BREASTFEEDING AND THE FIRST THREE MONTHS

IN GIVING BIRTH TO OUR BABIES, WE MAY FIND THAT WE GIVE BIRTH TO NEW POSSIBILITIES WITHIN OURSELVES.

Myla and Jon Kabat-Zinn

You’ve experienced pregnancy and made it through labour and delivery (phew!). And now you’re finally here: Welcome to parenthood. We know you’ll be excited and emotional while you learn what it means to be a mother or father. This is an adventure like no other, and it starts now.

If you’ve just delivered in a hospital, your room will be bustling with doctors and nurses who will examine your newborn and get you prepped for what happens next. Procedures vary by hospital, but this will give you an idea of how your first minutes, hours and days will unfold. We’ll also give you the lowdown on everything you need to know about infants, and answer some common how-to questions.

THE FIRST FIVE MINUTES

Right after delivery, the doctors, midwives and nurses on the scene will suction Baby’s nose and mouth and your newborn will breathe on his or her own. (Yes, you’ll hear those first cries.) Your partner will be asked if they would like to cut the umbilical cord, and your baby’s Apgar score will be calculated. Baby is then measured, weighed and wiped clean. As long as they are maintaining a good body temperature, you can ask to hold them skin-to-skin and get some bonding time in.

The Apgar test (which stands for appearance, pulse, grimace, activity and respiration) is based on breathing, heart rate, colour, muscle tone and reflex response one minute after birth and again at five minutes. If your newborn has a low score (the range is one to 10; the higher the score, the better), the test will be repeated every five minutes until the numbers come up. (Don’t let a low result scare you. It’s typical for scores to rise to normal levels pretty quickly.)

THE FIRST 24 HOURS

New moms around the world are used to keeping their wee ones with them post-birth, so don’t be surprised to learn that you’ll have your baby in your room with you, regardless of if you give birth at home or in the hospital. Besides being able to fawn over your new addition, bunking with your little one lets you get used to his or her cues. Your baby will continue to be monitored (pulse and abdomen checks, etc.) and things like head and chest circumference will be measured. You’re likely to encounter Baby’s first dirty diaper (that dark, tarry poop is called meconium), and you can pick up tips from your nurse or midwife on handling the umbilical cord stump and how to properly hold, burp, bathe and swaddle your baby. If you have a boy and have chosen to have him circumcised, the nurse can also teach you how to care for the area. When you notice the baby’s

hunger cues (hands to mouth, turning their heads to look for food), you can ask for a bottle of formula or get help learning to breastfeed, if you choose to. If you opt for the latter, many hospitals have lactation consultants who can tell you everything you need to know about nursing, including what to expect, different ways to hold Baby, how to determine whether they’re getting enough, etc. (You’ll read more about breastfeeding later.)

If you’ve delivered vaginally in the hospital, you’ll likely be out of the hospital between 24 and 48 hours; if you’ve had a C-section, you’re looking at a two- to four-day stay. Either way, your baby will need to undergo a few tests prior to going home, including a check for jaundice (if babies have yellowish skin they’ll be placed in an isolette—also known as an incubator—under a special phototherapy light to help) and a hearing test. Babies will also be weighed (expect a dip in weight; don’t worry, they gain it back after a few days of eating) and their heels are pricked to screen for a variety of metabolic diseases. Have someone bring in your baby’s car seat before you’re discharged—nurses will want to see you have a safe one.

AT HOME

Feeling overwhelmed? Good news—we’ve all been there.

First of all, know that there’s help available after getting home from the hospital. If you used a midwife or hired a doula for your labour and delivery, they will check in to ensure you and the baby are doing well. Public health nurses are also a great option—they’ll come to your home to assist with breastfeeding and can field any other health-related questions you have about your recovery or Baby’s growth. If you have relatives or friends nearby who offer a hand, you might really appreciate having someone you trust around so you can shower or grab a nap. And if you’re not up for guests or don’t feel you need help, that’s fine too.

BABY BASICS

If you feel like you’re examining your kiddo 24/7, don’t worry. You’ll feel better when you realize that everything is “normal” when it comes to how your baby looks, moves, sounds, eats and sleeps.

BODY

Skin When they’re fresh out of the oven, most newborns are very red because they have a red blood count that is higher than an adult’s. Babies are born covered in a white “waterproofing” substance called vernix, especially under the arms, behind the ears and in the groin area. If you spot a skin rash, like tiny white spots on the nose, or acne, rest assured it’ll disappear soon. You might also notice birthmarks—sometimes they’re found

over the eyelids or at the back of the neck. These flat, pinkish-red spots— dubbed “stork bites” often become more noticeable when Baby cries. They’ll also disappear.

Spots that look like bruises found just above the bum are called “Mongolian spots” and they’re caused by pigment in the deep layers of the skin.

If Baby was jaundiced in the hospital, it normally takes about four days before the skin loses its yellowish tinge. That said, babies who breastfeed can look yellow for several weeks, even though they’re thriving. You shouldn’t stop breastfeeding as long as your paediatrician has checked Baby and given the all clear. Jaundice will gradually disappear. Fontanelle The fontanelle is the soft spot on your baby’s head—it’s the space between four of the growing head bones that’s covered by a tough inner skin and is well protected. Be mindful of it but don’t be afraid of gently washing your baby’s scalp. Eyes Yup, babies spend a lot of time asleep. Still, when they do open those peepers, parents always want to know what colour their child’s eyes are. If your babe is born with brown eyes, he or she will always have brown eyes. But infants with blue eyes may not end up being blue-eyed down the road—it can actually take up to nine months before the final colour settles in.

If you notice your baby is waking up with runny eyes, little spots of yellow pus, or with his or her eyelids stuck together, it’s likely a blocked tear duct. It’s not serious and is easily treated with antibiotic drops. The tear duct often unblocks itself. (If it doesn’t, a doctor can fix it with a very simple procedure.) Hair Some babies are born almost bald, while others are born with lots of locks. Don’t be surprised if some falls out soon after birth; it will grow back. Genitals BABY GIRL: There may be some mucus coming from your baby’s vagina and even blood (pseudo-menstruation). This is caused by hormone changes and is nothing to worry about.

BABY BOY: Your baby’s testicles may seem quite big, but this is completely normal. The tip of the penis is covered by foreskin designed to protect the tip of the penis. Don’t try to pull it back. When your child is older, it will loosen and it will be easy to wash underneath the foreskin.

Some parents opt to circumcise their sons, and they do so for a variety of reasons, including religious or cultural. Circumcision is a surgical procedure to remove the layer of skin (foreskin) that covers the head (glans) of the penis and part of the shaft. While it’s not medically necessary—and routine circumcisions are not currently recommended

by the Canadian Paediatric Society—it’s up to parents whether or not they choose to go this route. Problems after circumcision are usually minor. It’s important to keep the area as clean as possible, changing the bandage every time you change his diaper. Use petroleum jelly to keep the bandage from sticking. Get in touch with your doctor if you see more than a few drops of blood during healing (about seven to 10 days), if swelling persists after 48 hours or if he develops a fever. Movements Your baby will sleep most of the time, but you will notice them moving around—babies stretch, sometimes tremble and often make suckling and eye movements. When babies are awake, their arms and legs will move in various directions, and they’ll grasp hold of anything placed near their hands. When tummy time is introduced, babies’ heads move from side to side. (Just be aware that neck muscles aren’t strong, and the head should be supported when Baby is lifted.) When it comes to sounds, don’t be startled by Baby’s reactions to loud noises—he or she might jerk and cry. They’ll just need a cuddle to calm down.

Reflexes Your babe is born with reflexes and these may be the most physical developments you see for a few weeks. These reflexes include sucking (they have a natural instinct to suck); rooting (the hunt for food is on—watch how Baby’s head turns when the nipple is offered); startling (when babies hear a loud noise or see a quick movement, they throw their heads back and extend their arms and legs, then draw back in); and grasping (your baby’s hand will curl into a grasp when his or her palm is touched). Breathing You’ll start to get used to Baby’s breathing, and his or her wee sniffles, sneezes, coughs and hiccups. It’s totally normal to hear breathing that sounds irregular—sometimes slow, sometimes fast. And when babies get upset—we’re talking really upset—they’ll cry super hard and their skin might even turn blue for a few seconds. There are also abnormal things to watch out for, including constant, fast breathing or hard breathing during feeding. Call your healthcare provider if Baby’s skin looks blue or pale, or if you hear noises like grunting with breathing or wheezing coming from their chest.

HEALTH AND BEHAVIOUR

Crying You know what they say—babies do nothing but eat, sleep, poop and cry. The last one is their way of telling you what they want or feel. Maybe they’re tired or hungry? Perhaps bored or uncomfortable? Too hot or too cold? Soon you’ll learn what all the different cries mean. The bottom line is a crying baby demands love and attention, so don’t

hesitate to cuddle—you can’t spoil an infant. Just give into letting them feel safe, comfortable and content. Colic First off, babies cry. All babies. There’s no skipping over the crying part. But some babies cry more than others and for longer periods of time. Those who bawl for more than three hours a day, more than three days a week, are likely to have colic. Colic goes away on its own but it can happen to the healthiest of babies between about two to five weeks— there’s really no rhyme or reason why some get it and others don’t. What’s more, medical experts aren’t even sure what causes colic—it could be anything from a food sensitivity or a digestion issue to just getting used to life outside the womb.

Colicky babies can be difficult to soothe. They have high-pitched cries, their limbs often stiffen and their backs arch. While there’s no “cure” for colic, there are ways to help. First, make sure they have a clean diaper and they’re not hungry. Start burping more during feedings. If bottlefeeding, try other types of bottles to see if Baby swallows less air or ask your healthcare provider if you should switch formula. Breastfeeding moms might want to consider cutting certain things from their diets, including caffeine, dairy, eggs and soy. Some babies calm down when rocked or when parents pace, and some find a pacifier helps.

Remember, it’s not unusual to feel anxious, panicked or frustrated if your baby won’t stop crying. If you’re alone with the baby, bring in reinforcements—your best bet is to call a family member or friend to take care of the little one and relieve you for a bit. If you don’t have anyone nearby to help, put the baby back in his or her crib, close the door and take a break. (Deep breathing or listening to music can help.) Check on him or her after 10 minutes. If you feel like hurting yourself or the baby, call 911. Never shake a baby. Sleep Patterns Expect lots of slumber in those early weeks. Babies usually sleep for a couple hours at a time and then wake to be fed. (If your baby isn’t waking on his or her own, wake to feed after three or four hours.) Babies generally don’t sleep through the night (six to eight hours at a time) until they’re about three months old or older.

A reminder from the Canadian Paediatric Society: Babies should be put to bed (naps and for the night) on their backs, without anything in the crib with them (that means no blankets, pillows or stuffies). Sudden Infant Death Syndrome (SIDS) is much less common in babies who sleep alone in their own crib on their backs. Common Newborn Ailments We know you’ll be keeping a close eye on Baby, so you should definitely be aware of a few very common health issues. Some babies are born with blocked tear ducts, for instance, which

are completely harmless. You might notice tearing or mucus in the corner of the eye, but by 14 days tear ducts usually open without treatment or intervention. Cradle cap is another one that most babies suffer from— you’ll notice a red scalp with heavy flaking that’s caused by a buildup of oil. It doesn’t look nice, but it doesn’t hurt. Simply wash his or her head with Baby shampoo often and use a soft brush to remove scales. The most common ailment is arguably diaper rash—pretty much every baby gets it, thanks to the moisture buildup under the diaper. To avoid rashes, change diapers more often and use barrier cream on the bum. If rashes persist, let your paediatrician know.

BABY AND PARENTS

Bonding Babies form very strong emotional bonds from the get-go and nurturing this bonding during the first few weeks is key. When you respond quickly to comfort his or her crying, Baby will learn to depend on you. Comforting babies is the best way to love them. Other ways to foster that bond include speaking and singing quietly to Baby, trading facial expressions and making time for skin-to-skin contact. Baby Blues Mom, let’s be frank: Your hormones are all over the place, you’re beyond tired, you’re likely a ball of worry and you’re dealing with learning to be a parent. It’s totally normal for things to feel a little, well, out of control right now. If you’re feeling down, take heart. Feeling blue is common and doesn’t always lead to postpartum depression. Ask family and friends for help. While you’re at it, try to ease some of the pressure you’ve likely put on yourself—the less rigid you are, the better. If you feel like your worries or feelings of sadness are progressing, call your healthcare provider—they’ll put you in touch with someone who can help.

HOW-TOS TO KNOW

Many first-time parents haven’t had experience around infants, but they learn quickly by following some of these techniques. Holding a Newborn You’ll want to ensure your hands are clean before picking up the baby. (Their immune systems are still developing, so using soap and water or hand sanitizer is a good idea.) Keep their head and neck supported and find a comfortable position—you’ll no doubt master cradle hold and shoulder hold within the first few days. Remember to always be gentle—it’s important not to shake the baby. Comforting and Calming The physical closeness you have with your newborn will foster your emotional connection—that’s one reason why healthcare providers suggest skin-to-skin contact just after birth.

If you choose to breastfeed, there’s a lot of time for the nursing parent to spend fostering physical closeness, but nursing isn’t the only way to bond with or soothe a baby. You and your partner can continue to practise skin-to-skin at home while feeding, bathing or cuddling. Little ones also respond well to singing, cooing and talking in calm voices, and they love being rocked. Infant massage is also a popular way to calm and soothe, plus experts say it can help with growth and development. (There are plenty of how-to videos online.) Swaddling Remember the nurse in the hospital handing you your perfectly packaged baby wrapped tightly in a blanket? It turns out babies love feeling like burritos—it keeps them warm, relaxed and feeling secure. Swaddling is an art and, thankfully, it’s easy to learn. (There are lots of videos on proper swaddling online.) Just make sure not to overheat Baby, restrict leg movement or have the swaddle blanket above the chin.

Burping This one takes some practice. Most experts suggest burping babies often—the air that they swallow while eating can make them gassy and, yes, fussy. If you’re breastfeeding, burp when you switch breasts; if you’re bottle-feeding, burp every two or three ounces. There are a few ways to get the job done, but the one most parents seem to favour is done like this: Sit Baby on your lap. Support his or her head using one hand to cradle Baby’s chin (in the palm of your hand—ensure you’re cradling the chin and not the throat) and let the heel of your hand rest on his or her chest. Gently pat his or her back using your other hand. If you don’t get a burp after a few minutes, try a different position (like over the shoulder) and keep Baby upright. Diapering Don’t worry if you’ve never diapered a baby—you’re about to become a pro. Whether you choose cloth or disposable, prepare for the onslaught of poop-filled diapers; you’ll be changing dirty diapers about 10 times a day for the next while. Ensure everything you need is within reach—consider using a diaper caddy that you can easily move from room to room. When your baby’s diaper is wet or soiled, lay them down on their back and take off the diaper. Gently clean the tummy and genital area with wipes or a washcloth (girls should be wiped front to back), then apply diaper ointment, petroleum jelly or barrier cream. Diapers should fit snugly around Baby’s tummy, but not too tight. Don’t forget to wash your hands before and after.

Bathing Babies don’t need daily baths. In fact, most experts say it’s better for their skin to be bathed two or three times a week. Sponge baths are preferred for the first month (until the umbilical cord stump falls off and the belly button area heals). Using warm water, a soft washcloth and

unscented baby soap, gently clean Baby’s eyes, nose, ears and face. When cleaning the rest of the body, make sure to wipe in and around those super-cute creases around the neck and don’t forget to gently wash Baby’s head. It goes without saying but bears repeating: Never leave your kiddo alone in the sink or tub. Cord Care Right after Baby is born, the umbilical cord is white, soft and like jelly. It quickly becomes dry, hard and black, and it will fall off in a week or two. You can clean the area with cotton swabs and water. Continue until the cord is dry and healed. If the cord has an odour, yellow discharge or redness on the nearby skin, let your paediatrician know as it might be infected.

FEEDING

New parents always ask how often babies should eat. The answer? Whenever they’re hungry. You’ll find you’re feeding on demand—that means you’re giving your babe what they need when they need it. This goes for whether you’re nursing or bottle-feeding. When your kiddo shows you those cues (fingers in the mouth, sucking noises, rooting and crying), it’s time to feed. Newborns generally eat every one to three hours. Breastfed babies vary in timing based on your milk supply, speed of letdown, how hungry they are and how fast they fall asleep, while formula-fed babies will eat two or three ounces at a time. Monitoring how much they eat is easy when you’re bottle-feeding, but it can be difficult when nursing. As long as they are wetting six diapers and pooping a couple times a day, it’s all good. If you have questions about your baby’s feeding schedule or you’re concerned about growth, your healthcare provider can help. Breastfeeding You’ve no doubt heard breastfeeding’s many merits. Yes, what you’ve heard is true: Babies who nurse are usually less likely to get colds and flus; they’re less likely to have allergies; breastmilk is easy to digest, so babies get fewer digestive problems; it’s environmentally friendly and it’s always fresh and the right temperature. It’s also good for Mom: It helps the uterus go back to its pre-pregnancy shape quicker; it’s super convenient (no getting bottles ready or packing them up!); and it’s much cheaper than formula. What’s more, the Canadian Pediatric Society recommends that all babies be exclusively breastfed for the first six months.

All that said, we’re not going to sugar coat it—some women find breastfeeding difficult, unnatural and uncomfortable. But don’t worry, there are lots of tips and tricks to make it easier, starting with how to hold your baby while nursing.

Breastfeeding Positions

SIDE-LYING POSITION: Mom lies on her side, stomach to stomach with Baby. Mom can cradle Baby with her arm, resting on the side supporting her breast properly with the other hand. Using the arm holding the baby, move the baby close enough to guide the breast to the mouth. CRADLE: Baby is positioned across Mom’s abdomen so that the baby’s whole body faces the mother’s body and the baby’s head is supported by the mother’s arm. Baby’s lower arm is tucked around Mom’s waist. Baby’s ear, shoulder and hip should be in a straight line. FOOTBALL: This works well for moms who’ve had a Caesarean birth or have flat or inverted nipples, as well as for small babies. Mom sits upright with pillows at her side. She supports the back of Baby’s neck with her hand, allowing Baby’s head to tilt back a little. Holding the breast, Mom tickles Baby’s lower lip and waits for the mouth to open. CROSS-CRADLE: Mom sits upright with good back support and a pillow in front of her. Lie Baby across Mom’s body facing. She holds her breast with one hand and supports the back of Baby’s neck and shoulders with her other hand. This position works well for babies who have difficulty with latching.

What is Colostrum This is the liquid your baby gets for the first few days, before your milk comes in. It’s rich in vitamins, protein and substances that protect Baby from germs. This liquid gold is thicker than milk and more yellow in colour. Babies often only take a little at a time so feed frequently. Putting Baby to Breast When your baby starts to suckle, a message is sent to your brain to produce milk. The message is then sent to your breasts and hormones are released. Deep in your breast tissue are bunches of tiny, milk-making cells. These cells start to make milk.

At this point, your baby’s face should be facing your breast (not the ceiling) and the body should be in line. If you look down, his or her ears, tips of the shoulder and hip bone will be in a straight line. The neck shouldn’t be twisted. Baby’s nose should be across from your nipple. When you are holding your baby in a firm hold, you are in control. Baby is facing your breast with his or her mouth just below your nipple. Now you have to have patience and wait for a big mouth (yawns are always good here). Sometimes, touching Baby’s lips gently with your nipple may tease the mouth open. When you see that big mouth, very quickly push your baby onto your breast, aiming upwards and backwards at the roof of their mouth. Don’t try to push your

nipple into the mouth, it will just get stuck at the front of the mouth and that will be painful.

When it comes to latching, you should notice his or her mouth will be filled with breast tissue so there’s no space left in the mouth. Place your nipple as far at the back of Baby’s mouth as possible. When you do this, your baby will be able to reach the part of your breast where the milk is, behind the areola (the brown part that surrounds the nipple). If you feel pain, it means Baby’s jaws are together on your nipple. If this keeps happening, expect your nipple to get super sore and possibly even bleed. It’s not easy to see what a proper latch looks like, but you can feel it. Your baby’s nose will be touching your breast and the lower jaw will be under your areola. Some mothers worry their babies aren’t able to breathe with a face full of breast, but if they have trouble breathing, they instinctively come off the breast on their own. If there’s pain, just take Baby off and try latching again. When you’re ready to switch breasts or need to take Baby off, put your (clean) finger into the side of his or her mouth to break the suction. Is Baby Feeding Well? Once Baby is latched on, you’ll see little jaw movements. As your milk lets down, you will see the jaw rhythm change to big open-and-close movements. The movement can be seen right up to the top of the ears. As Baby swallows, you’ll hear those swallowing, gulping noises—it may be a small sound, like a soft “ka” in the back of the throat. Later, as the milk has more volume, you can hear swallowing much more easily. You’ll also notice a pattern of suckling when he or she is feeding— suck, swallow, suck, swallow, pause, repeat. This pattern continues throughout the feed. Infants usually come off the breast by themselves or fall asleep. Now’s the time to burp Baby and move to the second breast. Length and Frequency of Feeding Moms used to be told to time their babies at the breast. We now know that babies will tell us when they’re ready to swap. Letting babies feed at the first breast for as long as they want allows them to get lots of that high-fat milk (hindmilk). Don’t worry if Baby doesn’t feed for long when on the second breast, or if he or she doesn’t want the second breast. Start with that side next time you feed.

Breastmilk is easily digested, and new babies have small tummies. They may want to feed every 90 minutes to three hours during the day, and every three to four hours at night. The pattern will change as the weeks go by. As the baby grows, they will take more milk and last longer between feeds. The best signs to look for that babies are getting enough milk are if they’re soaking six to eight diapers a day by the second week; if they’re doing at least one big poop a day; if they appear content between feeds; and if their clothes start getting a bit snug.

Changes in Your Milk By about the third day of nursing, your milk changes. The milk that comes in has more water than colostrum, so your breasts will feel fuller. (Feeding frequently prevents engorgement, which helps prevent that super-full feeling.) Within about two weeks, your milk changes again into mature milk and continues changing to meet the baby’s needs while you are breastfeeding. Baby’s Growth Spurts Babies seem to want to feed more often at about three weeks and six weeks, then again at three months and six months. If you notice your baby wanting to feed more often, or being fussy around these milestones, just feed more often. Your milk supply will catch up to the demand quickly. Breast Pain Pain in your breast tissue is likely due to a blocked duct— the result of milk left in a duct. If you feel the painful area with your fingers, you may notice a lump. Warm compresses and massage should clear it. You’ll also want to check that your positioning and latch are good when nursing.

If you see redness in your breast and start having flu-like symptoms, call your healthcare provider or lactation consultant as you may have an infection known as mastitis. Pain felt deep in the breast during let down or after a feed is often due to the muscle lining of the ducts being stretched as the milk passes through. Again, try warm compresses; this pain often goes away as time goes by.

If you feel burning or stabbing pain in the nipple or breast, thrush is likely the culprit. You might also see small white spots in your baby’s mouth—that’s because thrush is passed from Baby to Mom and Mom to Baby. You’ll need to see your doctor and get treatment for your nipples, as well as treatment for the baby. Engorgement Engorgement usually happens around the third day. It’s normal to feel a sense of fullness in your breasts as your milk increases in volume. (There’s also extra blood and other body fluids moving into the area that adds to the fullness.) The best thing you can do is feed your baby as much as possible when engorged.

If your breasts feel really full, it may be hard for your baby to latch onto the areola. If this is the case, you can express some milk in order to soften the area around your nipples. If you can’t put your baby to breast, use an electric pump to keep your breasts soft. Pump every two to three hours and save the breastmilk for your baby.

The truth is, some moms always feel engorged, no matter what they do. It’s not super fun when your breasts become rock hard. Consider using warm compresses and gentle massaging, as well as expressing.

Breastmilk Storage You can keep breastmilk in the fridge for up to five days. When storing milk for freezing, it will keep well in a freezer compartment in the fridge for two weeks; in a self-contained freezer unit for up to four months; and in a deep freeze at zero degrees for six months or longer. Don’t forget to label and date all milk. Support While many women say breastfeeding feels totally natural, other moms report feeling the opposite—it doesn’t feel easy or “normal” for many of us. If you’re having a tough time and want to keep nursing, there are plenty of ways to get help. Many communities have a support network, so you can call your local health department, La Leche League or look for a lactation consultant online.

Bottle-Feeding Infant formula is a great alternative to breastmilk for babies—it’s nutritious and babies thrive on formula, growing nice and healthy. If this is the route you choose, you’ll find that all products with the words “infant formula” on the label provide enough nutrition for your baby—today they’re made to be as close to breastmilk as possible. How to Formula Feed Bottle-feeding can give Mom just as much bonding time as nursing, and it can also let the other parent, grandparents, etc., have that special time too.

Hold Baby close, keeping his or her back and neck straight. Baby’s head should be tipped back slightly and held higher than her body so that formula doesn’t get into her inner ear when she swallows. Brush the nipple against his or her lips or cheeks. Hold the bottle on an angle so that the nipple is always full of milk and so that Baby doesn’t suck in air.

When everything is going well, Baby will suck and swallow easily without coughing, gagging or coming off the bottle to cry. If you see any of these behaviours, stop feeding and check the nipple—milk might be pouring out too quickly or too slowly. It’s totally normal for babies to spit up a little formula during or after a feeding. Burp after feeding. How to Know When Your Baby Has Had Enough Formula Babies will let parents know when they’re done—they simply stop feeding when they’re full. Your babe has had enough when sucking slows, when they turn their heads away or when they fall asleep. In time you’ll learn your little one’s signs and you’ll be confident knowing they have eaten enough. Throw out any formula left in the bottle within one hour after the feeding begins and don’t reheat the milk. Storing Formula Keep prepared bottles at the back of the fridge and use them within 24 hours. Open cans of powder should be used within one month, while refrigerated cans of liquid concentrate and ready-tofeed formula need to be used within 24 hours of opening. Do not freeze any kind of formula because it changes the fat content.