Pediatrician Myth-Busters: Infant Feeding
Having a newborn baby comes with so many questions and uncertainties, including knowing what, when, and how to feed them. To ease worried parents' minds, I'm breaking down some of the most common infant feeding myths and offering some easy-to-follow pediatrician advice.
Myth #1: "Newborns should be on a strict feeding schedule."
Truth: Newborns tend to do very well when they're fed with an "on-demand" schedule. On-demand refers to the practice of watching for infant hunger cues (for example, smacking their lips or sucking on their hands) to guide the feeding cadence rather than following a predetermined schedule dictated by the clock. On average, most newborns will eat about eight to 12 times in a 24-hour period. Reassuring signs that your baby is feeding enough include wet diapers and stools, a content demeanor between feedings, and good weight gain documented by those early pediatrician check-ups. Feeding babies solely based on a strict, timed schedule can potentially risk their undernourishment in the early days and weeks. Many parents worry that an on-demand feeding approach in the beginning will lead to a chaotic schedule later on, but we pediatricians actually find quite the opposite. Feeding on-demand during the newborn period often leads to good weight gain and satisfied and thriving babies, which ultimately leads to well-established and predictable feeding intervals after those first few weeks.
Myth #2: "Mixing breastfeeding and bottle feeding is a no-no."
Truth: Once breastfeeding is well-established, most babies do fine with introducing bottles. Whatever your reason whether it's because you're returning to work, or you are wanting to involve your partner or other family member in your baby's feedings bottle feeding can complement breastfeeding. I suggest starting with a slow-flow nipple to help establish the suck-swallow-breath coordination, as well as to prevent the infant from completing a feeding too quickly. I also encourage parents to try "paced feedings." Paced feedings describe the practice of holding baby in a more upright position, with the bottle in a horizontal position, and tipping the bottle down every few sucks. This will allow the infant to have more control over feeding, as well as determine if they are full, which is more like breastfeeding. Remember to watch your baby's cues as they grow to determine if the nipple flow rate needs to be increased.
Myth #3: "Pacifiers interfere with breastfeeding and should never be offered to infants."
Truth: Most of the time and just like bottles pacifiers can be introduced once breastfeeding is going well. The biggest concerns with pacifier use are caregivers missing baby's hunger cues, and using the pacifier to soothe instead of feeding the fussy (and potentially hungry) baby. As long as that isn't the case, then pacifiers can be a good method for calming and comforting babies, among other soothing techniques. Plus, non-nutritive sucking (sucking for the purpose of soothing and not for eating) is considered a normal part of newborn development; there is even evidence (a study from 2005) that suggests pacifier use during naps and bedtimes may reduce the risk of sudden infant death syndrome (SIDS).
Myth #4: "Feeding your newborn is natural and easy."
Truth: As evidenced in reading about these other myths, there is often a significant learning curve for both baby and caregiver when it comes to feeding. Although breastfeeding is a natural act, it is certainly not simple or easy for all mothers or babies. Working with a certified lactation consultant can be a huge help in establishing a good latch and troubleshooting any other breastfeeding issues. Just like anything else new, it takes practice for breastfeeding to feel "easy." Bottle feeding also takes practice, so don't become discouraged if your baby turns their nose up at bottle feeding in the beginning. Feeding time can be an incredibly warm bonding time for babies and parents, so remove the added pressure to feel like it needs to go perfectly from the beginning. Over time, you'll both find it gets easier and more enjoyable.
Sara DuMond, MD, FAAP is a board-certified pediatrician practicing in Charlotte, NC. She is a 2000 AOA graduate of West Virginia University Medical School and completed her residency in Pediatrics at Carolinas Medical Center in 2003. She practiced general office pediatrics in the Charlotte area prior to founding Pediatric Housecalls in 2011, a mobile pediatric practice serving children throughout North and South Carolina. In addition to her clinical duties, she is member of the Dr. Brown's Medical Expert Panel, and a frequent contributor to numerous publications, including Parents, Good Housekeeping, WebMD, and Romper. She lives in Charlotte with her husband, three kids, and one goofy golden retriever.
Myth #1: "Newborns should be on a strict feeding schedule."
Truth: Newborns tend to do very well when they're fed with an "on-demand" schedule. On-demand refers to the practice of watching for infant hunger cues (for example, smacking their lips or sucking on their hands) to guide the feeding cadence rather than following a predetermined schedule dictated by the clock. On average, most newborns will eat about eight to 12 times in a 24-hour period. Reassuring signs that your baby is feeding enough include wet diapers and stools, a content demeanor between feedings, and good weight gain documented by those early pediatrician check-ups. Feeding babies solely based on a strict, timed schedule can potentially risk their undernourishment in the early days and weeks. Many parents worry that an on-demand feeding approach in the beginning will lead to a chaotic schedule later on, but we pediatricians actually find quite the opposite. Feeding on-demand during the newborn period often leads to good weight gain and satisfied and thriving babies, which ultimately leads to well-established and predictable feeding intervals after those first few weeks.
Myth #2: "Mixing breastfeeding and bottle feeding is a no-no."
Truth: Once breastfeeding is well-established, most babies do fine with introducing bottles. Whatever your reason whether it's because you're returning to work, or you are wanting to involve your partner or other family member in your baby's feedings bottle feeding can complement breastfeeding. I suggest starting with a slow-flow nipple to help establish the suck-swallow-breath coordination, as well as to prevent the infant from completing a feeding too quickly. I also encourage parents to try "paced feedings." Paced feedings describe the practice of holding baby in a more upright position, with the bottle in a horizontal position, and tipping the bottle down every few sucks. This will allow the infant to have more control over feeding, as well as determine if they are full, which is more like breastfeeding. Remember to watch your baby's cues as they grow to determine if the nipple flow rate needs to be increased.
Myth #3: "Pacifiers interfere with breastfeeding and should never be offered to infants."
Truth: Most of the time and just like bottles pacifiers can be introduced once breastfeeding is going well. The biggest concerns with pacifier use are caregivers missing baby's hunger cues, and using the pacifier to soothe instead of feeding the fussy (and potentially hungry) baby. As long as that isn't the case, then pacifiers can be a good method for calming and comforting babies, among other soothing techniques. Plus, non-nutritive sucking (sucking for the purpose of soothing and not for eating) is considered a normal part of newborn development; there is even evidence (a study from 2005) that suggests pacifier use during naps and bedtimes may reduce the risk of sudden infant death syndrome (SIDS).
Myth #4: "Feeding your newborn is natural and easy."
Truth: As evidenced in reading about these other myths, there is often a significant learning curve for both baby and caregiver when it comes to feeding. Although breastfeeding is a natural act, it is certainly not simple or easy for all mothers or babies. Working with a certified lactation consultant can be a huge help in establishing a good latch and troubleshooting any other breastfeeding issues. Just like anything else new, it takes practice for breastfeeding to feel "easy." Bottle feeding also takes practice, so don't become discouraged if your baby turns their nose up at bottle feeding in the beginning. Feeding time can be an incredibly warm bonding time for babies and parents, so remove the added pressure to feel like it needs to go perfectly from the beginning. Over time, you'll both find it gets easier and more enjoyable.
About the author:
Sara DuMond, MD, FAAP is a board-certified pediatrician practicing in Charlotte, NC. She is a 2000 AOA graduate of West Virginia University Medical School and completed her residency in Pediatrics at Carolinas Medical Center in 2003. She practiced general office pediatrics in the Charlotte area prior to founding Pediatric Housecalls in 2011, a mobile pediatric practice serving children throughout North and South Carolina. In addition to her clinical duties, she is member of the Dr. Brown's Medical Expert Panel, and a frequent contributor to numerous publications, including Parents, Good Housekeeping, WebMD, and Romper. She lives in Charlotte with her husband, three kids, and one goofy golden retriever.