Feeding
And Growing
By the
time your baby is around two weeks old, he will have
learned about feeding either at the breast or from a
bottle. Those first confusing days, when neither of you knew
quite what you were doing, are over.
The baby
wants to eat. He wants you to feed him because he cannot feed
himself. You want to feed him because you know that he must eat
if he is to grow and be healthy. So you and your baby are both
on the same side. To worry or to fight over feeding is a waste
of both your energies and a waste of fun for you
both.
The fun
part is important. If you watch the baby at the beginning of a
feeding you can see that he is hungry and that the feeling of
the milk going down inside him is lessening the hunger pain.
You can see that he is enjoying being held and cuddled while he
sucks. And you can see that the actual sucking is
important to him too. After three or four gulping minutes he
settles into a perfect rhythm; a burst of sucks and then a
breath and a rest and another burst of sucking. Soon an
expression of blissful satisfaction spreads across his face.
The rhythm slows a little; the pauses get longer, the bursts of
sucking shorter. Now he is drunk with milk and pleasure, almost
sleep. Just giving the odd suck now and again to remind himself
that the milk is still there for him.
[picture]
It all
sounds easy. And for some parents with some babies it is easy.
But for others it is not. The baby may go on with the unsettled
and unsettling behavior which is typical of the newborn period
for longer than you expect. This is especially likely if he was
a premature baby of if he had any particular difficulties
immediately after birth. He may produce some new and puzzling
behavior over feeding, or you may be so anxious to do right by
him that you cannot believe it is meant to be as
straightforward as it seems.
If your
baby is reasonably contented most of the time, is gaining
weight steadily and is getting increasingly active when he is
awake, you can be sure that there is nothing the matter with
his feeding from his point of view.
If he does
not seem to be thriving in this easy, cheerful way, you will,
of course, consult your doctor. But consider first the
possibility that he is simply not getting enough to eat at the
times when he is hungry.
Growth
Babies gain
something like 1oz (28g) each day from the time they are ten
days old until they are around three months. But after the
first quarter year, the rate of growth slows down a little. In
the second three months your baby will gain around 5-6oz
(140-170g) each week, and around 2-1/2in (6cm) overall. As we
stressed before, regularity of gain is more important
than amount. A baby whose weight gain, week by week,
has been neatly following the shape of the curves on the
average growth chart but who suddenly slows right down so that
the curve flattens off, may be being underfed. However, if the
baby has always gained more slowly than most babies, so that
the curve has always been flatter than average, you may just
have a baby who is meant to gain rather
slowly.
One- to
Three-Months
Like they did as newborns, most
babies grow quickly in weight and length during the first few
months of life.
How Much Do Babies This Age Grow?
After losing some of the birth
weight (up to 10%) during the first few days of life, your baby
should have regained that weight and then some, gaining at
least 2/3oz (18.9g) per
day.
For the first three months, baby
will likely continue to grow at a similar rate, while also
gaining 1 to 1.5in (2.54 to 3.81cm) in length per month.
These are just averages. Your baby may grow somewhat faster or
slower, and is likely to experience growth spurts along with
other times of slower growth.
Your pediatrician will measure
your baby's weight, length, and head circumference and track
your baby's growth pattern on a standardized growth chart
(there are different charts for boys and girls). Generally,
whether your baby is large, small, or medium-sized, as long as
your child's growth pattern stays consistent over time, chances
are excellent that he is doing
fine.
If your baby is born premature,
keep in mind that his growth or development should not be
compared with that of a child who is carried
full-term.
Preemies will need to be followed
more closely and may need to be weighed weekly during the first
months to make sure they are growing properly. They have some
catching up to do!
Should I Be Concerned?
If your 1- to 3-month-old is not
growing at the expected rate, or the growth rate slows, your
doctor will want to make sure your baby is eating enough and
absorbing what is being
eaten.
The doctor may ask you
about:
How many feedings a day your baby
gets
How much your baby eats at each
feeding
-
A baby generally
nurses for at least 10 minutes, should be heard to
swallow, and should seem satisfied when done.
Bottle-fed babies eat about 3 to 4oz (85 to 115g) a
feeding during the first month, with an extra ounce
(28g) per feeding for each additional
month.
How often your baby urinates
How many
bowel movements your baby has each day, and their volume
and consistency
Most of the time, a baby's growth
will simply be tracked over the next few months during routine
well-baby visits. But if your doctor is concerned about your
baby's growth, your doctor will want to see your baby more
frequently. Breast-feeding mothers may benefit from meeting
with a lactation counselor who can make suggestions to
improve technique.
You may have heard the term
"failure to thrive," which describes a baby who is not gaining
weight normally but does not get at the cause. Sometimes, there
may be a medical reason for slow growth, which would require
further evaluation.
Call your doctor if your baby is
not feeding well or if you have concerns about your baby's
growth or development. Call the doctor immediately if your
infant is vomiting every feeding, not wetting his diapers,
has a fever, or seems listless or
unresponsive.
What is Next?
In most cases, breast milk or
formula is all a baby needs for the first 6 months of life, but
some doctors may recommend introducing iron-fortified rice
cereal at 4 months. Talk with your doctor before starting any
solids or changing formula.
Four- to
Seven-Months
Babies
this age continue to bloom - in size, physical skills, and
ability to interact with the world. In most cases, this is
the age when babies begin to respond to their name, reach
for objects, sit alone, and make happy sounds - or show
frustration when a new skill proves too hard to master right
away.
Many of
the new skills they are learning will come in handy for
eating solid food. In fact, sometime during this period,
your baby will probably get that first taste of food beyond
breast milk or formula. Although breast-feeding or
formula-feeding will continue to be the main source of
nourishment, your baby can start to explore different
tastes and textures. As long as your baby continues to grow
steadily, eating habits shouldn't be a cause for
concern.
How Much Do Babies This Age
Grow?
Babies
continue to grow quickly in this period, gaining an average
of about 1.5 to 2lbs (0.7 to 0.9kg) a month at
first. At about 6 months, growth often slows slightly, to
about 1 to 1.25lbs (0.5 to 0.6kg) a month. That rate
usually continues until the first birthday, when growth
slows a bit more. Babies' length also continues to increase
greatly, perhaps 2in (6 cm) during this
period.
There is
no strict rule of thumb about how much a baby should weigh
at this stage, but by 8 months most weigh about 2.5 times
more than they did at birth. A 7lb (3.2kg) newborn, in other
words, is likely to weigh 17 to 18 pounds (7.7 to 8.2kg) by
the end of this period.
Since
your child's birth, the doctor has been recording growth in
weight, length, and head size (circumference) during your
regular well-baby visits. The doctor tracks these figures on
standard growth charts. Ask your doctor to show you your
baby's growth record. By now, you should begin to see a
personal growth curve emerging - expect your child to
continue growing along this curve.
Should I Be
Concerned?
Is my
baby too fat? Too thin? Is my child destined to be tall or
short? Parents often worry about growth and may compare a
baby with siblings and peers. It is important to remember
that kids come in a wide range of shapes and
sizes. Growth
depends on many factors, including:
-
genes passed
on by the parents (kids tend to resemble their
parents in height)
-
the amount and quality of food a child
eats
-
overall
health
-
the functioning of the hormones that control
aspects of
growth
Based on
the growth chart, the doctor can determine whether your
child is growing as expected. If at any time you are
concerned about your baby's weight or growth in general,
discuss your worries with your
doctor. In
response to your concerns, the doctor may ask you these
questions:
-
How many
feedings a day does your baby
get?
-
How much does your baby eat at each
feeding?
-
How long does
a breast-feeding baby nurse at each
feeding?
-
What else are you feeding your
baby?
-
How frequent
are your baby's bowel movements? What do they look
like?
-
How often does your baby
urinate?
In
addition, the doctor may ask questions about your baby's
health and development. All of these factors together will
help the doctor decide if your baby is growing at an
appropriate pace. The doctor may recommend further medical
evaluation if he or she thinks there may be an underlying
problem that needs to be addressed.
Premature
babies may still be behind in size compared with their
full-term peers, but they should also be growing steadily at
their own rate.
What
About the Chubby
Baby?
With all
the concern about childhood obesity, parents may worry that
their baby is getting too fat. A few babies and toddlers are
overweight. For these children, professional advice from the
baby's doctor can be useful.
But
never withhold food from a baby in an attempt to cause
weight loss. To grow and develop as they should, babies need
proper nutrition, including fat, in their diet. Rather than
limiting food intake, make sure the foods your baby eats are
nutritious rather than full of "empty" calories. For
instance, many babies drink a lot of apple juice, which is
high in calories and has little nutritional value. Juice is
not recommended for infants younger than 6 months. After 6
months, 100% fruit juice can be introduced in a sippy cup
(limited to less than 4oz (114ml), a
day).
Introduce
pureed vegetables and fruits without added sugar and do not
give your baby desserts or other sweets that are high in
sugar and offer little nutritional value. Also, look for the
cues that your baby is full, and do not use food to keep a
baby quiet or occupied. A crying baby may just be looking
for some attention.
If you
are concerned about your baby's weight - or even if you
are not - encourage your child to be active. For a baby
this age, that means providing plenty of time when the baby
is free to move around in a safe space rather than being
confined to a carrier, stroller, or other equipment that
limits movement.
It also
means playing in ways that encourage your baby to develop
skills, such as reaching for objects, rolling, and crawling.
Some parents take babies this age to organized exercise
programs. That is fine if you and the baby both enjoy it,
but such programs are not necessary.
You
might also want to look at your own habits. If parents are
overweight, have unhealthy eating habits, and get little
physical activity, their kids are much more likely to grow
up to be overweight. Your child is growing so fast that
before you know it, he will be copying what you do. It
is never too early to start improving your own habits so you
can be a better role model for the ones you love. Besides,
being in good shape to run, jump, bike, and actively play
with your child can be one of the great joys of being a
parent. It is like being a kid again.
What's
Next?
Your baby's rapid
growth will start to slow down as the first birthday
approaches. Expect big changes in the coming months as
your infant becomes more mobile.
Fretting for Food when Weight
Gain is Normal
Although
there are many reasons for fretfulness which have nothing to do
with food, the way a baby is fed can cause discontent even if
the weight gain is normal.
This fully-fed baby may be
hungry.
That sounds
like a contradiction but it is not. His normal weight gain
shows that his body is receiving enough food for its needs
every 24 hours. But that does not mean that there cannot
be many times during any 24-hour period when he feels hungry
enough to be miserable. Think of a child at boarding school. He
is fed a carefully planned diet which keeps him growing at an
appropriate rate. Yet he complains that he is always starving.
Why? Because that careful diet is doled out to him at
pre-determined times and in pre-set quantities; he is fed
according to his overall needs but not according to
his immediate appetite. If you jettison all your
ideas about "proper" feeding times and feed the baby when he is
hungry, he will probably drink exactly the same number of
ounces as before and gain the same number too. But he may do it
with half the number of crying jags.
This fully-fed baby may be
thirsty.
If the baby
is allowed to feed whenever he is hungry, is gaining weight
normally, but still seems very fretful, it may be his water
intake that needs adjusting. Milk is food and drink in one.
There is no way a baby who is thirsty but not hungry can get
the water without the food. Breast-fed babies are better off in
this respect because, as we have seen, breast milk contains
less sodium than most formulas and sodium can be thirst-making.
Furthermore, the first milk a baby takes from a reasonably full
breast (the foremilk) is more thirst-quenching than the richer
hindmilk which follows. A minute or two at the breast may solve
your thirsty breast-fed baby's problem, but even then he may
need extra water in hot weather or when he is
feverish.
Any baby
who cries for the breast or a bottle, sucks eagerly for a few
seconds and then stops and cries again should be offered a
couple of ounces of water which has been boiled and
cooled.
Apart from
this, babies should be offered the chance of at least two extra
drinks of boiled water every day. There is no harm in offering
water much more often than this. If he is not thirsty, he will
not drink it.
|