Feeding Your Baby: The First Year

Deciding how to feed your baby, whether nursing or bottle feeding or both, is a very personal choice. However, when to feed your baby breastmilk or fortified formula, and then solids, follows a typical pattern. Every baby is unique, and their feeding habits are too. If you’re going to feed your newborn infant formula, ask baby’s healthcare provider—likely a pediatrician or advanced practice nurse—what formula they would recommend you begin with baby at birth.

During your hospital or birthing center stay, ask if there is a lactation specialist or consultant you can talk to if you’re interested in learning about baby’s feeding and fullness cues, for example. You may be surprised to learn that when you eat healthy and well, so does baby! If abundant fiber makes you gassy, don’t be surprised when it does the same for your newborn.

During the first few days after birth, your breasts make colostrum—food so rich in nutrients and infection-fighting antibodies that it’s called liquid gold. It’s all your newborn needs. From the first latch, you and baby begin to learn together about breastfeeding. This process takes patience, rest, family support and a healthy diet with plenty of water.

Baby should be placed on your chest, skin-to-skin, at birth, to promote bonding and breastfeeding success. Babies are most alert and awake in the first hour. Your nurse will help you bring baby to latch onto the areola—the darkened area around the nipple—with a wide-open mouth.

You’ll likely find your baby is sleepy after the first feeding and for the next 24 hours. Keep baby close-by, holding them skin-to-skin if possible. You’ll notice when baby begins to rustle and root around telling you they’re ready to feed again. Feed your baby on demand—meaning for as long and as often as baby wants to eat.

Crying is a late hunger cue from baby; a crying baby may need calming before latching. Expect your baby to breastfeed at least 8-10 times in a 24-hour period. Let baby nurse anytime they want to; the more baby nurses, the sooner your milk comes in.

The first four months of your baby’s life should only include breastmilk or formula; baby’s digestive system just isn’t ready yet for solids. The first few weeks of newborn feeding can be demanding—just when you feel like you may be falling into an eat/sleep pattern with your little one, they’ll surprise you with a change in routine.

A breastfeeding routine takes a couple weeks to establish and will likely change throughout the first four months. Baby will want to nurse more often at first but will eventually begin to put more time between feedings.

However, as baby has growth spurts, they may revert to more frequent feeding periodically. Your breastmilk will change according to the needs of your infant. A good indicator that your baby is well fed and hydrated is at least six wet diapers a day. Keep in mind, babies cry for a variety of reasons, so they may not always be hungry.

Babies need to eat every 3-4 hours while they’re awake. So, whether you’re nursing or feeding infant formula to your little one, know their tiny tummies mean they get hungry sooner than you do.

Formula fed babies may stay fuller longer, as their body may take a bit longer to process formula. When feeding formula, follow the manufacturer’s advice along with your baby’s weight in guiding you as to how much your little one needs.

A good rule of thumb is that babies need approximately 2 ounces per pound of body weight within a 24-hour period. So, a seven-pound baby would eat 14 ounces a day and increase accordingly as the baby gains weight.

Always hold baby semi-upright to bottle feed, and never heat the formula (or breastmilk!) in the microwave. Babies have a very strong suck reflex; follow your baby’s cues as to when they have had enough. Offer a pacifier to learn if baby is still hungry or just soothing themself by sucking.

Overfeeding can cause tummy discomfort, and may lead to a fussy baby, and often parents mistake this as a wish for more food. A baby does not have to finish a bottle and should never go to bed with a bottle, which can result in tooth decay and choking.

Many moms both nurse and feed their breastmilk to baby in a bottle once breastfeeding is working out well (usually 12 weeks or so from baby’s birth). Pumping and freezing your breastmilk will help you maintain a good nursing supply.

Don’t be surprised if your nursing baby balks at a bottle of your milk the first time you feed them this way; it’s not as warm as your soft breast, mama. Hold baby close to you when you first try bottle feeding your milk, or have your partner give it a go since baby may not be expecting to nurse from them.

It may take trying several times through a week or more to get baby comfortable in both nursing and bottle feeding.

When your baby is comfortable feeding from a bottle, try pumping your milk every 3 hours or so as if your baby was nursing. Some moms like to pump at the end of each nursing session to help build or maintain their breastmilk supply.

Breastmilk can stay in the fridge for up to 96 hours or 4 days and frozen for 6 months (label it with the date it was pumped), and like formula, never heat breastmilk in a microwave. Always heat it gently in a warm water bath. Swish and swirl the milk or formula in the bottle to ensure it’s at a consistent temperature and consistency.

It’s okay to feed both breastmilk and formula, but your baby might have a preference. Some babies adapt very well to both types of food, and others take time to adjust to the differences between human milk and formula. You and baby will learn together what works best for you both.

Many healthcare experts, including the Academy of Pediatrics, recommend exclusive breastfeeding for the first six months, however, some infants begin solid foods between four and six months. Every baby is different, and if you have questions or concerns about how your baby is feeding, you should discuss it with your baby’s healthcare provider.

Baby will cue you that they’re ready to get more adventurous at mealtime. When eating, baby should always be upright to prevent choking. Some highchairs have a reclining feature—ensure baby is always upright for eating and can sit in their chair with good head control. You may find baby is watching you lift food to your mouth; they may reach out as if to ask for some. Try giving baby a spoon to hold and play with before you try spoon feeding.

Don’t start with the steak and potatoes, and skip dessert. Your baby’s first foods, other than human milk or formula, should be dried rice cereals mixed with breastmilk or formula. Start with a small amount, about a teaspoon, and dilute it with human milk or water to a very soft consistency. Start with just a small spoonful, baby may only get a little bit in their mouth and down the first feeding.

Eating solids will take time to master—baby has been thrusting their tongue during nursing, now they must use it to move food in their mouth. Do not be surprised if your baby pushes everything out with their tongue the first few feeds—this is their natural reflex!

Be patient as baby learns and make it fun. Once baby has mastered eating up to 4 ounces of rice cereal, you can move on to new foods. Try introducing one food at a time, across three to five days, to determine if baby likes the flavor or has a strong reaction to the new food. This timeline helps you watch your baby for reactions that would indicate food allergies, like rash, vomiting, or diarrhea that can’t be otherwise explained.

Begin with rice cereal, then introduce vegetables, then fruit, and meats last. As baby learns to eat, mash all foods to a very soft consistency—and get ready for the mess! As baby gets the hang of taking food into their mouth and moving it around, you can start to ease up on the mashing and introduce smaller bits of softer foods—baby's learning to chew—even with their gums. Follow their lead and always sit with baby during any meal should they start choking. As baby grows, you can increase the size and introduce a firmer consistency in their foods to help them develop strong jaws and ease their teeth in.

A bit of advice: Don’t jump straight to foods if baby isn’t crazy about carrots—the order in which you introduce flavors is important. Starting with sweeter foods, like applesauce, may make it more difficult to get baby to eat the nutrient dense veggie foods they need.

Start with the veggies first and they’ll be more likely to continue to eat them even after sweeter foods like fruits are added. Limit meals times to about fifteen to twenty minutes, and eliminate television, phones, and any other distractions because your baby is learning a new skill that requires your attention should they choke. Talk to baby and pretend to eat along with them; engage with baby and mealtimes will be easy for you both.

As your baby consumes more solid food, they will drink less breastmilk or formula (but keep adding one or the other of these foods to their diet the first full year). You can continue feeding breastmilk for as long as you would like. Skip juices, never leave your baby alone with a bottle, and don’t give them a bottle to eat as they lay down for sleep.

As your baby develops grasping skills and can bring food to their mouths, you can move away from mashed foods. Choosing store bought or making your own baby food is appropriate. The journey you and your baby take though the feeding cycle should be enjoyable if you can manage to stay flexible and patient. If you have any concerns, always check-in with your health care provider. Bon appetite’!