What to Expect the First Year (67 page)

When you're breastfeeding, figuring out whether your baby's getting the right amount to eat is a pretty simple calculation—if enough's coming out, enough's going in. With bottle-feeding, there's some higher math to do. While there's no magic formula for how much formula to pour into each bottle, how much you can expect your little one to drink, or how much will get the sitter through the day or you through the week, there are general guidelines you can look to. Not surprisingly, a lot depends on your baby's weight, age, and, once solids are introduced, how much he or she is eating.

• Infants under 6 months (those not supplementing with solids) should be taking about 2 to 2½ ounces of formula per pound of body weight over a 24-hour period. So, if your baby weighs 10 pounds, that would translate to approximately 20 to 25 ounces of formula a day. In a 24-hour period, you'll be feeding your baby around 3 to 4 ounces about every 4 hours.

• Babies under 6 months generally don't need more than 32 ounces of formula a day. Once solids are added to the mix, the number of formula ounces can be scaled back a bit.

• Most babies start off with 2 to 4 ounces per feeding during the first month and increase that amount by about 1 ounce per month until they reach 6 to 8 ounces per bottle. As your tiny one's tummy gets bigger and is able to hold more food at one sitting, he or she will probably drink fewer bottles a day with more formula in each bottle. The average 6-month-old, for instance, could be consuming 4 or 5 bottles of 6 to 8 ounces each day.

But because these are just rough guidelines, and because every baby is different (and even the same baby's needs are different on different days), you shouldn't expect your infant to follow this formula for formula precisely. How much your baby needs to take may vary somewhat—from day to day and feeding to feeding—and may differ significantly from the needs of baby buddies the same age. Keep in mind, too, that your baby's consumption won't just depend on weight, but on age, too. A large 6-week-old, for example, probably won't be able to drink as much as a small 3-month-old—even if they weigh about the same.

Most of all, remember that bottlefed babies, just like breastfed babies, know when they've had enough—and enough, for a young infant, is like a feast. So take your cues from baby's hunger and feed to appetite instead of to a specified number of ounces. As long as your baby is gaining enough weight, is wetting and dirtying enough diapers, and is happy and healthy, you can be sure you're on target. For more reassurance, check with your baby's pediatrician on formula intake.

“My baby was doing great at the breast—now, suddenly, he has pretty much been refusing to nurse for the past 8 hours. Could something be wrong with my milk?”

Something is probably wrong—though not necessarily with your milk. Temporary rejection of the breast, also called a nursing strike (even in nonunion babies), is not unusual and almost always has a specific cause, the most common of which are:

Mom's diet.
Have you been indulging in garlicky pesto? Feasting your chops and chopsticks on General Tso's chicken? Honoring Saint Patrick with corned beef and cabbage? If so, your baby may simply be protesting the spicy and/or strong flavors you've been seasoning his milk with. If you figure out what turns your baby off, avoid eating it until after you've weaned him. Many babies, on the other hand, don't mind the strong spices in their mama's milk, especially if they became accustomed to those flavors in utero through highly flavored amniotic fluid. In fact, some especially relish the taste of breast milk that comes with a kick.

A cold.
A baby who can't breathe through a stuffy nose can't nurse and breathe through his mouth at the same time—understandably, he opts for breathing. If your baby has been stuffed up, gently suction baby's nostrils with
an infant nasal aspirator. Is that snot too crusty? Soften it first with saline spray.

Teething.
Though most babies don't start struggling with teeth until at least 5 or 6 months, a few begin much earlier, and an occasional baby actually pops a pearly or two in the first 4 months. Nursing often puts pressure on swollen gums, making suckling painful. When budding teeth are the cause of breast rejection, a baby usually starts nursing eagerly, only to pull away in pain.

An earache.
Because ear pain can radiate to the jaw, the sucking motions of nursing can make discomfort worse.
Click here
for other clues to ear infection.

Thrush.
If your baby has this yeast infection in his mouth, breastfeeding may be painful. Be sure the condition is treated so that the infection isn't passed on to you through cracked nipples or spread elsewhere on baby (
click here
).

Slow let-down.
A very hungry baby may grow impatient when milk doesn't flow immediately (let-down can take as long as 5 minutes to occur in some nursing moms), and may push away the nipple in frustration before let-down begins. To avoid this problem, express a little milk before you pick him up, so that he'll get something for his efforts the moment he starts to suck.

A hormonal change in you.
A new pregnancy (unlikely now if you're nursing exclusively, more possible if you've started your baby on supplemental formula feedings) can produce hormones that change the taste of breast milk, causing baby to reject the breast. So can the return of your period, which again isn't usually an issue until partial weaning begins.

Your stress level.
Maybe you're stressed because you've recently returned to work. Maybe it's because it's bill-paying time, or because the dishwasher just broke—again. Maybe it's just because you've had a really bad day. Whatever the reason, if you're worried or upset, you may be communicating your tension to your baby, making him too unsettled to settle down for nursing. Try to relax yourself before offering the breast.

Distraction … in baby.
As your little one becomes ever more alert, he may start realizing there's more to life than mommy's breasts. Ever more easily distracted by the world around him, he may struggle to get a look at it, even as you're struggling to feed him. If that seems to be the case with your curious little cutie, try breastfeeding in a quiet, darkened, boring location.

Once in a while, there appears to be no obvious explanation for a baby's turning down the breast. Like an adult, a baby can be “off his feed” for a meal or two. Fortunately, this kind of hiatus is usually temporary. In the meantime, these suggestions may help you ride out the nursing strike:

• Don't try substitutes. Offering a bottle of formula when your baby balks at the breast could exacerbate the problem by decreasing your milk supply. Most nursing strikes, even longer-term ones, last only a day or two.

• Try some breast in a bottle. Express some milk and give it to your baby in a bottle if he continuously rejects the breast (though this won't work if it's something in the milk that's bothering him). Again, the strike is likely to last only a day or two, after which your baby will be ready to take milk from the source again.

• Try, try again. Even if he rejects it for a few feedings, chances are he'll
surprise you and start right back where he left off.

• Slow down on solids. If you've started your baby on solid food, he may be eating too much, curbing his appetite for breast milk. At this age, breast milk is still more important than any solids (in fact, solids aren't usually recommended until 6 months), so cut down on the amount of solids you're feeding and always offer the breast first.

If rejection of nursing continues beyond a day or two, if you're concerned your baby isn't getting enough to eat, or if it occurs in connection with other signs of illness, check in with the doctor.

“My baby won't lie still when I'm changing her—she's always trying to turn over. How can I get her to cooperate?”

Realistically, you can't count on much diaper-changing cooperation at this increasingly active stage, and (sigh!) you'll likely see less and less as the months go by. Not surprisingly. After all, your baby turtle is both frustrated by being immobilized on her back, and bored with diaper business as usual—a combo that can set off a tussle with each change. The tricks: Be quick (have all the diapering supplies ready and waiting before you lay baby on the table) and provide distractions (a mobile above the changing table or any toy to occupy her hands and, hopefully, her interest). Engaging your baby in a song or a cooing conversation or a few belly raspberries may also divert her long enough to get the job done. Or try a change of diaper-changing locale—on a towel on the living room floor, for example, or in the middle of your bed (don't leave her side for a moment, of course).

“I'd like my baby to see what's going on around him when he's in the stroller, but he doesn't sit yet. Is it okay to prop him up?”

There's no need for your little one to take the world lying down anymore. As long as your baby can hold up his head well and doesn't crumple, slump over, or slide down when propped up, he's ready—and probably eager—for the props. Besides providing a welcome change of position, sitting affords your baby an expanded view of the world. Instead of just the sky or the inside of the stroller, an upright baby can see people, stores, houses, trees, dogs, other babies in strollers, older children, buses, cars—and all the other amazing things that inhabit his growing universe. He's also likely to stay happy longer than he would lying down, which will make outings more fun for both of you. Use a specially designed head support to help keep your baby's head upright when propped. Using a supportive shopping cart cover can keep him propped while you shop, too (just make sure it's designed for his age and size).

He'll also welcome props at home. Use specially designed propping pillows and let him play from a different vantage point. You'll know he's had enough of his more upright position when he starts to complain, wriggle, or slump down (it's hard work, after all).

A prop up will give your baby a new view of the world.

“I really need to keep my baby in the infant seat once in a while so I can get things done. But she fusses as soon as I put her in.”

Some babies are perfectly content to sit in an infant seat and watch the world (and their parents) go by. Others—usually those born with more get-up-and-go than they are able to get up and go with yet—are bored and frustrated by stints in the seat. Your baby may be among those who resist such confinement—in which case keeping her content in infant seats may be ever-challenging. To give yourself a fighting chance:

• Limit the captivity. Reserve the infant seat for times when you absolutely need your baby safely confined and near you (as when you're attempting a shower).

• Try a change of scenery. An infant seat with a view is less likely to provoke instant rejection. Place the seat on the floor in front of a mirror (she may enjoy interacting with her reflection) or in a safe spot next to you (there's nothing more fascinating than a parent in action).

• Add some entertainment. A toy bar can turn an ordinary infant seat into a personal entertainment center, particularly if toys are rotated to keep interest up and boredom from setting in. If toys seem to make baby fussier, it may be because she's overtired or overstimulated, in which case removing the entertainment may calm her.

• Make a motion. Turning on the rocking motion may soothe your baby while she's in the seat (though some babies are actually upset by the movement, so as always, take your cues from her reaction). Or put her in a bouncer that allows her to make her own motion.

• Let her loose. While younger infants are often satisfied to sit, older ones begin craving some freedom of movement. So instead of plunking her in the infant seat, try placing her on a blanket or play mat—tummy down—in the middle of the floor. This may not only placate her, but give her a chance to practice her rolling-over and creeping skills (though once she's mobile, you'll have to stay by her side for safety's sake).

• Consider a different approach. It's possible your baby has outgrown the infant seat, both physically and developmentally. If you need to keep her in one place sometimes, try a play mat/gym or a well-stocked play yard.

“My baby cries every time I strap him into the car seat—I dread getting into the car as much as he does.”

Though the purr of the car's engine and the motion of driving are both soothing and sleep-inducing to many infants (some will drop off to dreamland the moment the ignition powers on), not all babies agree that getting there
is half the fun—especially when getting there means being strapped into a car seat. Rest assured that your son's not the only confinement-phobic baby on the block. Fussing in the car seat is common, particularly once babies become more active—and especially since facing the rear can be lonely and boring. To keep everyone happier on the road: