Sometimes it can be quite challenging to get your child to eat vegetables, especially if your child is a picky eater. Pouches that mix fruits and vegetables are a great way to increase the acceptance of veggies by your little one. Try to incorporate a few veggie-only purees throughout the week to get your child used to the taste of vegetables – the more exposure they have to veggies, the more likely it is they’ll enjoy them!
An important stage in feeding is transitioning from purees into lumpier textures, or soft solids. These purees allow your little one to learn how to manipulate foods in his mouth, as well as begin to use a chewing motion. Pouches can be a great way to help your infant progress through textures and develop these important feeding skills. You can achieve this by mixing a pouch in a bowl with steamed and slightly mashed vegetables, meats or whole grains, then feeding it to your little one with a spoon.
Some ideas for foods that can be steamed, gently mashed, then mixed with a pouch include – carrots, potatoes, squash, peas, green beans, and even proteins such as cooked ground beef, finely shredded chicken, beans or gently smushed fish.
As the popularity of pouches continues to rise, so does the innovations of pouches, that have ingredients like fruits and veggies and incorporate important nutrients like omega-3 ALA’s and fiber. Feeding directly from the pouch can be a part of a healthy feeding routine that also includes spoon feeding and self-feeding to help a child develop.
feeding cues may include smacking or licking lips, opening and closing mouth,
sucking on lips, tongue, hands, toys, etc. You may even see some of these early
hunger cues when your baby is just starting to wake up from his nap and is
still sleepy. However, at around 6-8 weeks, sucking on fingers/hands may not actually
indicate hunger, as your baby is learning to explore his hands and may even
your baby is presenting active feeding cues, you may see him rooting (mouth
wide open, looking for a nipple) on whoever is carrying him; other cues include
trying to move towards the breast, hitting at the breast, fidgeting, squirming,
Late feeding cues include crying, fussing, a red face
from crying, and baby moving his head frantically side to side. Crying is
actually a late indicator of hunger, and it can be difficult to feed at this
point as the baby will need to be calmed down before he is able to be fed.
You may hear from various providers that baby needs to be eating every 2 hours.
Every baby is different, and some can go longer stretches (4-5 hours) between a
couple of feedings. On average, a newborn will feed 10 to 12 times in a 24 hour
period. As long as baby is audibly sucking/swallowing at the breast or bottle,
having 5-8 wet diapers by their fifth
day of life (or by the time your milk comes in), 2-4 dirty diapers per day,
appears sleepy and relaxed at the end of a feed, and your pediatrician is
satisfied with weight gain then he is likely getting enough. Once your baby has established a
good weight gain pattern, you shouldn’t need to wake him to feed and can let
him set his own pattern, responding to his feeding cues accordingly.
Soon after you
get the hang of understanding your newborn’s feeding cues, he’ll be old enough
to start solids, and with that comes the introduction of understanding new
feeding cues! The
World Health Organization as well as American Academy of Pediatrics recommend
introducing solid foods around 6 months of age, when he shows the signs of
You want to be sure your baby shows signs of developmental readiness before you begin solids. These include sitting upright unassisted, having lost the tongue-thrust reflux as shown by no longer pushing food out of their mouth with their tongue, and being interested in solids by showing eagerness to be part of mealtime. While most babies are developmentally ready for solids around 6 months, some don’t show any interest in solids until closer to 9 months. Letting your baby touch the food, smell it, see it, and play with it is all beneficial exposure to get him used to food in general. For more information on signs of readiness, check out Introducing Solids: Signs of Readiness . We like to say: “Under One, Just for Fun” because during this time introducing food will be about learning to eat and trying different tastes and textures, rather than to provide a majority of baby’s calories. Breastmilk or formula should still be baby’s primary source of calories under the age of 1 year. For that reason, it is important to feed your baby solids about an hour after he has had breastmilk or formula in order to make sure introduction of solids doesn’t cause a significant decrease in breastmilk or formula intake. Aim to feed solids once or twice per day, 1 to 2 tablespoons at a time. Once baby gets the hang of eating, you can graduate up to eating 2-3 times per day, 2 to 4 tablespoons at a time. When spoon feeding baby, it is important to go slowly and follow your baby’s cues. This helps ensure you’re not spooning food into their mouth faster than they’re ready for it nor offering one more scoop just to finish the last of the jar. You’ll notice your baby has many different facial expressions with each new bite of baby food, from scrunching his nose to puckering his lips. Even a facial expression that may register as dislike isn’t always the case. Your baby is tasting new foods for the first time and may simply be trying to make sense of the new flavors and textures in his mouth! Repeated exposure to a variety of flavors and textures is important for expanding your baby’s palate. A baby will give you the cue that he’s ready and interested in more food by happily opening his mouth wide towards the spoon. He’ll make it just as clear when he’s all done eating. A baby will turn his face or pull away from you, close his mouth, squirm in his chair, or bat away at the spoon when he’s decided he is done eating, so don’t try to get in one more bite! This helps to maintain a positive feeding experience and you and your baby will both look forward to the next meal.
Lactose itself is the sugar found in dairy products. Lactose
intolerance is a digestive problem that can cause discomfort such as bloating,
cramping, diarrhea, and gas. Because of a deficiency of an enzyme in the body
called lactase, people who are lactose intolerant are unable to digest this
milk sugar. The best treatment is avoiding dairy products and choosing lactose-free
products. Lactose intolerance is not very common in babies and typically shows
up in children after the age of 3.
While lactose intolerance is rare in babies and tots, some
little ones with dairy sensitivities may actually have an intolerance or
allergy to the milk proteins whey and casein (versus the milk sugar with
A milk allergy or intolerance could potentially cause a wide
range of symptoms from a rash, hives, itching, and swelling to a more
life-threatening reaction such as anaphylaxis. Babies who have a milk allergy
may also experience frequent loose stools that may possibly contain blood or
mucus, frequent spitting up, vomiting, and discomfort. A cow’s milk allergy is the most common food
allergy in infants and young children with approximately 2.5 percent of
children younger than 3 years being allergic to milk. Fortunately, most
children will eventually outgrow this as they get older and their digestive
Your pediatrician may ask for a stool sample to check for
blood, as sometimes the blood is not visible to the eye. Breastfeeding moms
must eliminate dairy in their diet since the milk proteins pass through
breastmilk, while formula feeding moms will likely need to switch to a specialized
When eliminating dairy in your own diet or trying to figure
out what foods to offer your tot, reading labels is critical. The following
words will indicate the presence of milk in the product:
You may wonder how you or your child’s nutritional status
may be impacted when foregoing dairy products. Fortunately, there are many
foods that can supply the important nutrients that dairy provides, such as
protein, calcium, magnesium, and vitamin D. All whole fruits, vegetables,
legumes, nuts, seeds, meat, poultry, fish, grains, and eggs are dairy free. There
are also many non-dairy substitutes on the market, such as soy yogurt or
coconut milk so you can still cook and bake dairy-free with ease. When it comes
to meeting your and your baby’s nutritional needs, choose a variety of these
non-dairy containing foods.
The primary goal is to be your own detective, read labels,
and make inquiries at restaurants or other events involving food. Allergens can
be hidden in coatings, thickeners, spices, natural flavors, and other ingredients
found in fresh, frozen, refrigerated, and shelf-stable foods. Preparing meals and snacks at home can help
you maintain control over food sources and help prevent cross-contamination.
This meal plan is created for women who are truly allergic, or who are breastfeeding and need to undergo an elimination diet to determine what foods their infant may have an intolerance or allergy to. Taking these foods out during pregnancy or breastfeeding, if not warranted, may actually promote intolerance in your infant as complete avoidance will prevent the immune system from learning that these foods are not actually harmful. If you are breastfeeding and your infant is showing symptoms of allergy or intolerance, and you have discussed the issue with your and/or your infant’s healthcare provider (HCP), this meal plan may be used to eliminate the major allergens.
This diet can be tricky. Make sure to work closely with your HCP as he or she knows what is best for you and your baby. To determine which foods were not tolerated by your baby, your HCP may have you add these foods back into your diet one at a time after they have been eliminated for 2-4 weeks, or until your infant stops having symptoms.
Choosing meals and snacks from the below listed options will
help eliminate major allergens (dairy, soy, eggs, gluten, and peanuts) while
helping you maintain adequate nutrient intake.
The first decision concerns timing: when should you begin feeding your baby? Research points to six months as the ideal time for introduction of solids because your little one’s intestines are mostly developed. Other important signs of readiness for food include ensuring your baby can sit up with minimal support, keep her head up and steady, and show interest in the foods you’re eating. (For more information on when to start solids, please see Introducing Solids: Signs of Readiness)
Introduction of food
is complementary to breastmilk and/or formula feeding, which should remain the
primary source of nutrients and calories up through the first year. Think
of eating as a way for your baby to explore food, tastes, and textures; rather
than a way for them to get most of their nutrients. This will allow you and your baby to set
aside frustration and have more fun with the process.
There are different methods that parents may choose when it
comes to baby’s first bites. Below
reviews the traditional as well as alternative approaches to feeding, including
their pros and cons.
This technique has been around longest and is the one
recommended by most pediatricians. It
begins with spoon-feeding purees, graduating to lumpy mixtures, soft solids,
and soft table foods; progressively advancing textures as the baby matures and
While many pediatricians still recommend fortified single grains mixed with breastmilk or formula as the first food, followed by pureed vegetables and fruit, there is no medical evidence indicating that solids should be introduced in any specific order. This includes the theory that vegetables should be introduced before fruit. Babies have a natural preference for sweet tastes regardless of which foods come first. Rather than worry about the order of produce introduced, the primary goal is to introduce many flavors to set your infant up for successful eating both now and in the future.
The traditional method also suggests adding one new food
every 2 to 3 days to check for intolerance or possible allergic reactions,
although this recommendation is becoming less frequently used by professional
organizations such as the AAP. After each new food, watch for symptoms such as
diarrhea, rash, or vomiting. If these occur, consult with your infant’s health
care provider to discuss the next steps. Vegetables and proteins are high in
nutrients per serving, so having them as a consistent part of your baby’s diet
alongside fruits and grains, will ensure a variety of quality nutrients are
Another older recommendation is to wait until between 7 to 8 months to introduce proteins such as chicken, turkey, fish, beef, and dairy foods (excluding cow’s milk, which should be introduced at 1 year). Research indicates this may not be necessary, and in fact introducing meat early, particularly to breastfed babies, will help them meet their increasing iron and zinc needs. Simply ensure the proteins are a texture your baby is able to tolerate. This might mean introducing ground beef, pureed chicken, or mashed fish initially until he is able to chew (or ‘gum’) advancing textures. (See: What’s the Deal with Seafood for more information on which fish are high in mercury and should be avoided for infants).
Though some health care providers counsel to hold off on offering fish, eggs, and other potential allergens until your infant is one year or older, new research indicates earlier introduction may actually help prevent allergies. (To learn more, please see: Introducing Major Allergens)
When your baby is able to bring her hands to her mouth,
typically between 8 and 10 months, finger foods may be introduced. During this time she is developing her
ability to ‘gum’ foods, as well as developing pincer and fine motor skills
needed for self-feeding. Very soft foods
cut into small pieces are still needed as baby does not have enough teeth to
break up hard foods.
This progressive technique discourages spoon feeding and
supports infants to self-feed from the beginning. The theory behind this method is that infants
should be in control of what and how much they eat. Proponents also say BLW
helps to better develop infants’ chewing skills and hand-eye coordination. Because infants have more control of their
ability to grasp and swallow at 6 months, BLW is recommended to start around
this age and not sooner.
Per Baby Led Weaning, first foods should be soft enough to ‘smush’ between the fingers and cut into a ‘strip’ for the baby to grasp. Advocates for this technique advise adults to never put food in the baby’s mouth. This allows the infant to be in control of the entire feeding experience. Example first foods include: Banana, avocado, mango; steamed sweet potato, carrots, broccoli, asparagus; steamed apple and pear; well-cooked fish and scrambled eggs; over-cooked pasta, etc. Foods that are choking hazards should be avoided, as with any feeding method. (See: Preventing Choking for more information).
Some proponents also promote feeding baby what the family is
eating (“table food”); however, these foods may be too high in salt and
sugar. Feeding family foods may be
acceptable so long as a separate dish is prepared without these added
Potential advantages: Greater acceptance of foods, weight
management, promotion of oral motor and chewing skills. It should be noted that
some of these benefits are contested.
Potential disadvantages include: Not meeting infant’s
increasing iron needs, not meeting calorie needs, too much added sodium or
sugar, risk of choking.
For more information on the potential benefits and disadvantages of Baby Led Weaning, please read Introducing Solids: Baby Led Weaning.
This method is similar to the traditional method in that you
may choose to start with pureed foods and advance textures as appropriate; but
it differs in that a much wider variety of foods are offered from the
start. This includes: fruits,
vegetables, eggs, fish, chicken, meat, combination foods, mixed grains, beans,
dairy (still not cow’s milk to drink though), etc. Another difference is that this method does
not require waiting 2 to 3 days to introduce a new food, but rather new foods
are introduced anytime and in any combination – not just one at a time. As long as the food is a consistency that
your baby can handle, the food is within the realm of possibility.
As with any feeding strategy, avoiding foods with added salt
and sugar is key to your infant’s health as well as the foundation to building
healthy taste preferences. Should you
decide to follow this more relaxed strategy, it may be important to keep a food
log of what your infant eats so that if symptoms of a possible food intolerance
or allergy pop up, you can see what items it may be linked to.
Baby feeding is exciting, yet can also be riddled with
questions of how to proceed and progress. Speak with your infant’s pediatrician
to gather more information and ensure they support the method you choose. This
will allow for better care of your infant as you introduce solids.
If you’re unsure of how to start, begin with what you are
most comfortable with and progress as you see best and safest for you and your
baby. If you begin using one method and
it doesn’t feel right, there is no harm in switching to another. But most of all, enjoy the journey!
No matter which feeding style you choose, make sure that the
first foods you introduce are very soft. Infants do not have teeth so what you offer
must be soft enough for your baby to mash with their tongue or gums. Examples:
Avoid adding salt or sugar to your infant’s food. Advance
textures when your baby is ready.
Read Introducing Solids: First Foods and Advancing Textures for information on introducing solids to your infant.
2. Finger Foods
When your baby is ready to feed herself, or if you choose
the Baby Led Weaning method, here are some finger foods to try. Place four to five pieces of food on your
infant’s tray to start, adding more as she feeds herself (or attempts to!).
Soft Finger foods:
Once your baby becomes better at ‘gumming’ foods well before
swallowing, slightly firmer foods may be tried in addition to the above foods.
3. Foods to avoid
Some foods pose choking risks for infants and toddlers due
to their shape or hard texture. Here are
some foods that should be avoided:
To learn more, please read our article on Preventing Choking
4. Go with the method that feels right to you
Know that there are no studies showing any one feeding
method as superior to another, so go with the one that is right for you and
your family. Whether you choose the
traditional, Baby Led Weaning, or the ‘anything’ approach, how your baby reacts
to it – and how comfortable you are – is the best indicator that it is working…
or not! Taking into account the benefits
and disadvantages of each will help you feed your baby what they need both for
health and exploration. For additional
support, speak with your pediatrician about your decision. And remember that you can switch techniques
at any point!
5. Meet your baby’s iron needs
Iron needs increase after 6 months of age, so including
foods with iron is an important part of feeding. Note that iron from vegetables and beans is
better absorbed when eaten with vitamin C.
Pair these foods with some citrus fruit to accomplish this.
Food high in iron:
For other nutrients that your baby needs between the ages of 6 and 12 months, read this article: Nutritional Requirements for 6-12 Month Olds.
6 months: Exploration
7 to 8 months:
Exploration and Flavor immersion
* If there
aren’t any food allergies in baby’s/your immediate family, then your little one
is likely low risk for an allergy. The current recommendation is to
introduce all foods (including peanut butter, eggs, fish, soy, and other
allergens) when your baby is developmentally ready for that texture, as early
as 6 months.
8 to 10 months:
Flavor immersion and Finger Foods
10 to 12 months:
Finger foods and Family meals
12 + months: Regular
eating and Bottle weaning
A mother who was planning on breastfeeding her baby may not know what to do when her baby will be spending days, weeks or even months in the NICU. While pumping for your NICU baby can be time consuming and challenging, it can be an important way for you to be involved with your baby’s care, and breast milk offers significant health benefits to your baby, especially if he is premature or ill. And even if your baby needs supplementation from formula or specialized human milk fortifier, he will still be getting the benefits of your breastmilk in any amount you can provide.
It is important to
begin pumping right away for your baby. It typically takes between 2 and 5 days
for your milk to come in. Before this
happens, your body makes colostrum; the yellow, thick ‘first milk’. This is
nutrient-dense, packed with all sorts of good things such as immune factors,
and sustains your baby until your milk comes in. You may only get a few drops
of colostrum – this is normal!, but every bit is beneficial.
Healthy newborns typically eat 10 to 12 times per 24 hours – that’s
every 2-3 hours. This is normal as their
bellies are very small, so they need to eat more frequently. Your goal is to mimic the frequency of normal
breastfeeding and establish your milk supply with pumping. Milk supply is typically based on
a supply and demand relationship, so the more the breasts are stimulated and
emptied, the more the body is signaled to make milk. The best way to set up
your milk supply for your baby is to pump completely and frequently, at least
8-12 times per day for at least the first 3-4 weeks. Aim to pump at the
same time each day so that your body knows to make milk at that time. Even if
your baby is unable to eat much or any of your breast milk at the beginning,
keep pumping consistently, as the first month is very important for setting up
your supply. Establishing milk supply will enable you to be prepared if and
when your baby is ready and able to nurse.
After the first month, you
may be able to pump eight times per day and maintain an adequate milk supply
for your growing baby. If your baby is able to be held while in the NICU,
holding your baby skin-to-skin helps stimulate your milk production hormones,
and is recommended before pumping. If you are unable to hold your baby, you can
pump close by while you’re visiting in the NICU, look at pictures or videos of
your baby, or even smell an article of their used clothing
for extra stimulation while you pump. While it is normal to feel stressed when
your baby is ill or in the NICU, try to find support through family and friends
and NICU support staff, as stress can negatively impact milk supply. Also,
taking care of yourself through good nutrition and hydration can help support
your milk supply.
If your baby was born
prematurely, the milk that you express is a little different than what is
produced when babies are born at full term. It is much higher in protein and
minerals, and contains different types of fat that are easy for him to
digest. You will not be getting as much
volume because your baby’s tummy is very small (likely the size of a marble!).
So if you are not getting a lot, do not fear! That is normal.
electric breast pump is the most effective type of breast pump, and most moms
find they’re able to get more milk when using a hospital grade pump. Electric
breast pumps that pump both breasts at the same time are also effective, but
for the exclusive pumper – even if your goal is to eventually nurse – a
hospital grade pump is recommended and can typically be rented monthly from
It is important to
practice safely handling the pumped milk when you are transporting it to the
hospital. Milk storage guidelines are different for premature or hospitalized
babies, as these babies are more at risk for infection. Whenever possible, take
your pump to the hospital to pump fresh milk for baby’s next feeding. It is
important to discuss storage and transportation guidelines for pumped milk for
your premature or ill baby with the NICU medical providers.
You will be spending a lot of time pumping. Try some of these things to
make the best of it:
Make sure to let the
medical personnel at the hospital know you’d like to provide breastmilk for
your baby. Getting their support will be
key to helping make your breastfeeding goals work. Many NICU’s have a lactation
consultant on staff. Ask your baby’s nurse to meet with that person to help
support you in a more personalized way.
Vitamin B12 is a nutrient
that helps keep the body’s nerve and blood cells healthy and helps make DNA,
material in all cells. Vitamin B12 also helps prevent a type of anemia
anemia that makes people tired and weak.
vitamin B12 is believed to combine with folic acid to help prevent spina bifida
and other spinal and central nervous system birth defects in your baby.
Vitamin B12 that is
found in food needs the acidic environment of the stomach to separate it from
the protein that it is bound to. The synthetic B12 found in supplements does
not need to be separated, so if you have a low acid level (maybe you are taking
medication to treat reflux or peptic ulcer disease for an extended time period)
then you may have low blood levels of B12 and a supplement taken by mouth
should be just fine.
Vitamin B12 is
naturally found in animal products, including fish, meat, poultry, eggs, milk,
and milk products. Vitamin B12 is generally not present in plant foods however
it is commonly fortified and found in breakfast cereals, soy and other
plant-based milks, nutrition bars, meat substitutes, and Red Star Vegetarian
Support Nutritional Yeast.
The top food sources
of Vitamin B12 are clams, liver, certain fortified breakfast cereals, fish,
beef and dairy products.
Supplemental vitamin B12 for vegans and lacto-ovo
vegetarians is recommended during both pregnancy and lactation to ensure that
enough vitamin B12 is transferred to the fetus and infant. Pregnant and
lactating women who follow strict vegetarian or vegan diets should consult with
their health care practitioner regarding vitamin B12 supplements for
themselves, their babies and their children.
for vitamin B12 vary. They are as follows:
foods supplemented with vitamin B12 such as breakfast cereals fortified with
100% of vitamin B12.
foods that are naturally high in vitamin B12 such as clams, liver, sockeye
salmon and rainbow trout.
you are a vegan or vegetarian, talk to your health care practitioner about a
vitamin B12 supplement.
your diet is low on animal foods such as meat, fish, poultry, milk, cheese and
eggs look for fortified vitamin B12 foods. Check nutrition labels because not
all fortified foods have the same amounts.
you are a long time user of certain medications to treat gastroesophageal
reflux, peptic ulcer disease or are on metformin, talk to your health care
practitioner about checking your vitamin B12 levels or supplementation.
Paced bottle feeding is a method of feeding a baby with
breastfeeding difficulties or is temporarily away from mom. It helps “pace” the
feed similarly to a breastfeed, where baby controls the flow, and not the
It can be very useful in instances of extended latching
difficulties, instances when mom and baby are separated temporarily but want
the breastfeeding relationship to be maintained, and any other time that a
parent and/or lactation consultant or healthcare provider deems it useful.
It’s most useful for babies under 6 months old and can be
particularly effective for younger infants.
It’s important to keep in mind that this is just one method
that can help feed baby during latching difficulties or mom’s absence. Some
lactation providers are fond of a supplemental nursing system, some help moms
practice finger feeding, and there are still even more methods than that!
Some of the above methods need to be used and taught by a
trained lactation provider, while paced bottle feeding can easily be described.
Steps to paced bottle
Discuss the various methods of
feeding baby with your healthcare provider. Every method
doesn’t necessarily work for every mom, and it’s important to see which one
works for you – even if that means some experimenting!
If your goal is to get baby to
latch, don’t lose sight of it! For moms using this as an intermediate step to get baby to
latch, then keep trying to latch and working on it with your lactation
Educate other family members and
care providers about the technique.
Moments after birth your new babe is wiped off and put into
your arms. Did you know that this is also an important part of the
breastfeeding process? Skin to skin contact is when your naked baby (diaper and head cap only) is placed directly
on your bare chest. A blanket covering your baby and you is then placed on top,
to keep you both warm. This important first connection is a special time when
your baby is first meeting his family. Skin to skin contact promotes bonding
between you and your baby, helps lower your baby’s stress levels and is an
important first step in your breastfeeding journey.
Evidence shows that babies who have early skin to skin
contact, keeping mother and baby together during and after birth, promotes
greater breastfeeding outcomes. Babies are born with the instinct to be placed
in this position and perform the “breast crawl” to move down to the breast to
breastfeed for the first time. It is during this time that your baby’s
breastfeeding reflexes come alive; some of which include familiarization with the
nipple and breast as well as suckling.
The research also shows that even babies who are born
prematurely are more metabolically stable and breathe better if they are skin
to skin immediately after birth, if the baby is medically able. The same is
true for post cesarean births. Skin to skin contact can begin in the operating
room when mom is alert and responsive. It is important that mom be alert and
have someone else in the room who is available should any emergency arise.
Skin to skin contact during the weeks and months postpartum,
can last as long as mom and baby are comfortable. It stimulates the let down
process in breastfeeding and continues the bonding process. Partners can also
partake in the skin to skin process to promote bonding and the feeling of
comfort and safety between them and your baby. Non breastfeeding moms can also
share in this wonderful experience and bond with baby, as well.
Make sure your birth plan includes
putting baby skin to skin immediately after birth. In most birth circumstances, even
c-sections, babies can be put skin to skin without any issue. . If mom is under
heavy anesthesia or sedation, you may
need to recover a bit before skin to skin, and/or be supervised while doing
skin to skin. Dad/partner/birthing coach can do skin to skin while mom is
Practice proper technique. Make sure mom and baby are truly chest to chest, with no
clothing or blanket between skin. A
diaper and head cap is fine for baby. Both can be covered with a blanket if the
room is cold. If baby is not attempting to breastfeed, make sure his head is
turned to the side. If baby is on mom, make sure he is between, not on, mom’s
If you’re sleepy, make sure that
someone is alert and supervising the interaction. In this cozy situation, it’s easy
to drift off to sleep, but for safety’s sake, make sure someone is supervising
you while you are doing skin to skin with your baby, especially if you are
under the influence of any sedatives.
It can certainly be concerning to see your baby expel what
appears to be a large amount of liquid from his tiny body; however, spitting
up, sometimes called uncomplicated reflux, can be totally common in healthy
babies. In fact, about half of babies under three months experience this at
least once per day and, more often, several times a day. Normally a muscle,
(called the lower esophageal sphincter) between the esophagus and the stomach,
keeps the contents of the stomach where they belong. In babies, this muscle
isn’t fully developed yet, allowing the food to quickly make its way back up
the esophagus and out of the mouth (and all over your clothes!) Since your
baby’s stomach is so small, swallowing too much air during a feeding or getting
too much milk too fast, such as when mom’s breasts are overfull, can also
contribute to some milk being brought back up.
Although it appears that your baby may have spit up his
entire feeding, the amount that actually comes back up is usually only a
tablespoon or two, as opposed to the several ounces he just consumed. If your
baby is happy, not in any obvious discomfort or distress, eating and gaining
weight well, having enough wet and dirty diapers daily, then the spitting up is
a “laundry” issue (sorry, mom!) and not a medical concern. Spitting up usually
peaks around 4 months of age but can continue up to the first birthday. Most
babies outgrow or show a significant decrease in the amount they spit up by 7-8
months, once they learn to sit up on their own and have started eating more
If your baby is experiencing any of these symptoms in
conjunction with spitting up, be sure to contact your pediatrician: refusing
feedings, appears to be in pain or discomfort during or after a feeding, isn’t
gaining weight, weight loss, spits up very forcefully, spitting up blood or
green/yellow fluid, breathing issues like wheezing and arching of the back/neck
with apparent pain or distress.
See the What To Do section for tips on how to help manage
spitting up in infants.