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Child feeding

Breast feeding

What is the right diet for a lactating mother?

A healthy diet of cereals, pulses, fruits and vegetables is what a mother needs to produce milk. Milk and milk products are a good source of protein and calcium and it is good if a lactating mother can include some of them in her diet. Non-vegetarian foods like eggs, meat and fish are also good sources of protein and can be added to the diet. She should also consume plenty of fluids to replenish the fluids used for milk production. It is not necessary to consume excess of fat/oil, nor are there any specific foods that she should avoid. However a lactating mother should consult a doctor before consuming any medicines since some of them can be secreted in the milk.

What is the best milk for my baby

Breast milk is the best form of nutrition for the baby. It is fresh, hygienic and ideally suited to meet all his requirements. It protects the baby from getting infections and helps in improving bonding with the baby. Every mother can produce enough milk to meet the requirements of her baby till he is 6 months of age. Even if a woman has twins, her milk flow often increases enough to meet the requirement of both the babies. Mothers should practice exclusive breastfeeding during the first 6 months of life. No other milk, not even water should be given during this period since breast milk will meet all the fluid and nutritional needs of the baby.


What are the advantages of breastfeeding for the mother?

Breastfeeding increases the period of lactation amenorrhea after childbirth. This prevents the mother from becoming pregnant. It also helps the mother to lose the excess weight she puts on during pregnancy


When should I initiate breastfeeding?

Your baby should be put to the breast within one hour in case of normal birth and four hours in case of Caesarean Section. The initial yellowish and thick fluidis rich in proteins and protective antibodies. Do not giveghutti/honeyetc. as the nourishment of the baby is delayed, increasing the chances of infection and delaying the stimulation for milk production.


How often should l feed my baby?

Feed your baby as often it is required. As a rough guide, most babies would require to be fed every 3 hours or so. If they are alert and awake for a while they may take a feed even earlier; if they sleep soundly, the interval may even extend to 4-5 hours. A baby must receive at least 8 feeds in 24 hours. Including 1 -2 feeds at night. During the first 6 months of life, a baby does not need anything apart from breast milk, not even water.


Should I give water to my baby as it is the summer season?

Breastfed is sufficient for your baby for the first six months and there is no need to give water separately. The initial part of the milk is rich in water and it provides the adequate amount of water required for your baby. The latter part of the milk is thicker and is rich in nutrients and calories to provide adequate nourishment to your baby


What is the need for burping my baby?

Burping helps to get rid of some of the air that babies tend to swallow during feeding. This air will cause discomfort and pain in abdomen of the baby. The baby will cry.


How do I burp my baby?

To burp your baby, gently pat the baby's back repeatedly, there is no need to pound hard on your baby's back. For the first 6 months or so, keep your baby in an upright position for 10 to 15 minutes or longer after feeding to prevent the milk from coming back up. Do not worry if your baby spits up a few times


What shall I do if my milk is not sufficient?

Almost all mothers can produce milk in sufficient quantity for their baby. You must breast-feed your baby more frequently, which will increase the milk production. If the baby is passing urine 6 times in 24 hours, then it denotes sufficient milk production


Can I feed my baby if I have a Caesarean Section?

Yes, you must start feeding your baby within 4 hours. It might be difficult to feed initially, but you can turn to your side, take someone's help and feed your baby.


Can my baby and I sleep on the same bed?

Yes, you should make your baby sleep with you. It will be helpful in establishing an emotional bond with your baby, and also increase milk production.


What is the harm in bottle-feeding?

Firstly the child will stop taking breast feed. Secondly while preparing a bottle of milk various other things like a spoon, sugar, bottle, lid, nipple and your hands are used which may not be clean and may introduce infection. If a bottle has to be used, then remember

  1. Boiling the bottle, nipple and lid for 20-25 minutes
  2. Washing your hands properly before touching the bottle.
  3. Do not dip your finger into the milk for checking the temperature.


It usually takes 2-3 days after delivery for milk flow to get established. Does the baby get anything from the breast before that happens?

Yes, before the mature milk is formed, breasts supply colostrum, a golden yellow fluid which is a very concentrated form of milk, rich with nutrients and antibodies. This colostrum gives energy, protects from infection and acts as a laxative. It also helps in clearing meconium (black tarry stool) and bilirubin (which may make baby jaundiced or yellow) from baby.


What is the correct way of breast feeding?

The mother should sit up comfortably and hold the baby in her lap. The baby‘s body should be supported on the mother‘s arm, turned towards the mother, and held close to her body (fig. 1). The baby should be fed on each breast for about 10-15 minutes each, shifting to the other breast once one breast is completely empty. Some times a baby may be satisfied by feeding at one breast only. In that case, the alternate breast should be offered first during the next feed. During first 4-6 weeks babies need to be fed round the clock. After that, gradually the night feeds can be reduced to a late night feed and an early morning one.


How do I know my baby is receiving adequate milk?

A healthy baby regulates his own milk intake and there is no need to monitor the amount of milk taken by him. If the baby passes urine six times or more in a 24-hour period, it means that the baby is getting a good amount of breast milk. These babies gain weight more than 125 gms every week after day 10 of life. Another sign that there is good milk transfer is that breasts soften after nursing.


How the twin infants should be fed?

Breast milk is best for the baby. Many mothers of twins‘ babies are also able to produce enough milk for both babies with good diet and family support. The mother should continue breast feeding babies. Even partial breastfeeding is better than artificial feeding. If baby is not satisfied after giving breast feeds, feeding should be supplemented with any of the following milk by cup (katori)/ spoon:

  1. Age appropriate infant formula – has better composition than animal milk, however is costly, need preparation each time before feed. Follow dilution directions mentioned on pack
  2. Fresh animal milk - cow, goat or other animal milk available.


In sickness how can I breast feed my baby?

Breast milk is the best thing you can give to you baby in her first six months of life. She gets deprived of it when you are sick or if you are a working mother. In those circumstances you can express your breast milk, store it and have your baby only the breast milk whenever she demands it. You can feed your baby if you are having minor illness.


Expressing breast milk

What are the ways of expressing breast milk?

You can either express the breast milk manually or take the help of an electrical pump.

Is manual pumping better than pumping with an electrical pump?

Although a breast pump is quite expensive, if you get comfortable using it, then it is probably a more convenient and faster option than manual pumping. However, many women have difficulty getting used to it. Manual pumping is a long and tedious procedure and sometimes the amount of milk collected does not justify the time and effort invested in the procedure. But it still seems the most popular alternative.


How do I express breast milk?

Sit comfortably and gently massage your breasts. Using your thumb and index finger, press on the margins of the areola (dark portion of the breast) and collect milk in a clean and boiled katori.


Give me some tips for expressing breast milk?

  1. If you are pumping your breast manually, keep a sterilized bowl, container and a funnel handy. Wash your hands before you begin expressing milk
  2. Choose a time of the day when your breasts are fullest. You should expect to pump your breast once every three or four hours if you need to store the milk. On an average, each collection can take from 20 minutes to 40 minutes.
  3. If you are using a pump, make sure that it is sterilized. Clean it immediately after you have finished collecting the milk. Carry a bottle brush and detergent with you if you are away from home.
  4. Choose a time when you will have privacy and will not be interrupted by doorbells, telephone calls, etc.
  5. While you may wash your hands with soap and water, avoid using soap, creams or ointments on your nipples
  6. Drink a full glass of water, juice, soup, etc. before you begin. A warm drink may better stimulate the milk ducts
  7. Think about your baby, apply hot fomentation to your nipples for five to ten minutes, take a hot shower, or massage your breasts. All this should make it easier for the milk to come down.


How should I store the expressed breast milk?

Freshly expressed breast milk may be kept at room temperature for up to 8 hours. Fresh breast milk may be kept in a refrigerator for up to 24 hours


Complementary feeding

What is complementary feeding and when should it be started?

Complementary feeding refers to adding semi-solid foods to an infant‘s diet who has, so far been accustomed to mother‘s milk only. Exclusive breast feeding should be carried out until 6 months of age. After 6 months breast feed is not adequate to meet the nutritional requirement of baby. Hence, he/she should be gradually introduced to semi solid and later to solid food.

What are the qualities of good complementary foods?

Complementary feeds should be able to meet energy, protein and micronutrient gap that cannot be met with breastfeeds for a child beyond 6 months of age. The child should be given freshly cooked; energy dense family food that is soft in consistency and thick (stays easily on the spoon and does not run). Complementary feeds should include a variety of food items like cereals, pulses, animal foods , dark and leafy green vegetables and fruits so that they are able to meet the protein, iron and other micronutrients requirements of the growing child.


Should breastfeeding be discontinued after the introduction of complementary feeding?

No, breastfeeding should be continued even after starting a solid diet. Babies should be breastfeed as long as possible, even up to 2 years of age and beyond. However, it should be kept in mind that as the child grows older; he receives more and more of his nutritional requirements from other foods. Breast milk increasingly supplements the other foods, rather than being the main source of nourishment


What are the common complementary foods suitable for an infant?

The choice of complementary food should be decided in cultural and social context. It should be soft, freshly prepared, hygienic and offered in a mashed/ homogenised form to a young infant accustomed only to the milk. While many ready-made semisolid foods for infants are available commercially, mothers can prepare healthy food suitable for the baby with resources readily available at home. Most of the packaged foods are much more expensive, and do not offer any advantage over home cooked foods. Examples of complimentary foods include suji (semolina) cooked in milk, mashed daal, khichdi, thick stew made from boiled and blended rice, pulses and seasonal vegetables, mashed bananas etc


How should I feed my infants upto 1 year of age?

Once a baby completes 6 months of age, complementary foods should be introduced one at a time. In the beginning, offer a small quantity, say a spoonful or two once a day. Over the next few days, gradually increase the quantity till it can replace a milk feed (roughly 1 katori serving). Introduce another food and gradually increase its quantity in a similar manner. Avoid introducing too many foods at the same time, letting the baby develop a taste for one food at a time. As the child starts teething and gets used to the new food consistency, start chopping the soft food in small pieces rather than mashing it completely. Now the baby can have rice mixed with dal, chapati soaked in dal/vegetables etc. by the time a child is one year old, he should be able to have most foods cooked at home. Usually, a breast fed baby should get at least 3 servings of semi-solid food, about 1 katori serving each by one year of age. The mother should take care to wash her hands and feed the child herself.


How should I feed my child older than 1 year?

During this time, a child should be eating every thing cooked at home. The serving size can be increased upto 11/2 katori each and at least 5 servings should be offered. Introduce a variety in child‘s food which should include cereals, pulses, fresh vegetables and fruits, milk and milk products. A little oil/butter can be added to increase the energy content of foods. The child should be given his own separate plate. As the child grows older, he should be encouraged to eat on his own, though the mother should sit with the child and help him eat. This does not mean forcing a child to eat. Rather, the child should be allowed to develop his own sense of satiety and this should be respected. A child beyond two years of age should have 3 main meals along with the rest of the family with 2-3 mid-meal snacks which could include milk, fruits, biscuits etc. This is the time for development of healthy eating habits and parents should ensure that their child learns to enjoy fresh, home cooked healthy food.


What can be the causes of food refusal when complementary foods are being introduced?

The child can refuse to take food during introduction of complementary feeds if

  1. He/she is not hungry
  2. He/she is tired, sleepy or interested in playing at that time
  3. Dislikes the food being offered
  4. The child is being rushed because of time constrains
  5. He/she is uncomfortable because of a wet nappy
  6. The food is too hot or remembers a previous food which was too hot.
  7. A child should never be force-fed. Try to find the cause of food refusal and act accordingly. Mother should learn to recognize and respond to signs of hunger in the child. The meal times should be pleasant for the entire family rather than a source of anxiety for the mother and child.


Feeding related concerns

What to do if my baby regurgitates the milk?

"Spitting up", or regurgitation, is very common during a baby's first few months of life. About 40% of normal, healthy babies spit up, usually right after feeding. The liquid your baby regurgitates may look very similar to the milk she or he was just fed; or, if it has been partially digested, it may appear curdled and smell like sour milk. Though it may seem like your baby is spitting up a lot of milk, that's not likely to be the case. The liquid spit up during regurgitation is usually made up mostly of saliva and gastric juices, and only a small amount of milk. You can follow these rules to prevent regurgitation of milk:

  1. Feed smaller amounts and more frequently
  2. Burp your infant after each feed.
  3. After meals, try to hold your baby in an upright position for at least 20 minutes.
  4. Avoid pressure on the abdomen.

How should a working mother feed her baby after joining duties?

Working mothers should keep expressed breast milk for their babies and feed with katori/ spoon. Expressed breast milk may be kept for 6 hrs at room temperature and 24 hrs in refrigerato


Can a child be started on bottle feeds before 6 months of age?

Bottle fed babies has more sickness like diarrhoea and other illnesses. The baby should be exclusively breast feed till 6 months and complementary foods should be introduced there after. Undiluted animal milk can also be given at this stage after boiling using a cup.



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