Feeding your baby

Lesson 1

Fed with love

Feeding is one of the first ways you love your baby. The Dietary Guidelines for Americans, the American Academy of Pediatrics and the World Health Organization all recommend breast milk alone for about the first 6 months, then breastfeeding alongside solid foods until a child is 2 or older.

Breastfeeding doesn’t work out for every mother and baby. When it can’t, or when it isn’t enough, infant formula prepared the right way is a safe way to feed your baby. A baby who is fed, held and loved is what matters most.

Lesson 2

The first days

• Expect to feed often. A newborn may want to eat every 1 to 3 hours, about 8 to 12 times in 24 hours, and you may need to wake your baby to feed.
• Tiny tummy. At birth a baby’s stomach holds 1 to 2 teaspoons, about the size of a toy marble. By day 10 it holds about 2 ounces, like a ping-pong ball.
• Watch your baby, not the clock. Hungry babies put their hands to their mouth, turn toward the breast or bottle, smack or lick their lips, and clench their hands. Crying is often a late sign of hunger.
• Full looks like this: a closed mouth, a head turned away, relaxed hands.

Is my baby getting enough?

• By day 5, at least 6 wet diapers and 3 or more poops a day.
• Losing some weight in the first week is normal. Babies should be back to their birth weight by day 10 to 14.
• Checkups at 3 to 5 days old, and again at 2 to 3 weeks, catch problems early.

Call your baby’s doctor if there are fewer diapers than that by day 5, or if your baby is still losing weight after day 5. For a drop-in weight check on the islands, call 360-298-5150.

Lesson 3

Getting help with breastfeeding

Breastfeeding is natural, but it is also a skill that you and your baby learn together. Get help early, before a small problem becomes a reason to stop.

• The county’s feeding line. San Juan County’s feeding support is open to every family in the county, and peer counselors are on call 24 hours a day. Orcas: 360-298-5827. En español: 360-317-5989.
• Visits at home. Growing Families San Juan Islands sends a nurse or community health worker to you, free: 360-378-4474.
• A breast pump. WIC gives its participants electric and manual pumps at no charge, and county staff can help you order one through your insurance. Apple Health covers pumps, and most health plans must cover a pump and breastfeeding support.
• Someone to call. The federal Office on Women’s Health helpline takes breastfeeding questions in English and Spanish, weekdays from 6 a.m. to 3 p.m. Pacific: 1-800-994-9662.
• Other mothers. La Leche League Leaders give free support, and meetings are free, in person and online: find a Leader.

Dads make a difference here. See Becoming a dad.

Lesson 4

Formula, made safely

These steps come from the CDC, the Food and Drug Administration and the American Academy of Pediatrics.

• Follow the label exactly. Measure the water first, then add the powder. Never add extra water to stretch formula: it thins out the nutrients, and it can cause growth problems and a dangerous salt imbalance.
• Use it or chill it. Use prepared formula within 2 hours of mixing, and within 1 hour of the start of a feeding. If you won’t use it within 2 hours, put it in the refrigerator right away and use it within 24 hours.
• Throw out what’s left in the bottle after a feeding.
• Extra care for the youngest. For a baby under 2 months old, born before 37 weeks or with a weakened immune system, boil the water and wait about five minutes before mixing in the powder. It will still be too hot to drink, so let it cool, and test a few drops on your wrist first.
• Never use a microwave to warm a bottle.
• Never make formula at home. The FDA warns that homemade formula can be contaminated and can lack nutrients a baby needs. Don’t give cow’s milk as a drink before 12 months either: the CDC says it may put a baby at risk of intestinal bleeding.

In the first days, start with 1 to 2 ounces every 2 to 3 hours. By the end of the first month most babies take 3 to 4 ounces at a feeding, and usually no more than about 32 ounces in a day. Hold your baby close, tilt the bottle so milk comes only when your baby sucks, and let your baby take breaks.

Lesson 5

Storing breast milk

The CDC’s limits for freshly pumped milk:

• Never refreeze breast milk after it has thawed.
• Once milk is warmed or comes to room temperature, use it within 2 hours.
• If your baby doesn’t finish a bottle, use what’s left within 2 hours.
• Never thaw or heat breast milk in a microwave.
• For the ferry: milk keeps in an insulated cooler with frozen ice packs for up to 24 hours.

Lesson 6

Starting solid foods

Most babies are ready for solid foods at about 6 months. The CDC says starting before 4 months is not recommended.

• Signs of readiness: sits up alone or with support, controls their head and neck, opens their mouth when food is offered, swallows food instead of pushing it back out, and brings objects to their mouth.
• Allergy foods: introduce foods like eggs, nut butters and wheat along with other foods. If your baby has severe eczema or an egg allergy, talk with your baby’s doctor first about when and how to introduce peanut.
• Not before 12 months: honey, cow’s milk as a drink, and fruit or vegetable juice.
• Choking hazards: whole grapes and berries, whole or chopped nuts, spoonfuls of nut butter, popcorn, hot dogs, hard raw vegetables, large chunks of meat or cheese, and round or hard candy.
• Vitamin D: babies who get any breast milk need 400 IU of vitamin D a day, starting shortly after birth, the CDC says.
• Iron: at about 6 months, babies need a source of iron besides breast milk. Ask your baby’s doctor whether a supplement is needed sooner.

Lesson 7

Alcohol, tobacco, caffeine and medicines

• Alcohol. The CDC says not drinking is the safest choice while breastfeeding. Up to one standard drink in a day is not known to harm a baby, and waiting at least 2 hours after a drink before nursing is safest. Pumping and dumping does not clear alcohol from your milk any faster.
• Tobacco and vaping. Mothers who smoke or vape can still breastfeed, and quitting is best for you both: 1-800-QUIT-NOW.
• Marijuana. The CDC says breastfeeding mothers should avoid marijuana in any form, including CBD.
• Caffeine. About 300 milligrams a day or less, around 2 to 3 cups of coffee, is considered a low to moderate amount.
• Medicines. Most have little or no effect on a nursing baby, and a few should be avoided. Ask your clinician or pharmacist before you start or stop one. MotherToBaby’s experts answer questions at 866-626-6847.

Lesson 8

Your rights

• In public. Washington law protects a mother’s right to breastfeed her child in any public place, and it says breastfeeding is not indecent exposure. If a business tells you to stop, cover up or leave, you can file a complaint with the Washington State Human Rights Commission within six months: 1-800-233-3247.
• At work, under federal law. Most employees have a right to break time and a private place that isn’t a bathroom to pump, for one year after the birth.
• At work, under Washington law. Starting January 1, 2027, every employer in Washington must give paid break time to pump for two years after the birth, in addition to meal and rest breaks. Until then, the state rule applies to employers with 15 or more employees.

Check yourself

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