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This
is not an information sheet on all the ins
and outs of working outside the home and
breastfeeding. This sheet provides information
on how your baby can be fed when you are
not with him. It is addressed in particular
to the mother who is returning to paid work
when the baby is about 6 months of age.
New mothers should stay home with their
babies for as long as practical and take
full advantage of the 52 weeks maternity
leave to which mothers have a right in Canada.
If you cannot take a full year, take at
least 6 months, better 7 months (from the
point of view of ease of continuing breastfeeding
while away from your baby). Your baby will
never be this age again.
Some Myths:
1. Babies must learn
to take a bottle so that they can be fed
when the mother is not there.
Not true. Some exclusively breastfed babies
will not take a bottle by 2 or 3 months
of age. Most, who have not taken a bottle,
and even some who did accept a bottle in
the first weeks of life will not take one
by the time they are 4 or 5 months of age.
This is no tragedy, and there is no reason
to give a bottle early so that the baby
knows how. If your baby is refusing to take
a bottle, do not try to force him; you and
he may become very frustrated and there
is just no need to go through all this.
If the baby is at least 6 months of age
when you start back at outside work, the
baby quite simply does not need to take
a bottle. If he is even 4 months, he does
not need to take a bottle. He can be fed
liquids or solids off a spoon just as any
other 6 month old and by 6 months of age
he can be taking enough so that he will
not be hungry during the day. Furthermore,
he can start learning to drink from a cup
even by 5 or 6 months of age. The cup can
be an open cup and does not need to have
a spout. Start with water as your baby may
spill a fair amount at first. If, however,
he has not got the hang of the cup by the
time you must leave him, do not worry, he
can take fluids off a spoon, or the solid
foods can be mixed with more liquid (expressed
milk, juice, water). Obviously, if the baby
is to be taking a fair amount of a variety
of foods by 6 months of age, he may need
to be started on solids by 5 months of age.
However, some babies prefer to wait for
the mother in order to drink something.
This is fine; many babies sleep 12 hours
at night without drinking or eating at all.
2. But getting the baby
to take a bottle surely won’t hurt.
Not necessarily true. Some babies do fine
with both. The occasional bottle, when breastfeeding
is going well, will not hurt. But if the
baby is getting several bottles a day on
a regular basis, and, in addition, your
milk supply decreases because the baby is
nursing less, it is quite possible that
the baby will start refusing the breast,
even if he is older than 6 months of age.
3. Babies need to drink
milk when the mother is not at home.
Not true. Three or four good nursings during
a 24 hour period plus a variety of solid
foods gives the baby all he needs nutritionally,
and thus he does not need any other type
of milk when you are at your outside job.
Of course, solid foods can be mixed with
expressed milk or other milk, but this is
not necessary.
4. If the baby is to
get milk other than breastmilk, it needs
to be artificial baby milk (infant formula)
until the baby is at least 9 months of age.
Not true. If the baby is breastfeeding a
few times a day and getting fair quantities
of a variety of solid foods, infant formula
is neither necessary nor desirable. Indeed,
babies who have not had infant formula before
5 or 6 months of age often refuse to drink
it because it tastes pretty bad. (If you
want to convince yourself of how little
we know about breastmilk, ask yourself why
it is that, although breastmilk and infant
formulas have the same amount of sugar,
breastmilk is so much sweeter). If you want
to give the baby some other sort of milk,
homogenized milk is acceptable at 6 months
of age, as long as it is not the baby’s
only food. In fact, if the baby is taking
good quantities of a wide variety of foods,
breastfeeding 3 or 4 times a day, and growing
well, homogenized milk or 2% milk is good
enough, but also not necessary.
5. Babies need to drink
milk to get calcium.
Not true. If you are worried about the baby’s
intake of calcium, he can eat cheese or
yogurt. There is no need to drink the calcium.
Besides, if the baby is also breastfeeding,
breastmilk still contains calcium.
6. Followup formulas
(artificial milk for infants over 6 months
of age) are specially adapted to the needs
of infants 6 to 12 months of age.
Not true. They are completely unnecessary
and are specially adapted to the needs of
the formula companies’ profit margins.
They also are part of a marketing strategy
that tries to get around restrictions on
the advertising of artificial baby milks
directly to the public (widely disregarded
in any case). In Europe now, there are special
formulas available for the toddler (1-3
years of age). Some people will buy anything,
it seems. But these toddler formulas will
soon be here. You can bet on it. Bottom
line über alles. We will all soon be
on formula from birth to death.
7. The breastfed baby
4 months of age needs to be getting more
iron than can be provided by breastmilk
alone.
Not true. For the baby born at term who
is breastfeeding exclusively, all the iron
required is provided by breastmilk. However,
by 6 months of age, more or less, it is
prudent for the baby to begin getting more
iron than that provided by breastmilk alone.
The best way for your baby to get iron is
through his food, and the best source of
iron is meat, not formula, and not infant
cereals.
8. The best way to assure
the baby’s getting enough iron is to
give him infant cereals.
Not true. Infant cereals do contain a lot
of iron, but most of it is not absorbed,
and this amount of iron seems to cause constipation
in some babies. Furthermore, some breastfed
babies who have had only breastmilk to 5
or 6 months of age do not like cereal. There
is nothing wrong with infant cereal, but
pushing this food on reluctant babies may
result in later feeding problems. The best
way to ensure the baby is getting enough
iron is to continue breastfeeding, and introduce
solid foods in a relaxed, enjoyable way
at the appropriate time (See handout #16
Starting
Solid Foods). The appropriate time is
when the baby is showing interest in eating
by reaching out for and trying to eat food
the parents or other members of the family
are eating. This occurs usually about 4
1/2 to 5 1/2 months of age. A baby this
age can eat what the parents eat, with few
exceptions. There is no need to be obsessive
about the order in which foods are introduced,
or trying to keep the baby eating only one
food/week. The easiest way to give extra
iron for the 6 to 12 month old baby is meat,
the iron of which is very well absorbed.
Start feeding the baby solids in a way that
makes eating enjoyable, and the baby will
eat iron containing foods just fine.
Questions? (416) 813-5757
(option 3) or drjacknewman@sympatico.ca
or my book Dr. Jack Newman’s Guide
to Breastfeeding (called The Ultimate Breastfeeding
Book of Answers in the USA)
Handout #17 What to Feed...
Revised January 2005
Written by Jack Newman, MD, FRCPC. ©
2005
This handout may be copied
and distributed without further permission,
on the condition that it is not used in
any context in which the WHO code on the
marketing of breastmilk substitutes is violated
1. Breastfeeding:
Starting out right
a) The
importance of Skin-to-Skin contact
2. Colic in the Breastfed Baby
3. a) Sore Nipples
b) Treatments
for Sore Nipple and Sore Breasts
4. Is my baby getting enough?
5. Using a Lactation Aid
6. Using Gentian Violet
7. Breastfeeding and Jaundice
8. Finger Feeding
9. a) You should continue breastfeeding
(Medications and breastfeeding)
b) You
should continue breastfeeding (Illness in the mother or baby)
10. Breastfeeding and other foods
11. Some breastfeeding myths
12. More breastfeeding myths
13. Still more breastfeeding
myths
14. More and more breastfeeding
myths
15. Breast compression
16. Starting solid foods
17. What to feed the baby when
the mother is working outside the home
18. How to know a health professional
is not supportive of breastfeeding
19. a) Domperidone 1
b) Domperidone
2
20. Fluconazole
21. Breastfeed a toddler –
Why on earth?
22. Blocked ducts and
mastitis
23. Breastfeeding your adopted baby
24. Miscellaneous treatments for problems
25. Slow weight gain after
the first few months
26. When the Baby refuses to
latch on
27. Expressing Milk
28. Toxins and Infant Feeding
How breastmilk protects Newborns
Risks of formula feeding
Breastfeeding and guilt
Candida protocol
Protocol to increase the intake
of Breastmilk by the Baby ("Not enough milk")
When latching
Protocols for Induced Lactation
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