Formula

            If a mom wants to use formula to feed her infant or to supplement breastfeeding, she is faced with lots of choices. There are many kinds of formula with many different added ingredients. There is both the brand names and the generic or “store brand” formulas. Finally, there are milk-based (made from milk product) and soy-based (made from soy beans).

Many of the additive products claim to “help decrease gas” or “quiet baby’s tummy”. These are mostly marketing tools aimed at the desperate mom with a fussy baby who will do anything to get a good night’s sleep. The same is true for “rice added” to eliminate “reflux” and “lactose-free” products. Milk-based formulas are all the same and the claims that they decrease fussiness are rarely based on any real science. I have always contended that the generic formulas were as good as the brand names, but in the last years of my career, many generic products were being produced in a country that was proven to be untrustworthy in many of the products that it shipped to America. There were even infant deaths in that country from drinking unsafe formula. After years of recommending generic formulas and medications, I had to stop doing it and start recommending brand names.  It is a difficult choice for young parents on a tight budget. Not only do I recommend brand-name formulas, but they should contain long-chain polyunsaturated fatty acids (LCPUFAs) which have been shown to improve infant's vision.

            The real difference in formulas is the base product they are made from. Some infants are allergic to milk and cannot drink milk-based formulas.  This is not “lactose intolerance”, which only very rarely exists in infants, but true allergy. These infants are much more fussy, especially after eating. Most infants fuss a little during or after eating because food in the stomach causes increased intestinal movement and the sensation is new and unpleasant to them. But milk allergic infants fuss a lot and stop feeding and cry even when they are still hungry. Another good sign of milk allergy is loose or bloody stools. This is not superficial, streaky blood in the stool, which is usually caused by a small tear in the rectum, but blood mixed in with the stool. The milk-allergic baby may also have poor weight gain. If your infant has problems feeding, especially if people in your family have lots of allergies, try a soy-based formula. If the infant is milk allergic, the problems should improve rapidly – within a week. If the problem continues or seems at anytime to be getting worse, see your caregiver.

Feeding Your Newborn

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The best way to feed your newborn baby is to breast-feed. Even though breast-feeding doesn’t work for every mom, I always encourage moms to try it. But whether breast or formula feeding, every mom needs to know that babies are born fed. All term infants lose weight in the first days of life because they are born with extra water and nutrition. Nature knows that mom and baby both need a day or two to recover from birth. Mothers are told to breastfeed their baby within the first hour of life. Sometimes the baby latches on and the feeding goes well, but I have found that often the baby is not hungry, sucks twice and falls asleep. Many times I walked into a mother’s room and found her frustrated and in tears because “my baby won’t feed” or “I can’t wake my baby up” when the baby was less than 24 hours old! Mothers are also told to wake the infant up every two hours to feed. Trying to wake and feed an infant every two hours on top of the stress of labor and delivery can often leave a mother exhausted.

            If your infant is a healthy, term infant, don’t make the initiation of feeding a “succeed or fail “situation. Think of feeding in the first days of life as practice. During the day, it is okay to try to feed your newborn about every two or three hours. If he acts hungry and latches on, fine, but if he is too sleepy to wake up, he isn’t hungry, he is tired. Let him sleep and get some sleep yourself. You are going to try to feed him again in 2 hours and he won’t get malnourished in two hours. After 10 p.m., however, sleeping babies belong in the crib. If the baby gets hungry, he will wake up and cry and you will feed him. You don’t need to wake up wake up a healthy, term infant during the night to feed. What you and your baby both need is rest and recovery. Every day of life, your newborn should spend more time awake and feed more actively but it takes three to four days to get feeding going well.

            It has also become a fad to advise mothers not to “overfeed” their infant.  Only the baby knows how much he needs. If he is acting hungry, feed him. When he is full, he will fall asleep and drop off the breast or stop actively feeding. If he is sucking once or twice and falling asleep, he is not hungry; he is tired and you need to put him in the crib (co-sleeping is dangerous). Babies are smarted than grownups – they don’t overeat.

            If your baby is premature or ill, none of the above information applies and he may need special feedings or a more regulated schedule. If your infant was awake and feeding well but then becomes less active, you need to consult with the baby’s caregiver right away.