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    Questions and answers About Breastfeeding

    Dr. Medhat Shaaban, MD
    Consultant Pediatrics & Allergy

    Kara McNulty and her newborn daughter, Katye, are meeting with their pediatrician for the first time Kara naturally has many questions about how to care for her baby, and some of the most important ones are about feeding Katye. Kara wants to breast-feed her but needs more information about it.

    Q.1. Why exactly is breast milk preferable to formula?
    Breast milk is more easily digested, provides excellent nutrition, and contains anti bodies that protect against infection.

    Q.2. I've heard several terms-colostrum, let-down reflex, foremilk, aftermilk-used in discussions of breast-feeding, but I'm not sure what they mean Could you explain them?
    Colostrum is the thin, slightly yellowish milk secreted a few days before and e after a mother gives birth. It is high in protein and provides the baby with some protection against infection.
    The let-down reflex is a natural reflex caused by a hormone that is released when the baby sucks, causing milk to flow toward the nipples.
    Foremilk is the milk released at the beginning of any breast-feeding. It is low in fat and calories Hindmilk is the milk released later during a breast-feeding It has a higher fat content that may help control the baby's appetite.

    Q.3. How often should I nurse?
    Unlike the formula-fed baby with a four-hour feeding schedule, the breast-fed newborn typically nurses every two to three hours,and sometimes more often than that. A five-hour interval between feedings may occur at night, but repeated long stretches without nursing can impair the supply of breast milk, limit the infant's intake and result in inadequate weight gain.

    Q.4. How long should I nurse?
    Unless the nipples are sore, a typical routine is 10 minutes on the first breast and as long as the infant desires on the second. Since the infant nurses more vigorously on the first breast, feeding should be initiated on alternate sides

    Q.5. How can I tell that the baby Is getting enough?
    With adequate nursing,the breast-fed newborn voids colorless urine six or more times a day and passes a soft, yellow, seedy Stool after most feedings. Signs of inadequate intake are infrequent Stools and infrequent urination or urine that is concentrated and yellow. Moreover, a dehydrated infant may have a diaper stain with a "brick dust" appearance due to the presence of crystals in the urine.

    Q.6. When should I start feeding my baby solid foods?
    At four or five months of age. Start with cereals, then add fruits and vegetables Meat will Come later.

    Q.7. How do I begin getting baby used to solid foods?
    Find a time of day when your baby is in a good mood and is not tired. Do not hurry the feeding If baby is not ready, try again in a week. Try a new food for one week before adding another. This way, if there is an allergic reaction, you will know which food caused it. Learn the signals that your baby has had enough. Baby may start to play, blow bubbles, wave arms, push the spoon away or turn away. Do not force your baby to eat more.

    Q.8. How do I feed my baby cereal?
    Start with one teaspoon of thinned cereal Add more cereal to make it thicker as baby learns to swallow it. As time goes on, feed more until baby is eating two or three tablespoons daily. Begin with rice, oat or barley cereal Sugar only adds calories that can make your baby fat but not strong. Learning to eat from a spoon is an important part of growing up, so don't put cereal in baby's bottle.

    Q.9. How do I feed vegetables and fruits?
    Offer only one new food every week. Baby may be surprised by a new taste and not accept it at first. If your baby refuses to eat a particular food, wait a month or so and try again. A baby like an adult, has likes and dislikes.
    Warmed food may taste better, Heat only the amount to be fed, not the entire jar, and after the feeding, throw away the uneaten portion. Even if serving unheated food, put just the amount you plan to use in the dish. Do not feed from a jar.

    Q.10. Can you offer any other advice?
    Use plain vegetables, fruits or juices, not a mixture. This way, if the baby has an allergic reaction, you will know what caused it.

    Buy and prepare your own bananas for better nutrition. Bananas in jars have tapioca added, which replaces Some of the nutrients.
    Be sure baby eats many different vegetables. Incidentally, white potatoes are filling but do not contain the Vitamin A and iron that green and yellow vegetables do.

    Dr. Medhat Shaaban, MD., is a Board Certified Physician and a member of the American Academy of Pediatrics.

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