How to properly feed a baby with a mixture. When supplementary feeding is needed for infants: rules for mixed feeding

Often there are situations when a young mother cannot fully breastfeed. In such cases, women first of all begin to think about mixed nutrition. But is it always justified, and in what situations is it really necessary to choose supplementary feeding during breastfeeding.

When to Introduce Supplementation

Often at a pediatrician’s appointment, you can hear the following phrase: “I have low-fat milk and my newborn baby is hungry all the time, prescribe complementary foods for us, I will supplement him.” There are a lot of such women who, for some reason, consider their milk inappropriate for the needs of the child. They are trying by all means and methods to increase the amount of milk and give it fat content. When all their attempts do not bring the right results, they come to the conclusion that the child urgently needs to be supplemented. However, breastfeeding experts say that in most cases there is no such need, and mothers simply worry in vain.

The mammary glands are arranged in such a way that the amount of milk secreted corresponds to the volume of the product eaten by the child. This means that if your baby eats 100 ml of milk, about the same amount will be added to the next feeding.

However, women whose baby does not go to bed immediately after a meal, or who needs to breastfeed, in their opinion, too often, begin to introduce complementary foods on their own. Under no circumstances should this be done!

Situations when complementary foods are needed:

1. Mom's illness, accompanied by antibiotics. In this case, supplementary feeding with a mixture is introduced only for the period of treatment. During this period, breastfeeding should be left only in the morning.
2. Absence of mother during the day. If a woman cannot stay at home with a child and leaves the decree ahead of time, you can supplement the newborn during the mother's absence.
3. A serious violation of the immune system in the mother. Weakened immunity can occur in the case of the birth of twins or with a caesarean section. In such situations, the mother may be advised to choose a mixed diet for the baby.
4. Multiple births. If 2 or more children were born, it makes sense to introduce complementary foods so that all the babies are full.

All about colic in newborns

In other cases, problems with a lack of milk are mostly contrived by a caring mother. To understand whether your baby is full, you just need to regularly weigh the child. Weight gain within the normal range indicates that the baby is getting enough milk.

How to introduce supplementary nutrition

If, due to circumstances, your child still needs complementary foods, you should choose the right mixture. The health of the child and his development depends on this. Supplementary feeding in the form of a mixture is introduced only in the first 6 months of a baby's life. Older children can be supplemented with cereals and vegetable purees.

For newborn babies up to six months, pediatricians recommend choosing mixtures for mixed nutrition - hydrolysers.

Their taste is not as pleasant as mother's milk and you can avoid completely breastfeeding.

When introducing a mixed diet, it is very important to follow the feeding schedule. If breastfeeding occurs at the request of the child, then formula feeding should be no more than every 3 hours during the daytime. Also, to calculate the required amount of the mixture, it is necessary to observe the urination of the baby. In the first days, it is necessary to give the child a minimum amount of supplementary feeding with a mixture. If at the same time the baby pees less than 8 times a day, the volume should be increased. All recommendations for the correct introduction of supplementary feeding should be given to you by a pediatrician who can calculate the correct amount of nutrition and the number of feedings with the mixture per day.

If the child has not eaten a single portion of the mixture, pour it out correctly, it is strictly forbidden to re-feed the previously diluted product! It is best to feed the baby with a mixture from a spoon. This is due to the fact that it is much easier for a baby to suckle a bottle, and he may refuse to suckle at the breast.

Choice of additional power supply

When choosing a formula for supplementary feeding, follow three rules:

• Usefulness of the product. The mixture should contain all the necessary vitamins and minerals.
• Hypoallergenic. The mixture should not contain sugar, flavorings and other components that can provoke allergic reactions in the baby. If you are lactose intolerant, choose a formula based on soy protein.
• Quality. The quality of products must be confirmed by certificates and additional clinical studies. When choosing, pay special attention to the expiration date and storage rules of the product.

How to care for your baby immediately after birth and throughout the first year of life

The tricks of mixed nutrition

Despite the fact that experts advise to supplement the child with a spoon, many mothers simply do not find the strength to feed the baby for hours in microscopic doses. After suffering for a day or two, they go to the pharmacy and buy a bottle for the mixture. Mixed nutrition with this approach can provoke a complete rejection of mother's breast in favor of a bottle. In order to avoid this, it is necessary to make it so that the child sucks milk from the bottle as difficult as from the breast. To do this, you need to purchase bottles with a very small hole in the nipple, then sucking will be just as difficult and the child will not feel the difference, which means he will not prefer light formula feeding.

How to return natural feeding

Often, women want to return to breastfeeding and abandon mixed nutrition completely. It's possible. However, simply taking and canceling supplementary feeding will not work. It takes some time for a newborn to fully return to breastfeeding. Today, breastfeeding experts strongly recommend that breastfeeding be reintroduced after the situation that led to supplementation has returned to normal.

The time required to wean from mixed feeding is directly dependent on the amount of formula the child receives.

If the daily amount of supplementary feeding is less than 100 ml, it can be abandoned within a few days, simply replacing one feeding of formula per day with breastfeeding.

If the child receives more than 100 ml of formula per day, it is necessary to reduce the volume of each feeding in favor of breastfeeding. To do this, before each feeding, give the baby both breasts first. This will allow you to reduce the amount of complementary foods and increase lactation. Further, when you achieve a reduction in the total amount of supplementary feeding by half, you can simply replace supplementary feeding with breastfeeding gradually.

Is it possible to introduce complementary foods at 4 months while breastfeeding

Worries that you have little milk and the baby will remain hungry are groundless in this case.

The more intensively you breastfeed the baby, the more milk will be.

During this period, mom needs to sleep more, eat well and drink plenty of fluids.

Remember that no formula can replace breast milk and the feeling of closeness and love that a baby feels at his mother's breast. The child must eat mother's milk, because this is conceived by nature itself, which does not make mistakes and does not involve mixed nutrition.

Mixed feeding of newborns is a reasonable alternative when mother's milk is not enough. It allows you to maintain lactation and provide the baby with at least partially natural nutrition. If you feed the baby correctly, mixed feeding will only benefit him. Many women eventually manage to completely and transfer the baby to breast milk.

Mixed feeding is a method of feeding in which an infant receives infant formula at the same time as breast milk. The amount of additional food should not exceed 50% of the infant's daily food intake. If formula milk makes up the bulk of the diet, feeding is considered artificial.

Properly organized mixed feeding of a newborn helps to maintain breastfeeding and increase milk production. Baby food cannot completely replace mother's milk. It contains many valuable substances that are not found in artificial analogues. Natural food is ideal for the development of crumbs and protects it from diseases. Equally important is the psychological contact between mother and child, which is established during breastfeeding. The process of sucking mother's milk soothes the newborn, gives him a sense of security and comfort.

• You need to start eating with breast milk. The infant should be allowed to empty both breasts before offering infant formula. By allowing the baby to suck all the milk out of the breast, a significant increase in its production can be achieved. Before breastfeeding, only some of the therapeutic mixtures prescribed by the pediatrician can be offered to the baby.
• Do not offer baby food in a bottle with a nipple. Satisfying his need to suck, the baby may lose interest in mother's milk. If at the same time there is a large hole in the nipple of the bottle, it will be much easier to suck on it than on the breast. In this case, the baby may completely refuse to suck mother's milk. It is best to feed the baby with infant formula from a spoon. This method is the most uncomfortable for the baby. Therefore, he will tend to breastfeed more.
• To maintain lactation and increase the amount of milk produced, it is necessary to breastfeed the baby at night. During this period, the greatest amount of the hormone prolactin, which is responsible for lactation, is produced.
• You can give only infant formula in one of the feedings. This scheme is convenient for women who need to leave daily for several hours.
• It is recommended to breastfeed your baby on demand. You can offer breast milk when your baby is upset, unable to sleep, or not feeling well. The more a newborn suckles at the breast, the more milk the mammary glands will produce.
• If you carefully follow all the recommendations, the amount of milk will gradually increase. As you need to reduce the amount of infant formula. Thus, it is possible to transfer the child to full breastfeeding.

How to calculate the required amount of infant formula

The amount of additional nutrition is calculated depending on the child's body weight deficit. If a newborn at 3 weeks of age weighs 3100 g (birth weight 3000 g) and has all signs of malnutrition, he needs additional nutrition. The body weight deficit is 3400 g - 3100 g \u003d 300 g. To calculate the required daily amount of food, you need 3100 g: 5 \u003d 620 ml. With seven meals a day, the baby should eat about 90 ml of milk per feeding.

Control weighing allows you to determine the amount of milk that the baby sucks from the mother during one feeding. If its amount fluctuates between 60-70 ml, it is necessary to prepare a one-time portion of baby food 40-30 ml.

If one feeding is completely replaced by infant formula, the serving volume should be increased to 90 ml.

The pediatrician will help calculate the optimal amount of infant formula. It will take into account the individual characteristics of the child, his state of health and the maturity of the digestive system.

What mixtures can be used for supplementary feeding?

With mixed feeding, the doctor will tell you how to choose the right formula. If the baby is completely healthy and has no disorders in the digestive organs, you can give him Nutrilon, Humana, Nan, Hipp.

When a baby suffers from constipation, regurgitation and colic, it is better to include Nan, Nutrilon, Nutrilak or Agusha fermented milk formulas in his diet. They contain lactic acid bacteria and bifidobacteria, which help to restore a healthy balance of microflora in the intestines of the child.

If the baby has an intolerance to cow's milk, you can feed it with an infant formula based on goat's milk (Kabrita, Nanny) or soy (Nan-soy, Frisosoy, Enfamil-soy, Similak isomil). Such products are in most cases well tolerated by children.

For babies with protein intolerance, products with split proteins are made. Such mixtures do not cause a negative reaction in the child, but have an unpleasant taste and low nutritional value. They can only be used as directed by a doctor.

If mixed feeding of the baby is carried out, one should not strive at any cost to feed him the entire prepared portion of infant formula. If he refuses to eat, the feeding should be stopped.

For the next meal, you do not need to prepare an increased portion of the mixture, trying to compensate for the volume that the baby refused during the previous feeding. You should always prepare the portion of baby food recommended by your doctor.

After the baby has eaten the proposed mixture, you can again offer him a breast. If the baby is not satisfied, he will suckle with pleasure at the breast.

Infant formula is digested longer than mother's milk. The number of feedings with mixed feeding will be 1 less than with breastfeeding.

To prevent the baby from weaning from the breast, you can use a special device for feeding newborns. It is a container for baby food with a straw attached to it. The tube is fixed near the mother's nipple. The child captures it along with the nipple and receives additional nutrition in the most favorable conditions for him.

Mixed-fed babies need to introduce their first complementary foods 2-3 weeks earlier than those who are breastfed.

There is no need to be upset about the fact that you have to supplement your baby with infant formula. Critical periods occur in all lactating women. As the baby grows, so does his need for food. The mammary glands need time to provide for the increased appetite of the crumbs. For some women, adaptation takes a little longer.

We need to think about how to properly organize mixed feeding and restore lactation faster. You need to drink more fluids, eat well, get enough rest, get enough sleep and regularly visit the fresh air.

Good day to all visitors of our blog!

Today we bring to your attention the topic of supplementary feeding with mixtures during breastfeeding (HF) - a very controversial one and will be surrounded by myths and prejudices. To begin with, it should be clarified that supplementary feeding is the transfer of an infant (from 0 to 6 months) to mixed feeding, when a mixture is added to breast milk.

Adherents of “pure” natural feeding consider supplementary feeding with formula during breastfeeding a departure from the norm and convince young mothers to give their baby only their own milk. However, there are situations when it is simply impossible to do without supplementary feeding, and it is the only way out of a difficult situation. In what cases do children really need additional food, how to introduce it correctly and how much is needed at a certain age - you will learn from this article.

After the birth of a baby, the mammary glands of a woman are actively functioning, producing a special fluid to feed him. Mother's milk contains all the vitamins, minerals and other useful and nutritious substances necessary for the baby. In the first three days after childbirth, a thick, viscous liquid (colostrum) is released from the nipples in a small amount, which is able to satisfy all the needs of the infant's body for food.

However, there are situations when, for medical reasons, a mother cannot breastfeed a newborn for a certain time, or there is too little colostrum, or milk did not come on time. In such cases, the medical staff of the maternity ward is forced to resort to the first supplement and give the baby a bottle with a small amount of additional food.

Other reasons that determine the need for complementary foods

Young and inexperienced mothers are simply shocked by the lack of breast milk. They do not understand why, why, why, and can get nervous and depressed. To save them from such a state, let's put everything on the shelves.

prematurity

Premature birth is not a sentence for the impossibility of breastfeeding. At first, the baby really needs to be supplemented with baby food, as he is too weak to suckle well at the breast. But after he is strong enough to produce the necessary amount of milk for himself, only the breast can be left for nutrition.

Neurology

Newborn babies may have neurological abnormalities, and as a result, they cannot grasp and suckle the breast correctly. The diagnosis and the first use of artificial nutrition take place in the maternity hospital under the guidance of specialists, and when discharged home, the mother is given the necessary recommendations.

Hypolactation

It is not worth making such a diagnosis on your own: it is better to call for help from a lactologist. The lack of mother's milk is extremely rare, and this phenomenon quickly passes. In a situation of hypolactation, it is better to practice supplementary feeding in small quantities after the main meals. The normalization of lactation will lead to the attachment of the baby to the breast as often as possible.

Often, supplementation of a newborn with a mixture during breastfeeding is required only for a while. It is good if the mother makes every effort to maintain lactation, and does not decide to completely abandon breastfeeding and switch to artificial nutrition.

Frequent communication with the baby, tactile contact, joint night (and sometimes daytime) sleep and attachment to the breast on demand are important to maintain lactation.

How to properly supplement with formula while breastfeeding

Symptoms of a lack of mother's milk are lethargy and nervousness of the baby: he lies almost motionless, constantly cries and screams, does not calm down at the breast, pulls on the nipple and constantly twitches instead of calmly sucking.

Also, a baby who is not full will not gain weight, and regular monitoring of grams eaten will show a small amount of milk absorbed. Noticing such manifestations, the mother should call a pediatrician and a lactologist to the house to help make the right decision.

The most common and familiar way of feeding - a bottle - may not be suitable for all babies. Also, after a bottle, many children refuse to breastfeed, not wanting to try to get milk. Therefore, when choosing this method, it is important to choose the right nipple: it should not be wide and have a very small hole.

Each mother can choose a method that will be convenient for her and the baby will like:

1. Silicone spoon - half filled, and the mixture is gently poured over the cheek.
2. A spoon-bottle is a very convenient modern device: food is poured inside the bottle, which through a special hole enters the spoon attached at the usual location of the nipple.
3. Pipette - will be convenient only when the amount of complementary foods is small.
4. Syringe for injection (without a needle) or syringe dispenser (from packages of antipyretic drugs) - the contents are also poured over the cheek.
5. Cup - before pouring food, you need to sterilize a small beaker (it is better to purchase a special one, and not use medicine dispensers). Tilt the cup to the lower lip of the baby, moisten it with porridge and wait for the baby to swallow it.
6. The SNS system is a modern way of supplementing feeding: a special silicone bottle is filled with food and put on mother's neck. A thin tube coming out of the nipple is attached to the mother's nipple. A newborn attached to the breast captures both the nipple and the tube at the same time.

The most important rule of supplementation is to offer baby food only after he has fed from the breast. It is best to clarify the rules on how to introduce formula supplementation during breastfeeding from specialists, and strictly follow their instructions.

Mixture selection and volume calculation for competent supplementary feeding

Breastfeeding specialists advise, if necessary, to organize supplementary feeding using the mixture that was given to the baby in the maternity hospital. If this was not the case, then the pediatrician and your personal observations of the baby will help in choosing the mixture in the modern baby food market.

Requirements for mixtures for newborns:

• maximum adaptation to breast milk, the boxes should be marked “from 0 to 6”;
• lack of individual intolerance (rash, redness, increased regurgitation and colic, swelling and constipation);
• expiration date and storage conditions in the store.

Accounting for body weight

At the age of less than 10 days from birth, an amount of complementary foods equal to 2% of body weight in grams is given. Children from 10 days to 2 months are offered a fifth of the total weight.

Milk rate table

Having studied according to the table how much you should eat per day or at a time, you can calculate the amount of additional food. To do this, it is necessary to weigh the baby before and after eating and determine how much he has not eaten - this is how much he should be fed.

You can offer your baby a bottle of complementary foods according to one of two schemes, which will be the most convenient for the mother.

Scheme one. By the hour.

Supplementary feeding is carried out 5 times in the interval from 6 to 24 hours, after the same number of hours. The first time - at 6 o'clock, then at 10 and so on, until night. Thus, the last feeding with supplementary feeding will be at 22:00. Avoid supplementing with formula at night, as nightly feedings will help increase milk production throughout the day.

Scheme two. Before and after sleep

The older the child gets, the more the duration and number of daytime naps decreases. In order to supplement according to this scheme, you need to divide the total amount of food the baby needs by the number of his dreams per day. Offer porridge to the crumbs should be before he falls asleep, and after waking up.

For supplementary feeding, but against artificial feeding

It is clear that mixed feeding is much better than artificial feeding. When an infant is fully formula-fed, he is not receiving the necessary vitamins and minerals. Mother's milk, like no other product, contains many substances necessary for the formation of all systems and organs. It allows the gastrointestinal tract of the crumbs to gradually adapt to a new life, forms the correct absorption of products.

Also, supplementary feeding is additional worries for the mother, on whose shoulders, with the advent of a new family member, many responsibilities and tasks fall. It is important to choose and change baby food correctly in case of negative manifestations on the part of the child's body. You also need to choose the appropriate method of supplementary feeding and calculate the required amount. Therefore, before introducing it, the mother should think carefully: is it worth doing it.

And in no case should you give up, putting an end to breastfeeding: you need to fight for it, because this wonderful and most convenient opportunity is inherent in a woman by nature itself!

Conclusion

Supplementation of a breastfed infant may be introduced for a variety of reasons. Newborns are supplemented with expressed breast milk, donor milk, but more often, of course, they use it.

Dokorm, what is it?

Dokorm- this is an additional food for the child, which is introduced in order to compensate for the lack of breast milk. Do not confuse supplementary feeding with complementary foods, supplementary feeding is prescribed if necessary according to indications, more often due to the absence or lack of breast milk, and complementary foods are additional nutrition that is introduced to all children from a certain age, when the mother has enough milk, but it is no longer can meet the nutritional needs of the child.

Feeding newborns in the maternity hospital

In the first few days after childbirth, the mother secretes colostrum, its volume is only a few milliliters, but this small amount is enough to provide the newborn baby with the necessary nutrients, colostrum is quite high in calories and contains vitamins and antibodies valuable for the newborn. Due to the small amount of food, the baby does not have difficulty eating from the mother's breast, and his swallowing, sucking and breathing skills develop. On the third, fourth day, when milk appears, the child is able to fully eat. But every young mother periodically thinks about whether the baby has enough milk or should resort to supplementary feeding. Here are the most common fears in which the introduction of supplementary feeding is not required.

• The loss of a child in the first days of 5-7% of birth weight, a disturbing mother, is the norm and does not happen at all because the child does not eat enough, it’s just that a small organism gets used to new “habitat conditions”, very soon the little one will again begin to intensively add to weight. And by the time he leaves the hospital, his weight will be the same as at birth, this is one of the conditions for discharge.
• The newborn sleeps a lot. This is also absolutely normal, the child gets tired during childbirth no less than the mother, so he sleeps a lot. If it still seems to the mother that the baby is sleeping too long, then it is better to try to wake him up and feed him, otherwise he will get very hungry, and the mother may not have enough milk. In the worst case, you will have to introduce supplementary feeding with a mixture while breastfeeding. Yes, and for the formation of lactation is much better as often as possible.
• The child is restless. The baby does not always cry when he is hungry, later the mother will understand that there are many reasons for crying - (wet diaper, the child is cold, hot, etc.)
• The baby cries and turns away from the breast, this fact does not necessarily indicate that the mother does not have milk, more often the baby simply does not yet know how to eat milk from the breast. Mom needs to be patient and teach him, you need to put the baby to the breast for a short time, the more often the better.
• The baby is applied to the breast too often. In fact, if a child is upset or sick, he can be breastfed up to 40 times a day, and this does not mean at all that he is hungry every time and it is necessary to introduce supplementary feeding during breastfeeding. This is just a physiological need for a baby to be close to his mother, to feel her warmth and love.

Of course, a tired mother sometimes wants to supplement her baby with formula and relax, but this is not necessary. There are indications for the introduction of supplementary feeding, they can be symbolically divided into unconditional and conditional.

Unconditional indications for the introduction of supplementary feeding:

• For some reason, the mother cannot be near the child;
• The baby has intolerance to mother's milk;
• The mother is taking medications that can harm the baby.

Conditional indications for the introduction of supplementary feeding

Indications from the child:

• Low blood glucose in a newborn that does not rise even after breastfeeding;
• Severe dehydration with weight loss greater than 10% and elevated sodium levels, regardless of breastfeeding;
• Weight loss in a child due to a lack of breast milk in the mother;
• Delayed stool in a newborn;
• Milk is not digested enough, despite the normal amount of it in the mother;
• There is a need for additional administration of vitamins and other nutrients.

Mother's testimony:

• Lack of milk, which remains even five days after the removal of the placenta;
• Lack of milk due to Sheehan's syndrome, which can occur due to severe blood loss during childbirth;
• Underdevelopment of the mammary glands or violation of their function as a result of surgery or pathology;
• Unbearable pain during feeding, which doctors cannot stop despite all attempts.

How to determine the lack of breast milk

If everything is clear with unconditional indications for the introduction of supplementary feeding, then with conditional indications the question arises of how to determine that the child really does not have enough milk and supplementary feeding of a breast-fed child is necessary. For this purpose, pediatricians, together with young mothers, usually use the following methods:

• Counting the volume of urine.
• Counting the number of urination.
• Expected weight gain method.
• Measure the baby's weight before and after feeding.
• Intuitive method.

How much milk a child should eat is calculated based on his age, weight and health of the baby. The most generalized calculation method is the dependence of the amount of food on the body weight of the child. At the age of 2.5 months, the child should eat 1/5 of his weight, from 2.5 to 4 months - 1/6 and 1/7 from 4 to 6 months.

The amount of formula supplementation while breastfeeding will depend on the difference between the amount of milk the baby eats and the amount he should consume.

The introduction of supplementary feeding with a lack of breast milk

The decision to immediately introduce supplementary feeding when there is a shortage of breast milk depends on what percentage of the daily ration the child is not getting. If the deficit is not more than 50%, then doctors first take all the necessary measures to stimulate lactation and introduce supplementary feeding of children with a mixture no earlier than a week later, only if the situation does not change. A deficit of more than 75% forces doctors to immediately decide on the introduction of supplementary feeding, but at the same time, attempts should not be left with the mother. If the amount of mother's milk increases, then the amount of supplementary feeding decreases.

Choice of complementary foods

Here, all doctors give an unequivocal answer - breast milk. Theoretically, if possible, it is necessary to use the mother's expressed milk, if not, then feed the baby with donor milk. But in practice, in the maternity hospital, supplementary feeding of children with a mixture is more often used. The most hypoallergenic are mixtures based on protein hydrolysates. They are well tolerated by almost all newborns. Upon returning home, the mother, under the supervision of a pediatrician, can change the mixture or leave the one that was given to the child in the maternity hospital.

Feeding methods

There are a lot of ways to supplement breastfeeding with a mixture, each of them has its pros and cons. I propose to consider each of the methods in more detail.

small bottle


pros: One of the easiest ways, does not require special skills from both mother and child.

Minuses: If a bottle is used to supplement a breastfed baby, then there is a danger of breast rejection. The baby takes the bottle and the breast in various ways, the tongue is involved in feeding from the breast, he presses the breast to his palate with it, the cheeks are mainly involved in feeding from the bottle, it is easier to eat from the bottle, and the baby subsequently chooses it.

To minimize this risk, several conditions must be met:

• Be sure to pick up a bottle of the correct rectangular or oval shape, without narrowing in the center. The nipple should be small, not very hard and round in shape, as close as possible to the shape of the female nipple. Large holes in the nipple do not need to be made, this interferes with the realization of the sucking reflex in the newborn. Milk should not flow too quickly, the baby should make little effort, the optimal process of bottle feeding should be 15-20 minutes
• The correct feeding technique is that if the mother has milk, then you must first feed the baby with milk from the breast, and then give a bottle. Bottle feeding should be done in the same position as breastfeeding.

Syringe without needle


pros: Cheap way, can be used as a disposable

Minuses: A small volume of the syringe, there is a risk of extinction of the sucking reflex when supplementing a breastfed baby.

For supplementary feeding, the largest syringes of 5-10 ml are used, the principle of feeding is similar to injections - milk flows out of the syringe when pressed.

Options for supplementary feeding with a syringe may be as follows:

• The child sucks a syringe through which milk slowly flows
• Milk enters the baby's mouth through the tube at the end of the syringe.
• The baby sucks on the mother's finger or breast, and milk is introduced into the corner of the mouth through a tube. This option is most preferable when supplementing infant formula with partial breastfeeding.

Syringes with a tube can be bought at a pharmacy, such are used by dentists in their work, it is not difficult to build it yourself by putting a venous catheter on the end of the syringe. But here it is necessary to remember that the catheter must be changed after each feeding, because the mixture remains in the tube, which can deteriorate and harm the baby.

Tea spoon


pros: The method is simple and inexpensive, can be used for a cold and in other cases when sucking is difficult. The spoon is easy to disinfect.

Minuses: At first, using a spoon when supplementing formula is quite difficult because the baby will spit out most of the milk or formula. This method is least suitable for supplementing infant formula while breastfeeding, as it does not develop the sucking reflex. It is better to use it when there is little time left for the introduction of complementary foods and accustoming the child to an "adult" diet.

To help your child learn to eat with a spoon, you can try:

• Quickly pour the contents of the spoon into the middle of the tongue;
• Pour milk over the cheek;

The next portion of milk should be given only when the baby has swallowed the previous one. You can understand that the child is full when he stops opening his mouth or starts spitting out the mixture.

soft spoon


pros: More baby-friendly material, plus the spoon is inserted into the bottle, there is no need to constantly scoop up a new portion with the danger of spilling.

Minuses: It costs more than the above devices.

It is easy to use a soft spoon, milk is poured out by pressing on the protrusions located on the sides of the spoon, you need not press hard so that the mixture enters the spoon in a small amount.

But here one cannot exclude the possibility that if the child does not eat from an ordinary spoon, then he may not eat from this one either.

Cup

pros: The cup is very easy to wash between feedings, the baby eats from a cup even faster than from a bottle. Feeding from a cup reduces the likelihood of swallowing air, respectively, less spitting up and colic.

Minuses: Cup feeding also requires certain skills. Not suitable for children with a weak sucking reflex.

Any cup can be used to feed babies with a mixture, but it is better to purchase a special one with thin walls and from a material that can be easily sanitized. But doctors recommend supplementing with a cup if the baby is not breastfeeding at all. Supplementing babies with formula from a cup while breastfeeding can negatively affect their desire to breastfeed. It is better to feed when the child is upright or half-sitting, you can not pour milk into the child's mouth, he must drink it himself. Premature babies mostly lap up milk, while those born on time sip it. The cup must be constantly gently tilted so that the child does not stop eating or swallow air.

pros: Form and method of feeding as close as possible to breastfeeding, low risk of swallowing air.

Minuses: High price. It is mainly used for feeding children with genetic abnormalities, due to which the child does not have a sucking reflex.

Using a cup is not difficult, the main thing is to pour the necessary portion of milk and release the air. The flow of milk can be adjusted by turning the cup.

finger feeding

pros: One of the most physiological of all methods of breastfeeding with formula, there is always tactile contact between the baby and mother during feeding.

Minuses: Can cause breast rejection due to the fact that when using this method, the child does not need to make efforts to "get" milk.

Milk is fed through a syringe or probe into the baby's mouth while he sucks his finger, you can use a syringe with a tube.

Supplementation at the breast

pros: The most natural way to supplement a breastfed baby. The baby gets used to eating from the breast, additionally stimulates the production of milk in the mother.

Minuses: Not suitable for babies who do not want to breastfeed. Difficulties with sterilization of tubules.

The system of use is not simple, and usually consists of a bottle and a tube attached to it, while the bottle is slightly raised to allow milk to flow into the tube. The child is applied to the chest and a tube is inserted into his mouth, the child simultaneously sucks the breast and milk from the tube. Sometimes the child is first fed simply from the breast, then a probe is inserted into the corner of the mouth.

Such a system can be purchased at the store, there are several options from different manufacturers, or you can make it yourself by attaching a tube to a feeding bottle. The tube must be washed, boiled, and it is better to change after each feeding. Many mothers use this particular system to introduce supplementary feeding, because physical contact with the newborn is important for them, and because the baby suckles, the milk arrives in it. The strength of the milk flow in the system can be adjusted.

Pipette


Pros: May be used when other means cannot be used, mainly for feeding premature or weak newborns

Minuses: very small volume, feeding even a very small child is stretched over time for a long time.

For supplementary feeding, you need to use a pipette with a blunt tip, before feeding, you can give the child a clean finger, and introduce milk into the corner of the mouth.

Which feeding method to choose

If possible, doctors advise choosing a method of supplementary feeding at the breast, this guarantees the development of a sucking reflex in the baby and gives a great chance to increase the production of breast milk in the mother.

If the lack of breast milk is small, or only periodic supplementation is required for a breastfed baby, then a syringe or spoon can be used. Periodic supplementation may be required when "crises" lactations, which often occur from 3 to 6 weeks, at 3,4,7,8 months of lactation, such periods do not last long, only 3-5 days.

Negative consequences of the introduction of supplementary feeding

The negative consequences of supplementary feeding mainly occur when breast milk is refused.

• Supplementing babies with formula can cause a lack of antibodies and beneficial microflora for the intestines of the newborn.
• Poisoning or infectious diseases if hygiene conditions are not observed.
• Reduced milk production when supplementing with formula while breastfeeding.
• An improperly selected mixture can cause a child to lose significant body weight and increase bilirubin levels.
• Supplementing babies with formula while breastfeeding may negate the possibility of returning to breastfeeding, as formula saturates the baby for a longer period, and he is less likely to be applied to the breast, as a result, the mother's milk becomes less.

Basic rules for supplementation

Regardless of which option you choose for supplementary feeding, you must follow the general rules.

• Breast before and after feeding. No matter how much milk a mother has, it is still the most valuable source of nutrition for the baby, so it is necessary to give the baby a breast, even if there is little milk.
• Don't force the child forcibly eat the whole mixture, let him decide when he is full. Next time make a little less mixture.
• Feed only a calm baby. If the newborn is upset, you should first calm him down, and then offer to eat.
• And the most important thing to remember for young mothers is that even if they had to introduce supplementary feeding, there is still the opportunity to return to breastfeeding, often formula supplementation is introduced as a temporary measure and if you follow the advice of a pediatrician, you can return full lactation within 7-10 days.

Health to you and your children!

When a baby is not gaining weight well, many mothers worry about whether they have enough milk, whether the baby is getting all the nutrients he needs when breastfeeding. And many of them are ready to supplement the child with a mixture, without delving into the essence of the problem. Let's take a closer look at when to introduce the first supplement while breastfeeding, and when it is not required, even with poor weight gain.

What is supplement

Supplementary feeding is the use of mixtures during breastfeeding (HF) of a newborn baby until he reaches six months of age. The functional purpose of supplementary feeding with HB is to provide the baby with the necessary nutrients that he does not receive from mother's milk for various reasons. When breastfeeding, supplementary feeding is introduced in exceptional cases or for medical reasons.

Let's consider under what conditions it is not necessary to introduce supplementary feeding during breastfeeding, and what circumstances force the mixture to be introduced into the child's diet. Let's start with what moms put forward as arguments for the introduction of supplementary feeding and, by the way, some doctors are influenced by this evidence.

Common reasons for supplementation

Often, young mothers, because of doubts about their abilities, make a mistake, which is based on the start of supplementary feeding in the early stages. This happens in the postpartum period, at a time when the volume of breast milk has not stabilized, and it seems that the baby is not full. This situation is aggravated by the crying of the baby, which the mother regards as the request of the baby for additional nutrition.

After taking the mixture, the baby calms down and sleeps well. And thus, an erroneous opinion is formed about the need for mandatory supplementary feeding. Plus, some mothers are too lazy to breastfeed, and some have cracked nipples, which causes pain during feeding, and supplementation seems to them a way out of this situation.

Note! According to physiological data, immediately after childbirth, the amount of milk is always small, and this is the norm. In addition, during this period, the baby's kidneys are still "immature", they are just beginning to adapt to the existence in the external environment and, in terms of their functional abilities, are not able to process large volumes of liquid. Therefore, the body of a woman produces a special milk - colostrum. Colostrum has a very thick consistency, it is small, but it sufficiently satisfies the needs of the newborn. From the 5th day after birth, transitional milk begins to be produced, which is already becoming more liquid, in order for lactation to be good, it is required to put the baby to the breast as often as possible. The properties and composition of breast milk are discussed in detail in another article on our website.

When supplementation is not required

Conditions that indicate the absence of the need to supplement the baby:

■ If the baby behaves anxiously at the mother's breast. This situation does not always mean the absence or insufficient amount of breast milk. This concern may be due to the confusion and inability of the baby to handle the nipple, the child may have colic or something else. The pediatrician should examine the child, and if everything is in order from the side of health, then you can sort out this situation by eliminating the nipples and pacifiers, which form an unnatural way of grabbing the nipple, as well as frequent attachment of the baby to the breast.

■ Also, one of the factors that cause a child to cry is the pathological structure of the tongue, which manifests itself in the presence of a short frenulum. This deficiency does not allow the child to capture the breast in a natural way.

■ Repetitive attachment of the baby to the mother's breast is a normal physiological need of the child's body, and does not mean at all the fact that the baby is hungry and needs additional feeding.

■ Volumes of milk expressed do not regulate the introduction of complementary foods. If the child is breastfed, there is no need to pump.

■ According to the WHO, the start of supplementary feeding is not rational for children under the age of six months who are breastfed, as well as supplementing infants with water. The use of mixtures is carried out only for medical reasons, and after consultation with a pediatrician.

When to introduce breastfeeding

Situations that determine the need for the introduction of additional infant formula feeding:

■ If the baby was born before the due date. Premature babies are unable to breastfeed due to weakness. In such a situation, supplementary feeding contributes to the rapid recovery of the child's body.

■ The presence of neurological pathologies. Infants with this diagnosis cannot coordinate their actions for proper nipple latch. Diagnosis of these pathologies takes place in the maternity hospital and parents at discharge have a number of recommendations for the introduction of mixtures for feeding the child.

■ Not enough breast milk (hypolactation). Proper organization of breastfeeding, adherence to the breastfeeding regimen will allow you to normalize the amount of milk and subsequently refuse mixed feeding.

■ Practice shows that formula supplementation during breastfeeding is a temporary phenomenon. The main task for a young mother at this stage is to maintain lactation and exclude the possibility of transferring the baby to artificial feeding.

■ Constant pastime with the baby, tactile contact, joint rest and sleep with the baby, as well as unlimited attachment of the baby to the mammary glands will increase the amount of breast milk to the required norm.

What to give formula to a child

If, as a result of a consultative examination, supplementary feeding is prescribed by a pediatrician, first of all, you should seriously consider the selection of the necessary utensils for feeding. The most common mistake in this case is the use of a classic container in the form of an ordinary bottle with a nipple for feeding. But as proven by experts, such an approach to supplementary feeding can ensure that the baby completely refuses natural feeding, which is associated with the need to make more efforts than when feeding with mixtures from a bottle. This is due to the fact that the way the nipple and nipple are gripped are quite different, despite the company's claim to create perfectly anatomically shaped nipples. At the moment, rubber products that would completely repeat the female nipple have not been created. Therefore, a baby who is supplemented with mixtures through a bottle sooner or later has to make a choice and, as a rule, he is not in favor of the breast.

The difference between breastfeeding and a nipple with a bottle is very significant and are as follows:

- Capture depth. When breastfeeding, the baby must latch onto the nipple completely with the areola, while foraging through the nipple does not require a deep latch.

- The amount of effort. The supply of food from the nipple is easy and unhindered, which cannot be said about the natural way of eating. When extracting milk from the mammary glands, the baby will have to make great efforts, some babies even sweat when they suckle the breast.

- Functionality of gums and tongue. With natural feeding, the tongue is involved. When supplementing, the process of obtaining food is carried out by chewing the gums.

The ease of feeding the mixture from the bottle justifies the conditions for the complete refusal of the baby from natural feeding. In this case, there is a complete replacement of breast milk with mixtures, the benefits of which are much less than from breast milk.

You can prevent your baby from breastfeeding by using alternative supplemental feeding aids. Let's look at what dishes will not discourage a child from sucking at the breast.

- Spoon. In pediatrics, it is allowed to use an ordinary teaspoon, made of silicone or a special one combined with a baby bottle for feeding. A half-filled spoon is inserted into the child's oral cavity, and its contents are brought into the area between the cheek and gum. After making sure that the baby has swallowed the mixture, you can lay the next portion.

- Pipette, syringe. Feeding rules remain the same. In small portions, the milk mixture is introduced into the mouth, but in no case on the root of the tongue. It is recommended to use plastic pipettes with a safe spout, rounded shape and dosing syringes from medicines that lower the child's temperature during fever.

- Beaker. Miniature variations of this item of utensils are used, made of materials that are safe for the health and life of the baby. The filled container is applied to the child's lower lip and moistened with milk mixture. After waiting until the child licks his lips, you can re-apply the next part of the food to her. Sometimes children lick the mixture from the beaker with their tongue, like kittens. This technology of supplementary feeding is considered the most common and practical form in infancy.

- SNS technology. It is completed with a soft bottle made of silicone-containing plastic and a tube of thin diameter with a latch to hold it on the mammary gland. This container is filled with a mixture, the tube is attached to the nipple, to which the child is applied. This system ensures the simultaneous flow of breast milk and formula into the baby's stomach.

The SNS system in Russian pediatrics is not very popular. But world experts say that this is the best way to introduce complementary foods. Due to its use, the tactile contact of the mother with the child is maintained, the function of milk separation by the mammary gland is maintained and the use of milk formula in an amount corresponding to the needs of the child is ensured.

All utensils and utensils for feeding the baby should be sterilized before each use, normal washing is not enough. The dishes should be boiled or kept over steam, but it is best to use a special jar sterilizer.

Rules for the introduction of the mixture

Any method of introducing supplementary feeding requires strict compliance with the following conditions:

Attaching the baby to the mother's breast immediately before and immediately after additional feeding.

The beginning of the process of feeding a child should be carried out only in a calm state, both mother and child.

Strict adherence to dosage portions.

Avoid force feeding.

Compensate for the sucking reflex is beyond the power of any objects for the introduction of complementary foods. Accordingly, regular breastfeeding will solve two problems at once:

Realization of the need for infants in sucking;

Additional stimulation of the functioning of the mammary glands.

An increase in the volume of lactation will allow you to abandon supplementary feeding in full in the shortest possible time. An increase in lactation can be achieved by taking medications and natural lactation stimulants.

How to give formula to a child

In order for the child to gain weight correctly (the table of weight gain for a child up to a year is displayed on our website), you need to know exactly how much the child will not receive breast milk. Previously, pediatricians relied on the established standards, which stated: at the age of two months, supplementary feeding with natural feeding should not exceed 60 grams per day, at 3 months - the norm is 90 grams, and at six months of age - 240 grams. However, these indicators do not always correspond to the real needs of the child.

This is due to the fact that with such norms, the volume of breast milk produced is not taken into account. This method often led to the fact that the child was completely transferred to artificial feeding. Therefore, the European specialists of the association La Leche League International and AKEV recommend to abandon this scheme and follow the following tactics when calculating the volume of supplementary feeding, which is based on counting urination per day. The rate of urination of the baby per day is 12 times, it has been established that such an amount is excreted with sufficient food intake. Therefore, this check is essential when introducing supplementary feeding. The amount of mixture needed for supplementary feeding is calculated according to the following formula: the number of urinations not performed is multiplied by grams corresponding to the age of the child.

1 month - 10 grams
2 months - 20 grams
3 months - 30 grams
4 months - 40 grams
5 months - 50 grams
6 months - 60 grams.

In addition, it is necessary to stimulate the secretion of milk by the mammary gland. This is done by frequent breastfeeding, excluding nipples and pacifiers, and feeding at night, in particular between 3 and 8 hours. If the child urinates more than 12 times a day, the volume of the mixture should be gradually reduced, up to complete failure.

The scheme for introducing supplementary feeding to a child can be carried out according to two principles, the first is better for newborns, and the second for infants.

1. Sleep. The norm of the mixture for a day is divided into equal parts, which are served to the child before bedtime and immediately after waking up. With this scheme, increased control over the receipt of the entire daily volume of the mixture per day is required.

2. By the clock. The daily volume of the mixture is divided into 5 parts. Feeding should be done every 4 hours, starting with morning feeding. At night, it is recommended to refrain from feeding the mixture, it is better to offer the baby a breast.

conclusions

The relevance of the problem of the introduction of supplementary feeding during natural feeding is solved by an integrated approach, which takes into account many indicators (weight gain, health status, allergies, the number of urination). Please note that you cannot administer the formula to the child on your own, only the pediatrician can recommend supplementary feeding if there are indications for this. During supplementary feeding, it is required to eliminate all errors in breastfeeding (increase the frequency of application, master the technique of correctly grasping the nipple, abandon the pacifier and nipple, maximize the amount of time spent with the baby, take drugs that increase lactation), and the correct selection of the amount of mixture consumed will ensure a child with missing food for a while until lactation returns to normal. Remember, if the frequency of urination is normal, the introduction of supplementary feeding is not required, even though the baby is not gaining weight, unless, of course, there is no medical indication for the introduction of supplementary feeding.