Home
> Breastfeeding
> Jack Newman's Breastfeeding
Handouts
What to Feed the Baby when the Mother is Working outside the Home
Handout #17 What to feed... Revised January
2005
Written by Jack Newman, MD, FRCPC. © 2005
This is not an information
sheet on all the ins and outs of working outside the home and breastfeeding.
This sheet provides information on how your baby can be fed when
you are not with him. It is addressed in particular to the mother
who is returning to paid work when the baby is about 6 months of
age. New mothers should stay home with their babies for as long
as practical and take full advantage of the 52 weeks maternity
leave to which mothers have a right in Canada.
If you cannot take a full year, take at least 6 months, better 7
months (from the point of view of ease of continuing breastfeeding
while away from your baby). Your baby will never be this age again.
Some Myths:
1. Babies must learn to take a bottle
so that they can be fed when the mother is not there.
Not true. Some exclusively breastfed babies
will not take a bottle by 2 or 3 months of age. Most, who have not
taken a bottle, and even some who did accept a bottle in the first
weeks of life will not take one by the time they are 4 or 5 months
of age. This is no tragedy, and there is no reason
to give a bottle early so that the baby knows how. If your baby
is refusing to take a bottle, do not try to force him; you and he
may become very frustrated and there is just no need
to go through all this. If the baby is at least 6 months of
age when you start back at outside work, the baby quite simply does
not need to take a bottle. If he is even 4 months, he does
not need to take a bottle. He can be fed liquids or solids off a
spoon just as any other 6 month old and by 6 months of age he can
be taking enough so that he will not be hungry during the day. Furthermore,
he can start learning to drink from a cup even by 5 or 6 months
of age. The cup can be an open cup and does not need to have a spout.
Start with water as your baby may spill a fair amount at first.
If, however, he has not got the hang of the cup by the time you
must leave him, do not worry, he can take fluids off a spoon, or
the solid foods can be mixed with more liquid (expressed milk, juice,
water). Obviously, if the baby is to be taking a fair amount of
a variety of foods by 6 months of age, he may need to be started
on solids by 5 months of age. However, some babies prefer to wait
for the mother in order to drink something. This is fine; many babies
sleep 12 hours at night without drinking or eating at all.
2. But getting the baby to take a
bottle surely won't hurt.
Not necessarily true. Some babies do fine with
both. The occasional bottle, when breastfeeding is going well, will
not hurt. But if the baby is getting several bottles a day on a
regular basis, and, in addition, your milk supply decreases because
the baby is nursing less, it is quite possible that the baby will
start refusing the breast, even if he is older than 6 months of
age.
3. Babies need to drink milk when
the mother is not at home.
Not true. Three or four good nursings during
a 24 hour period plus a variety of solid foods gives the baby all
he needs nutritionally, and thus he does not need any other
type of milk when you are at your outside job. Of course, solid
foods can be mixed with expressed milk or other milk, but this is
not necessary.
4. If the baby is to get milk other
than breastmilk, it needs to be artificial baby milk (infant formula)
until the baby is at least 9 months of age.
Not true. If the baby is breastfeeding a few
times a day and getting fair quantities of a variety of solid foods,
infant formula is neither necessary nor desirable. Indeed, babies
who have not had infant formula before 5 or 6 months of age often
refuse to drink it because it tastes pretty bad. (If you want to
convince yourself of how little we know about breastmilk, ask yourself
why it is that, although breastmilk and infant formulas have the
same amount of sugar, breastmilk is so much sweeter). If you want
to give the baby some other sort of milk, homogenized milk is acceptable
at 6 months of age, as long as it is not the baby’s only food.
In fact, if the baby is taking good quantities of a wide variety
of foods, breastfeeding 3 or 4 times a day, and growing well, homogenized
milk or 2% milk is good enough, but also not necessary.
5. Babies need to drink milk to
get calcium.
Not true. If you are worried about the baby’s
intake of calcium, he can eat cheese or yogurt. There is no need
to drink the calcium. Besides, if the baby is also breastfeeding,
breastmilk still contains calcium.
6. Followup formulas (artificial
milk for infants over 6 months of age) are specially adapted to
the needs of infants 6 to 12 months of age.
Not true. They are completely unnecessary and
are specially adapted to the needs of the formula companies’
profit margins. They also are part of a marketing strategy that
tries to get around restrictions on the advertising of artificial
baby milks directly to the public (widely disregarded in any case).
In Europe now, there are special formulas available for the toddler
(1-3 years of age). Some people will buy anything, it seems. But
these toddler formulas will soon be here. You can bet on it. Bottom
line über alles. We will all soon be on formula from
birth to death.
7. The breastfed baby 4 months of
age needs to be getting more iron than can be provided by breastmilk
alone.
Not true. For the baby born at term who is
breastfeeding exclusively, all the iron required is provided by
breastmilk. However, by 6 months of age, more or less, it is prudent
for the baby to begin getting more iron than that provided
by breastmilk alone. The best way for your baby to get iron is through
his food, and the best source of iron is meat, not formula, and
not infant cereals.
8. The best way to assure the baby's
getting enough iron is to give him infant cereals.
Not true. Infant cereals do contain a lot of
iron, but most of it is not absorbed, and this amount of iron seems
to cause constipation in some babies. Furthermore, some breastfed
babies who have had only breastmilk to 5 or 6 months of age do not
like cereal. There is nothing wrong with infant cereal, but pushing
this food on reluctant babies may result in later feeding problems.
The best way to ensure the baby is getting enough iron
is to continue breastfeeding, and introduce solid foods in a relaxed,
enjoyable way at the appropriate time (See handout #16 Starting
Solid Foods). The appropriate time is when the baby is
showing interest in eating by reaching out for and trying to eat
food the parents or other members of the family are eating. This
occurs usually about 4 1/2 to 5 1/2 months of age. A baby this age
can eat what the parents eat, with few exceptions. There is no need
to be obsessive about the order in which foods are introduced, or
trying to keep the baby eating only one food/week. The easiest way
to give extra iron for the 6 to 12 month old baby is meat, the iron
of which is very well absorbed. Start feeding the baby solids in
a way that makes eating enjoyable, and the baby will eat iron containing
foods just fine.
Questions?
see
my book Dr. Jack Newman's Guide to Breastfeeding (called
The
Ultimate Breastfeeding Book of Answers in the USA)
Handout #17 What to feed... Revised January
2005
Written by Jack Newman, MD, FRCPC. © 2005
This
handout may be copied and distributed without further permission,
on
the condition that it is not used in any context in which
the WHO code on the marketing of breastmilk substitutes is violated
