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HEALTHY FOOD CHOICES FOR A NEWBORN
DR. DAVID HILL: Today, we're going to talk about what to feed your newborn infant up to age four months. Here, the data are quite clear. Women who can nurse should at least attempt it. Now there are some conditions that interfere with nursing. Babies with certain rare genetic disorders like lacticemia cannot take human breast milk. Mother's who have untreated tuberculosis, HIV or active herpes lesions on the breast should not nurse for health reasons. And there are certain medications that are dangerous for the baby. Your doctor should be able to tell you which ones these are if you're taking them. On the other hand, many women believe that if they smoke, they shouldn't nurse. That's not true all. Inverted nipples can be a slight problem but a good lactation consultant should be able to help you figure out your way through it.
Some babies may need to formula feed, and if they do any formula that is iron fortified should be fine. If the baby has a milk protein allergy, you may need to use a highly hydrolyzed casein formula such as Alimentum or Neocate. Your doctor can help you sort through those formula choices to find one that works best for you. Almost no babies need a lactose-free formula unless they're recovering from diarrhea or have a very rare genetic disorder that prevents them from being able to process lactose properly. But that accounts for fewer than one in 10,000 babies, even if you or dad does not process lactose. Nursing should begin right after birth and it should occur whenever the baby wants to eat. Every two to three hours is normal, but it maybe more often than that.
If your newborn goes more than four hours without nursing, you may want to make him up and see if he's ready to eat. Bottle-fed babies likewise should eat every time that they're hungry. Don't wait for them to cry, but look for signs, just chewing on the hand or rooting around for something to eat. Initially, your bottle-fed baby may take only one ounce with every feed, every two or three hours, but soon that will go up to two ounces and three ounces and you'll expect the baby to eat to three ounces every two or three hours on average. The baby's doctor will check weight and you can monitor urine output and stool output to make sure your baby's getting enough.
We look for a bowel movement as often as every single feed or as rarely as once every couple of days. Urine should be at least five times a day and as much as every feed to know that feeding's going well. To review, if you can, you should breastfeed your baby although there are some conditions that preclude that. Formula-fed babies do fine on most iron fortified formulas. Baby should eat whenever they show signs of hunger as much as they want to. Your doctor can help you with problems you might have with nursing or with finding the right formula for your baby. And that is what to feed your baby up to age four months.