Когда прикармливать малыша на грудном вскармливании: когда вводить по месяцам, когда и чем

Кормим малыша правильно, или Когда вводить прикорм при грудном вскармливании

Прикорм — это питание, которое предлагают малышу по достижении им определенного возраста. Вводимые продукты дополняют грудное молоко, позволяя детскому организму получить больший спектр питательных веществ, витаминов и минералов. В первый год жизни очень важно сформировать правильный и сбалансированный рацион питания, так как именно в этот период закладываются основы здоровья ребенка. Всех родителей волнует вопрос о том, когда вводить прикорм при грудном вскармливании, какие продукты предлагать ребенку, по какой схеме. В этой статье мы постараемся ответить на все эти важные вопросы.

Когда вводить прикорм при грудном вскармливании: меню шестимесячного малыша

Российские педиатры советуют вводить первый прикорм ребенку, находящемуся на грудном вскармливании, когда он достигает шестимесячного возраста. Именно к концу первого полугодия жизни у него формируется готовность к принятию иной, помимо молока, пищи. У ребенка прекращает функционировать выталкивающий рефлекс языка, то есть малыш может проглотить что-либо съестное, предложенное на ложечке. К этому времени малыш учится сидеть, наклоняться к ложке и отклонять корпус, показывая нежелание есть. В целом ребенок становится более активным и подвижным, поэтому его деятельность начинает требовать более серьезной «подпитки». Шестимесячные детки уже показывают интерес к пище: наблюдают за трапезой родителей и проявляют желание попробовать их еду. Считается, что грудное молоко к 6 месячному возрасту перестает удовлетворять на 100% потребности растущего организма. Тем не менее, даже если вы отмечаете у своего малыша несколько признаков готовности к опробованию новых продуктов, начало прикорма при грудном вскармливании вы должны обсудить с педиатром. Именно врач подскажет, какой именно продукт подойдет для первого прикорма вашему ребенку, и когда конкретно необходимо начинать обогащать рацион грудничка. Итак, мы рассмотрели, когда вводить прикорм при грудном вскармливании наиболее оптимально. Шесть месяцев — это возраст, который, по мнению Союза педиатров России, наиболее подходит для введения продукта первого прикорма. Тем не менее, все дети индивидуальны, и более точное время для опробования новой пищи вам подскажет ваш специалист.

Когда вводить прикорм при грудном вскармливании и как? Основные правила ознакомления ребенка с новым продуктом

На шестом месяце жизни малыша кормят 5 раз в день, выдерживая между приемами пищи промежутки в 3,5 часа. Ночной перерыв составляет 10 часов. Первый прикорм желательно предложить в обед (12-13 часов), либо в иное время, помимо утреннего и вечернего. Новый продукт предлагается перед кормлением грудью, это повышает шансы того, что малыш заинтересуется едой и проглотит ее с большим энтузиазмом. Начинают прикармливать с очень малой дозы — половины чайной ложечки каши или овощного пюре. И в течение последующих 10 дней постепенно доводят дозу до необходимого для ребенка объема (около 150 г). Для введения пищи стоит приобрести специальную мягкую силиконовую ложечку, снижающую вероятность случайного травмирования ротовой полости крохи. Предлагать еду стоит очень осторожно и терпеливо, ни в коем случае нельзя оказывать давление, настаивать и принуждать малыша. После того, как у вас получилось ввести один продукт, начинайте «разбавлять» его новым видом овощей или каш. К примеру, прикармливать можно начинать с кабачкового пюре, через 10 дней к нему добавляем половину ложечки пюре из цветной капусты. И постепенно увеличиваем количество цветной капусты, уменьшая при этом объем кабачкового пюре. Чуть позже в овощи можно будет добавлять растительное масло — оливковое, подсолнечное и др.

Схема прикорма при грудном вскармливании, рекомендуемая российскими педиатрами

Существует два основных варианта введения прикорма:

• начало прикорма с монокомпонентных безглютеновых каш на воде — рис, гречка, кукуруза;
• начало прикорма с пюре из овоща одного вида (зеленого или белого окраса) — кабачка, цветной капусты, горошка, капусты брокколи, стручковой фасоли.

Введение овощей советуют начинать для ребенка с признаками рахита, пищевой аллергии, анемии. Деткам с малой массой тела, а также часто срыгивающим малышам в качестве первого продукта прикорма можно предложить кашу. Стоить помнить, что все каши готовятся на воде, либо с использованием грудного молока. Цельное коровье молоко нежелательно использовать до восьмимесячного возраста. Неплохой альтернативной самостоятельному приготовлению пищи считаются готовые каши. Они производятся из качественного сырья и обогащаются различными витаминами и микроэлементами. В первые разы кашу разводят до очень жидкого состояния, а затем постепенно делают ее гуще, доводя до консистенции жидкой сметаны. Постепенно можно добавлять в нее сливочное масло.

Когда вводить прикорм при грудном вскармливании: меню семимесячного малыша

После ознакомления с первым видом продуктов можно переходить к расширению рациона. Следующим шагом станет формирование прообраза «завтрака» — замена десятичасового кормления иными продуктами, кроме грудного молока. Если сначала вы кормили ребенка овощами на обед, то теперь на очереди — каши. Выбор первой крупы зависит от вашего ребенка: если малыш склонен к запорам, желательно начинать с гречки, если имеет место диатез — с риса или кукурузы. Каши вводятся точно так же, как и овощи: начиная с половины чайной ложечки на завтрак и постепенно доводя порционный объем до 150 г. В случае если блюдом первого прикорма это были каши, в 7 месяцев малышу необходимо предложить овощи. Также в это время вводится желток (куриное яйцо варится вкрутую). Начинают ввод желтка с нескольких крупинок, доводя общий объем продукта до 1 шт. дважды в неделю. Желток можно перетирать с грудным молоком или перемешивать с кашей или овощным пюре.

Как и когда вводить прикорм при грудном вскармливании? Мясные и кисломолочные продукты

На восьмом месяце жизни пришло время познакомить вашего ребенка с мясными продуктами. Мясное пюре предлагается по аналогии с кашами и овощами, начиная с 1/2 чайной ложки, в течение недели объем доводят до 40-50 г. Все мясные блюда должны быть хорошо измельченными, чтобы малыш мог легко проглотить их и не подавиться. Хорошей альтернативой домашнему приготовлению являются промышленные монокомпонентные мясные консервы — без соли, приправ и иных ненужных добавок. Для первого ознакомления с мясом подойдет говядина, индейка, кролик. Итак, введение любого продукта проводится по одной схеме. Сначала малышу предлагается совсем небольшое количество еды, тщательно отслеживается его реакция. Если все проходит хорошо, объем пищи постепенно увеличивают. После введения каш, овощей и мяса в рацион ребенка с 9-го месяца жизни начинают включать кисломолочные продукты (творог, кефир) и хлебобулочные изделия. А с 10-го месяца — фруктовые пюре и соки (яблоко, груша, слива и пр.). На 11 месяце жизни можно предложить ребенку рыбу. Таким образом, к году формируется полноценный рацион и режим питания, и малыш приобщается к взрослой пище, питаясь разнообразно и качественно.

90000 My baby fusses or cries when breastfeeding 90001 90002 By Kelly Bonyata, BS, IBCLC 90003 90004 90002 © Lsantilli — Fotolia.com 90003 90002 Some babies will fuss, cry or pull off the breast during breastfeeding. There are a number of reasons why this might be happening. It’s pretty common to see this type of behavior at around 6-8 weeks, though it can occur at any time. If your baby is generally fussy (not just when nursing) see My baby is fussy! Is something wrong? 90003 90009 90010 90009 Determining the problem 90010 90002 Here are some of the problem-solving steps I go through when my baby is fussy at the breast or a mother asks me why her baby is fussing while breastfeeding: 90003 90002 90016 How old is baby? 90017 Most babies go through growth spurts during the first few days at home and around 7-10 days, 2-3 weeks, 4-6 weeks, 3 months, 4 months, 6 months, 9 months, etc.Many babies are fussy during growth spurts. 90003 90002 90016 Is baby working on anything new developmentally? 90017 Babies who are starting to notice the world around them can be notoriously distractible. Any kind of new developmental step that baby is working on can affect nursing temporarily, whether it be fussy nursing behavior or simply more frequent nursing. 90003 90002 90016 When is baby fussing? 90017 To figure out the cause it’s helpful to pay attention to 90026 when 90027 the fussy behavior happens, both during the nursing session and during the day.90003 90002 If baby is fussy right when your milk is letting down (or immediately after), there’s a good chance that the fussy nursing is related to a fast let-down. If baby is fussy before let-down, or a few minutes into nursing (and a while after let-down), then baby may be impatient for the fast flow of milk that comes with let-down. Fussing at the end of a nursing session (or what seems to be the end) may mean that baby needs to burp, or is ready to finish nursing, or just wants to suck (and does not want to deal with a new let- down at this point), or wants to continue nursing on the other side or with a faster flow of milk.90003 90002 If the fussy behavior is mainly in the mornings, it might be due to a faster than usual let-down if baby has just had a longer sleep period and mom’s breasts are fuller than usual. If baby is fussier during evening nursings, it may be due to the normal fussy time that most babies have during the evening. Although most babies do not react to foods that mom eats, some do. If you eat a particular food at about the same time each day (or most days) and baby has a regular time where she fusses during nursing, try not eating that food for a week or two to see if things improve.90003 90002 90016 Does fussing occur on both sides equally or only on one side? 90017 Most moms have a faster let-down and / or a more abundant milk supply on one side than the other, so if your baby fusses more on one side, it may be due to these differences. 90003 90002 90016 What else is going on with baby? 90017 Is she sick or teething? Is something new or different going on in her environment? Has she started solids or is she trying a new food? Is she exhibiting other symptoms besides the fussy nursing? 90003 90002 Below are discussions of some of the different things that can lead to fussy nursing behavior.Keep in mind that the problem may also be a 90026 combination 90027 of several things. 90003 90009 Does baby need to burp? 90010 90002 Many babies will cry, fuss, pull off the breast, etc. if they need to burp. Try to burp between breasts and after a feeding, but do not worry if baby does not burp and is content. Breastfed babies overall do not take in as much air during a feeding as bottle-fed babies do, so usually do not need to burp as often. If baby has been crying before she nurses, or is so hungry that she nurses «frantically» or if mom has a fast let-down, baby could be taking in more air and may need to be burped more often.90003 90002 Burping is usually only necessary during the first few months, though it may extend longer. Once your baby is moving more freely, she will be able to relieve the gastric gas herself. This usually will occur between the 4th and 6th month, but may be shorter in some children and longer in others. 90003 90002 If baby has a hard time burping, try burping more often during a feeding. The best burping position is one that applies firm pressure to the baby’s tummy. Placing baby over the shoulder 90026 way 90027 up so that there is pressure on baby’s abdomen often works well.Walking around while doing this might distract her long enough to get a good burp. You may even want to lie baby down on her stomach and burp her that way. 90003 90009 90010 90009 Growth spurt 90010 90002 Babies often pull off and fuss during growth spurts. Most babies go through growth spurts, sometimes called 90026 frequency days 90027, during the first few days at home and around 7-10 days, 2-3 weeks, 4-6 weeks, 3 months, 4 months, 6 months and 9 months ( more or less). More growth spurt information in this link.90003 90009 90010 90009 Distractible baby 90010 90002 If baby seems to be pulling off the breast at any distraction (real or imaginary), then see The Distractible Baby. 90003 90009 90010 90009 Forceful let-down 90010 90002 Some babies will pull off the breast soon after let-down if mom has a forceful let-down. Baby may be frustrated by the too-fast flow of milk with let-down. A too-forceful let-down can also cause excessive gas or spitting up / vomiting. There is more information here on symptoms of and how to deal with a fast let-down reflex.90003 90009 90010 90009 Slow let-down 90010 90002 Some babies get very impatient if mom has a slow let-down. There is more information here on speeding up a slow let-down reflex. 90003 90009 Baby wants a faster milk flow 90010 90002 Even very young babies can be quick to notice that pulling off, kneading the breast, etc. can cause an additional let-down, and can facilitate a faster, easier milk flow. Some babies become impatient with the slower milk flow following the initial fast flow at let-down.This may or may not be related to a slow let-down. 90003 90002 When a feeding begins at the breast there are drops of milk. Then when the initial let-down occurs (several seconds to a minute into the feeding), the milk flow speeds up quite a bit. At that time it may drip very quickly, squirt, or even spray. Some minutes later it slows again and the baby must continue to suck vigorously in order to elicit further let-downs. This pattern can continue through successive, multiple let-downs as long as the baby is continuing to nurse vigorously.Eventually, baby will learn that the flow will pick back up again if she’ll only continue to vigorously suck / swallow. 90003 90002 With bottle feeding, the flow is instant and continuous. The baby is required to work very little. Once a baby has had a bottle, especially a lot of bottles, she may begin to prefer the ease of bottle-feeding over the work of breastfeeding. She may become frustrated at the breast after the first let-down occurs and the flow of milk begins to slow. 90003 90002 If baby is getting bottles you might consider putting them away, at least for a while.When you must use a bottle, only use a newborn nipple for as long as baby will tolerate it so that she never gets a really fast flow of milk from the bottle, but has to work a little more to get the milk. 90003 90002 Sometimes babies of moms with oversupply or fast let-down will also get very used to the fast flow and object when it normally slows somewhere between 3 weeks to 3 months. 90003 90002 It can be helpful to do some breast compression when this fussiness starts or right before you expect it to.This will help speed up the milk flow again. Once compression stops helping, try switching baby to the other side when she begins to fuss and back and forth again (after using compression) as you need to. 90003 90009 90010 90009 Baby is done nursing for the moment 90010 90002 If baby is fussing after she’s been nursing for a while, and you’ve ruled out other causes, she may be in the process of changing her nursing pattern. Babies become very efficient at the breast with growth and maturity.They can milk the breast in a lot less time per feeding session than they required before. Baby’s frustration may just be a sign that she’s finished and wants to move on. 90003 90002 On a similar note, an occasional baby will just want to suck at the end of a nursing session and the flow of milk with let-down frustrates her. You might see if offering her a finger or pacifier (if baby is older than 4-6 weeks) to suck on during these times seems to help. 90003 90009 90010 90009 Baby prefers one side 90010 90002 Sometimes babies will refuse or fuss at a breast when the let-down is slower or too forceful, or the supply a bit lower.They in turn will prefer the side which lets down more / less quickly and in which the supply is more bountiful. See also: Lopsided! What can I do? 90003 90009 90010 90009 Fussy in the evening 90010 90002 Many young babies tend to pull off and fuss at the breast in the evening. See the article Cluster Feeding and Fussy Evenings. 90003 90009 90010 90009 Teething 90010 90002 Teething can cause fussy nursing behavior, as some babies experience gum discomfort with sucking. Baby might start to nurse, but then pull off and cry or fuss and not want to nurse anymore.See Teething for more information and tips. 90003 90009 90010 90009 Thrush 90010 90002 Frequent pulling off the breast can be a symptom of thrush. 90003 90009 90010 90009 Stuffy nose 90010 90002 A stuffy nose can cause fussy nursing behavior. If your baby has a stuffy nose and is having a hard time breathing and nursing at the same time, see colds & congestion. 90003 90009 90010 90009 Allergy or food sensitivity 90010 90002 Some babies with allergies or food sensitivities exhibit fussy nursing behavior.Often when there is a sensitivity to something in mom’s diet, baby will come to the breast hungry but when she tastes / smells something in the milk that will cause her GI distress, she pulls off, bats her head back and forth, etc. Sensitivities to foods in mom’s diet are rare. If this is the problem, you will most likely notice other symptoms, such as excessive spitting up or vomiting, colic, diarrhea, rash, persistent congestion or runny nose, or excessive gas. More information on food sensitivities in babies and links to more allergy information can be found in my article Dairy and other Food Sensitivities in Breastfed Babies.90003 90009 90010 90009 Low milk supply 90010 90002 Low milk supply can cause baby to be fussy at the breast. If you feel that your milk supply may be low, see this page for more info: Increasing low milk supply. 90003 90009 90010 90009 Reflux 90010 90002 Reflux can result in baby being fussy at the breast. See Reflux and Breastfeeding for more information. 90003 90009 90010 90009 Tongue-Tie 90010 90002 Tongue-Tie can result in baby being fussy at the breast. See Breastfeeding a Baby with Tongue-Tie (Resources) for more information.90003 90002 90003 .90000 Weaning: When and how to stop breastfeeding 90001 90002 What does it mean to have weaned a child? 90003 90004 Your baby is considered weaned when he stops nursing and gets 90005 all 90006 his nutrition from sources other than the breast. Although babies are also weaned from the bottle, the term usually refers to when a baby stops breastfeeding. 90007 90004 Weaning does not necessarily signal the end of the intimate bond you and your child created through nursing. It just means you’re nourishing and nurturing him in different ways.90007 90004 For example, if you often nursed your child for comfort, you’ll have to find other ways to make him feel better. Read a book, sing a song together, or play outside instead. If your child protests, try to stay calm and be firm. If you need to, hand him to your partner for a cuddle. 90007 90002 When should I start weaning? 90003 90004 You’re the best judge of when it’s time to wean, and you do not have to set a deadline until you and your child are ready. The American Academy of Pediatrics recommends that mothers breastfeed for at least a year — and encourages women to breastfeed even longer if both you and your baby want to.90007 90004 Despite what friends, relatives, or even strangers may say, there’s no right or wrong way to wean. You can choose a time that feels right to you, or let your child wean naturally when she’s older. 90007 90004 90019 Baby-led weaning: 90020 Weaning is easiest when your child begins to lose interest in nursing, and that can happen any time after she starts eating solids (around 4 to 6 months). Some babies are more interested in solid food than breast milk by 12 months, after they’ve tried a variety of foods and can drink from a cup.90007 90004 Toddlers may become less interested in nursing when they grow more active and are not inclined to sit still long enough to nurse. If your child is fussy and impatient while nursing or is easily distracted, she may be giving you signs that she’s ready. 90007 90004 90019 Mother-led weaning: 90020 You may decide to start weaning because you’re returning to work. Or maybe it just feels like the right time. If you’re ready but your child is not showing signs she wants to stop nursing, you can wean her off the breast gradually.90007 90004 When it’s the mother’s idea, weaning can take a lot of time and patience. It also depends on your child’s age and how she adjusts to change. 90007 90004 It’s a good idea to avoid the ‘cold turkey’ approach to weaning. For example, a weekend away from your baby or toddler is not a good way to end the breastfeeding relationship. Experts say that abruptly withholding your breast can be traumatic for your baby and could cause plugged ducts or a breast infection for you. 90007 90002 How do I wean? 90003 90004 Go slowly, and expect to see signs of frustration from your baby at first.Ease the transition by using these methods: 90007 90004 90019 Skip a feeding. 90020 See what happens if you offer a bottle or cup of milk instead of nursing. You can substitute pumped breast milk, formula, or whole cow’s milk (if your child is at least a year old). 90007 90004 Reducing feedings one at a time over a period of weeks gives your child time to adjust. Your milk supply also diminishes gradually this way, without leaving your breasts engorged or causing mastitis. 90007 90004 90019 Shorten nursing time.90020 Start by limiting how long your child is on the breast. If he usually nurses for ten minutes, try five. 90007 90004 Depending on his age, follow the feeding with a healthy snack, such as unsweetened applesauce or a cup of milk or formula. (Some babies younger than 6 months may not be ready for solids.) Solid food is complementary to breast milk until your baby is a year old. 90007 90004 Bedtime feedings may be harder to shorten because they’re usually the last to go. 90007 90004 90019 Postpone and distract.90020 Try postponing feedings if you’re only nursing a couple of times a day. 90007 90004 This method works well if you have an older child you can reason with. If your child asks to nurse, reassure him that you will soon and distract him with a different activity. If he wants to nurse in the early evening, explain that he has to wait until bedtime. 90007 90004 To ease your baby’s transition to a bottle, try putting a few drops of breast milk on his lips or tongue before slipping the bottle’s nipple into his mouth.You can also try giving him a small amount of breast milk in a bottle a couple of hours after breastfeeding but before he’s so hungry that he’s impatient and frustrated. 90007 90002 Will my child get enough nutrients? 90003 90004 Even exclusively breastfed infants need extra nutrients that breast milk can not provide, like vitamin D. If you wean your baby before she reaches her first birthday, she’ll need to continue to drink breast milk or iron-fortified formula until she’s a year old. Then once your child reaches toddlerhood, it’ll be necessary to give her a wider variety of foods that offer the range of nutrients she needs to help her grow.90007 90002 What to do when weaning becomes a struggle 90003 90004 If you’ve tried everything to wean your child and nothing is working, maybe the time is not right. 90007 90004 Have you recently gone back to work? Your child may still be adjusting to the new routine. 90007 90004 Is your child sick? Babies often want to nurse more frequently when they do not feel well. And breastfeeding a sick child is not only comforting, but also a good source of nutrition. 90007 90004 Is your household going through a major life change? Events such as a move or divorce can also make weaning more difficult.Even going through a new developmental stage can make it hard to wean. 90007 90004 Try again in another month. Sooner or later, it’ll happen. 90007 .90000 What should I know about giving my breastfed baby a pacifier? • KellyMom.com 90001 90002 By Kelly Bonyata, BS, IBCLC 90003 90004 90005 90006 When can I begin using a pacifier? 90007 90002 It is recommended that pacifiers and other types of artificial nipples be avoided for at least the first 3-4 weeks. I’d personally suggest that 90009 most 90010 breastfed babies — if they get a pacifier at all — would be better off without a pacifier until mom’s milk supply is well established (6-8 weeks, usually) and the 6 week growth spurt is over .That way you’ve established a good milk supply and do not lose any much-needed breast stimulation to a pacifier. 90003 90012 90002 flickr CC ff137 90003 90004 What should I consider before using a pacifier? 90007 90002 After the early weeks, pacifier use is less likely to cause problems as long as you are aware of the following: 90003 90019 90020 Never substitute a pacifier for a feeding at the breast or try to hold the baby off longer between feedings with one. (See Should baby be on a schedule?) 90021 90020 There are studies that indicate that babies who take a pacifier tend to wean earlier than those who do not.This is most likely because as a baby gets older — once he’s established on solid food — it is often his desire to suck that ensures he continues to seek out the breast often. Babies who use pacifiers are getting that need to suck met with something other than the breast, and therefore may decide to give up breastfeeding sooner than if they did not take a pacifier. 90021 90020 Some babies who take pacifiers are more prone to oral yeast (thrush) which can be transferred to mom’s nipples. 90021 90020 A number of studies have shown a link between pacifier use and an increased incidence of ear infections.90021 90020 Pacifiers can result in choking or strangulation if the pacifier breaks or if it is tied around the neck (which it never should be). Follow all safety guidelines and keep an eye out for the many pacifier safety recalls. Also, keep in mind that latex allergy is becoming an increasing problem — consider using a silicone pacifier rather than latex. 90021 90020 Prolonged pacifier use can result in teeth misalignment, and can also occasionally lead to shaping of the soft palate or speech problems.90021 90020 Giving baby a pacifier will increase mom’s chances of ovulating and getting pregnant. Exclusive breastfeeding, depending upon your breastfeeding frequency and other factors, is a method of birth control that can be more than 98% effective during the first 6 months and 94% effective during the second six months. Ensuring that all of baby’s sucking needs are met at the breast increases the effectiveness of this method of contraception. 90021 90034 90004 When to avoid the pacifier 90007 90002 If you observe any of the following problems, it would be a good idea to discontinue pacifier use, at least until the problem is resolved: 90003 90019 90020 Pacifier use reduces your baby’s frequency or duration of feeds (newborns should be nursing at least 8 to 12 times a day).90021 90020 Baby is having difficulties nursing well (this may be due to nipple confusion). 90021 90020 Baby is having problems with weight gain (in which case baby needs to nurse as often as possible). 90021 90020 Mom is having problems with sore nipples (baby may be causing this due to nipple confusion) 90021 90020 Mom is having milk supply problems (in which case she needs to put baby to breast, not pacifier, at every opportunity in order to increase milk supply). 90021 90020 Mom and / or baby have thrush, particularly if it’s hard to get rid of or repeated.90021 90020 Baby is having repeated ear infections (an increased incidence of ear infections has been linked to pacifier use). 90021 90034 90004 Can pacifiers help prevent SIDS? 90007 90002 Have you heard that pacifier use might help to prevent SIDS? Here’s what the American Academy of Pediatrics Section on Breastfeeding says about this in their February 2012 Policy Statement: 90003 90059 90002 Given the documentation that early use of pacifiers may be associated with less successful breastfeeding, pacifier use in the neonatal period should be limited to specific medical situations.These include uses for pain relief, as a calming agent, or as part of structured program for enhancing oral motor function. Because pacifier use has been associated with a reduction in SIDS incidence, mothers of healthy term infants should be instructed to use pacifiers at infant nap or sleep time after breastfeeding is well established, at approximately 3 to 4 weeks of age. 90003 90062 90004 In conclusion … 90007 90002 As long as you keep the above in mind and only use a pacifier sparingly, it is up to you whether and when you wish to comfort baby yourself or with a pacifier.However, keep in mind that there is no scientific evidence that suggests that babies have a need to suck 90009 independant 90010 of the need for food. When a baby is indicating a sucking need, it’s generally best that baby be encouraged to breastfeed, especially if there is a weight gain concern. The breast was the first pacifier and in most cases remains the best. 90003 90002 90003 90004 More information 90007 90002 Is your baby nursing all the time? 90005 @ 90006 90076 90003 90002 Pacifiers by Diane Wiessinger, MS, IBCLC 90003 90002 Pacifiers: In or Out? and Giving a pacifier to a breastfed baby by Dr.William and Martha Sears 90003 90002 Top Ten Reasons for NOT Using a Pacifier by Linda J. Smith, IBCLC 90003 90002 Perils of the Pacifier by Bruce A. Epstein, MD 90003 90002 AAP Guide to Thumb Sucking and Pacifiers (including safety guidelines) 90003 90002 Nipple Confusion from AskDrSears.com 90003 90002 The Truth About «Nipple Confusion» by Paula Yount 90003 90002 Introducing Bottles and Pacifiers to a Breastfed Baby by Anne Smith 90003 90002 Dealing with Nipple Confusion from 90009 Breastfeeding and the Working Mother 90010 by Cecilia Mitchell Miller 90003 90002 The Pitfalls of Supplementing a Breastfed Baby by Cheryl Taylor White 90003 90002 Late Nipple Confusion by Carrie Ganz, from NEW BEGINNINGS, Vol.16 No. 2, March-April 1999 року, p. 43. 90003 90002 Nursing Through Confusion by Olga April (a mom’s story) 90003 90004 Some Journal Articles on Pacifier Use and Breastfeeding 90007 90002 Kair LR, Kenron D, Etheredge K, Jaffe AC, Phillipi CA. Pacifier Restriction and Exclusive Breastfeeding. Pediatrics. 2013 Apr; 131 (4). 90003 90002 Howard CR, Howard FM, Lanphear B, Eberly S, deBlieck EA, Oakes D, Lawrence RA. Randomized clinical trial of pacifier use and bottle-feeding or cupfeeding and their effect on breastfeeding.Pediatrics. 2003 Mar; 111 (3): 511-8. 90003 90002 AM Vogel, BL Hutchison and EA Mitchell. The impact of pacifier use on breastfeeding: A prospective cohort study. J Paediatr Child Health 2001; Feb; 37 (1): 58-63. 90003 90002 Wojdan-Godek E, Mikiel-Kostyra K, Mazur J. Factors associated with exclusive breastfeeding of infants in Poland. Med Wieku Rozwoj 2000; 4 (3 Suppl 1): 15-24. 90003 90002 Aarts, C., Hörnell, A., Kylberg, E., Hofvander, Y., Gebre-Medhin, M. Breastfeeding Patterns in Relation to Thumb Sucking and Pacifier Use.90009 Pediatrics 90010 1999; 104: 50e. 90003 90002 Cynthia R. Howard, Fred M. Howard, Bruce Lanphear, Elisabeth A. deBlieck, Shirley Eberly, and Ruth A. Lawrence. The Effects of Early Pacifier Use on Breastfeeding Duration. 90009 Pediatrics 90010 1999; 103: e33. 90003 90002 Riva E, Banderali G, Agostoni C, Silano M, Radaelli G, Giovannini M. Factors associated with initiation and duration of breastfeeding in Italy. 90009 Acta Paediatr 90010. 1999 Apr; 88 (4): 411-5. 90003 90002 Hornell A, Aarts C, Kylberg E, Hofvander Y, Gebre-Medhin M.Breastfeeding patterns in exclusively breastfed infants: a longitudinal prospective study in Uppsala, Sweden. Acta Paediatr 1999 Feb; 88 (2): 203-11. 90003 90002 Righard L. Are breastfeeding problems related to incorrect breastfeeding technique and the use of pacifiers and bottles? Birth 1998 Mar; 25 (1): 40-4. 90003 90002 Righard L, Alade MO. Breastfeeding and the use of pacifiers. 90009 Birth 90010 1997 Jun; 24 (2): 116-20. 90003 90002 Cesar Gomes Victora, Dominique Pareja Behague, Fernando Celso Barros, Maria Teresa Anselmo Olinto, and Elizabeth Weiderpass.Pacifier Use and Short Breastfeeding Duration: Cause, Consequence, or Coincidence? 90009 Pediatrics 90010 1997; 99: 445-453. 90003 90002 FC Barros, CG Victora, TC Semer, S Tonioli Filho, E Tomasi, and E Weiderpass. 90139 Use of pacifiers is associated with decreased breast-feeding duration. 90009 Pediatrics 90010 1995; 95: 497-499. 90003 90004 Some Journal Articles on Pacifier Use in General 90007 90002 Warren JJ, Levy SM, Kirchner HL, Nowak AJ, Bergus GR. Pacifier use and the occurrence of otitis media in the first year of life.90009 Pediatr Dent 90010. 2001 Mar-Apr; 23 (2): 103-7. 90003 90002 Larsson E. Sucking, chewing, and feeding habits and the development of crossbite: a longitudinal study of girls from birth to 3 years of age. 90009 Angle Orthod 90010. 2001 Apr; 71 (2): 116-9. 90003 90002 Martinez Sanchez L, Diaz Gonzalez E, GarciaTornel Florensa S, Gaspa Marti J. Pacifier use. risks and benefits. An Esp Pediatr. 2000; 53 (6): 580-5. 90003 90002 Marjo Niemelä, Outi Pihakari, Tytti Pokka, Marja Uhari, and Matti Uhari.Pacifier as a Risk Factor for Acute Otitis Media: A Randomized, Controlled Trial of Parental Counseling. 90009 Pediatrics 90010 2000; 106: 483-488. A Finnish study on pacifiers has found that reduced pacifier use in children can decrease the incidence of acute otitis media, or ear infections. The study, published in the September issue of Pediatrics, the journal of the American Academy of Pediatrics, followed two groups of children under 18 months. In one group, pacifier use was decreased by 21 percent, while children in the second group used pacifiers continuously.The first group had a 29 percent lower incidence of acute otitis media than the second. Researchers concluded that restricting pacifier use to when a child is falling asleep could prevent such infections. 90003 90002 Fleming, P. J, Blair, P. S, Pollard, K., Platt, M. W., Leach, C., Smith, I., Berry, P J, Golding, J., the CESDI SUDI Research Team. Pacifier use and sudden infant death syndrome: results from the CESDI / SUDI case control study. Arch. Dis. Child. 1999; 81: 112-116. 90003 90002 Kate North, Peter Fleming, Jean Golding, and the ALSPAC Study Team.Pacifier Use and Morbidity in the First Six Months of Life. 90009 Pediatrics 90010 1999; 103: e34. 90003 90002 Ollila P, Niemela M, Uhari M, Larmas M. Prolonged pacifier-sucking and use of a nursing bottle at night: possible risk factors for dental caries in children. 90009 Acta Odontol Scand 90010 1998 Aug; 56 (4): 233-7. 90003 90002 Jackson JM, Mourino AP. Pacifier use and otitis media in infants twelve months of age or younger. 90009 Pediatr Dent 90010. 1999 Jul-Aug; 21 (4): 255-60. 90003 90002 Uhari M, Mantysaari K, Niemela M.A meta-analytic review of the risk factors for acute otitis media. 90009 Clin Infect Dis 90010 тисячу дев’ятсот дев’яносто шість Jun; 22 (6): 1079-83. 90003 90002 M Niemela, M Uhari, and M Mottonen. A pacifier increases the risk of recurrent acute otitis media in children in day care centers. 90009 Pediatrics 90010 1995; 96: 884-888. 90003 90002 Darwazeh AM, al-Bashir A. Oral candidal flora in healthy infants. J Oral Pathol Med 1995 Sep; 24 (8): 361-4. 90003 .90000 Breastfeeding — deciding when to stop 90001 Stopping breastfeeding is called weaning. It is up to you and your baby to decide when the time is right. The World Health Organization recommends that all babies be exclusively breastfed for six months, then gradually introduced to appropriate family foods after six months while continuing to breastfeed for two years or beyond. 90002 Some babies decrease the number of breastfeeds as they begin to be able to digest solid food. The first foods are really tastes and not much is digested or able to be used by the baby.It is often not until nine to 12 months or later that babies are able to actually ingest (swallow) and use the solid foods that they eat. 90003 90004 90005 Breastmilk in the first year 90006 Breastmilk contains all the nourishment needed to promote normal healthy growth and development in babies in their first six months of life and remains the most important food during their first year. Babies weaned from breastmilk prior to their first birthday will need to be given infant formula. Please consult your maternal and child health nurse for further information on this.90002 Infant formulas are generally not necessary after the first 12 months, as your child should be then receiving a large range of family foods including dairy products. 90003 90004 90005 Breastfeeding benefits 90006 Breastfeeding even for a short time is beneficial. In the first few days after your baby’s birth, your breasts produce colostrum. This rich substance contains vital ingredients, including immunoglobulin or cells that help build your baby’s immune system. There is ample evidence that babies who are breastfed for the first six months of life do not suffer from as many (or as severe) episodes of common childhood illnesses.These include gastroenteritis, respiratory illnesses and middle ear infections. 90003 90005 Stopping breastfeeding early 90006 Sometimes, weaning needs to happen earlier or more quickly than planned. It is normal for a mother to feel sad when she weans, especially if it is earlier than expected. A mother may feel she has no choice but to wean. However, most breastfeeding difficulties can be overcome with help. An Australian Breastfeeding Association counsellor, lactation consultant or maternal and child health nurse can offer you information and support.90002 Returning to the paid workforce need not mean having to wean. Many women combine breastfeeding with part or full-time work, study and other commitments. 90003 90004 90005 Take your time to wean your baby 90006 Depending on your baby’s age and need for sucking, you can wean either to a cup or bottle. If you decide on a bottle, eventually your baby will need to be weaned from that. Start with whichever breastfeed of the day your baby seems least interested in. Then cut out another breastfeed every few days or even each week, depending on your comfort and your baby’s willingness to cooperate.90002 The concentration of antibodies to bacterial and viral diseases is increased as weaning progresses and milk supply reduces. This ensures that your baby is protected as they are being introduced to new foods and exploring new surroundings. Remember to give your baby plenty of cuddles during the weaning process so that you and your baby still have plenty of close time together. 90004 90002 Slowly reducing the number of breastfeeds protects your baby during the weaning period and will also help you avoid problems such as mastitis.If you need to wean your baby quickly, talk to a healthcare professional or a lactation consultant about caring for your breasts. 90003 90004 90005 When to introduce solid foods 90006 Breastmilk or infant formula should be your baby’s main source of nutrition for around the first year of life. Health professionals recommend exclusive breastfeeding for six months, with a gradual introduction of appropriate family foods in the second six months and ongoing breastfeeding for two years or beyond.90002 Babies show they are ready to start solids when they: 90004 90029 90030 Start showing interest when others are eating 90031 90030 Start making gestures that seem to say ‘feed me too’ 90031 90030 Stop pushing out any food put in their mouth (disappearance of the tongue-thrust reflex) 90031 90030 Start being able to hold their head up and sit without support. 90031 90038 Talk to your maternal and child health nurse about your baby’s readiness to eat. 90003 90005 Iron requirements 90006 A baby born at full term has a store of iron passed on from the mother during pregnancy.You may be concerned about your baby’s store of iron running low at around six months of age. Breastmilk contains small amounts of readily absorbed iron, and recent studies have shown that the risk of iron deficiency is very low in full-term healthy breastfed babies who continue to breastfeed past six months as solids are introduced. 90003 90005 Breastfeeding while pregnant 90006 If you become pregnant, you may choose to continue to breastfeed or you may like to gradually wean your baby. This is an individual choice.Whether or not you choose to continue breastfeeding, it is important to maintain a healthy diet. Seek advice from your health professional or the Australian Breastfeeding Association. 90003 90005 Extended breastfeeding 90006 Some mothers and babies enjoy breastfeeding so much they are in no hurry to stop. Family members and friends may feel uncomfortable about it, but do not give in to pressure if you and your child are happy. It is not unusual for children up to four years of age to continue to be breastfed.90002 It can be helpful to have information to give your family and friends about why you have decided to keep breastfeeding. This may include information about the continued health benefits, security and comfort for your child. 90003 90004 90005 The child who refuses to be weaned 90006 You may be ready to cease breastfeeding, but your child may resist all your attempts to do so. Your approach will depend on your child’s age. There are many strategies for weaning a baby. 90002 If your child can talk and understand well, talk with them about your breastfeeding.Explain that you are going to stop and introduce other ways that you can enjoy being close together. You could seek professional advice about weaning or difficulties associated with weaning. 90003 90004 90005 Where to get help 90006 90029 90030 Australian Breastfeeding Association Breastfeeding Helpline Tel. 1800 mum 2 mum (686 2 686) 90031 90030 A lactation consultant — contact the Lactation Consultants of Australia and New Zealand Tel. (02) 8211 2704 90031 90030 Maternal and child health nurse 90031 90030 The Maternal Child Health Line is available 24 hours a day Tel.132 229 90031 90030 Your doctor 90031 90038 90005 Things to remember 90006 90029 90030 It is up to you and your baby to decide when the time is right to stop breastfeeding. 90031 90030 Aim to breastfeed for six months, then gradually introduce appropriate family foods in the second six months while continuing to breastfeed. 90031 90030 Breastfeeding even for a short time is beneficial. 90031 90038 90002 90005 Content Partner 90006 90004 90002 This page has been produced in consultation with and approved by: Department of Health and Human Services — CHI — HSR & I — Maternity & Newborn Clinical Network 90004 90002 Last updated: February 2012 90004 Page content currently being reviewed.90002 Content on this website is provided for information purposes only. Information about a therapy, service, product or treatment does not in any way endorse or support such therapy, service, product or treatment and is not intended to replace advice from your doctor or other registered health professional. The information and materials contained on this website are not intended to constitute a comprehensive guide concerning all aspects of the therapy, product or treatment described on the website.All users are urged to always seek advice from a registered health care professional for diagnosis and answers to their medical questions and to ascertain whether the particular therapy, service, product or treatment described on the website is suitable in their circumstances. The State of Victoria and the Department of Health & Human Services shall not bear any liability for reliance by any user on the materials contained on this website. 90004 .