We may take it for granted, but for a newborn, eating is a huge accomplishment!
We see it happen so naturally in newborns, it seems simple. Newborn puppies find their mama’s teat before they can open their eyes, latch on and feed instinctively. Newborn humans typically need to be fed within the first hour of birth. Off they go, it's a
|Thanks to www.creativecommons.org|
If you're lucky, all will go well with those mealtimes. You'll be looking for ways to make meaningful, bonding, quality times. Here are some suggestions to support fun during these mealtime frenzies:
- Set the feeding area up for comfort! Bring a pillow or two nearby in case you need a quick adjustment. Don’t forget the remote control, a drink and perhaps a snack for yourself. Create a place you can prop your feet up.
- Set the mood with appropriate lighting and sound. Music is preferable to television, as it frees you to watch baby and respond to her signs during the meal. However, this is not the time to play blaring rap or heavy metal music. Music with a steady rhythm is shown to be calming, whereas irregular rhythm (like jazz) stimulates the nervous system. If you do watch television, be aware of what you’re watching while feeding your baby. If the show is suspenseful (yes, baby feels your body tension) or even just too loud, baby won’t be able to maintain the right alertness level. Perhaps you think baby sleeps through these loud or scary shows, so it doesn’t matter. Newborns will fall asleep if they are OVER-AROUSED as easily as if they are tired. You don’t want to over-arouse baby, and you don’t want to put baby to sleep during mealtime. Adjust the environment to find the just-right stimulation that supports baby’s ability to calmly complete mealtime.
- If you’re inclined to hum or sing, go ahead! Mealtime is a good time to do the things that support your happiness and help baby feel happy, too. Watch baby’s body and face for signs of contentment. Enjoy them together. A recent scientific study found that mother's voice helps normalize (ie., modulate) baby's arousal state. If baby's stressed, it calms. If baby's too groggy, it alerts. Find this study here.
- Interact with eye contact and facial expression as suits the two of you. At first, newborns cannot establish eye to eye gaze, but they may try to focus on your face briefly. This develops readily in the first couple of months, so it won’t be long until baby wants to engage with you eye to eye. These times can really touch your heart. Smiles start to be shared, as do other facial expressions, even during feeding. These back and forth playful exchanges of love and contentment are super-healthy—for both of you! If you're uncomfortable with eye contact, now is the time to get some practice for yourself! Baby won't judge you, so go ahead and give it a try.
|Thanks to www.creativecommons.org|
Sweet baby gazing time!
But sometimes things aren't so simple. If you're having any trouble with mealtime, read on. . .
|Photo courtesy of www.milkmatters.org.uk|
Babies need plenty of nutrition for all the growing they're doing, so if there's a problem feeding, they need your help. You may be surprised to find that feeding is an extremely complex task, requiring a delicate balance of structure and function on both the feeder and the feedee’s parts. If one small thing goes awry, the whole process can be thrown off, with potentially disastrous results.
Think about it.
|Note loosened sphincter permitting gastric juices to splash into the esophagus. Picture from: https://www.webmd.com/heartburn-gerd/ss/slideshow-heartburn-overview|
- Position baby more upright during feeds (about 45 degree angle). This employs gravity to help the fluid stay in the stomach. Be sure to provide adequate head, neck, shoulder and torso support so that swallowing is still supported.
- Interrupt feeding every 1.5-2 ounces to facilitate burping. Place baby prone on your chest and shoulder rather than sitting forward on your lap. Burping with baby sitting places more pressure on the organs which can push fluid out of the stomach. Burping with baby laying on your chest and shoulder with her body straighter helps keep the fluid in the stomach.
- Try a slower flow nipple. See here for a chart of real-life flow rates for various brands. Slowing the flow and taking frequent breaks can help by giving more time for the stomach to process what it has so it doesn’t get backed up.
- Try anti-gas bottle feeders, such as Dr. Brown’s, which keep gas from getting into the fluid as baby feeds. Be sure to read and follow the instructions that come with the bottle. Don’t shake a bottle prior to feeding. This adds gas bubbles to the fluid. Swirl or gently stir instead.
- Try thicker formula or a thickening agent approved for infant use. Be sure to only thicken slightly. This is best done with doctor’s advice, and with a feeding therapist’s close supervision as you establish the best viscosity. Thickeners like rice cereal can be dangerous because they can clump and cause baby to gag or choke on clumps. Only use this if your doctor recommends it, and even then watch very closely for signs of gagging (in the mouth) or choking (in the "tube."
- HOLD baby upright for 30 minutes after meals. Laying on your chest position is optimal, according to recent research, following the recall of supine-incline infant sleepers. If baby must lay down, lying on his left side after meals is preferable to the right. This is due to the angle of the structures; when lying on the left, food is more likely to stay in the stomach rather than being forced out.
|Note in chart pictured, how fewer episodes occur in the left side position. This is from research found at this site: https://www.slideshare.net/TauhidBhuiyan1/gastroesophageal-reflux-in-preterm-neonate|
References for the above are blended into the text. If you see a different color text, except for red and green which are used to highlight, you should be able to click on it to the source or further reading. Most photos also have clickable links to their source for more information.