Baby and Beyond - The Feeding Survival Guide: Paula Elbirt, MD
By Paula Elbirt
Babies grow and change so fast, and their diet requirements change with them. We learned how to meet the nutrition needs of your child at every stage of life when pediatrician Paula M. Elbirt, MD, was our guest in the WebMD University Student Lounge.
The opinions expressed herein are the guest's alone. If you have questions about your health, you should consult your personal physician. This event is meant for informational purposes only and is sponsored by Enfamil.
Moderator: Welcome to WebMD University: "Feeding Yourself, Feeding Your Baby." This event is sponsored by Enfamil. Our instructor today is pediatrician "Dr. Paula," Paula M. Elbirt, MD.
Dr. Paula: Parenting is the hardest and most rewarding job out there. I am privileged to be both a parent and a guide for parents so enjoy this hour and remember your children are your most precious gift to the future.
Member: What do you think of Enfamil Lipil? I have a 7-month-old on Enfamil with Iron. He was breastfed for his first five months and weaned himself.
Dr. Paula: This new formula has been long awaited and adds to the importance of knowing what we're feeding our babies by expanding the quality of supplementary feedings. Breast is still superior on many levels that cannot as of now be replicated in the laboratory, but the addition of these essential oils or fatty acids takes us a huge step closer to the right stuff. I look forward to other formulas and early infant first foods similarly being manufactured with these essential fatty acids, so look for them.
Member: I am nursing a healthy 8-month-old girl and working full time, so I pump while I am at work. I am only able to pump three 3-ounce bottles to leave for her during the day. She is eating some foods, but I am concerned that I am not leaving enough milk for her. How much milk should an 8-month-old be drinking in a 10-hour period?
Dr. Paula: Yours is a very common problem compounded by the anxiety you feel about how much milk your baby is getting directly from your body. Pumping does, in fact, result in fewer ounces produced than direct breastfeeding but the majority of the benefits that we expect from breast milk is still provided at this age by the 10 ounces or so of milk that you are providing. Most infants at this age still drink closer to 25 ounces a day so you may need to provide formula supplementation if you cannot nurse more often, but it would be just as advantageous to your baby if you would nurse after work directly and let nature provide the correct total amount in that way. Your body will adjust to producing more milk at night by this method and your baby will not need as much or perhaps any formula supplementation. Also know that at 10 months, you will see a natural decline in milk intake so that by 1 year of age, many infants only require 16-20 ounces of milk a day.
Member: Why does pumping produce less milk?
Dr. Paula: Clearly, the human system of contact between an actual baby's mouth and your actual nipple is the most advantageous. Anything less similar to that such as a pump will decrease the quantity by removing some of the basic natural stimulants that exist when mouth touches nipple. Some people have measured oxytocin levels produced during pumping and, not surprisingly, the levels are lower than with direct breastfeeding. It also hurts more to pump for some women and that signal also turns down production.
Member: I have a 1-year-old who has recently started waking up at night, sometimes two times, and wants a bottle. She had been sleeping all night while I was breastfeeding but seems to only want the bottle during the night.
Dr. Paula: Your baby misses the physical contact with your body and probably no longer needs nighttime feeds. In fact, continuing to offer nighttime bottles may contribute to more frequent wakeups, not to mention nutritional imbalances. What your baby needs to eat during the day may be diminished by large intakes at night or if not, may just add unnecessary calories. I strongly suggest holding your baby when she wakes, preferably close to your chest, and then lying your baby back down with a light garment like a T-shirt that you were holding together with your baby during that wakeup. This will provide most of what your baby really is looking for and hopefully diminish the nutritional errors that are made when this common situation occurs. Good luck and persist because your baby is willful and strong and won't go easily back to sleep for a good week or so. Don't give up!
Member: She refuses the bottle during the day and we are constantly playing with her. She will eat her food but not the bottle.