How you feed your newborn is the first nutrition decision you make for your child.
These guidelines on breastfeeding and bottle feeding can help you know what's right for
you and your baby.
Breast or Bottle?
The American Academy of Pediatrics (AAP) recommends that babies be breastfed exclusively
for about the first 6 months. Following the introduction of solid foods, breastfeeding
should continue through the first year of life and even beyond, if desired.
But breastfeeding isn't possible or preferable for all new moms. Deciding to breastfeed
or bottle feed a baby is usually based on the mother's comfort level with breastfeeding
and her lifestyle. In some cases, breastfeeding may not be recommended for a
mom and her baby. If you have any questions about whether to breastfeed or formula
feed, talk to your pediatrician.
Remember, your baby's nutritional and emotional needs will be met whether you choose
to breastfeed or formula feed.
Breastfeeding your newborn has many advantages. Perhaps most important, breast
milk is the perfect food for a baby's digestive system. It has the nutrients that
a newborn needs, and all of its components — lactose, protein (whey and casein),
and fat — are easily digested. Commercial formulas try to imitate breast milk,
and come close, but cannot match its exact composition.
Also, breast milk has antibodies that help protect babies from many infectious
illnesses, including diarrhea and respiratory infections. Studies suggest that breastfed
babies are less likely to develop medical problems such as diabetes, high cholesterol,
asthma, and allergies.
Breastfeeding also may decrease the chances that a child will become overweight
Breastfeeding is great for moms too. It burns calories, so nursing moms get back
in shape quicker. Breastfeeding also may protect mom from breast cancer and ovarian
Some moms find breastfeeding easier and quicker than formula feeding — it
needs no preparation and you don't run out of breast milk in the middle of the night.
Also, breastfeeding costs little. Nursing mothers do need to eat more and may want
to buy nursing bras and pads, a breast pump, or other equipment. But these expenses
are generally less than the cost of formula.
Breastfeeding meets a variety of emotional needs for both moms and babies —
the skin-to-skin contact can enhance the emotional connection, and providing complete
nourishment can help a new mother feel confident in her ability to care for her newborn.
Limitations of Breastfeeding
With all the good things known about breastfeeding, why doesn't every mother choose
Breastfeeding requires a big commitment from a mother. Some new moms feel tied
down by the demands of a nursing newborn. Because breast milk is easily digested,
breastfed babies tend to eat more often than babies who are fed formula. This means
mom may find herself in demand as often as every 2 or 3 hours in the first few weeks.
This can be tiring, but it's not long before babies feed less frequently and sleep
longer at night.
Some new mothers need to get back to work outside the home or separate from their
babies from time to time for other reasons. Some of these moms opt for formula feeding
so other caregivers can give the baby a bottle. Mothers who want to continue breastfeeding
can use a breast pump to collect breast milk to be given in a bottle so their babies
still get its benefits even when mom isn't available to breastfeed.
Other family members (dads most of all) may want to share in feeding the baby.
When mom is breastfeeding, dad or siblings may want to stay close by. Helping mom
get comfortable, or providing a burp cloth when needed, will let them be part of the
When breastfeeding is established, other family members can help out by giving
the baby pumped breast milk in a bottle when mom needs a break.
Sometimes a woman may feel embarrassed or worried about breastfeeding. These feelings
usually disappear once a successful breastfeeding process is set. It's often helpful
to seek advice from those who've gone through the experience. Most hospitals and birthing
centers can provide in-depth instruction on breastfeeding techniques to new mothers.
Your pediatrician, nurse practitioner, or nurse can answer questions or put you
in touch with a lactation consultant or a breastfeeding support group.
In some cases, a mother's health may affect her ability to breastfeed. For example,
mothers undergoing chemotherapy for cancer and moms who are infected with human immunodeficiency
virus (HIV, the virus that
causes AIDS) should not breastfeed.
If you have a medical condition or take any medicines regularly, or if you or your
baby gets sick, talk with your doctor about whether it's OK to breastfeed. If you
have to stop nursing temporarily, continue to pump breast milk to maintain milk production.
In some situations, it may not possible to breastfeed, such as when a baby is sick
or born prematurely. Mothers should talk with their baby's doctor about expressing
and storing milk. Even if the infant cannot breastfeed, breast milk may be given via
a feeding tube or bottle.
Sometimes mothers who have inverted nipples may have trouble breastfeeding, but
with the help of a lactation consultant this usually can be overcome. Likewise, women
who have had plastic surgery on their breasts should be able to successfully breastfeed.
Talk with your doctor if you have any concerns.
Avoid using pacifiers or bottles until breastfeeding is established, usually after
the first month of life. Introducing them before breastfeeding might cause "nipple
confusion," and can lead to an infant giving up the breast.
About Formula Feeding
Commercially prepared infant formula is a nutritious alternative to breast milk.
Bottle feeding can offer more freedom and flexibility for moms, and it makes it easier
to know how much the baby is getting.
Because babies digest formula more slowly than breast milk, a baby who is getting
formula may need fewer feedings than one who breastfeeds. Formula feeding also can
make it easier to feed the baby in public, and lets the father and other family members
help feed the baby, which can enhance bonding.
Limitations of Formula Feeding
Just as breastfeeding has its unique demands, so does bottle feeding. Bottle feeding
requires organization and preparation, especially if you want to take your baby out.
Also, formula can be pretty expensive.
It's important to make sure that you have enough formula on hand, and bottles that
are clean and ready to be used.
Here are a few guidelines for formula feeding:
Carefully follow directions on the label when preparing formula.
Bottles left out of the refrigerator longer than 1 hour and any formula left in
the bottle that a baby doesn't finish should be discarded.
Prepared bottles of formula should be stored in the refrigerator up to 24 hours
and can be carefully warmed just before feeding. You don't have to warm formula, but
most babies prefer it.
A bottle of formula can be warmed by holding it in running warm water or setting
it in a pan of warm water. A bottle of formula (or breast milk) should never
be warmed in a microwave. The bottle can heat unevenly and leave "hot spots" that
can burn a baby's mouth.
How Often Do Newborns Eat?
Your newborn will nurse about 8 to 12 times per day during the first weeks of life.
In the beginning, mothers may want to try nursing 10–15 minutes on each breast,
then adjust the time as necessary.
Breastfeeding should be on demand (when your baby is hungry),
which is generally every 1–3 hours. As newborns get older, they'll nurse less
often and have longer stretches between feedings. Newborn babies who are getting formula
will likely take about 2–3 ounces every 2–4 hours. Newborns should not
go more than about 4–5 hours without feeding.
Signs that babies are hungry include:
moving their heads from side to side
opening their mouths
sticking out their tongues
placing their hands and fists to their mouths
puckering their lips as if to suck
nuzzling again their mothers' breasts
A feeding schedule is not necessary; you and your baby will eventually establish
your routine. Babies know (and will let their parents know) when they're hungry and
when they've had enough. Watch for signs that your baby is full (slowing down, spitting
out the bottle or unlatching from breast, closing the mouth, turning away from the
breast or bottle) and stop the feeding when these signs appear.
As babies grow, they begin to eat more at each feeding and can go longer between
feedings. There may be other times when your infant seems hungrier than usual. Continue
to nurse or feed on demand. Nursing mothers need not worry — breastfeeding stimulates
milk production and your supply of breast milk will adjust to your baby's demand for
Is My Newborn Getting Enough to Eat?
New moms often worry about whether their babies are getting enough to eat. It's
important for all infants to be seen by their pediatrician 48 to 72 hours after a
mother and newborn leave the hospital. During this visit, the baby will be weighed
and examined, and feeding questions and concerns can be addressed.
You can be assured that your baby is getting enough to eat if he or she seems satisfied,
produces about six to eight wet diapers a day, has regular bowel movements, sleeps
well, is alert when awake, and is gaining weight. A baby who is fussing, crying, seems
hungry, and does not appear satisfied after feeding may not be getting enough to eat.
If you're concerned that your baby isn't getting enough to eat, call your doctor.
Many infants "spit up" a small amount after eating or during burping, but a baby
should not vomit after feeding. Vomiting after every feeding might be a sign of an
allergy, digestive problem, or other problem that needs medical attention. If you
have concerns that your baby is spitting up too much, call your doctor.
Should Newborns Get Nutritional Supplements?
Breast milk has the right combination of vitamins and easily absorbed iron for
newborns. A healthy infant being nursed by a healthy mother does not need any additional
vitamins or nutritional supplements, with the exception of vitamin
The AAP recommends that all breastfed babies begin getting vitamin D supplements
within the first few days of life, continuing until they get enough vitamin D-fortified
formula or milk (after 1 year of age).
Iron-fortified formula contains the right blend of vitamins and minerals for a
baby, so supplements usually aren't necessary. Infants drinking less than 1 liter,
or about a quart, of formula a day may need a vitamin D supplement.
Water, juice, and other foods usually aren't necessary during a baby's first 6
months. Breast milk or formula provides everything babies need nutritionally until
they start eating solid
foods. Talk to your doctor if you have any questions about feeding your newborn.