Newborn Nutrition

Breastfeeding vs.. Formula Feeding

The American Academy of Pediatrics (AAP), the American Medical Association (AMA), and the World Health Organization (WHO) all recommend breastfeeding, because it is the best way to defend against infections, prevent allergies, and protect against a number of chronic conditions. The AAP recommends that babies are solely breastfed for the first 6 months. After that, they recommend breastfeeding until at least 12 months, and longer if the mother and baby are willing. However, some mothers cannot or choose not to breastfeed.

Formula feeding often generates concerns over bonding with your child. If you are a loving mother, you will develop a special bond with your child regardless of whether or not you breastfeed. Formula feeding can be more convenient, and provide the mother with more flexibility. It is equally nutritious, but does not contain the same antibodies or complexity as breast milk. Formula feeding can also be too expensive for some mothers, and require too much time and planning.

The decision to breastfeed or formula feed is very personal. This site may help you to weigh the pros and cons before making a decision. If you are having trouble, you should talk to your doctor.

1-3 Months Old

At this age, breast milk or formula will provide all of your baby's nutrition. As they age, growth spurts will increase their appetite, so you should continue to feed based off of demand. The following are just guidelines- it is important to pay attention to when your baby wants more or when they are finished. A baby who is getting enough might slow down, stop, or turn away from the breast or bottle.

For breastfeeding:

After the first few weeks, breastfed babies start to feed less often and sleep longer at night. If your baby is alert, content, and active, is steadily gaining weight, growing, and developing, feeds six to eight times per day, and is wetting and soiling diapers on a regular basis, they are eating enough. If they don't seem satisfied, even after eating, or are constantly crying or irritable, they may not be eating enough and you should call your doctor.

Breastfed babies also have less bowel movements after the first month or two. If they have not had a bowel movement after 3 days, call your doctor.

Babies that are exclusively breastfed will need vitamin D supplements starting a few days after birth, but should not need anything else such as water, juice, or solid foods.

For formula feeding:

As formula fed babies grow, they are able to eat more, go for longer stretches between eating, and sleep longer at night. During the second month, infants will probably need 4-5 ounces a feeding, and by the end of the third month they may need an extra ounce. Because it is easier for babies to drink from a bottle than a breast, you should pay close attention to any signs of them being full, and make sure that the holes in the bottle top are the right size (the formula should drip out slowly, not pour out). Never prop a bottle prop. Propping a bottle might cause choking and it increases the chances of getting ear infections and tooth decay.

4-7 Months Old

Experts recommend beginning to introduce solids around 6 months. The following questions can help you determine if your baby is ready:

  • Is your baby's tongue-thrust reflex gone or diminished? This reflex, which prevents infants from choking, also causes them to push food out of their mouths.
  • Can your baby support his or her own head? To eat solid food, an infant needs good head and neck control and should be able to sit up.
  • Is your baby interested in food? A 6-month-old baby who stares and grabs at your food at dinnertime is clearly ready for some variety in the food department.

If your doctor tells you to start introducing solids, but your baby is hesitant, try waiting a few days or weeks and trying again. Solid foods are supplements, and formulas or breast milk will provide their nutritional needs.

You should be careful about introducing solid foods, and should follow this procedure:

  • Pick a time of the day to introduce solids when your baby is not too tired or cranky. It might be best to let them breastfeed for a little bit or give them part of a bottle first.
  • Have your baby sit upright in your lap, an upright infant seat, or a highchair if they can sit well.
  • Place the spoon near your child's lips and allow them to smell it and taste it.
  • If they reject the first spoon, wait a minute and try again.
  • Do not be alarmed if most of the food ends up on the chair, the bib, or your baby's chin.
  • Once they readily eat the first food, you can start introducing others, such as pureed vegetables and fruit

While your baby is learning to eat solids, you should still be feeding them as usual with breast milk or formula.

Some foods should be avoided during this time. For more information, visit KidsHealth, or consult your doctor.

8-12 Months Old

At this point, babies may start to try table foods. However, it is still important that you do not give them honey until after their first birthday, or give them regular cow's milk.

You can start introducing baby food, foods that are a bit coarser and require more chewing, or ground-up or mashed versions of whatever the rest of the family is eating. It is important to keep food relatively soft so as to avoid choking hazards.

Around 9 months old your baby should be able to hold some of their own food, or you can try introducing a safe baby spoon. Try and have them finger hold food or hold the spoon while you do the feeding so that they can begin learning to self-feed.

At this age, babies enjoy being at the table. Try and have them eat with the rest of the family, and consider setting regular meal times.

If you're formula feeding, after the first birthday you should try switching to cow's milk fed from a sippy cup, not a bottle. If you're breast feeding you can continue past the first birthday if you wish, or you can stop.

It is important to watch for your baby's signs of fullness as they switch from breast milk or formula to solid foods. A child who is full may suck with less enthusiasm, stop, or turn away from the breast or the bottle. With solid foods, your baby may turn away, refuse to open his or her mouth, or spit the food out.

For more information, and food safety information: MedlinePlus, and FDA.