Feeding

Feeding children is important and knowing a little bit about what a baby eats is important. Like all medicine, you need to recognise the normal before you can recognise the abnormal. If somebody comes in with failure to thrive, you don't want to make a diagnosis of neglect when the mother is just having trouble feeding her kids.

A common alternative to milk is eating clothing. Although nutritionally unhelpful, babies often have it to hand. The same can be said for lego, pets and soil.

Breast-feeding

'Breast is best' is a common saying, both in the fields of baby feeding, and across various pornography sites. There are various advantages of breast-feeding: it helps with the emotional bond between mother and child; evidence shows that it reduces the rate of infant infection, probably due to immunoglobulins; it contains all the nutrients at the correct levels; and is associated with reduced rates of IBD and paediatric diabetes.

(There have been claims it increases IQ by 7 points, but there are too many other factors for this research to have been useful.)

Bottle-feeding

Babies who are bottle-fed are usually given milk made from formula based on cow's milk. The differences in the various formulas are in the casein:whey ratio. A ratio of 40:60 has less curd and a smaller amino acid profile is similar to that of breast-milk. Higher casein levels mean there is more protein and are said to be useful for "hungrier" babies in order to lower the number of feeds required.

Overfeeding

30ml = 1oz is incredibly useful when thinking about bottle-feeding. For whatever reason, even the youngest parents talk in old money when it comes to bottle-feeding their baby. They need ~150ml/kg per 24h over 4-6 feeds. So, a 5 kg baby needs:

Over 24h the baby needs

5 x 150ml = 750ml

With 6 feeds, mls per feed

750/6 = 125ml per feed

In oz per feed

125/30 ≈ 4oz

Which means that if the mother is feeding her baby considerably more than 6 x 4oz a day, the problem of her baby vomiting is probably overfeeding.

This is harder to identify with breast-feeding. Usually, about 15-30 mins is about right for a feed (I think - I should really ask a paediatrician) and again, 4-6 feeds a day.

Posseting is bringing up small amounts of food, usually after feeding. This is a normal variant and doesn't mean the baby is starving. Nervous (especially first-time) parents will need to be reassured that their child isn't going to vomit to death even it does need to have its bib changed more regularly.

Weaning

Weaning (the introduction of solids) should be started with a spoon using puréed food or cereals (but soft ones - no Crunchy Nut yet). Follow-on formula maybe used at 6 months and at ~1 year cow's milk can be introduced if the infant is able to cope.