a short time are evident.

Nursing Nutrition

Eat well and avoid calorie-restricted diets during breastfeeding to ensure adequate energy for milk production. The composition of breast milk will vary according to your diet. The fat-soluble vitamins A, D, E and K and minerals are drawn from storage in your body so that your recent dietary deficiencies are not evident in the breast milk. The water-soluble vitamins C and B-complex are not stored by you and may therefore be deficient in breast milk if you don't meet your dietary needs. Many women choose to continue taking their prenatal vitamin throughout breastfeeding. In some countries, DMA, a type of omega-3 fatty acid, is now included in prenatal vitamins to improve infant brain and eye development and ward off post-natal depression. Speak to your doctor about the possibility of taking a DHA supplement while breastfeeding. If you consume a strict vegetarian diet you will likely be advised by your doctor to take a daily vitamin supplement. All women should drink plenty of fluids while breastfeeding, as it is easy to become dehydrated, which may then lead to exhaustion.

How to Get Started

Ideally breastfeeding should begin as soon as possible after birth. For the first 48 to 72 hours, breast milk consists only of a clear substance called colostrum. Colostrum is extremely rich in antibodies and plays a crucial role in development of the infant's immune system. As colostrum is low in calories, the breastfed newborn will lose weight in the first 3 to 4 days of life. Early breastfeeding patterns can lie very erratic, and parents may think the baby couldn't possibly be getting enough; however, the infant has a good reserve to help her withstand this early phase. Weight loss is a normal part of early life and it is important for parents not to be discouraged. It is also important to resist supplementing colostrum with formula, or "sugar water" as was once common practice in many hospitals. "Today these measures are only taken if medically necessary and are not for normal weight loss alone. The best treatment for the "hungry" baby is more practice at breastfeeding. This also encourages the breast milk to replace colostrum within 2 to 4 days.

In the early weeks newborns should be breastfed whenever they show signs of hunger. Early signs of hunger include increased activity, opening the mouth and turning the head in search of food, or attempting to "latch on." Crying is a late sign of hunger. Once milk has replaced the colostrum, newborns will feed approximately eight to ten times in 24 bouts. It is important to hold baby upright for burping following a feed; however, babies may occasionally not burp and need not be continuously patted to do so.

At I week of age, adequate breastfeeding is indicated by at least six wet diapers and three to four stools per day. In these early weeks newborns who have not nursed for a period of 4 hours should be roused to feed.

In time, the duration of each feed will become shorter and nursing will occur less frequently. Sometime alter the first month, babies may be encouraged to have fewer feeds during night hours with increased duration of morning feeds. I his may be accomplished by comforting the baby in other ways, such as holding, rocking or changing.

If discharged from die hospital less than 48 hours after delivery, babies should be evaluated by a health care professional within the first 5 days of life. You should contact your doctor about possible inadequate feeding, die appearance of a yellow tinge to the skin or whites of the eyes (jaundice), vomiting or temperature above 1OO.4°F/38.0°C.

For concerns regarding breastfeeding, contact your doctor, community nurse or local La Leche League.