Birth to four months
- Breastmilk or formula
- Amount will increase from two to three ounces to six to eight ounces per feeding
- Feedings will decrease from six to eight to four to five per day as baby begins to sleep through the night
Four to six months through nine months
- Breast milk or formula should be the primary source of nutrition
- The amount will remain at six to eight ounces per feeding
- The number of feedings will decrease to four to five a day
- Baby should start to drink some liquids from a cup
- Solid foods may be added to baby's diet as recommended by your baby's doctor
- Individual foods should be introduced one at a time to determine tolerance of each food
- Cereal should be spoon fed and not placed in the bottle
10 months through 12 months
- Breastmilk or formula should continue to be the primary source of nutrition
- The amount of formula will be about six to eight ounces three to four times a day
- Solid foods introduced earlier should continue to be fed
- Additional foods such as cottage cheese, toast, soups and other soft table foods may be introduced
Weight gain and growth
Generally, babies gain approximately a half to one ounce of weight daily. There may be some days when your baby does not gain weight at all, but will gain more the next day. A healthy, premature baby whose intake is good and who was the right size for the time he or she was born can be expected to grow at the same rate as a full-term baby of the same "corrected age." Normal size for age is usually reached at about 10 months after the time your baby should have been born.
The preschool child who was a very low birth weight baby (less than 1500 grams or three and a half pounds) may tend to be slender although normal height. The baby born small for his gestational age may tend to remain small during childhood.
The very ill premature baby born with the appropriate weight may have very rapid catch-up growth at six to nine months corrected age. If the growth continues, his or her size will continue to increase. If the growth slows, the child may remain small.
Feeding problems
Spitting
- Premature infants tend to spit more than full-term newborns. The "valve" or opening between the esophagus (tube that connects the mouth and the stomach) and the stomach is not tight, so he or she tends to spit up small amounts with feeding and burping. If spitting becomes a serious problem, your baby may be tested for gastro-esophageal reflux (called G-E reflux or reflux).
Reflux (gastro-esophageal reflux or G-E reflux)
- Reflux means formula comes up from the stomach into a part of the esophagus (tube that connects the mouth and stomach). Reflux may cause vomiting, apnea (short periods when your baby does not breathe) or result in failure of your baby to gain weight. If your baby has reflux, the doctor may recommend placing him on their stomach or right side after feeding, raising the head of the bed slightly or thickening the formula with cereal. Reflux usually slowly improves and finally disappears at three to four months corrected age in some babies and not until nine to 12 months in others.
Colic
- Colic is unexplained bouts of crying, often with stomach fullness or stomach spasms. It does not mean that your child is ill. Your baby may stiffen his or her legs, scream loudly, pass gas or vomit. Colic frequently occurs at the same time of the day, typically during the evening hours.lt generally lasts for up to three months corrected age. Constant crying is one of the most trying of the symptoms of colic.
- Colic is not caused by incorrect feeding methods and changing your baby's formula usually has no effect. Often no cause can be found. Some experts feel this crying is a way for baby to "let off steam" after a lot of stimulation throughout the day.
- Suggestions that may help your baby include frequent burping, putting a warm towel or blanket under your baby's stomach (be careful not to burn the baby), walking or rocking the baby, wrapping the baby warmly and snugly, laying him or her on his or her stomach and keeping him or her in a quiet place (dim lights and low noise).
- There are no drugs that cure colic. Drugs often prescribed for colic are supposed to relieve spasms of the intestinal muscles and/or are sedatives. Often they do not work. We do not recommend using drugs with babies unless there is evidence they are safe and effective. If there were a miracle drug, we would use it.
- Call the doctor if...
- baby's appetite suddenly decreases for several feedings and your baby seems uninterested in the breast or bottle.
- vomiting continues.
- vomiting is forceful.
- vomit is green.
Vitamins
If your baby weighs less than 2500 grams or five and a half pounds and is taking less than 16 ounces of formula in 24 hours, the doctor may order extra vitamins. Formula provides enough vitamins once your baby takes a quart (32 ounces) every day. Premature babies usually drink a quart of formula around the time they are six to eight months of age. The usual dose of multiple vitamins is one dropperful daily. Mix vitamins in a little formula so they do not taste so strong.
Iron
Babies grow very fast during their first year and need iron to grow. All babies need iron for proper brain growth and development. Without enough iron, babies may develop iron deficiency anemia (low blood count). Premature infants who are bottlefed are usually discharged from the hospital on formula with iron (iron fortified). Iron in the formula is not the cause of colic, constipation or spitting up. Some babies will be sent home on additional iron drops if they are feeding less than 16 ounces of formula a day.
Fluoride
When it is close to the time for your baby to go home, the doctor may start your baby on fluoride drops. If the local water supply has less than 0.3 parts fluoride per million parts water (ppm), your baby needs fluoride supplement (0.7-1.2 ppm is considered best). Your local doctor or health department will have this information.
If you use bottled water or well water, your baby needs fluoride drops. The American Dental Association suggests fluoride supplementation until 13 years of age. Breastfed babies may be discharged on fluoride drops.
My Baby
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