Hungry breastfed infants
When breastfeeding, intervals between feeds can be very unpredictable during the first few weeks of life and patterns of feeding can change from one day to the next. It is advisable for mothers to observe signs of hunger as opposed to getting fixated on establishing set feeding routines. Signs of hunger include the infant moving around in a restless way and making sucking motions with the lips and tongue. From about 3 weeks onwards, most breastfed infants tend to establish their routine of feeding.1
The frequency of feeds will vary from one infant to another. Some infants will feed every 1 ½ – 2 hours (timed from the start of one feed to the start of the next) whereas other infants may leave a longer gap of 3-4 hours between feeds. By the time an infant is 4 months old they tend take 5 breastfeeds per day and by the time they are 6 months this can be between 4-5 breast feeds per day.1
It is best that mothers only feed their baby when he or she is actually hungry and not every time the infant cries. When an infant cries it is not always a sign that the baby is hungry but they could be just over-tired, too cold, too warm, over-stimulated, or have a dirty nappy. Holding and swaddling a crying infant may help settle them also. Crying develops in the later stages of hunger.2
Hungry bottlefed infants
Bottle fed infants should be fed on demand. This does not mean that they cannot establish a feeding routine but it does mean that the infant should be allowed to decide how much formula they take at each feed.
Feeding patterns of bottlefed infants can also be very unpredictable in the first few weeks of life but after about 3 weeks they tend to establish a routine. Every infant is different. Some may prefer to have larger volumes of milk throughout the day whereas other babies may prefer to have smaller volumes of milk more frequently throughout the day. Initially new born infants tend to feed every 2-3 hours but by around 2 months they tend to feed every 4 hours.1
Some infants will sleep through most of the night whereas other infants may wake up during the night for a feed which is equally normal. It is important that parents allow the infant to set their own feeding routine and practices such as waking them up for a feed or using two different types of formulas should not be followed.
Establishing true hunger
- If parents think the infant is hungry and is not being satisfied by the whey dominant formula the baby is on, it is important to investigate further before moving onto a casein-based formula.
- For the first 6 months, infants should be taking 150-200ml of infant formula per kg bodyweight per day1. To establish if an infant is getting too much formula it is important to record the total volume of feed taken over a 24 hour period.
- Also consider growth spurts which usually occur 2 weeks, 3 weeks, 6 weeks, or 3 months. Infants will demand more milk during these growth spurts.
- If the infant is not exceeding the recommended amount of formula, increase the frequency and volume of their whey-dominant formula.
- If the infant is getting the correct amount of formula but is not being satisfied and is too young to start weaning (weaning onto solid foods should not commence before 17 weeks) a casein-dominant formula such as Aptamil Hungry Milk can introduced.
- Aptamil Hungry Milk contains 80% casein protein and 20% whey protein. Casein protein takes longer to digest than whey protein therefore a casein dominant formula will delay gastric emptying and keep the infant satisfied for longer3.
- Under no circumstances should any type of solid food be introduced before the Department of Health & Children and FSAI’s recommendation of 17 weeks. Weaning should commence at about 6 months – no sooner than 17 weeks and not delayed after 6 months4.
- Risks of early weaning include increased risk of respiratory illness and cough5-6, increased body fat in childhood, and increased risk of allergies8, eczema9, and enteritis5.
- Tarrant et al. 2010 showed that out of 400 Irish mothers surveyed, 71% of them had weaned onto solids before 17 weeks and almost 23% had weaned their infant onto solids by 12 weeks. Introducing a casein dominant formula may help to alleviate the early introduction of solids and is preferable to early weaning 10.
Benefits of a Casein dominant formula
- slows down gastric emptying resulting in a fuller stomach for longer11
- may help delay the early introduction of solids4
- Dunne T et al. Feed your child well. A handbook for parent in Ireland. A & A Farmer Ltd. 2008
- Food Safety Authority of Ireland, recommendations for a national feeding policy.(FSAI 1999)
- Bleakney G, Infant Feeding Guidelines. Department of public health, Medicine and Nursing. EHSSB March 2006.
- Food Safety Authority of Ireland. Scientific Recommendations for a National Infant Feeding Policy. 2nd Edition. 2011.
- Popkin BM et al. Breast-feeding and diarrheal morbidity. Pediatrics 1990;88:874–82.
- Brown KH, Black RE, Lopez De Romana G, et al. Infant feeding practices and their relationship with diarrheal and other disease in Huascar (lima). Pediatrics 1989;83:31–40.
- Wilson A et al. Relation of infant diet to childhood health: seven year follow up of cohort of children in Dundee infant feeding study. BMJ 1998; 316: 21-5.
- Armentia A et al. Early introduction of cereals into children’s diets as a risk factor for grass pollen asthma. Clin Exp Allergy. 2001; 31:1250 –1255
- Forsyth JS et al. Relation between early introduction of solid food to infants and their weight and illnesses during the first two years of life. BMJ. 1993; 306:1572–1576
- Tarrant et al. Factors associated with weaning practices in term infants: a prospective observational study in Ireland. Brit J Nutr. 2010; doi:10.1017/S0007114510002412
- Billeaud C et al. Gastric emptying in infants with or without gastro-oesophageal reflux according to the type of milk. Eur J Clin Nutr 1990; 44:577-83.