Breastfeeding A to Z

Is Your Baby Getting Anything Besides Breastmilk?

Breastmilk is optimal nutrition for your baby. Unless your healthcare provider instructs you otherwise, breastmilk is all your baby needs to eat right now.

According to the 2005 American Academy of Pediatrics (AAP) policy statement:  Exclusive breastfeeding is sufficient to support optimal growth and development for approximately the first 6 months of life and provides continuing, protection against diarrhea and respiratory tract infection.  Breastfeeding should be continued for a least the first year of life and beyond for as long as mutually desired by mother and child. (1)

The current AAP statement (2) continues to recommend 6 months of exclusive nursing and continuation of breastfeeding for 1 year or longer as mutually desired by mother and infant.

Your baby doesn’t need water, sugar water or formula. Water or sugar water does not give babies the calories they need and makes them feel full so they do not breastfeed as often as they need to. Remember a baby’s stomach is only the size of their closed fist–it is not a big place. Your baby will get all the calories they need from breastmilk alone. They do not need anything in addition, unless directed by your healthcare provider.

Giving other feedings in the first couple weeks can decrease the amount of breastmilk you make. This is because the more the baby nurses the more milk the breast makes. If you think you are not making enough milk, you need to increase the amount of milk that is removed from the breast. You can do this by breastfeeding your baby more often, or using a breast pump or both. A lactation consultant can watch a feeding and can help pinpoint any problems with feeding your baby if you have any concerns about how breastfeeding is going.  See Where to Find Breastfeeding Help

Your baby does not need anything nutritionally besides breastmilk until they are 6 months old, although, Vitamin D supplements have been recommended for breastfed babies to prevent rickets.  This is because Vitamin D is made in our skin from exposure to sunlight and according to the American Academy of Pediatrics:

. . . dermatologist and cancer experts advise caution in exposure to sun, especially in childhood, and recommend regular use of sunscreens.  Sunscreens markedly decrease vitamin D production in the skin (3)

Discuss doing this with your healthcare provider.

Families sometimes want to know, if they are not able to provide breastmilk exclusively, what they can give their baby.  This is a discussion to have with your healthcare provider, especially if you have a family history of allergies.  If you are not able to provide breastmilk exclusively, remember the immunities and other benefits breastmilk provides are dose related.  So the more breastmilk you are able to give, even if you do supplement with formula, the better. (4)  Cathy Breedon, RD, PhD, has written a three part series on choosing formulas.  This may assist you when you discuss with your healthcare provider what to do if you need something besides breastmilk.  See reference section below.

Realize there is no nutritional reason to offer solid food until your baby is approximately 6 months old.  Lack of sleep is often a reason given for introducing solid foods prior to that.  It seems very tempting when you are walking into walls, bleary-eyed from lack of sleep, to seek any means to get more sleep.  But introducing solid foods earlier than about 6 months of age has not been shown to increase sleep.  Especially, the younger your baby is. (5)

There are on the other hand, serious concerns if solid foods are given too early.  It can increase the risk of your baby being allergic or sensitized to foods, because they receive them before their intestinal tract is mature enough to handle them.  It also increases the risk of choking because your baby’s tongue-thrusting reflex is still strong until about 4-5 months of age.  You want to wait until they can sit-up supported and take solid foods from a spoon before introducing.  Putting solid foods in a bottle is not helpful either.  If your baby is not ready to take solid foods from a spoon, they are not developmentally ready to take something besides milk in their diet–no matter how it is offered. (5)

Often parents or grandparents have used solid foods early in their children’s lives and felt it helped them sleep better.  Part of the reason this may have happened, was if their child was being bottle-fed an evaporated milk formula.  This type of formula, made at home from evaporated milk, was used before the iron-fortified formulas we know today were widely available.  Evaporated milk formulas were low in iron and Vitamin A & C, so by 6-weeks of age, to be nutritionally complete, those nutrients needed to be added to a baby’s diet.  The only way to provide for iron, Vitamin A & C was to add iron-fortified baby cereal, fruits and vegetables to a baby’s diet (6)  This made the early use of solid foods more commonplace to provide a nutritionally complete diet.  It was found with time, this was not the best for baby’s growth and development.

Remember baby formula is a relative newcomer to feeding babies.  Before about 1900, wet-nursing (someone breastfeeding the baby that was not their mother) was the only alternative to breastfeeding that was likely to allow the baby to survive. (5)

References:

  1. American Academy of Pediatrics Policy Statement on Breastfeeding and the Use of Human Milk, Pediatrics, Vol. 115, No. 2 February 2005, pp 496-506.
  2. American Academy of Pediatrics Policy Statement on Breastfeeding and the Use of Human Milk, Pediatrics, 129(3) Mar 2012.
  3. Gartner, L, Greer, F, Prevention of Rickets and Vitamin D Deficiency: New Guidelines for Vitamin D Intake, Pediatrics Vol. 111, No. 4, April 2003, pp 908-10.
  4. Lawrence, RA, Lawrence, RM, Breastfeeding: A Guide for the Medical Professional, 7th edition, Maryland Heights, MO, Elsevier Mosby, 2011, pp 154-55.
  5. Wambach, K, Riordan, J, Breastfeeding and Human Lactation, 5th edition, Burlington, MA, Jones & Bartlett Learning, 2016, pp 49, 700, 704-5.  Note: publishing date does say 2016.
  6. Breedon, C, Michigan WIC Conference Presentation, Grayling, Michigan, June 24, 1998.

Dr. Breedon article links:

Part 1  http://talwd.org/pdf/fwpart3/Aunt%20C%20Choosing%20Infant%20Milks%20andFormulas%20SC%20Part%201%20BF%201-11%20THIS.pdf

Part 2  http://ons.wvdhhr.org/Portals/20/PDFs/Aunt%20C%20Choosing%20Infant%20Milks%20andFormulas%20Part2%20commercial%20formulas%204-12%20THIS.pdf

Part 3  http://talwd.org/pdf/fwpart3/Aunt%20C%20formula%20Part%203%20%20just%20infant%20cows%20milk%20&%20evaporated%20milk%20formula%202-11%20sc%20pdf.pdf