Step by step guide to feeding



For the first 12 months feeding baby may well become central to your peace of mind. We offer tips to help with those early stages 

You've spent nine months growing a baby in your tummy, now comes the next challenge - keeping that baby full of delicious and life-giving nutrients so she gets the best possible start in life. We outline the basics in our step-by-step feature on feeding babies up to the age of one. We give you the experts' advice as well as a few hard-earned pointers from the OHbaby! team's own experiences - including some of the products we simply couldn't do without. 

Newborn
(and up to six months)
 

You leave your dignity at the door when a baby arrives - and that's not just in the delivery suite. By day three your breasts seemed to have ballooned into pillows.

"My boobs were bigger than my baby's head!" describes one member of the OHbaby! team, who found her AA chest had swollen to a DD.

So what do you need in preparation? OHbaby! staff, who notch up 20 babies among us, and counting, suggest stocking up on the following:

  • A nice comfy bra for sleeping in
  • Comfy breast pads
  • PureLan nipple cream
  • Also consider a breast pump, if you expect to be expressing milk, and a steriliser for expressed milk or formula.

The latch
Issue 18Step By Step1Many women struggle with breastfeeding and it can take a while for both mother and baby to learn a good technique. The most important step is getting the correct latch - it will save you many tears. According to lactation consultant Maggie Morgan, the best way to get baby to latch on is to position him tummy to tummy so he's facing inwards. Your arm should be along the baby's back with your hand around the base of the neck so the head can tilt gently back and the chin comes to the breast first. The other hand supports the breast. Your baby's chin should touch the breast below the nipple with the nipple pointing towards the nose. Gently stimulate the baby by touching the mouth with the nipple until the baby opens his mouth wide. When the mouth is wide open, bring the baby onto the breast in a quick action. The baby should get a good mouthful of breast. You need to wait until the baby has started suckling well and there is no discomfort before moving the arm supporting the baby so he's cradled comfortably.

Click here for more advice from Maggie Morgan.

Once you've got the correct latch, you may well find breastfeeding a relaxing, feel-good experience, and that look of adoration from your milk-drunk wee one, his eyes rolling back as he gazes up at you, as if to say, "I'm the happiest baby ever", is your reward.

Make sure you look after yourself when you're breastfeeding as you'll find you get very hungry! So eat lots of high-quality protein, fruit, vegies and cake.

Feeding frustrations
Issue 18Step By Step2If you're having trouble with breastfeeding the first person to contact is your midwife. You could also try Plunketline, 0800 933 922, or pay for a lactation consultant, ph: 0800 452 282. La Leche League, which has local branches throughout the country, offers information and support over the phone or by email. To find a contact in your area go to www.lalecheleague.org.nz


Avoiding mastitis
If you do get cracked or sore nipples have some PureLan nipple cream on hand and some really comfy breast pads. It's also important to be aware of any lumpiness in the breast or engorgement as this may be a precursor to mastitis (breast infection). This is a painful condition caused either by bacteria getting in as a result of cracked nipples or by blocked milk ducts.

 Some women seem to be more prone than others to mastitis and get repeated bouts. It can happen when weaning or particularly if you've got an over-supply of milk. In most cases you'll need a course of antibiotics to get rid of it but if it's the result of lumpiness in the breast try gentle massage in the shower first, or with a warm facecloth over the breast, to see if you can shift the blockage.

The first signs of mastitis are a red, painful breast and flu symptoms. Get yourself to a doctor fast or ring Plunketline, 0800 933 922, or Healthline, 0800 611 116.

Bottle feeding
Whether you're using formula or expressed milk, hygiene takes top priority. Some parents use specially designed electric or microwave sterilisers but you can always use a pot on the stove (boiling for five minutes) or antibacterial tablets (such as Milton) in a bowl of water.

With BPA-free bottles readily available the concern over drinking warm liquids from plastic bottles has abated but some people still prefer glass.

The Closer to Nature model, with its wide, breast-shaped teat, has proved a hit - it won gold in the OHbaby! Awards last year. Whatever type you choose, it can pay to get baby used to bottles if you plan to get her on formula or expressed milk further down the line. The odd bottle now and then in the early days may make rejection less likely later.

If feeding your baby formula pay close attention to the instructions and if your baby is under three months always use cooled boiled water. Always measure the correct amount of water first before adding the formula powder, as using too much or too little water can make your baby very sick. Milk that's not drunk must be thrown out as bugs can grow very quickly in the baby's bottle.

For detailed instructions on preparing and feeding babies formula milk go to http://www.health.govt.nz/yourhealth-topics/maternity/breastfeeding/when-you-cant-breastfeed/formula-feeding and download "Feeding Your Baby Infant Formula".


18Feeding1

1  HOTmilk luminous nursing bra $63.90, www.breastmates.co.nz
2  PureLan RRP$24.95 (37g) www.babycity.co.nz
3  Philips Avent 3 in 1 Steam Steriliser RRP$199.99, The Baby Factory
4  Medela Swing Breastpump $279, The Baby Factory
5  Philips Avent stacking cups RRP$37.99, The Baby Factory
6  Nuk 2 in 1 Bottle/Teat Brush, RRP$13.99 &
7  Nuk FC Glass Bottle 120ml, RRP$25.99,
Baby City, The Baby Factory and selected pharmacies & baby stores throughout NZ. For the nearest stockist freephone 0800 333 006 or www.nuk.net.nz
 

Starting solids
(around six months)

The number one rule when your baby is about to start solids is get your camera out and make sure it's fully charged up, if you don't already have the video set up on a tripod. Babies make the cutest faces when they try real food and you'll want to capture every puckered-up grimace and pumpkin-smeared grin.

While it's tempting to get your baby into solids early, it can often backfire  - there may be vomiting or gagging because baby hasn't yet learned how to breathe and eat at the same time.  You also run the risk of creating a fussy eater, as his first taste of solids have been bad experiences.

You'll know bubs is ready when he starts trying to pinch food off your plate. Other signs of readiness are:

⭐ He can sit up without help and can grasp objects.
⭐ He's around six months in age.
⭐ He seems unsatisfied with the usual fare, ie milk.
⭐ He watches closely while you eat and attempts to grab food.
⭐ He no longer sticks out his tongue in preparation for fluids.

OHbaby! expert and nutritionist Leanne Cooper says your baby should show most of these signs - you don't want to be guided by your own eagerness. Leanne also advises starting first with vegies as babies naturally prefer sweet foods so try not to encourage a sweet tooth early on. At the same time it's good to excite baby's taste buds - so baby rice, which is super bland on its own, may not cut the mustard. "As a first food most babies don't like it," she says.

Savoury first
Leanne recommends avocado or tasty, slightly sweet vegies such as kumara, pumpkin or corn, of course puréed to  a paste and thinned down with breast or formula milk at first. Then start mixing in a teaspoon or two of baby rice for the added iron.

Leanne also recommends introducing a new food every three to five days and check for reactions. The most common foods to cause allergic reaction are eggs, milk, seafood, nuts, soy and wheat.

Try to offer as many different foods as possible and don't be shy about offering unusual mixtures. Leanne says unsweetened yoghurt mixed with avocado or kumara is delicious! 

In the earliest days you might want to get baby to suck food off your (clean) finger, then move on to a spoon with smooth edges.

Remember to offer water in a sipper cup to avoid constipation.

As a nutritionist, Leanne recommends home-made baby food, but recognises busy mums often rely on jars or pouches in the cupboard. Just look out for products with apple juice listed as one of the main ingredients - apple juice should be avoided until your child is over three, and the same applies to pear juice. The high level of fructose in these juices makes it hard for babies to absorb nutrients and can cause diarrhoea, says Leanne. However, the flesh of apple and pear is fine - you can try it grated, stewed or cut into chunks for an older baby.

While Leanne urges a variety of food she sounds a word of warning about giving whole milk to babies under 12 months. Early research has shown a link between cow's milk and diabetes. It can even cause intestinal bleeding!

Her warning doesn't extend to yoghurt and cheese, however, which she would introduce as early as six months. Yoghurt, the naturally made, unsweetened variety, is a great way to introduce healthy bacteria in the gut. Cheddar cheese, likewise, is a good, low-lactose protein. (Plunket, however, recommends dairy products other than whole milk from seven to eight months).

Cooked, mushed chicken, fish and meat can be introduced from six months.

What a lovely mess
Babies get food everywhere when they're eating solids and that's all part of their learning - they love to feel the texture and see how far it throws. Most of it will come out in the wash but first a word of warning about banana.

While it looks innocent, banana can permanently stain light-coloured baby clothes, particularly wool, so we recommend a bib at all times. 

 18Feeding
1  Tommee Tippee heat sensor spoons, RRP$10.99 per set*
2  Philips Avent Steamer/Blender, RRP$249.99, The Baby Factory
3  Baby Björn Soft Bib, RRP$29.95, www.bpmchildcare.co.nz
4  Tommee Tippee Fresh Food Feeder, RRP$10.99*
5  Tripp Trapp Highchair, $425, www.babycity.co.nz
6  Tommee Tippee Stayput Bowl, RRP$16.99*
7  Watties Baby Basics Trainer Cup, RRP$14.99*
*from supermarkets and baby stores 

Finger foods
(eight to 12 months)
 

By now baby will hopefully be clamouring to try new foods and may be at the stage where he's eating pretty much what the rest of the family is eating, albeit in mushed form.

It's good to introduce mashed foods around eight months and then, at nine months, pieces of cooked (soft) vegetables and finger foods.

Other great finger foods for snacks or dinner are cooked pasta spirals or macaroni, cubes of kiwifruit and other fruit, such as banana, in a mesh bag.

You can also make your own rusks: Take a slice of bread, cut off the crusts and smear over some Marmite. Roll it up and then squeeze it in your hand so there are no loose bits. Microwave in the oven for 30-60 seconds until it's hard but not burnt. It won't look particularly attractive but baby will love gnawing on it.

One lump or two?
So your baby's going strong on her puréed vegies and loves her baby rice but every time you try to make it a bit lumpy she seems to gag on it, and then she won't have a bar of any of it. It's important to have lumps from nine months to avoid fussy eating habits later but if your littlie is gagging go back to the start.

Start again on the assumption that she wasn't ready," says nutritionist Leanne Cooper. Try with a different food, puréed, and then very gradually make the texture slightly chunkier, moving on to a fork mash.

Fussy feeders
Babies can go off their solids for all sorts of reasons including teething, which tends to start around six months, or being too tired. Leanne says babies naturally go through fussy stages at around six months, 36 weeks, 44 weeks and around 12 months. The trick is to persevere, as rejection probably doesn't mean a permanent dislike of a certain food.

To reduce the chance of rejection, Leanne suggests the following:

⭐ Offer solids before a milk feed if the baby is more than six months.

⭐Offer a new food mixed with a favourite.

⭐ Try feeding in other settings - sitting on a rug on the floor, outside or on your lap.

⭐ Let your child see you eat the same food.

⭐ Offer iron-rich foods throughout the day, such as fortified baby rice.

⭐ Make sure all your feeding implements are super clean to prevent tummy  trouble. To avoid constipation introduce a sipper cup containing water.

In What Do I Feed My Baby?, Leanne writes, "Of course, for some babies mushy food just doesn't measure up - and who can blame them? Don't worry, this is fine. Just be patient and keep trying. Some simply jump to finger foods at an appropriate age. Feeding meshes can be very useful here if you think you may have a bub who wants to self-feed."

Baby safety
Choking is a real danger because babies have small airways and can't chew well. Avoid small hard foods such as popcorn and ensure your baby sits down to eat.

According to St John, if your baby (under one) starts choking and can't breathe take these steps:

1. Lie him face down on your lap and using the heel of one hand, give up to five back blows firmly (but gently to avoid physical injury) between the shoulder blades. Make sure you support the head.

2. If the object doesn't come out, turn him face up across your lap. Put middle and index fingers in the centre of his breastbone, about one finger breadth below his nipples. Give five quick chest thrusts. Alternate between five back blows and five chest thrusts until the object is dislodged.

3. If he is unresponsive, start chest compressions and have someone call 111. Turn him on his back on any flat surface or your lap. Put two fingers of one hand at the centre of his chest, about one finger breadth below the nipples. Push down hard and fast 30 times (to one third of chest depth). Once you have done 30 compressions breathe into his mouth twice to see the chest rise.

Continue the cycle of 30 chest compressions and two breaths until the ambulance arrives.


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