Do I need to burp my newborn baby?

It depends. As a Melbourne lactation consultant, this is one of the top questions I am asked by lovely new mums about their beautiful newborn babies.

A breastfed baby takes in less air than a bottle fed baby & will generally bring up a burp in any position, without assistance. If your baby seems unsettled during or after a feed, try burping bub for a few minutes to see if it helps. If baby is settled, don’t worry about it – trying to burp a settled baby can lead to an unhappy baby!

A bottle fed baby may take in more air during feeding. Help your baby control the milk flow with ‘pace feeding’. Use a narrow neck teat, hold bub quite upright, hold the bottle horizontally and give breaks during feeding (see video link below). If baby is unsettled, burp during the feed or after. There is no evidence for/against burping; one small powered Indian study showed no significant reduction in colic in newborn babies who were burped.

When it comes to baby, there are no special rules – always look to baby for cues as to what they may need & follow your own instincts. If your baby is fussy during breastfeeding or bottle feeding, a session with a lactation consultant may help.

https://education.possumsonline.com/video/about-paced-bottle-feeding-renee-keogh

April 25, 2023

Babies & constipation

April 25, 2023

By Nicole Bando, Family & Paediatric Dietitian & Lactation Consultant

Constipation in babies occurs when a baby’s poo or stool in hard and difficult to pass. I spend a lot of time talking baby’s poo, as what goes in must come out! There is variation in how often babies poo, related to feed type; breast, formula or mixed, age & stage.

A breastfed baby: In the first 6 weeks, baby might poo 1-5 times per day or as infrequently as every 5 days or more. Their poo has a cottage cheese, mustard appearance and is soft, runny and easy to pass. A breastfed baby does not need additional water in the first 6 months. If baby’s poos are hard & painful to pass; this can be a sign of inadequate breast milk. Offer additional feeds. This can also be done in hot weather, or if baby has a temperature.

A formula/mixed fed baby’s stools will be firmer and a green/brown colour; baby may poo 1-2 times per day. This is because the protein in formula (cow’s milk protein) differs to human breastmilk protein. If baby’s poos are crumbly, pellet like or dry, ensure that you are making the formula up as per instructions. Additional water is generally not advised in the first few months of life, and extra feeds may be required. See your doctor if concerned.

Solids: At around 6 months, when solids are introduced, baby may take a few sips of water or expressed breast milk from a sippy cup at meal times. Introduce fibre containing foods, such as fruit, vegetables, wholegrain breads & cereals. If baby’s poos are hard to pass, stewed pear, apricots or prunes, or diluted prune juice can be offered a few times a week.

When to seek help: In the early months, constipation, poor growth, a very unsettled baby and blood or mucous in the poo are all indicators to seek medical attention. If you are concerned, check in with your doctor.

April 23, 2023

How do I introduce solids to my baby?

April 23, 2023

How do I introduce solids to my baby?

INTRODUCTION TO SOLID FOODS,
By Emma McShane, Dietitian

The World Health Organisation states ‘infants should be exclusively breastfed for six months and after this time continue breastfeeding with appropriate introduction to solids’ (2020).
When breastfeeding is not possible, bottle feeding is recommended.

How do you know if your baby is ready for solid foods?

Your baby has good head and neck control and can sit upright when supported
Your baby shows an interest in food e.g. looks at or reaches out for your food
Your baby opens their mouth when offered food on a spoon
Your baby has an increased appetite, is feeding more often, and wants more breast milk or formula at the end of their usual feed.

VARIETY OF FOODS:
It is important to include a variety of foods from the five core food groups in your baby’s diet.

CEREAL FOODS
Be sure to offer a variety of grains including wheat, rice, oats and corn.
Example of cereal foods: Bread, crackers, pasta, iron-fortified cereals e.g. Weet-bix, all bran

DAIRY FOODS
Yoghurt, cheese, and cow’s milk on cereal.
Cow’s milk should not be given as a drink (instead of breastmilk or formula), for babies under 12 months of age.

MEAT AND MEAT ALTERNATIVES
Beef, lamb, poultry, well-cooked egg, fish, other seafood, legumes (e.g. lentils and chickpeas)

VEGETABLES AND FRUITS
Can be grated, cooked, pureed or mashed.

Introducing Common allergy causing foods:

Common allergy causing foods should be included in your baby’s diet before nine months of age, as research has shown that early introduction may reduce the chance of your baby developing a food allergy.
These common allergy causing foods are: Eggs, Cow’s Milk, Wheat, Soy, Peanut, Tree nuts, Sesame Fish, Shellfish
It is important to introduce one new allergy causing food at a time, early in the day, and then wait a few days to try another new food, so that you can identify any foods that may cause an allergic reaction.
An example of how to introduce an allergy causing food, is to mix a small amount (1/4 tsp) of an allergy causing food e.g. hard-boiled egg or smooth peanut butter into your baby’s usual food e.g. vegetable puree. If there are no signs of an allergic reaction (These signs include: hives, welts, swelling of the lips, vomiting, or change in behaviour), then gradually increase the amount next time (1/2 tsp). If your baby does show signs of an allergic reaction, stop offering the food and seek immediate medical attention.
It is important that once you have introduced these foods, to include these foods in your baby’s meals at least twice a week.

The below is a guide of solids progression, showing texture, quantity and breast/bottle feeds; it may be highly variable for each baby. You may also choose a ‘Baby Led Weaning’ approach, this involves introducing solids through appropriately textured and sized finger foods and allows your baby to explore the food themselves. There is no set way to feed your baby, so do what feels best for your family.
The above is an approximate guide for food quantities and expected number of breast and bottle feeds, this is because there are no set guidelines, as each baby will progress differently. If you feel unsure about how to introduce solids to your baby, a Children’s Dietitian (Paediatric Dietitian) can provide specialised feeding advice.

6 MONTHS

TEXTURES
Coarsely pureed/mashed

QUANTITIES
1-2 tablespoons, twice a day (start with 1 meal and progress to 2 over weeks).

EXPECTED NUMBER OF BREASTFEEDS
Breastmilk is the main nutrition source. Continue breastfeeding on demand.

EXPECTED NUMBER OF BOTTLE FEEDS
If your baby is not breastfed, continue with bottle feeds, as this is still the baby’s main nutrition source. Slight decreases may be seen in the amounts taken.

EXAMPLE OF FOODS
Start with iron-rich foods; as your baby’s iron stores gained during pregnancy start to run low. These foods include fortified baby cereals, eggs, beans, lentils and soft cooked and pureed meat. Introducing allergy causing foods e.g. yoghurt added to pureed fruit and vegetables, Semolina porridge made with breast milk or infant formula.

6-8 MONTHS

TEXTURES
Lumpy, finely chopped, progressing to finger foods

QUANTITIES
Progressing 1-4 tablespoons of food 1-3 times/day by 8 months (slow progression) – up to ½ cup of food

EXPECTED NUMBER OF BREASTFEEDS
On demand

EXPECTED NUMBER OF BOTTLE FEEDS
3-5 times per day at 6-8 months

EXAMPLE OF FOODS
Peanut butter added to mashed foods or porridge, hummus mixed into mashed vegetables, finely shredded, soft meat added to puree vegetables.

8-10 MONTHS

TEXTURES
Grated, diced, chopped finger foods, progressing to regular menu
You’ll find your baby starts to play with their spoon.

QUANTITIES
Up to 1 cup of food at each meal
At 9 months: 3 meals
At around 10 months: Introduce mid-meals, roughly ½ to ¾ cup of food (e.g. ½ cup full fat yoghurt with cut up banana).

EXPECTED NUMBER OF BREASTFEEDS
On demand; By 9 months: 4-5 breastfeeds

EXPECTED NUMBER OF BOTTLE FEEDS
3-4 formula feeds at 9-12 months

EXAMPLE OF FOODS
Well-cooked spiral pasta as finger food, hard-boiled egg with mashed avocado, soft grated cheese as finger food, pikelets.

10-12 MONTHS

TEXTURES
Chopped finger foods, Begins spoon feeding

QUANTITIES
Small balanced meals 3x/day e.g. 1 scrambled egg, chopped soft fruit, 1 Weetbix with cow’s milk, plus mid-meal snacks 1-2x/day.

EXPECTED NUMBER OF BREASTFEEDS
On demand; 3-4 breastfeeds per day

EXPECTED NUMBER OF BOTTLE FEEDS
600mL Bottle feed/day

EXAMPLE OF FOODS
Omelettes, cottage cheese and fruit mixed together, bread offered as toast fingers or sandwiches, homemade fish fingers, pesto sauce with pasta.

1-5 YEARS

Family foods (avoid small, hard pieces of food). Can offer cow’s milk as a drink after 12 months.
Example foods: Scrambled eggs, Crumbed fish, vegetables dipped in hummus, pastas, cereals with cow’s milk

References:

Australian Breastfeeding Association. Breastfeeding and family foods. ABA, 2020. (Available from: https://www.breastfeeding.asn.au/, accessed May 31st, 2021).
Australasian Society of Clinical Immunology and Allergy. Introducing foods and allergy prevention fast facts. ASCIA, 2019. (Available from https://www.allergy.org.au/images/pcc/ff/ASCIA_Introducing_Foods_Fast_Facts_2019.pdf, accessed May 31st, 2021).
NIP Allergies in the Bub. Introducing solid foods. Prevent Allergies, 2018. (Available from https://preventallergies.org.au/introducing-solid-foods/, accessed 31st May 2021).
NIP Allergies in the Bub. Around 6 months (not before 4 months). Prevent Allergies, 2018). (Available from https://preventallergies.org.au/wp-content/uploads/2020/10/Food-Ideas-for-Babies-around-6-Months.pdf, accessed May 31st 2021).
NIP Allergies in the Bub. Around 7 to 9 months. Prevent Allergies, 2018. (Available from: https://preventallergies.org.au/wp-content/uploads/2020/06/RECIPE-IDEAS-FOR-BABIES-7-9-MONTHS.pdf, accessed May 31, 2021).
NIP Allergies in the Bub. Around 10 to 12 months. Prevent Allergies, 2018. (Available from: https://preventallergies.org.au/wp-content/uploads/2020/06/RECIPE-IDEAS-FOR-BABIES-10-12-MONTHS.pdf, accessed May 31, 2021).
Castle J., Jacobson M. (2013). Fearless Feeding. Jossey Bass. pp 40-54. Accessed May 31, 2021.
Surwald, D. (2017). Baby-led weaning & introduction of solids. Peninsula Health. Accessed June 10th 2021. Available from: https://www.peninsulahealth.org.au/2017/08/25/baby-led-weaning-introduction-of-solids/

Email: [email protected]

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Do I need to burp my newborn baby?

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