Feeding Your Newborn Baby: Expert Tips & Tricks

As a new parent, you may be wondering if it's better for your newborn to feed on a schedule or on demand. Feeding on demand is almost always recommended. Newborns eat 8-12 times in 24 hours. Studies show babies with complete access to feeding have a better chance of getting the full nutrients they need, compared to those with restricted feedings. Your baby's caloric needs change constantly as they grow, and only your baby knows how often they need to be fed.

Newborn babies should only be fed breast milk or formula. They provide new babies the balance of nutrition, fluid and electrolytes. Don't give a baby plain water, juice or other liquids. Newborns don't need rice cereal or other solid foods either. Your provider will talk to you about appropriate times to introduce other liquids and solid foods when your baby is older.

How Often and How Long Should My Baby Eat During the Day and Night?

• Baby should eat whenever hungry. This looks like squirming, sucking on fingers, smacking lips or crying. It usually starts one to three hours from start of the last feeding.
• Wake baby to feed if baby is still sleeping three hours from the last feeding in day or four hours at night.
• Baby should nurse 8-12 times or more every 24 hours (after first 24 hours of life).
• Nurse baby 10-15 minutes on each breast. Nurse both breasts at each feeding.
• Baby may nurse again if still hungry.
• Babies often cluster feed. They may want to eat every hour for three to four hours in a row. This is normal for the first three weeks. It helps you build your milk supply, and your baby eats what he/she needs.

What if My Baby is Too Sleepy or Refuses to Nurse?

• This is common in the first 24 hours of life.
• Take baby's clothes off and change their diaper to wake them. Place baby skin to skin to smell the breast.
• For the first few days, you may need to wake them to feed if they're still sleeping by three hours from the last day feeding and four hours at night.
• If baby still won't eat, allow him/her to sleep another hour, and try again. When you're in the hospital, call the nurses for help if baby still won't nurse.
• If you're at home and baby won't wake up to feed and has missed two feedings, pump your breasts and feed baby your pumped milk or formula with a slow flow nipple. (At home, give ½ to 1.5 oz range = 15-45 ml.)
• Call your baby's doctor if he/she eats fewer than 8 times in 24 hours.

What Should I Do if My Baby Refuses to Latch? 

• Offer the breast when baby first wakes.
• Avoid diaper and clothing changes. 
• If your breast is offered before the crying phase, (late stage of hunger) you have a better chance at a successful latch.
• Suck train before latching. If that's not effective, give a "jump start" using expressed breast milk of ½ to 1 oz via a slow flow nipple/bottle. Attempt latching with your baby again.
• Latch attempts should be brief, between one and five minutes. Trying too long may result in a power struggle with your baby. We don't want baby to perceive that the breast isn't a "happy" place to be.
• If your baby refuses to latch, take a time-out and place baby on your chest. Give your baby a hug and pump while a family member feeds your expressed breast milk.
• Ensure baby opens wide to latch to your breast. If a bottle/nipple is used to feed expressed breast milk, family should encourage a “wide open mouth” response as well.
• Try to avoid over feeding baby.
• Give up to two ounces, then swaddle and allow baby to non-nutritive suckle on a clean finger.
• If your baby doesn't settle after 30 minutes, consider offering another ½ -1 oz of breast milk. Remember, just because baby cries, doesn't mean it's a hunger cry.
• Pump every two to three hours if baby isn't latching and nurse 10-15 minutes per breast, with breast softening.
• If you can, try to rest when your baby rests.
• Let family do the housework, laundry and meals.

What If My Baby is Formula-Fed?

Continue to use the formula your baby started in the hospital. If you started with nursing and are transitioning to formula, or if you believe your baby needs a different formula, discuss these questions with your provider. They can help you make an informed decision about which formula to use. Most babies take one to two ounces by the time of discharge and increase to two to three ounces per feeding by the two-week check-up. 

If your baby is acting hungry after feedings (fussing or rooting), you can try increasing feedings by 1/2 oz at a time. Babies usually feed every 2-3 hours around the clock. If you have city water, tap water can usually be used to mix formula. If you have well water, discuss options with your provider. Formula should always be mixed according to package instructions, as diluted or concentrated formula can cause serious problems for the baby. If you have trouble obtaining formula for your baby, please talk to your provider about programs in your area that can help.

What Should I Do if My Baby Spits Up?

It's common for babies to spit up. Usually, this doesn't indicate a major problem. Overfeeding your baby happens if mom has an oversupply of breast milk, or if a baby fusses and is fed too much in an effort to soothe. Often, this is more food than their tummy can hold, and they spit up. Other times, spitting up is caused by an air bubble in the tummy. Babies can be “happy spitters," too. They may spit up frequently but are happy, well-fed and growing. These babies typically outgrow spitting up sometime in the first year of life. There's no need for special medical treatment.

To help with spitting up, burp your baby frequently during and after feedings. If they don't burp well after a feeding, try again in 10 or 15 minutes. Keep your baby upright for 20 minutes after feeding and don't jostle or move them too much after they eat. Wedges or other positioners aren't recommended due to SIDS risk, but you can try to put a thin blanket or towel under a firm crib mattress to elevate the head of the bed, or elevate the legs of a bassinet.

If your baby has pain with spitting up, very forceful vomiting, isn't feeding well or has green blood in his/her vomit, please contact your provider.

How To Help a Baby With Gas?

Gassiness is common in babies. If it doesn't bother your baby, you don't need to treat it. If your baby is fussy or uncomfortable, try bicycling the legs or massaging baby’s tummy. A warm washcloth or bath can also soothe your baby's tummy. If your baby is formula-fed, let bubbles settle before feeding. Burping also helps by eliminating bubbles of air that travel through the gut. Gas drops are safe but not always effective. If you baby has gas along with signs of severe pain, feeding difficulty or abdominal stools, contact your doctor.