Newborn Guidelines

We have prepared these discharge guidelines to help new parents in particular to manage the first few weeks at home with a newborn infant. If you find that your own ideas work better for you and your baby than do our suggestions, follow your instincts.

Feeding

In the hospital, you were probably feeding your baby about every four hours. Once settled at home, most babies eat every 2-3 hours if breast feeding, and every 3-4 hours if bottle feeding. There is rarely a strict feeding schedule in the early weeks, although one will often develop by 8 weeks or so. Until then, feed on demand, whenever the baby seems hungry.

Breastfeeding

The key to successful nursing is short but frequent feedings! Ideally, in the beginning, an infant will nurse for 10-15 minutes on each breast, about 7-10 times in 24 hours. Your breast milk is usually “in” by the third to fourth day after delivery. If you find that the baby is sleeping a great deal and having fewer than 7 feedings per day, we do suggest that you wake the baby more frequently, particularly during daytime hours. Remember to start each feeding with alternate breasts.

Early on, it is usual for a baby to nurse as often as every 2 hours. (Avoid allowing the baby to “snack” every hour.) Gradually, as the interval between feedings increases to every 3-4 hours, you may increase to 15-20 minutes per breast and find that the baby will nurse less often.

It may take two weeks (occasionally longer) for breastfeeding to become well-established. Please call us to help if you feel that nursing is not going as well as you had expected. The baby’s weight is usually checked in the office within 48-72 hours of discharge.

Whether you plan to breastfeed for a few weeks or several months, we recommend that you nurse exclusively for the first two weeks. After that, it is fine to begin one bottle daily of expressed breast milk or formula.

Weaning

At your two-week office visit, we will discuss your feeding plans, how long you would like to breastfeed, whether or not you are returning to work, whether formula supplements are needed, and when and how to wean from breastfeeding when you are ready to do so.

Formula Feeding

If you have chosen to bottle feed your baby, unless there is a family history of milk protein allergy, we recommend that you start with a milk-based formula (e.g., Similac or Enfamil). If the baby has trouble tolerating this, we will recommend an alternative. Remember that feedings are approximately every 3-4 hours, but without a strict schedule. Generally, a more predictable schedule develops by 8 weeks of age.

At first, most babies take 1-2 ounces per feeding but will increase fairly quickly to 3-4 ounces. By your 8-week visit, the baby may take 4-6 ounces per feeding. Remember to burp after each ounce. Once the baby is taking larger amounts, burp every 2-3 ounces and after each feeding.