HOW TO FEED YOUR BABY IT'S YOUR (INFORMED) DECISION [COMBO SET]

(Content Revised 10/2021)

Content

Make an informed decision on feeding your baby

Congratulations! You must be excited to welcome your baby. As expectant parents, you need to learn and prepare both physically and psychologically to take on the role of parents. Learning parenting knowledge and skills early can help you become happy parents and raise a healthy and lovely baby in a relaxed manner.

How to feed your baby is the first important decision of parenting. Studies show that quality nutrition for infants and young children can promote physical growth and brain development, enhance immunity and bring lifelong health benefits to your child. Apart from choosing the best nutrition for the baby's growth, the closeness between you and your baby during feeding also helps establish a parent-child bond through understanding his needs and temperament. This is a good start to learning parenting skills.

How should I feed my baby to provide optimal nutrition?

You may feel a bit confused by different suggestions from various sources. The Family Health Service of the Department of Health has prepared the following comprehensive and accurate information based on the latest scientific evidence for expectant parents to make an informed decision.

Breastfeeding

Benefits of breastfeeding

  • Breastmilk contains antibodies, living cells and other components that can enhance the baby's immunity.
  • Breastmilk is completely natural and rich in nutrients. Its composition will adjust according to the needs of the baby's growth at different stages.
  • Breastmilk contains enzymes that help digestion and absorption. It also helps the development of the brain, eyes and other organs.
  • The intimate contact and interactions between the mother and baby during breastfeeding enhance mother-baby bonding and promote the emotional development of the baby.
  • Breastfeeding saves family expenses, social resources and is environmentally friendly.
  • The taste of breastmilk changes according what mother eats. The baby can experience the taste of various foods through breastmilk. This can help him accept new foods more readily when solids are introduced.
  • Your baby takes the lead when breastfeeding. Your body will produce the amount of breastmilk according to his needs. This reduces the chance of overfeeding and childhood obesity in future.
  • Breastfeeding reduces the risk of sudden, unexpected and unexplained death of a baby during sleep. (Please read: Safe Sleep Sweet Dream)

Breastfed babies are smarter and healthier!

Benefits of breastfeeding to mothers

  • Helps the uterus return to normal size, reduces the risk of bleeding and anaemia after childbirth.
  • Helps to burn fat and reduce weight gained during pregnancy.
  • Long-term breastfeeding reduces the risks of ovarian and breast cancer.
  • Breastfeeding is convenient since the baby can be fed anytime and anywhere when the mother is with the baby.

Concerns about breastfeeding and possible challenges

  • Both you and your baby need time to learn the correct feeding skills.
  • In the first month, your baby needs to be fed frequently and you may feel tired. You need support and assistance from your family, friends and healthcare professionals.
  • Since you cannot see how much breastmilk your baby had, you may worry that she does not get enough, or you do not produce enough.
  • Other factors that may affect breastfeeding:
    • The birthing hospital has not implemented mother-baby-friendly practices.
    • Certain situations when you are separated from your baby because of the health condition of the baby or mother, or when you have to resume work.

You can always seek advice from your obstetric care provider or other healthcare professionals if you have any concerns about breastfeeding. Being well prepared before delivery can make breastfeeding easier. If you need more information on breastfeeding, please contact the relevant healthcare professionals, or visit the website of the Family Health Service of the Department of Health.

Breastmilk is a gift from nature for both the mother and baby.

Feeding formula milk

If the mother cannot breastfeed for some particular reason or decides not to breastfeed, then infant formula milk is the only substitute for breastmilk.

Flexibility of feeding babies with formula milk:

  • allows the baby to be fed by others and the mother can organise her time more flexibly.
  • allows family members to have close contact with the baby while feeding. They can also do night feeds.
  • makes feeding your baby in public places less inconvenient occasionally when other people are around.
  • supplements breastfeeding if exclusive breastfeeding is not feasible after resuming work.

Some mothers may find formula milk feeding convenient, but in fact, it can bring various problems.

Disadvantages of feeding babies with formula milk:

Compared to breastmilk:

  • The ingredients of formula milk do not provide optimal nutrition for the baby's growth, including the development of the brain, eyes and other organs.
  • Formula-fed babies are more susceptible to allergies (such as eczema) when compared to breastfed babies. They may be allergic to cow's milk protein.
  • Formula milk is more difficult to digest and may cause constipation more often.
  • Formula milk is manufactured by refining and processing cow's milk and therefore does not contain antibodies and living immune cells, making the baby more susceptible to infections (such as colds, pneumonia, middle ear infection and diarrhoea).
  • Your baby needs to wait for the preparation of formula milk when hungry, so it is not always simple and convenient.

Formula milk is not sterile:

  • Contamination by bacteria or chemical substances can occur during the manufacturing, transportation, storage and milk preparation process.
  • The feeding equipment must be disinfected before each feed and the multi-stepped proper preparation of formula milk must be followed to reduce the risk of formula feeding.

Problems with feeding babies with formula milk:

  • Your baby does not take the lead when bottle feeding. If the caregiver misses the hunger and fullness cues of the baby, the baby may be overfed and become an overweight child. "Eating more" is not equal to being "healthier."
  • When other people feed the baby, the mother needs to grasp opportunities to have time to bond with her baby.
  • Feeding babies with formula milk increases household spending, including the purchase of formula milk powder, bottles, dummies, sterilising equipment and so on. Also, there are the additional medical expenses, as the baby is more prone to illnesses.
  • There is a possibility that the brand of formula milk your baby is used to runs out of stock, creating unnecessary worries for the parents.

Directly breastfeeding the baby is the most natural way. After careful consideration, if you still decide to bottle-feed (either expressed breastmilk or formula milk), you must learn as much as you can about how to do it as safely as possible. You can ask healthcare professionals for the following information, or visit the website of the Family Health Service of the Department of Health:

Feeding your baby in the early days: what you need to know…Part 1

Q1： The added ingredients in formula milk (such as probiotics) are as good as breastmilk for enhancing immunity and promoting your baby's health.

A：Not true!

Breastfeeding:

  • Breastmilk contains unique natural antibodies, living cells, etc which strengthen your baby's resistance to diseases.
  • Breastmilk provides complete nutrition to promote growth.
  • Intimate contact between you and your baby during breastfeeding helps him feel secure, thereby enhancing mother-baby bonding and promotes the development of your baby's brain.

Formula milk:

  • No natural antibodies, growth factors or living cells, which help fight diseases.
  • The added ingredients are meant to mimic the composition of breastmilk. There is not enough evidence to prove these added substances have long-term health benefits for your baby.
  • Contamination is possible during manufacturing, storage and the transportation process.
  • Improper handling during preparation of formula milk can lead to bacteria growth which is a risk to your baby's health.

(Please read Chapter 1 of "Love, Starts from Breastfeeding..." for details.)

Q2：Breastfeeding must increase the physical burden on me.

A：Not true!

  • It may but you can make adjustment to alleviate this.
  • Whether breastfed or formula-fed, your newborn baby needs to be fed frequently both day and night in the first month making you feel tired. However, when you breastfeed, a hormone is produced which has the effect of improving your sleep quality.
  • During this period, you can:
    • Sleep while your baby sleeps
    • Minimise guest visits in order to have more time to rest
    • Do less housework or ask others to help
  • From 1 month onwards, your baby may feed 7-8 times per day and sleep longer at night. At this point, you may get more time to rest.

(Please read Chapters 3 of "Love, Starts from Breastfeeding..." for details.)

Q3:You and your partner should have frequent intimate skin–to-skin contact with your baby regardless of whether she is breastfed or formula-fed.

A: True!

Establishing a close and loving bonding between parents and the baby will help his brain development.

  • Starting from pregnancy, parents-to-be can always connect through gentle stroking, talking and singing to their baby.

    Both you and your partner can have more skin-to-skin contact with your baby especially before feeding, or when your baby is crying.

    Direct and intimate skin-to-skin contact can:

    • Provide your baby with emotional security and enhance mother-baby bonding
    • Provide your baby with warmth and stabilise his heartbeat and breathing
    • Help your body produce hormones that promote breastmilk secretion and uterine contractions
  • Respond to the baby's needs in a timely fashion.

(Please read Chapters 1 and 2 of "Love, Starts from Breastfeeding… " for details.)

Q4:Breastfeeding is not suitable for mothers who have the following conditions: flat or inverted nipples, hepatitis B carriers, or suffering from flu.

A: Not true!

  • There are only a few medical conditions that would make breastfeeding unsuitable.
  • Mothers with the following conditions can breastfeed their babies:
    • Having flat or inverted nipples: Apart from the nipple, the baby also takes in much of the areola during breastfeeding. Therefore, you can breastfeed your baby.
    • If you are a hepatitis B carrier: the baby will receive hepatitis B immunoglobulin and vaccine shortly after birth to prevent him from getting infected through the breastmilk. So it is safe to breastfeed.
    • If you have a cold or flu, the antibodies in your breastmilk can strengthen your baby's immunity. In general, commonly used medications for colds and flu are suitable for breastfeeding mothers.
  • Please seek advice from healthcare professionals if you have any questions.

(Please read Chapter 7 of "Love, Starts from Breastfeeding… " for details.)

Q5: Putting your baby to sleep in his cot next to your bed, helps you to respond to his needs in time.

A：True!

  • Sharing a room with your baby and staying close can help you better understand your baby's needs and respond promptly.
  • When you notice your baby's early cues of hunger, such as opening the mouth, or putting fingers into the mouth, you can start to feed him.
  • If you breastfeed your baby in a lying position, you should put him back in the cot after feeding to avoid accidents.

(Please read Chapter 2 of "Love, Starts from Breastfeeding… " for details.)

Q6: You should have a feeding schedule and give fixed amounts each feed.

A: Not true!

  • Every baby has his own pace for feeding. Sometimes the baby needs to be fed more frequently, and sometimes sleeps more. Furthermore, the milk taken per feeding may vary.
  • Baby should take the lead in feeding whether breastfed or formula-fed. Scheduled feeding and a set amount per feeding are not encouraged.
  • Start responsive feeding when you notice your baby's early feeding cues.
  • As long as your baby has enough wet diapers and bowel motions every day and has satisfactory weight gain, the milk taken is enough.

(Please read Chapter 2 and 3 of "Love, Starts from Breastfeeding…" for details.)

Q7: The amount of "first milk"(colostrum) produced in the first few days after delivery is small. I should feed my baby with formula milk first and only start breastfeeding after the breastmilk "comes-in.”

A: Not true!

  • A healthy full-term baby is born with sufficient reserves of water and nutrients. The baby needs colostrum only in the first few days.
  • Benefits of colostrum:
    • The thick colostrum helps your baby to learn and coordinate her suckling, swallowing and breathing skills.
    • The small amount of colostrum matches the stomach size of your newborn baby.
    • Colostrum contains lots of antibodies and living cells that can be considered as your baby's first natural vaccination.
  • Feeding your baby formula milk will reduce her desire to suckle at your breasts and in turn affect your milk production.

(Please read Chapter 3 of "Love, Starts from Breastfeeding… " for details.)

Q8: Giving my baby formula milk and water, using bottles and dummies will not affect breastfeeding.

A: Not true!

  • Breastmilk is more than 80% water. Therefore, an exclusively breastfed baby does not need extra water intake.
  • Giving formula milk, water or glucose water to your baby as supplements:
    • Reduces your baby's desire to breastfeed and thus decreases milk production.
    • Reduces the effect of the "protective film" formed in the baby's gut produced by breastfeeding exclusively, hence increases the risk of infection and allergy.
  • Sucking at a bottle or dummy is completely different from suckling at the breast.
    • Introducing the bottle or a dummy to your baby before 1 month may affect learning to suckle at the breast correctly.
    • If expressed breastmilk or formula milk supplement is necessary, you may consider feeding the baby with a small spoon or cup.

(Please read Chapters 1, 2, 4 and 5 of "Love, Starts from Breastfeeding… " for details.)

Q9: The nutritional value of breastmilk reduces 6 months after my baby is born, so I can stop breastfeeding.

A: Not true!

  • The World Health Organisation recommends breastfeeding exclusively during the first 6 months of the baby's life. When the baby is around 6 months old, solid foods should be gradually introduced and breastfeeding should continue up to 2 years old or above.
  • Breastmilk contains a wide range of nutrients and your body can adjust the content according to your baby's needs at different developmental stages.
    • The chances of having food allergies will be lower if you start introducing new foods to your baby while still being breastfed.
    • Your baby's ability to produce antibodies starts to become more mature only on reaching the age of 2 to 3 years. The natural antibodies, living cells and other factors in the breastmilk can reduce the risk of infections.
  • The longer you breastfeed, the greater the health benefits for both you and your baby.
  • Basically, there are no hard and fast rules. The best way is for you and your child to work out together when and how to wean.

(Please read Chapters 1 of "Love, Starts from Breastfeeding… " for details.)

Feeding your baby in the early days: what you need to know…Part 2

Q1. How do I know if my baby is getting enough milk?

A:

  • The more your baby feeds, the more she pees and poos.
  • Your baby passes dark green, sticky stools (meconium) after birth. Then the stool will gradually become soft yellowish or greenish in the first few days.
  • You will know whether your baby is getting enough milk by checking the wet diapers and bowel motions.
  • It is normal for your baby to lose some weight due to water loss in the first few days after birth. She will steadily regain weight afterwards.

(Please read Chapters 3 of "Love, Starts from Breastfeeding… " for details.)

Q2. How do I know my baby is hungry?

A:

  • It is important to let your baby take the lead when feeding. So you have to know the early cues when she is hungry.
  • Your baby's early hunger cues include opening the mouth, putting her hands into her mouth or making sucking sounds.
  • Crying or fussing is a relatively late hunger cue. It is more difficult for a crying baby to attach to the breast properly, possibly preventing effective suckling.

(Please read Chapters 2 of "Love, Starts from Breastfeeding… " for details.)

Q3:The more my baby suckles on the breast, the more milk I produce.

A:True

  • After your milk has "come-in", your breasts will gradually produce the appropriate amount of milk according to your baby's needs.
  • When your baby suckles, your body will make milk-producing hormones.
  • However, if the breastmilk cannot be removed effectively, your breasts will produce a substance that stops milk production decreasing the milk supply.
  • Frequent and effective suckling is the best way to help your breasts produce enough milk.

(Please read Chapters 2 and 3 of "Love, Starts from Breastfeeding… " for details.)

Q4. In the first few weeks, my baby needs to be fed frequently. I have to breastfeed at least 8 to 12 times a day.

A: True

  • In the first few weeks, the stomach of your newborn baby is small. Therefore, frequent feedings are needed.
  • A newborn baby tends to be sleepy and may not wake up to feed. Even so, you need to feed your baby at least 3 to 4 times on the first day.
  • From the second day onwards, your baby becomes more alert and needs more frequent feedings, about 8 to 12 times a day.
  • Your body makes more milk-producing hormones at night. Breastfeeding your baby during the night helps to boost milk production

(Please read Chapters 3 of "Love, Starts from Breastfeeding… " for details.)

Q5. Proper positioning and attachment are the keys to successful breastfeeding.

A: True

  • The proper breastfeeding position and helping your baby get a good attachment at your breast are the keys to successful breastfeeding. Both you and your baby need to learn to breastfeed especially in the first few days after birth. Do not hesitate to seek advice on breastfeeding from healthcare professionals.
  • The proper breastfeeding position:
    • You and your baby's body are well-supported, so that both of you feel comfortable during frequent breastfeeding.
    • This allows you to bring your baby to your breast more easily, and helps him attach properly to the breast.
  • With a good attachment, your baby can stimulate your breasts to produce more milk.

(Please read Chapters 4 of "Love, Starts from Breastfeeding… " for details.)

Q6. I can express milk when temporarily separated from my baby, or when my breasts are engorged.

A: True

  • If you cannot directly breastfeed your baby (for example, when the baby is sick or needs hospitalisation, or when you go back to work), you can express and store your breastmilk.
    • This ensures enough stimulation to the breasts and keeps up your milk supply to continue breastfeeding.
  • When your breasts are engorged and you cannot breastfeed your baby immediately, you can express some milk to relieve discomfort and reduce the risk of blocked ducts.
  • If the baby is not satisfied after direct breastfeeding, the mother may express and feed her the breastmilk, which in turn stimulates the breast to produce more milk.

(Please read Chapters 5 of "Love, Starts from Breastfeeding… " for details.)

Q7. It is better to give my baby expressed breastmilk in a bottle than direct breastfeeding, as I then know how much he takes.

A:Not true!

  • A healthy, full-term baby shows the urge to suckle when hungry and appears satisfied when full. Feeding your baby according to his need is far more pertinent than knowing how much is taken. Actually, as long as there are enough wet nappies, he is getting enough milk.
  • Advantages of direct breastfeeding:
    • Your baby takes the lead in feeding to match his needs.
    • Having close skin-to-skin contact helps your baby feel warm and secure. This also helps promote parent-child bonding.
    • Direct breastfeeding facilitates your baby's facial, oral muscles and jawbone development, as well as reduces the risk of middle ear infections.
  • Points to note before feeding your baby with a bottle:
    • The amount of milk may not suit your baby's actual need if the caregiver takes the lead in feeding.
    • You may hurt your breasts or nipples, or strain your hand muscles if you use inappropriate methods to express or pump your breastmilk.

(Please read Chapters 1 and 5 of "Love, Starts from Breastfeeding… "and the booklet "What You Need to Know about Breast Pumps" for details.)

Q8. Seek help immediately if you have any problems while feeding your baby.

A: True

  • Family members can offer support by taking care of the newborn baby. This can make your life less hectic and breastfeeding will be more enjoyable.
  • Learn more about infant feeding while expecting your baby. Involve and discuss with your partner and family your feeding decisions!
    • Your partner, your baby's grandparents and the "pei yue."
  • If you decide to breastfeed, remember to discuss with:：
    • Your obstetric doctor and midwife at the birthing hospital: Inform them that your plan to breastfeed as soon as possible after giving birth.
    • Your supervisor in the workplace: discuss breastfeeding arrangements when returning to work.
  • Seek help immediately if you have any problems feeding your baby.

(Please read Chapters 8 of "Love, Starts from Breastfeeding… " for details.)

If you want to know more about infant feeding, you may read "Love, Starts from Breastfeeding..." Booklet

You can ask healthcare professionals for the booklet "Guide to Bottle Feeding" if needed.

Family Health Service

Website: www.fhs.gov.hk

24-hour information hotline：2112 9900