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.

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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

• A breastfed baby may feed 8 to 12 times in a 24-hour period; bottle-fed babies usually eat less frequently, perhaps every 3 to 4 hours.

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

• Babies should have at least 4 to 6 wet diapers a day.

How many bowel movements your baby has each day, and their volume and consistency

• Breast-fed babies’ stools should be soft and slightly runny. The stools of formula-fed babies tend to be a little firmer, but should not be hard or formed. Frequency of bowel movements depends on age and type of feeding.

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.