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First few steps to remember in child care

Read on the steps to remember in child care by AloeMaa

1. Weight the baby after birth every day 

for 15 days to monitor weight loss, or lack thereof. 2 minutes maximum needed.

2. Expose the baby to the mother’s breast within 1 hour of birth

Allow babies to latch by themselves if possible, but help if necessary. Baby requires feeding every 2-3 hours during the first few weeks after birth – this includes night time feedings. If the baby is not feeding well, supplement with formula or donor milk (do NOT substitute water!!) 3 times a day until breastfeeding is established. Formula can be used as a last resort ONLY if no other options are available and mom plans on increasing her own fluid intake in order to produce more milk for later use when there are no donated human milk sources available.

3. Breastfeed exclusively for 6 months (start solids when baby starts to show signs of readiness). 

If breastfeeding is not possible, provide all infant formula in calibrated bottles. Formula should be supplemented with donor milk 3 times a day until mom increases her own fluid intake in order to produce more milk. All family members should begin to use pasteurized donor human milk when it becomes available (freeze as soon as possible after expression) when breastmilk is no longer an option.

4. Continue to breastfeed at least once per day past 6 months of age

continuing supplementation with donor milk until the toddler is eating well-rounded solid foods. Continue to offer donor milk if/when available because research shows benefits associated with continued breastfeeding through age 2.

5. Do not take the baby off the breast during an active infection

but work with your physician to continue feeding. Continue to pump also if possible to maintain milk supply. If mom is unable to pump or otherwise provide milk for her baby she should begin pumping (if able) and offering donor human milk as soon as mom’s condition has stabilized. Work closely with your medical team to ensure you are taking all necessary medications for treatment of your condition while breastfeeding.

6. Provide baby with plenty of skin-to-skin contact

as well as opportunities for self-soothing/swaddling to promote uninterrupted sleep. Encourage “Kangaroo Care” whenever possible and be mindful of positioning baby at breast so as to avoid compression of the delicate breast tissue & blood vessels which might limit milk flow or cause plugged ducts/engorgement later on down the road.

7. Baby should have an opportunity for breastfeeding 8-12 times per day

 or more if they are exhibiting strong feeding cues . About 2 hours after a newborn eats, they will begin rooting & lip smacking – this is a sign that letdown of hindmilk is about to occur and there’s no better time then right then. Breastfeeding should not be disrupted by the need to supplement with formula unless absolutely necessary for baby’s health & wellbeing.

8. Monitor weight gain closely – 

Pediatricians are advised not to weigh newborns or follow standard growth charts until they are 12 months old, but it is helpful to have an idea of what a healthy rate of weight gain looks like in order to identify possible causes if baby fails to thrive.

9. Do not introduce solids until 6 months – 

This is by far my most controversial advice; however, it is based on research that has shown that the introduction of solids before 6 months associated with decreased rates of breastfeeding success (see this study, for example). The main reason for avoiding solids in general (i.e. regardless of when they are introduced) is because there are no nutrients in solid foods (or breastmilk supplements) that we cannot be obtained from eating the foods themselves. 

10. There may be some benefits to offering infants foods 

Like avocado or egg yolks before 6 months which contain nutrients not found in significant amounts in other foods, but these easily obtained through a mother’s diet while continuing to nurse as usual (see this study , for example).

Offering solids to infants before 6 months is often justified because it “helped them sleep through the night” or some other equally ridiculous claim. It’s really quite simple: if you don’t offer solid foods, your infant will not usually be hungry enough to eat them (because they are still getting most of their calories from breast milk), and so they will not cry because of hunger. 

This, incidentally, is why babies who are fed formula do NOT need solid foods until 4-6 months old, even if the parents choose to introduce them before then – formula already contains all the calories, fat and other nutrients necessary for early life. But because mothers do not make enough milk during the day to satisfy an infant’s needs for growth (because they are spending long periods of time away from their babies), solid foods are needed to make up the difference because formula does not contain enough calories or fat at this age.

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