Mary DeWys, RN, BS, CIMI
Infant Developmental and Feeding Specialist
Harmony Through Touch TM
“...your heart and hands change lives”
“Let’s Learn” Parenting Series
Successful Ways to Feed Your Baby
Feedings Should:
·Be safe for baby
·Provide nutrition for adequate weight gain and growth and enjoyable for both of you
Feed Baby in a Quiet, Relaxed Setting
·Reduce light and noise so baby can focus only on feeding
·Wake a sleepy baby or calm a fussy baby before feeding.
What’s Your Baby’s Behavior Cues Telling You?
Babies have their own special ways of telling us what they need. They tell us by their body language (facial expressions, eyes, body movements, and the sounds they make). Read your baby’s cues and follow his/her lead.
“I’m Hungry” and “I’m Full” Cues
“Hunger” CuesSucking on fists/fingers, feeding sounds, smacking lips, restless, fusses/cries. Feed On-Demand when your baby signals “hunger” before hard crying. Crying babies need calming before feeding.
“I’m Full” Cues Turning head, pushing away, back arching, fussing, falling asleep or relaxed arms and legs.
I’m happy or I’m unhappy Cues
“I’m Happy and Ready to Play” Cues Your baby is happy and ready to play. I’m happy cues include: looking at you, reaching for you, smiles, happy face, coos/gurgles, and making eye contact. A calm and alert baby is ready to eat or ready to focus his/her attention to socialize or play.
“I’m Unhappy”Cues” show your baby is hungry, upset, tired, overstimulated and needs a change. It’s a signal for help. Unhappy cues include: turning away, frowning, frantic movements, stiff arms, fussing, crying, vomiting.
Social Play During Feedings
When your baby is sucking it’s his/her to socialize. When your baby pauses it is your turn to smile, talk softly, and touch. Social play builds a positive relationship with you and your baby. Premature babies can be easily overstimulated. Go slowly and follow his/her lead.
Make feeding a happy time for you and your baby. As your baby grows, smiles, laughs and finger plays with you, you and your baby will learn to treasure feeding time as your special time.
Good Positioning is Important
·Support baby’s head and shoulders in semi-upright position with head centered, not turned to one side.
·Keep head from tilting back or chin resting on chest.
·Have shoulders & arms forward with hands centered
·Keep hips and knees well flexed-will help sucking.
·Swaddle helps baby focus on mouth & good sucking.
·Small premature babies feed better in side lying position facing out while lying on parents lap. It supports baby’s body so muscles of face work better to take a bottle.
·Change baby’s positing as he/she gets older.
•Some babies benefit from gentle cheek and/or jaw support. This helps baby to suck better. Ask the feeding therapist or nurse to show you before trying.
•Cheek support - gently press both cheeks in and forward.
•Jaw support - place your finger under baby’s boney chin.
How to Tell a Feeding is Going Well:
·Steady stream of bubbles coming into the bottle as baby sucks. With breast feeding the nipple should be clasped well in the mouth and the baby keeps up with the flow of the milk.
·The feeding has a good rhythm, 2 to 3 sucks then a pause to swallow and breathe.
·Not much, if any, drooling.
·Lips stay pink.
·Body stays in a flexed position with arms close to center.
·Baby content, happy.
How to Tell if the Feeding is Not Going Well
Watch for Feeding Stress Cues
·Choking and coughing
·Faster breathing or panting breaths
·Forgetting to breathe after long sucking burst
·Wheezing/noisy breathing
·Change in skin color (pale, mottled, or bluish)
·Swallows many times to clear milk from throat
·Noisy swallows
·Widens eyes or has a worried look
·Back arching
·Fussing/crying
·Too tired to finish the feeding
·Frequent spitting up during or after feedings
STOP the feeding if your baby is having trouble
What to do if Feeding is Not Going Wells
•Try burping.
•Give a short rest break for baby to recover then restart the feeding.
•Stimulate “rooting” reflex to open the mouth. Stroke the side of your baby’s mouth and lips and his/her mouth will open. Insert the nipple and sucking will begin.
•External pacing can help babies organize suck–swallow-breathe sequence. If your baby does stop to swallow and breathe after every 1 to 3 sucks, feeding problems will occur. Your baby may need help learning to pace.
*After 2-3 sucks, tip the bottle down, so the nipple points up to the roof of the mouth.
*Allow your baby to swallow milk in the throat and breathe. When your baby is ready-
*Tip the bottle back up filling the nipple with milk.
*Repeat the above steps as needed.
*Keep the nipple in baby’s mouth without removing the nipple over and over.
*Continue to pace feeding until your baby paces suck-swallow-breath him/herself.
*Avoid jiggling or twisting the bottle during pauses between bursts of sucking. Your baby needs pauses.
Important: Correct Flow Rate of Milk from the Nipple
Does the flow of milk from breast or bottle match your baby’s sucking rate?
Fast flow can drown your baby resulting in coughing and choking. It is not a safe feeding.
Slow flow can take too much energy and tire out your baby out.
Babies let us know when feeding are going well or not going well.
Length of Feeding
Feedings should be 15-20 minutes.
Feedings 30 minutes and longer result in over-tired baby and are not effective.
Tips for Burping
·Hold baby on your lap in upright sitting position.
·Slowly lean baby back a few inches, then slowly bring baby upright, slowly bring baby forward.
·Keep your hand on baby’s chest.
·Gently rub the back and wait for burp. No hard patting
·Repeat as needed.
Babies Who Spit-up or Vomit often
•Tell the doctor if your baby vomits often, is irritable or if the vomit is yellow, green, red flecks, pink or dark red.
•Hold chest to chest in semi-upright position for 20 to 30 minutes after feeding.
•Avoid putting baby in infant seat after eating.
•Avoid bouncing baby after eating.
Place baby on tummy after eating only with doctors approval
•Place baby on his/her tummy with head of bed elevated 30 degrees, for 30 minutes if baby is awake and is being closely watched by an adult.
•Never thicken feedings or change formula without asking your doctor first.
Create a Routine
Premature babies tire easily during feedings and often fall asleep before they are done. As babies mature they stay awake longer. They begin to develop a feeding schedule around 8 to 12 weeks of age. This may take longer for premature babies.
•Feed every 2 ½ to 3 ½ hours or as indicated by their “hunger” cues.
•Bedtime and nap routine – train your baby to fall asleep naturally. Put your baby to bed while he/she is still awake. Your baby learn to fall asleep on their own. Do not put your baby to sleep in a swing or infant seat; they will sleep better in their bed.
•Fussiness does not always mean hunger, especially if it is not time for a feeding. Try other comfort measures such as a diaper change, burping, playing with baby, holding or rocking.
•Remember – Your baby needs to be placed on the back for sleeping.