Ways to feed your baby

Exclusive breastfeeding

• This means that you would like to avoid formula and give your baby only breastmilk
• This would also mean feeding the baby at the breast early and often from the first hour baby is born
• Exclusive breastfeeding can last for as long as you and baby desire, and can continue even when baby starts to eat solid foods (which you will discuss with your pediatrician)
• Some people find it helpful to hand express some milk into a spoon during the first days while baby is learning to latch and you are both getting the hang of things. This can help baby to get some extra early milk called colostrum and help your milk come in faster without interrupting the process of learning to latch baby to the breast.
• Babies that are exclusively breastfeeding need to feed at the breast about 8 to 12 times a day for about 30 minutes. This can be slightly more or less frequent depending on how much they take per feed but is a useful guide.
• Once home, babies that breastfeed exclusively become a little more regular with their schedule but they still may have times that they feed very often (“cluster feeding”) and other times when they take long naps
• Some people feel nervous about baby getting enough milk, but your doctors and nurses will help teach you hunger cues, and how to monitor your baby’s diapers for signs they are getting enough milk. They will also follow your baby’s weight closely in the beginning until breastfeeding is well established.
• Some people that are exclusively breastfeeding would also like their babies to know how to take a bottle, and that’s okay!
• You can still exclusively breastfeed your baby but also express some extra milk for the baby to learn how to use a bottle. Most people have more milk in the morning hours and find it helpful to pump for about 10 minutes after a morning feed to have some of their own milk on hand for bottle practice. If breastfeeding is going well, it is helpful to start this process around three weeks after you have the baby.
• This can also be a good way to start saving some milk for when you might go back to work, or need to leave the baby with someone else when you are out of the house.

• This method of feeding can take many shapes depending on your preferences, and can also happen at any age of the baby
• Most babies have no problem learning to take formula regardless of age because it is sweet and well received
• For some families they would like to begin mixed feeding from the very beginning of their baby’s life, but for others they would like to primarily breastfeed and then introduce formula at some point to allow for more feeding flexibility
• Regardless of your preference, if you would like to establish a healthy production of breast milk, it can be helpful to feed the baby at the breast early and often which in the first days and weeks of life - this helps set up the building blocks for breast milk production in your body. When a baby drinks formula in the first weeks it disrupts milk production, as your body gets less stimulation to make breastmilk and slows down production. This can make it hard to produce enough breastmilk later on.
• When you do start formula, it can be helpful to save formula bottles for late afternoon/evening when your breast milk volume is a little lower and you might be looking for some more rest. This way you can help your body to maximize breast milk production as well so that you are best able to meet your feeding goals.
• Once breastmilk production is well established, you can think about how you would like to organize your bottle- and breast-feeding schedule to best meet the needs of your family.
• If you are giving formula because your milk production has not increased enough, but you plan to exclusively breastfeed, hand express or pump milk whenever you give a bottle of formula. Your body needs frequent stimulation of the breasts and removal of milk in order to release the hormones that increase milk production. Even if you don’t see much milk come out don’t get frustrated – by pumping, hand expressing or latching your baby you are “placing an order” for your body to make more milk in the coming days.

• This feeding method would mean using a breast pump (usually a double electric pump) to express milk from your breasts on a regular schedule to feed your own milk to your baby from a bottle
• This method often is used by parents that have a difficult start to breastfeeding, baby has a challenging time with latching, or perhaps there was a hospital stay for either parent or baby that interrupted baby from learning to latch to the breast
• However, for some people that are not interested in direct breastfeeding but would still like to give their milk to their baby, this can be a first-choice option. We are still learning about the differences between direct breastfeeding and feeding pumped milk, but it is certainly healthier than formula.
• It is helpful during the first 2-3 days after giving birth to utilize hand expression and breast massage early and often to promote milk coming in
• It is also helpful to hold your baby skin to skin, even if not planning to latch baby directly to the breast – the baby contact on your chest skin releases the hormones that make milk
• All of this skin contact and hand expression helps to prepare the breastmilk production building blocks in your brain by stimulating important nerves in your breasts
• You should also plan to begin pumping with a double electric breast pump for about 15 minutes at least every 3 hours to help remind your brain that you are requesting milk production
• Once your milk “comes in,” usually about day two to three after baby is born, it helps to stick with this schedule of pumping every two to three hours for 15 minutes at a time. Overnight you can shift to every four hours or so to allow for more rest
• If your baby is born healthy and full term, it is okay to store your pump parts in the refrigerator in a clean bowl and wash once at night before bed in hot, soapy water, and repeat in the morning. This will make your schedule more manageable
• It can be very helpful to remind your brain that you are working on a healthy production by doing a “power pump” session a couple of times per week
  • This is usually done by pumping for 10 minutes, resting for 10 minutes, and repeating over the course of one hour
  • This helps to tell your brain that there is a baby looking for more milk by simulating a “cluster feed”
  • It can be easiest to do this when baby is sleeping or you have some extra help
• It is important to remember that while most people need to work hard to build a full milk production, for other people this kind of pumping schedule can put their bodies into over drive
  • If this begins to happen and you feel you are making more milk than you need or you are finding your breasts are constantly uncomfortably full, reach out to your provider for guidance and to help connect to a breastfeeding specialist.

• Sometimes we don’t have enough breastmilk for our babies at first – this can be due to problems in pregnancy or childbirth, prematurity, or difficulties latching. The hospital will offer you the option of donor milk or formula.
• By giving donor milk instead of formula, your baby’s gastrointestinal tract will develop as healthy as possible. Donor milk is also given to preterm babies, who have much lower risk of severe infections when they receive human milk instead of formula.
• Donor milk is breastmilk that others have donated to milk banks. Milk banks ensure that the donors are healthy by testing them and giving them guidelines about how to keep the milk safe. The milk is pasteurized, similar to the cow’s milk we buy at the store. At BMC, you will have access to donor milk for free while you are in the hospital, if needed. Donor milk can be a good bridge if your milk is taking longer than normal to come in.

• This method would mean beginning your baby on formula bottles only from the time they are born
• Small bottles of formula are available on hand at the hospital so you don’t have to bring your own to start, however it can be helpful to either choose or discuss with your pediatrician and/or WIC about which formula you will use when you go home
• It is important to follow your pediatrician’s advice on how often and how much formula to feed your baby
• Babies that eat from a bottle will often take more than they need because they love to suck, and have to keep up with the milk flowing because of gravity! Use the “paced” bottle feeding method to avoid this – learn about it here Also, a pacifier can help soothe baby after they take what they need from the bottle
• It will be important to clean bottles and prepare formula safety, all of which the pediatrician will review when you are at the hospital and before you leave to go home. See here Formula & Bottle Feeding Basics | Hey Mama (bmc.org) for more.
• It is important to remember that even if you choose to formula feed, your body will not immediately get that message
• Some important things to remember to help tell your body that you do not wish to produce breastmilk are:
  • Wearing a tight-fitting bra (plan on bringing a sports bra or chest band to the hospital)
  • Avoid stimulating the nipples, whether with your hands or even the water from the shower (some people wear their sports bra or chest band even while bathing in the first days after birth)
  • Using ice and even cold cabbage leaves to help reduce inflammation
  • Use ibuprofen as needed and prescribed for inflammation
  • Drink peppermint tea and/or chew Altoid mints
  • If your breasts/chest become very engorged and painful, talk with your provider about medication that can help dry the milk more quickly