Breast feeding

Feeding charts for healthy babies cause nothing but misery. It is high time that these become a thing of the past, with feeding at request becoming standard for both breast and bottle feeding.

A baby’s tiny stomach can stretch rapidly and unnaturally stretching from an early age. Large portions increase the likelihood of developing colic, reflux, and are believed to be a factor in the development of obesity and diabetes.

Visualiseer eens een babymaagje.

Try to picture a baby’s stomach.

The stomach of a baby immediately after birth is about the size of a marble (5-7 cc). On the third day, it is the size of a ping-pong ball. By the tenth day the size of a hen’s egg (60-80 cc).

When breastfeeding the first week should be dedicated to practice, and to getting used to each other. Feeding regularly, with good breast attachment, will ensure that milk production is stimulated. Bottle feeding follows a specialised scheme beginning in the first week after the birth.

WHAT NEXT?

Breastfeed your baby the moment he/she wakes up. Let your baby drink for as long as he/she wants to drink and remains awake. A baby who has had enough sleep, and suckles efficiently will need less than half an hour at the breast. Pay attention to symptoms of overtiredness. Many babies cry or whine if (over)tired. If you always interpret this as hunger, the need for sleep is ignored. Even a baby who has been eating well can show signs of overtiredness that can be mistaken for hunger signals, such as sucking on hands or twisting the head towards the breast. Do not doubt your instincts, and let your baby sleep.

Be aware of your own knowledge and instincts, or their limitations. A breast fed baby can get used to (excessively) large quantities. Do you tend to leave your baby on the breast for long intervals? Is an extra sip after winding/burping really necessary?

A baby receives constant nourishment in the womb. The feeling of satiety is learnt after birth. A baby who gets ‘refuelled’ at every feeding time will become used to this feeling.

Bottle fed babies often drink more than is healthy for them as milk flows more consistently from the bottle than the breast so babies tend to consume more milk from the bottle at each feed.

Breast milk from a bottle: 100-150 cc per kilogram of body weight per 24 hours.  Preferably given more frequently with less in the bottle. A 4 kg baby should then have 8 x 75cc instead of 5 x 120cc. Apart from the fact that this is more natural and healthy it also allows you to follow the rhythm of your baby more effectively.

The packaging of infant formula always incorporates a schedule based on the weight of the baby, with the number of feeds per 24 hours. Example: 5 feeds of 135-165cc for a 4 kg baby. This is far too much for a single feed. On the site of the nutrition centre you can find the following bottle feeding advice: “Most babies want a bottle on average 6 times per day, and most parents will not offer them food at more regular intervals because they believe this is wrong.  And the baby gets used to it. Or if it doesn’t, it sleeps badly and is restless.

follow your baby’s rhythm: tired? Let him sleep. Awake? feed him.

Once breast feeding is going well and your baby is sleeping for longer at more predictable times, and this also applies to swaddled babies, you can wake your baby three hours from the beginning of the last feed for a further feed.

If the baby is not growing at the recommended rate wake your baby earlier. A baby sleeps in cycles of 45-50 min. After a minimum of two of these cycles your baby has had enough rest, and will be able to feed correctly and efficiently which will also help with growth. You can visibly observe when a baby is in a lighter stage of sleep: subtle movements such as frowns, gentle shakes, mouth and tongue movements, sucking the hands and turning of the head. This all shows that your baby will not object to being woken for a feed. Do not do this before two cycles are completed (approximately 90 minute), or your baby will fall asleep at the breast without having had a proper feed.

We work together with Annette Drop, a lactation specialist from Delft. She gives practical breast feeding preparatory courses, and is also available for home visits.

Take a look at her website on: www.aidulac.nl

YOUR BABY’s NUTRITION:

We will support whichever choice you make regarding how your baby is fed. We will discuss your wishes during your pregnancy. Together with the maternity nurse you will receive help and guidance when feeding your new-born baby.

We adhere to the World Health Declaration and UNICEF recommendations related to a baby’s diet. These stats that breastfeeding offers great benefits to the health and development of the child, as well as to the health of the mother.

You will make the choice that you feel is correct for you and your baby.

Bottle feeding
You should consider all aspects when bottle feeding, such as the type of bottle, formula, how to wean, hygiene and much more. These aspects also need to be considered when switching from breast to bottle.

A wide variety of bottles are available. For a healthy baby use specially formulated powers in the first six months. At six months you can move on to follow-on milk.

When your baby has tummy problems such as colic you will need a special formula containing pre-biotics. These are easily digestible fibres which soften stool. There are also special foods for babies who tend to vomit.

It is increasingly common for babies to develop allergic reactions to certain substances in regular milk, in which case they should change over to special milk not containing such substances. There are also special diets for children with less common metabolic diseases.

The midwife will inform you of the possibilities during your baby’s first week.

Dutch tap water is suitable for baby food, unless you have lead pipes (commonly found in older houses pre 1945). If this is the case, use mineral water (not sparkling).

Preparing feeds:

• Make sure the bottle, teat and other equipment is clean. Rinse them with hot water, boil them and use a bottle steriliser or the dishwasher.
• Check the teat for splits and bumps. You should replace teats on average every six weeks.
• Wash your hands before preparing a bottle.
• The packaging states how much powder should be used. Usually this is one flat measuring spoon per 30 ml of water.
• Heat the water in the bottle heater, microwave or a Bain Marie until the correct (luke-warm) temperature is reached.
• Add the powder, shake the bottle…and you’re ready to go!

Breastfeeding
 Breast milk is the best food source for your new-born baby. In principle, all mothers can breastfeed; with the expertise of care providers and family support mothers can succeed with breastfeeding. Breast milk contains all the necessary nutrients your baby needs as well as additional substances that build up your baby’s immunity and positively influence the gastrointestinal tract, helping protect your baby from disease and illness. Breastfeeding saves time, energy and money. Your baby can be fed directly if hungry. Day and night milk is created and stored in your breasts. The temperature is always perfect and the stock almost unlimited. Your child will benefit from your breast milk as long as you continue to breast feed. The composition of your milk also adapts to the age of your baby.

10 World Health Organisation (WHO) criteria:

We work according to the 10 steps to successful breastfeeding as set up by the World Health Organisation (WHO).

  1. Have a written breastfeeding policy that is routinely communicated to all health care staff
  2. Train all health care staff in skills necessary to implement this policy.
  3. Inform all pregnant women about the benefits and management of breastfeeding.
  4. Help mothers initiate breastfeeding within a half-hour of birth.
  5. Show mothers how to breastfeed and how to maintain lactation, even if they should be separated from their infants.
  6. Give new-born infants no food or drink other than breast milk unless medically indicated.
  7. Practice rooming-in – allow mothers and infants to remain together – 24 hours a day.
  8. Encourage breastfeeding on demand.
  9. Do not give artificial teats or dummies (also called pacifiers or soothers) to breastfeeding infants.
  10. Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic.

Lactation specialist:

We work together with Annette drop, a lactation specialist. Breast feeding sounds simple and it is when you are given the correct information and guidance. Annette gives breastfeeding courses at the practice, or you can arrange an appointment where you can speak to her over the phone. She even makes home visits. You may register for the breastfeeding course from your 28th week of pregnancy.
Take a look at her website: www.aidulac.nl

Books (Dutch Language)
Borstvoeding
Compleet handboek voor ouders.
ISBN10 9048310938
ISBN13 9789048310937

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