I nurse my newborn on demand, but she always seems to be hungry. Can I get her on a schedule?
Unfortunately, a set schedule doesn't necessarily work for a newborn, says Laura Jana, MD, coauthor of Food Fights (American Academy of Pediatrics). "You don't want to say, 'I'm not feeding my baby because the baby book says every two to three hours,'" she explains. "You want to make sure you're feeding a new baby enough. Also, some newborns take a long time to eat, which can make you feel as though you're feeding your child constantly."
Keep in mind that you don't have to jump the minute your child fusses and assume he needs to be fed, says Dr. Jana. Your child could be crying for any number of reasons, such as feeling tired or overstimulated. Also, infants often want to nurse for comfort -- they need to suck but aren't hungry. Once your breastfeeding is established -- usually by 2 to 4 weeks of age -- it's good to offer a pacifier if you feel as though your baby has just eaten. As far as getting him on a schedule, once you go to your next well-baby visit and confirm that he's gaining weight properly, you can try holding him off for a reasonable two to three hours. But remember that babies go through growth spurts, such as between 3 and 6 weeks and at 4 months, when they'll want to nurse more often.
My baby always seems fussy after a feeding. Should I try changing her formula?
"Sometimes switching formulations -- say, from powder to concentrate, but not the brand -- can help, because your baby might be gassy from the bubbles that form when you mix the formula," says Dr. Jana. Typically, your doctor will recommend a new formula only if your child shows signs that she may be allergic or intolerant to the proteins in milk. Besides fussiness after feedings, signs of either of these conditions include blood in your baby's stool and vomiting or diarrhea. Babies with a milk protein allergy can also experience hives and respiratory problems.
If you're concerned, consult your child's doctor, who may recommend a hypoallergenic formula, which has cow's-milk proteins that are broken down enough to avoid causing a reaction in most babies. She may also test baby's poop for blood you can't see.
I've heard that soy can cause reproductive problems. Is soy formula safe?
Soybeans and other legumes contain a small amount of natural estrogen, which, since it's a hormone, could in theory affect a child's reproductive organs and maturation. Studies done on lab rats and monkeys that were fed soy or components of soy have found some adverse affects. But a National Institutes of Health report, released last year, concluded there's no evidence that feeding soy formula to babies leads to reproductive problems.
That said, soy formula shouldn't be your first choice when choosing what to feed baby, advises Jatinder Bhatia, MD, a member of the American Academy of Pediatrics' (AAP) committee on nutrition. The AAP says that when breastfeeding isn't possible, then parents should give infants formula made from cow's milk, and they should only offer soy formula when special situations exist -- such as when medically necessary. For instance, soy formula is fed to babies with galactosemia (a rare metabolic disorder) who can't consume milk with the sugars lactose or galactose. And it can be given to a child with a confirmed milk allergy who isn't also allergic to soy, which is often the case. The AAP also says a strict vegetarian who doesn't breastfeed can use soy formula -- as long as the infant isn't preterm.
My 6-month-old has been breastfed exclusively and won't take a bottle. I want to wean her onto formula. What can I do?
Babies are creatures of habit, so if she's used to having the breast, it's normal for her to balk at bottles. But there's hope. Betsy List, a lactation consultant and coordinator at the Center for Breastfeeding Medicine at Cincinnati Children's Hospital Medical Center, offers this plan: Before you move to formula, try putting some of your own expressed milk in the bottle. When your baby is a little hungry but not overly anxious to eat, have someone else offer the bottle ahead of her normal feeding time. Touch the corner of her mouth with the bottle's nipple and let her root for it. If she won't take the bottle, try again later or the next day.
"Use times when she is naturally curious or exploring her environment to practice with a bottle," List adds. "After your baby learns to take a bottle with your own milk, you can then gradually begin mixing in formula so she can adjust to the new taste."