Providing Quality Care for Children in North Georgia
As a part of our mission to provide comprehensive pediatric care for children in Dalton, GA and the surrounding areas, at Pediatrics of Dalton we strive to keep parents as informed as possible. Understanding your child’s well-being allows you to make decisions that are beneficial. It also helps our doctors and staff to work with you to make sure your child becomes a healthy adult. Below, we have provided common questions and answers for your convenience. Our office is also available to answer more specific concerns.
Benefits of Nursing
Infants require more than just nutrients to develop. Nursing an infant provides closeness to the mother and feeling of security, which is important for the infant’s developing temperament and well-being. Many infants will want non-nutritive suckling simply for the warmth and security it provides.
Nursing infants are less costly to the environment producing little or no trash (bottles, formula cans, etc.) from a feeding.
A breastfeeding mother who eats well and is healthy will not run out of milk for the infant. Whenever the infant needs to nurse the mother has a supply of milk to meet this need.
You may call at any time with a question about breastfeeding. Some other useful numbers are listed here.
What Should I know About Formula?
Unless you are breastfeeding, formula provides the simplest method of providing the proper amounts of vitamins and iron during the first year of life. Whole, 2% or skim milk do not provide adequate amounts of vitamins or iron and may actually lead to iron loss in the stool. Therefore, if you are not breast-feeding, use an infant formula such as Enfamil® with iron until age 1 year. After age one year we suggest the use of whole milk until age 2 years. Infants and children who receive less than 1 quart of Vitamin D containing milk should be supplemented with 400 IU each day of Vitamin D.
The amount of formula your baby takes will vary. Babies have a right not to be hungry sometimes, just like you, and you can’t make a baby want to eat. Most babies feed for 15 or 20 minutes but may feed up to 60 minutes, never longer. You will probably find that sometimes your baby will take his entire bottle and sometimes he won’t. Don’t worry. This is normal. As your baby grows and gains weight he will need more formula. When your baby takes his entire bottle pretty regularly, increase his daily formula according to his demands. Let baby be the judge; he knows how much food he wants and needs.
Age Average Quantity Taken At Each Feeding
1-2 weeks 2-3 ounces
3 weeks – 2 months 4-5 ounces
2-3 months 5-6 ounces
3-4 months 6-7 ounces
5-12 months 7-8 ounces
What Should I Do After Feeding?
Burping baby helps remove swallowed air. Even if fed properly both bottle-fed and breastfed, babies usually swallow some air. The way to help your baby get rid of this is to burp, or bubble him. Hold him upright over your shoulder and pat or rub his back very gently until he lets go of the air.
It isn’t always necessary to interrupt a feeding to burp baby but do it after each feeding. Of course, sometimes baby may not burp because he doesn’t need to. So don’t try to force him.
If your baby seems to have “gas” pains or “colic” you should be even more careful to burp him as well. Sometimes it helps to keep him in the upright position for 30 to 45 minutes after each feeding. When you lay baby down, be sure to place him on his back.
How Should I Introduce Solid Foods?
There is little evidence that the addition of solid foods to the normal infant’s diet of breastmilk/ formula before 4 months of age contributes in any significant way to his well being (i.e. does not sleep better or go longer between feedings) but may contribute to food allergies. The AAP currently recommends breast milk as the best nutrition for infants through age 6 months. If you feel your child needs solid food prior to 4 months, please talk with the doctor at his checkup or contact the nurse between 10 a.m. and 4 p.m.
New foods, when offered, are best given in small amounts (1-2 tablespoons once a day). They are best accepted if thin or dilute and usually are continued daily until the infant becomes accustomed to it. A new food may then be offered at 5-day intervals.
4-6 Months -Cereal, fruits and vegetables are usually added at weekly or greater
intervals in the order listed.
- Rice cereal or barley cereal (no mixed cereals). Start with 1 rounded tablespoon mixed with formula to make “soupy” consistency. This can be thickened as the·baby learns to swallow the solids.
- Strained applesauce or peaches should be added, starting with 1 tablespoon; increase this amount if the baby’s stool is too firm. Feed cereal mixed with fruit 3 times daily; morning, noon and night, and increase amounts given as baby desires.
- Vegetables should be given at a midday feeding. Thus, cereal and fruit may be given in the morning and evening and vegetables and fruit as “lunch”. Remember to introduce one at a time and then give a yellow and green vegetable each day.
6-8 Months -Fruit juices, meats, eggs and starchy foods are now added, again one at a time at weekly or greater intervals.
- Fruit juices should be strained and should be diluted with 1/2 water for 3 or 4 days, then gradually decrease the water until the juice is full strength. Juices should be offered between regular feedings. We do not recommend orange juice prior to 9 months, due to the frequency of allergic problems.
- Egg yolk may be added with the breakfast cereal 3 times per week.
- Begin feeding meats in the usual manner with either beef or lamb given with lunch and dinner. Meats should be used individually.
- Starches are offered for variety and to allow the infant to feed himself, but are poor in nutritional value. You may offer teething biscuits and Zwieback, also selected table foods such as toast, creamed potatoes, and Jell-O. This is also the time to begin to offer the cup with a very small amount of formula at a time.
8-9 Months – Junior Foods – These foods provide a transition between strained and table foods. They may not be necessary for your child. Try individual vegetables, fruits and meats first. Once these are tolerated, the mixed varieties may be used. Soft table foods and any food that can be thoroughly chopped in your blender can now be used and the finger foods, such as meat sticks, should be offered.
Pureed (strained), junior and table foods differ only in consistency and seasoning. You can change the consistency as your baby’s development requires by using the blender to puree or chop table food. When using table foods for an infant, you should remove his portion from the pan before adding seasonings other than a little salt or butter. The baby’s food will be less expensive when you can avoid buying special foods for him.
Whole eggs may be given at 9 months. You may use whole eggs in preparing the baby’s food, and scrambled eggs or dishes requiring whole egg may be fed. Ice cream is one of these. This is the time to really encourage drinking from the cup, as we like for the baby to be off the bottle by 15-18 months. Often the transition can be made by one year.
Information Regarding Stools
Your baby may have a bowel movement after each feeding or may have 1-2 stools a day. Some babies may go 48 hours without a stools and be normal. Your baby may strain when he has a stools, but unless the stool is hard and pellet-like,, this is perfectly normal. If stools are excessively watery or contain mucous or blood, call us.
Information Regarding Illness
Babies will frequently develop a stuffy nose due to milk lodging there during feeding and burping. The congestion can easily and safely be relieved by using two drops of saltwater solution in each nostril followed by suctioning with a bulb syringe. Salt Water Solution – 1/4 teaspoon of salt to an 8 ounce cup of water.
Fever is the way the human body responds to infection. Bacteria and viruses that make people sick live best at our normal temperature, 98.6°. When we’re sick, our body “turns up the thermostat” and gives us fever to fight the infection. Most physicians define fever as 101°. Temperature may be higher or lower, depending on where it is taken (in the mouth, under the arm, in the rectum), the time of day, and our activity level.
Signs of Dehydration
When a child has vomiting or diarrhea, it is important to watch for developing dehydration. Your child should urinate every 6 hours (every 8 hours if 6 or older). If your child is urinating less than this, call for an appointment.
Listlessness, sunken eyes and/or sunken “soft spot,” no tears when your child cries or noticeable weight loss are all signs that the child is not getting enough fluids. If these signs are present or the child has poor intake of liquids such that you are concerned call for an appointment.
Diet Lists for Vomiting and Diarrhea
- Breast milk
- Oral electrolyte solutions or electrolyte popsicles, these may be flavored with decaffeinated diet soda or Gatorade to improve the flavor if necessary
- All of the fluids named in List #1, plus:
- Clear soups, with rice or noodles
- Cereal (No milk or sugar)
- Fresh, well-ripened banana
- Rice cereal and strained bananas for infants
- Saltine crackers
- Dry toast, with jelly
- If desired, Jell-O
- Boiled rice, with broth, mashed potatoes (no milk or butter)
All of the foods and liquids in Lists 1 & 2, plus:
- Lean, broiled steak, ground if preferred
- Lean roast
- May use natural broth to moisten rice