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Baby Matters

Feeding Your Newborn and Recognizing Dehydration

January 1st, 2016

By Sara Calderon

Congratulations! You have a brand new baby! How do you know how much to feed your new baby? How often? How can you tell if your baby is not getting enough?

Your baby, born at term, has a stomach the size of a cherry. By the end of the first week that stomach will grow to the size of a small apricot. By the end of the first month it is the size of a large egg.

Babies do not need a large amount of milk at each feeding. With their small stomach size they benefit from smaller and more frequent feeds. Breastfeeding every 2 to 3 hours – or 8 times in a 24-hour period - is very normal. If you are breastfeeding, your body regulates milk supply to your baby’s own needs. As your baby’s stomach size and appetite grow, your body will produce more milk.

If you are bottle-feeding, remember your baby’s stomach size is small in those first few weeks. 1 - 2 oz (30-60 ml) of milk (breast milk or formula) every 2-3 hours is more than enough for your newborn baby.

Remember: small amounts and feed more often! With time your baby will be able to take larger amounts of milk and sleep 3-4 hours (or longer!) in between feeds.

Healthy, term babies eat in a “demand” fashion. They will cry out when they are hungry and they will settle once they get enough. Remember, in the first few weeks with small stomach sizes, babies might need to eat every 2 hours.

You will know your baby is getting enough by paying attention to the following:

  • Wet diapers: In the first day of life your baby might only have 1-3 wet diapers. Once your baby is feeding frequently your baby should be having at least 8 wet diapers in a 24-hour period. The urine should be a pale yellow colour.
  •  Stools (poopy diapers): In the first couple days your baby will pass meconium – the dark, tarry, sticky stool. Your baby might only have 1-3 stools the first day or two. The stool will then change to a more yellow, seedy stool if breastfeeding, and to a more yellow, pasty stool if formula feeding. Once your baby starts feeding frequently you might find your baby has 6-10 stools in a 24-hour period. Breastfed babies tend to stool more often. Formula fed babies may not stool as often.

When should you be concerned and have your baby looked at by a health care provider:

  •         If the number of wet diapers has decreased to less than 4 in 24 hours
  •         If your baby has not pooped in more than 2 days
  •         If your baby is not waking up for feeds and is extra sleepy
  •         If your baby seems irritable and does not settle with feeds
  •         If the soft spot on the top of your baby’s head feels sunken in
  •         If your baby has a persistent fever over 38°C

Sara Calderon is a Neonatal Nurse Practitioner (NNP) at the Stollery Children’s Hospital. She works in the NICUs in the Edmonton zone as well as the Sturgeon Community Hospital. She mainly provides clinical care for premature and ill infants in the NICUs but also assesses term newborn infants that come in with poor feeding and dehydration. She has been an NNP for 5 years and has 11 years of NICU experience.

 

Tags: advice, Babies

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