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Mixed feeding at 1 month. How to organize mixed feeding for babies. Calculation of the amount of the mixture for mixed nutrition of the baby

It is not uncommon for experienced mothers after childbirth to fall into a nervous state characteristic of primiparas. Out of nowhere, they have a bunch of doubts about their abilities. This is facilitated by many psychological factors that lead astray. Here, our mother regularly visits an Internet forum, reads articles about the benefits of breastfeeding, actively participates in the “scandal” of his opponents, and advocates progressive methods of education. Here she becomes pregnant again, gives birth - and suddenly ... Suddenly there are questions from her seemingly experienced person: “what should I do, the child gained more than a kilogram in the first month, and only 300 g in the second?”, “Why do I always have breasts “Empty”?”, “The child is worried when sucking - not enough milk?”

Increased suspiciousness that develops after childbirth has not been canceled. She is involved in hormones and maternal instinct, but most of all she depends on the psychological environment. A couple of wrong remarks can give rise to doubt in their ability to feed for a long time. And then the nervous mother wants to urgently reassure herself (first of all) and the child with something reliable. For example, a mixture. Breast milk is in disgrace - it is “low-fat”, it is “little”, it is “something not like that”. And with the mixture, everything is very clear. Supplemented - the child calmed down and "finally" sleeps, is silent, and even gains weight. Oh that weight! Until now, we have a stereotype in our heads: weight equals health. This approach leaves no chance for individual development to bypass clinics and analysis laboratories.

The main reasons why a child is transferred to mixed feeding, experts in breastfeeding call low awareness of mothers, subconscious reluctance to breastfeed, as well as rash (without prior diagnosis) advice from doctors.

What is mixed feeding?

Mixed feeding is a system of feeding a child in which supplementary feeding with a mixture is carried out on a par with breastfeeding without a clear regimen (on demand), while the volume of the mixture occupies no more than half of the total nutrition. It is recommended for the following reasons:

Insufficient weight gain;

prematurity;

Mom's illness, her taking medications that are incompatible with breastfeeding;

Life situation: for example, the family is low-income, and the mother needs to immediately go full-time.

Is mixed feeding always the road to artificial? Not at all. Everything depends on the goals. If a mother wants to keep breastfeeding, then she fulfills (to the best of her ability) all the recommendations for increasing lactation, feeding the baby with a mixture of no more than 30-50% of the daily amount of food. With the proper implementation of all the advice, and most importantly - the restoration of psychological comfort lost due to doubts and fears about the "loss of milk" - breastfeeding will definitely be restored. In many cases, the child completely switches to pure breastfeeding by the age of 6 months.

Competent transfer to mixed feeding

To switch to CB, you need to calculate the missing amount of food in grams per day, and you will supplement the calculated amount of formula several times a day. Your doctor or lactation consultant will help you with the calculations. If you are not going to transfer the child to the mixture in the future, be sure to ask for recommendations to increase lactation. As a rule, these are regular nightly attachments to the breast (especially pre-morning ones), skin-to-skin contact - when supplementing with a formula, the child is held near the breast; regular expression of milk, as well as supplementary feeding with a mixture not from a bottle, but from a spoon or syringe. The use of nipples should be avoided whenever possible. The mixture flows quickly from the nipple, the baby does not have to bother and he quickly gets used to it. After sucking on a bottle, babies cannot properly regulate their breathing when suckling at the breast and become anxious. For working mothers, in order not to lose milk, it is very important to breastfeed the baby at least in the morning and evening.

Supplement with the mixture only after applying the baby to the breast (both breasts). Over time, gradually reduce the amount of the mixture in favor of the chest. The number of attachments to the chest should be at least three to five times a day.

How to choose a mixture and calculate its correct amount? Recommendations Zabelina Tamara Alexandrovna, pediatrician of the medical center "XXI century", experience of medical practice - 20 years. (a source: http://mama.mc21.ru)

Approximately, you can use the following calculation: for a child under 10 days old, the daily volume of milk is equal to 2% of body weight at birth, multiplied by the child's age in days. Example: a child born with a body weight of 3200 on the 5th day of life should receive about 320 ml of milk per day (3200: 100x2x5 = 320), that is, with an average frequency of feedings from 8 to 10, the volume of each feeding is from 30 to 40 ml average. After 10 days to 2 months of life, the calculation is even simpler: the daily amount of food is 1/5 of body weight. Example: a child of 1 month with a body weight of 4500 per day should receive about 900 ml of milk. At this age, as a rule, the frequency of feedings is about 8 times a day, that is, on average, the child receives about 110 ml of milk per feeding (from 100 to 120 ml). The missing volume is filled with supplementary food - a mixture for baby food. When choosing a mixture, the age of the child is taken into account, as well as the presence of any problems when it becomes necessary to prescribe specialized, that is, therapeutic mixtures.

If the child is healthy, the following mixtures can be used as supplements: Nutrilon, Humana, Heinz, Nan, Insufferable, Mamex, Hipp. If there are signs of digestive disorders - colic, stool retention, unstable stool, to correct dysbiosis, with an increased risk of developing infections, mixtures of "nan sour-milk 1" for children of the first six months of life and "nan sour-milk 2" from 6 months are good; At a high risk of allergy to cow's milk - if its intolerance is detected in the parents, brothers or sisters of the baby - mixtures containing partially hydrolyzed protein are prescribed: "nan hypoallergenic 1" in the first half of the year and "nan hypoallergenic 2" after 6 months, "nutrilak hypoallergenic" , "Hipp Hypoallergenic 1", "Hipp Hypoallergenic 2", "Humana Hypoallergenic 1" and "Humana Hypoallergenic 2". If the child already has signs of an allergy to cow's milk, it is necessary to prescribe therapeutic - hydrolyzate mixtures as a supplement, in which the main allergens responsible for the development of food intolerance are destroyed by hydrolysis: "nutrilak peptidi sst", "frisopep", "alfare", " Nutrilon Pepti TSC”, “Pregestimil”, “Nutramigen”, “Damil Pepti”.

For children with lactase deficiency, including as dietary nutrition for acute intestinal infections, mixtures with a low lactose content are recommended: "Nutrilon low lactose", "Nutrilak low lactose", "Humana lp" (these are milk mixtures), mixtures based on protein hydrolysates - “frisopep”, “hipp ha 1”, “humana ha 1”. In addition, fermented milk mixtures contain less lactose due to the lactase activity of microorganisms. Mixtures in which lactose is completely absent - lactose-free dairy - “lactose-free mamex”, “lactose-free nan”, “lactose-free nutrilak”; lactose-free mixtures based on soy protein - Enfamil Soy, Heinz Soy, Soy Samp, Nan Soy, Nutrilon Soy, etc. ”, “nutramigen”, “nutrilon pepti tsc”. With persistent regurgitation, sometimes the pediatrician considers it necessary to prescribe an antireflux mixture. These mixtures have an increased viscosity due to the inclusion of thickeners (gum or starch) in their composition: “Nutrilak ar antireflux”, “Semper lemolak”, “Fries”, “Humana ar”, “Nutrilon antireflux”, etc.

Non-objective reasons for supplementary feeding: do not doubt yourself!

Consider the reasons that can be attributed to a hasty choice. That is, when the child actually did not need to be translated into ST, but his parents decided otherwise.

1. Lack of information. The facts below are NOT reasons to supplement with formula immediately.

The child worries about the chest, throws the chest;

The chest has ceased to be filled, no tides are felt;

Not enough milk when expressing;

The child in the first month of life added more than the norm (more than 600-800 g), and in the second he added little (less than 600 g);

Control weighing showed that the child sucks milk a little;

The child has a stomach ache, he has a rash (diathesis).

If a young mother cites them as an argument, it means that she urgently needs to refresh her knowledge with the right information. For example, read materials from the archive of our site:.

2. Breastfeeding Mistakes: improper grip on the breast, discomfort when sucking, accustoming to a strict feeding regimen. You need to contact a lactation consultant.

3. Unshakable faith in the pediatric scheme for feeding children up to a year and blind obedience to medical recommendations. It should be clearly understood that this scheme was developed many years ago on the basis of statistics on the health status of children who are mixed or artificially fed. New pediatric norms based on infant statistics have just taken over the world. Babies are still measured by artificials, hence the inflated norms for increases, early introduction of complementary foods, and so on. It is still more convenient for doctors to deal with artificial people, since they have everything in grams and in time. Children on breastfeeding are uncontrolled nutrition, unknown grams, incomprehensible composition of milk. Everything is in a fog. Many doctors make hasty advice about formula supplementation in order to make it easier for themselves to understand the child's daily routine and the amount of food he eats. A modern mother must understand that all outdated schemes do not take into account the individual characteristics of children.

The pediatric approach in our country for a long time meant instilling in mothers many fears, doubts, stereotypes. The system is gradually changing, becoming a thing of the past, but the remnants are tenacious. A good doctor should not "pull" the child to the scheme, but assess the individual situation. Any mother has a choice - to allow her child to be assessed on the assembly line or to find a doctor who has time to take into account individual characteristics. Such doctors come across in ordinary district clinics. Do not take it for granted if you are told that your child is obliged at 3 months to sleep all night until six in the morning without waking up - or weigh 200 g more, based on the plate. This is not the ultimate truth, but a pediatric approach that applies to all children equally. No one knows your child better than you - do not shift ALL responsibility to doctors!

4. Reluctance to breastfeed. One of the most common reasons. It can be camouflaged, expressed indirectly. Our body is a very smart system. When we inspire ourselves with fear that we are cold, he agrees and freezes. When we really, really don’t want something, he again agrees and reduces the influx of power in the indicated place. In particular, it reduces the production of milk and helpfully offers some sort of ailments in the assortment that help to end lactation - for example, my mother starts to have a headache from lack of sleep. A young mother can do her best to demonstrate the struggle with “fading” lactation, waving a list of lactogenic drugs and talking about her struggle for breastfeeding, but sooner or later she will be betrayed by irritation. In this case, there is a proverb: “It is better to feed a child with artificial nutrition, but from a pure heart, than with breast milk without goodwill.”

Typical behavior against the background of a subconscious reluctance to breastfeed is a constant appeal to some kind of schemes. Trying to establish lactation, mommy uses scales (control weighing), adjusts the regime according to books and advice, calculates grams and minutes. She needs all these events to demonstrate her “goodness”. They protect her from possible attacks by "GV fans" and future complexes. Another mother, unsure of herself, choosing supplementary feeding with a mixture, as it were, relieves herself of responsibility. She's so much easier. She is not to blame for the child's empirical need for a mixture - tables, norms, grams are to blame. Here I would like to separately note: breastfeeding should be pleasant for both mother and child. “Evil” feeding through “I don’t want” will not bring any benefit to the child. Harmonious translation into IV will correct the situation.

5. The more (in time) the child is separated from the mother after birth, the worse the “mother-baby” bond, the mother’s body reacts less to the needs of the child. They didn’t put it on the breast after childbirth, they discovered some problems - they took it to the ICU, kept it in the hospital for some time - all these reasons can lead to hormonal imbalance, lactation will begin to fade. The centuries-old experience of breastfeeding shows that breast milk appears even in nulliparous women who breastfeed other people's children (nurses in Russia often did not have their own children). The desire to breastfeed overcomes many obstacles: if it is not possible to breastfeed, the child is supplemented not with formula, but with expressed milk. In general, the child is your personal. If you are separated from your baby after childbirth, demand that you be provided with the conditions for normal breastfeeding. Often it is not common sense that prevents him, but the human factor (a disgruntled nurse).

6. Misinterpretation of lactation crises. At certain periods (usually in the third month of breastfeeding, sixth and ninth), there is a feeling of lack of milk. The baby begins to suck more often and longer - or vice versa, he drops his breast, is naughty, gains weight a little (less than in the first three months). It is at THREE MONTHS that the child begins to be supplemented with a mixture, transferring to mixed feeding (and later to artificial feeding). Mothers should study in a timely manner information about lactation crises, which should only be endured as an inevitable natural phenomenon.

Important: by the behavior at the breast it is impossible to determine whether the baby is full or hungry. This can be done by counting the daily number of urination, conducting a "wet diaper test" (at least 10-12 wet diapers per day). The most wrong action is to calm your nerves by feeding the baby with a mixture. You need to calm the nerves with valerian or persen - directly inside yourself. And also use all options for psychological relief.

6. Pressure from relatives. It is clear that the desire of grandmothers / neighbors / girlfriends to look smarter against the backdrop of an ever-doubting young mother. We all assert ourselves at the expense of someone or something, if there is not enough strength for self-realization. In this case, you can advise attending postpartum courses (in some schools, mothers are allowed to come with children), organizing forum parties - meet like-minded people more often, discuss common problems, be sure that you are not alone.

Some statistics: "one bottle of the mixture will not hurt" - or will it hurt?

* Breastfeeding and formula fed babies have different gut flora.

* Breastfeeding infants have a lower pH environment (acidic environment) in the intestines of about 5.1-5.4 pH during the first six weeks, represented mainly by bifidobacteria with a small amount of pathogenic microbes such as E coli, bacteroides, clostridia, and streptococci. And formula-fed babies have a high intestinal pH of about 5.9-7.3, with a variety of putrefactive bacterial flora.

* In breastfeeding infants who are supplemented with formula, the average pH is approximately 5.7-6.0 during the first four weeks, and decreases to 5.45 by the sixth week.

* When formula supplementation is given to breastfeeding infants during the first seven days of life, the production of the necessary acidic intestinal environment is delayed and can never be achieved thereafter.

* Breastfeeding infants supplemented with formula develop intestinal flora similar to formula-fed infants.

* As soon as formula supplementation begins, the bacterial flora of infants becomes similar to that of artificial babies, in which bifidobacteria no longer dominate, and colonization of anaerobic flora develops.

* Even small amounts of formula supplementation (one feeding every 24 hours) will lead to changes in the microflora in the intestines of the child.

* Administering formula to a breastfed infant results in disruption in the gut ecosystem.

* In allergy-prone families, breastfeeding infants can become sensitive to cow's milk protein even after one bottle of formula, (occasional supplementation, or scheduled supplementation in the nursery during the first three days of life).

Which is better: mixed feeding or artificial?

There is no consensus on this issue. It seems logical that formula supplementation in the amount of no more than 50% of the total nutrition is better, since at the same time the child continues to receive healthy breast milk. On the other hand, imagine: the baby has just been born. Nutrition is the building of the body, all vital systems. It is very important that the child immediately adapts to the proposed nutrition and begins to assimilate it harmoniously. In the case of mixed feeding, it turns out that the child is adapted to breast milk, but then he is offered a mixture, which also needs to be separately accustomed to. Often the children's body is lost from the periodic attack of "foreign" food and begins to weaken.

Supplementary feeding with a mixture is sometimes treated too lightly, prescribing it without the participation of a doctor. Breast milk and any (the most expensive and high-quality) mixture are not equal to each other. The composition of breast milk is unique, it is fully adapted to a particular child, has a different composition depending on his age, season, state of health and even time of day. No mixture will ever have these properties. Supplementation with the mixture must be discussed with a sane doctor who practices an individual approach and does not prescribe the mixture according to the advertisement. Transferring a child to mixed feeding is a very serious step! An allergy may occur to the mixture, it is selected individually.

Some mothers begin to supplement the baby with a mixture at night according to "grandmother's" advice, so that the child sleeps better. All children after birth need to relieve birth stress. Imagine what a child has to experience during childbirth. He felt bad, hurt, scared. He was pulled out of a nine-month rest. For another 2-3 months, he will relieve stress through sleep or contact with his mother. The child needs to constantly feel the mother to make sure: she did not leave him. Therefore, newborns are able to "hang" on the chest for several hours. Any mixture is a very sweet satisfying product. It takes longer to digest and “nails” the child to a long sleep. There is nothing natural and harmonious in such a dream, except for the convenience of the mother.

Exceptional harm is the supplementation of infants with kefir or goat's milk. These products are not adapted, not identical to breast milk or formula, and up to six months (goat milk is contraindicated up to a year) harm the body, providing a load on the kidneys, pancreas, reducing immunity.

And finally. If you had to transfer the baby to mixed feeding, and then to artificial feeding, under pressure of circumstances, this is not a reason for further complexes. This is your individual situation. Of course, breastfeeding is the ideal choice for a baby. Not being able to support him, you still give your child no less love, care, you constantly think that he is the best in the world. Here's what's most important.

On the photos: 1. Miroslava (mother Hryunichka), 2. Marusya (mother Valkyrie), 3. Polina (mother

Mixed feeding of newborns is an alternative to artificial. This opinion is wrong. With mixed feeding, the baby receives many times more benefits from mother's milk, and the missing amount is compensated by the mixture. What are the features of this method of feeding, breastfeeding consultants will tell.

The question of which is better, mixed or artificial feeding, should be decided unambiguously in favor of the first. Mixed feeding is not a transfer of the child to the mixture, which becomes absolutely not equal to the replacement of breast milk. This is an addition to the diet of a newborn with nutrition that the mother’s breast cannot provide at the moment.

Formula supplementation principles

Breastfeeding consultant Maria Gudanova, an expert of the AKEV Association, recommends adhering to the following principles in organizing formula supplementation.

  • The main food is breast milk. The task of the mixture is not to force it out of the child's diet, but to solve the problem of insufficient quantity. It is important to remember that no artificial formula can meet the needs of the baby as fully as your milk.
  • The mix is ​​temporary. Supplementary feeding is introduced only for a while, usually for several months. After six months, artificial nutrition is replaced with complementary foods: the missing amount of milk is compensated by cereals, vegetable and fruit purees.
  • Mom takes measures to increase lactation. The most effective way to increase breast milk production is to breastfeed frequently. The more often it is stimulated, the more milk comes. Therefore, give up any modes, apply the baby before bedtime and after waking up. Be sure to offer the breast for each search movement, without trying to replace it with a pacifier, a pacifier. Remove from the everyday life of the crumbs all objects that he can suck. Feed at night and in the morning, because from three in the morning the production of the hormone prolactin, which is responsible for lactation, is especially active. These measures will help you to establish the production of milk in the required quantity. And mixed feeding of an infant can be “rolled up” in a few weeks.

Mixed feeding is a more complex approach to feeding your baby than natural feeding. It is necessary to prepare the mixture in advance, keep it warm, be sure to sterilize the dishes after each use. Therefore, the transfer to such a diet should be carried out deliberately: is there really a need for it?

When to mix

Often, a mother begins to use the mixture in the child's diet because of a banal self-doubt. If the breast remains soft for a long time, when you try to express it, some “drops” stand out from it, and the baby behaves restlessly during feeding, there are fears: is there enough milk in the breast?

These fears are unfounded, warns breastfeeding expert Natalya Razakhatskaya. - The condition of the breast, the amount of expressed milk, the behavior of the child does not indicate the level of lactation.

If your mammary glands remain soft and not full for a long time, then your body has fully adapted to the feeding regimen. And milk is secreted from them during periods of attachment to the baby's breast. This is a sign of mature lactation. The volume of expressed milk is also not indicative. As a rule, it is very difficult to express something from the breast, but it is worth attaching the baby to it, and the food for him “flows like a river”.

The behavior of the baby at the breast does not indicate the amount of milk in it.

  • The baby cries, turns away. The baby may be overly excited or upset. This behavior is typical for children whose mothers adhere to the “according to the regime” nutrition schedule. The importance of breastfeeding for a baby is not only in getting the food that he needs much more often, every 3 hours. But also in the need to feel mother's warmth, to hear the beating of her heart, to feel safe. Physical contact with the mother is necessary, and its absence leads to resentment from the crumbs and excessive nervousness during application.
  • Feeding hurts the mother, and the baby drops the breast. In this case, we can talk about the wrong capture by the baby of the nipple. As a result of improper attachment, the child cannot empty the mammary glands fully, it is difficult and uncomfortable for him to suckle. Mom also experiences discomfort or severe pain. It is not difficult to change the situation: you need to learn the technique of proper attachment to the chest. If feeding is painless, then everything is in order.

Often, pediatricians give recommendations for the introduction of supplementary feeding, focusing on indirect signs. For example, within two months the baby gained weight well, and on the third he suddenly did not reach the norm. Or the baby spends too much time at the breast, literally “hangs” on it, while sleeping poorly and often crying.

Mixed feeding of the newborn should not be introduced in response to indirect signs. If your doctor recommends formula supplementation without understanding the problem, see another doctor or lactation specialist. It is important to understand the causes of breastfeeding disorders and eliminate them.

The only indicator of the need for supplementary feeding is the insufficient number of urination of the child per day. This sign is accepted in international practice. In the domestic one, a different approach is used - by gaining weight by control weighing.

How do you know if your baby really needs a supplement? The control value is taken 12 urination during the day. That is how much pee babies from the age of three months, receiving sufficient nutrition. You can calculate this only by removing the diaper for a day and using diapers.

If during the day the number of urination turned out to be less than normal, it is necessary to decide how to transfer the child to mixed feeding. If the baby peed the same amount or more, there is no reason to supplement with a mixture.

Mixed feeding technique

Feeding in a mixed diet occurs in a "free schedule". That is, the baby is applied to the breast as much as he needs. Mom is interested in breastfeeding him more often to increase the level of lactation.

In this case, the total amount of the mixture that the crumbs require during the day is divided into equal volumes, usually into five “portions”. Mom feeds them, starting with the first morning application and until the night. At night, the mixture is not offered to the baby.

Mix quantity

The main aspect in the question of how to properly organize mixed feeding is the required volume of the mixture. Domestic pediatricians recommend determining it by control weighing: weighed before applying to the breast, weighed after, determined how much the baby ate and subtracted this volume from the required for one feeding.

But in international practice, this approach is not applied. It is recognized as uninformative, since the amount eaten by the child in each feeding may vary. In the morning, he can drink very little milk if he sucked his mother’s breast in a dream a couple of hours before. But with a good appetite, he will eat in an hour and a half, when he gets hungry.

The “wet diaper test” that the mother has already performed in the past to determine whether the introduction of mixed feeding is really necessary to accurately determine the amount of supplementary formula.

To compensate for each insufficient urination, the child needs:

  • 30 ml of the mixture at the age of 3 months;
  • 40 ml of the mixture at the age of 4 months;
  • 50 ml of the mixture at the age of 5 months;
  • 60 ml of the mixture at the age of 6 months.

Now you can calculate how much food per day you additionally need. For example, a three-month-old child who has peed 10 times needs an additional 60 ml of the mixture per day. A baby at the age of 4 months, who peed 8 times, will need 160 ml of the mixture per day.

What to feed

So that mixed feeding does not replace natural feeding, do not rush to use a traditional bottle with a nipple. If you need a small amount of supplementary food during the day, use other devices.

  • A spoon. A soft silicone spoon will do. Fill it halfway and pour the contents into the baby's cheek. Make sure the baby has swallowed the “portion” and pour the next one into his mouth.
  • Pipette. Take a small amount of the mixture, insert the pipette into the corner of your lips and pour its contents into your mouth. This will allow the mixture to get into the cheek and prevent the baby from spitting it out.
  • Cup. Small beakers are recommended for feeding premature babies. It may be convenient for your child to sip from a glass.

If you need a lot of mixture, feeding from a spoon or pipette will be long and inconvenient. Use a tight nipple bottle with small holes. The baby must make an effort to suck out the contents. Otherwise, "light food" from the bottle can lead to complete rejection of the breast.

rules

How to feed with a mixed diet of an infant? Feedback from lactation consultants includes the following recommendations.

  • Breast to supplement. Each feeding should begin with attachment to the breast. Feed your baby from both breasts and then from a spoon or bottle.
  • Breast after feeding. The end of each feeding should also be your breast. It will allow the baby to calm down and fall asleep.
  • Feeding without discomfort. Find a comfortable position for the baby, use those accessories that do not cause protests on his part. Formula feeding should not cause him distress.
  • Feeding on demand. After applying to the breast, the baby can completely satisfy the feeling of hunger and refuse the mixture. Don't insist. Offer supplements only when the baby opens its mouth and does not turn away from food. If he has not eaten something now, do not add this amount to the remaining daily volume.
  • Supplementation is not needed. Do the "wet diaper test" weekly. So you can control the required amount of the mixture. If you have taken steps to increase lactation, you may not need supplementary feeding after a couple of weeks.

An excellent way to restore lactation is constant close contact with the child. Carry it on your hands, put it on your chest, sleep next to it, do a light and pleasant massage. The warmth and caress of the mother will help the baby overcome the fear and discontent that often cause the refusal of natural feeding.

Myths and prejudices

There are many prejudices associated with mixed feeding in our society.

  • The stool of a newborn with mixed feeding is unstable, there are problems with the tummy.“Many formula-fed children suffer from flatulence and constipation,” comments pediatrician Yevgenia Milyutina. “But the reason for them is not the very fact of obtaining the mixture, but its wrong choice or violation of the cooking technique.” Constipation in a mixed-fed infant may be. But if you choose and prepare the mixture correctly, introduce it little by little, and not immediately the entire volume per day, and continue to breastfeed, the risk of disturbances in the digestive system can be minimized.
  • Mixed feeding is the first step towards artificial feeding. What is the purpose of the mother. If the introduction of the mixture occurred for medical reasons and with a pronounced lack of milk, and the woman takes all the necessary measures to restore lactation, the duration of the use of supplementary feeding may be limited to several weeks. If a woman plans to transfer the baby to a mixture, as she considers natural feeding to be tedious, difficult, the result in the form of artificial feeding is inevitable.
  • The immunity of a child on mixed feeding suffers. Breast milk gives the baby the first passive immunity. And during the whole process of natural feeding, it ensures the formation of a full-fledged immune system. There are no immune factors in mixtures, so it has been proven that artificial babies get sick more and more often. However, with a mixed diet, the child still receives valuable substances for immunity from mother's milk. The risk that he will grow up sickly and weak is much lower than for artificial children.

Mixed nutrition of an infant should be introduced strictly according to indications. The decision to use formula should not be made lightly, simply because the mother assumes a lack of breast milk.

Do a "wet diaper test" to determine if it's really lacking and how much. Talk to your pediatrician about which formula to use for feeding. And make every effort to restore lactation. After all, there is no more valuable food for your baby than breast milk.

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Mixed and artificial feeding is not uncommon in our time. Why are mothers forced to abandon breastfeeding or limit the child to stay at the breast? Sometimes there are good reasons for this, but more often the fears of the mother and the condemnation of loved ones and doctors.

“Not enough milk”, - probably every second mother heard such a verdict. "Start formula feeding and ask your doctor how much formula to give and which one is best." Conclusions about the amount of milk in a nursing mother are usually made on the basis of the following observations of the child.

1. Frequent breastfeeding. This means a milk crisis in mom. The situation is very common, natural and solvable. You just need to keep feeding your baby. And within a maximum of 7 days, everything will return to normal, and the baby will begin to ask for breasts less often.

2. Sleeps badly at night. Many children, regardless of the type of food, often wake up at night until 1-2 years of age. This is how their nervous system works. In addition, there are many reasons for frequent awakenings. Not only hunger. Perhaps the child does not like the bed linen, the mattress seems uncomfortable, the bed is too cramped. Or the air in the room is dry and very stuffy. By the way, high-quality ventilation and an open window at night help to improve children's sleep.

3. Too often screams, is naughty. Up to 3-4 months of life, almost all children suffer from intestinal colic. Usually they are distinguished by the following signs - the child begins to scream, does not calm down for 1-2 hours every day at about the same time. For example, before going to bed. In this case, mixed feeding will certainly not help him, and Dr. Komarovsky advises simply to survive this time - to carry the child in her arms more, apply a warm diaper to his tummy, massage the tummy, but just do not breastfeed too often.

4. Sucks at the breast, but after a while she drops it and screams. Examine the baby's mouth. This can be with candidiasis (thrush) in the oral cavity of a child or stomatitis.
If the child tightens his legs when he throws his chest, poops or farts, it hurts his stomach. The amount of milk has nothing to do with it. Perhaps the problem is the child's lack of the lactase enzyme in the intestines. This goes away with age and after the introduction of complementary foods. Sometimes, to improve the well-being of the child, before feeding, he needs to be given this enzyme to drink in the form of a dietary supplement.

5. Chest feels empty. Especially in the evenings. This is due to hormonal surges and a woman's fatigue. However, just because the breast feels empty does not mean that if the baby starts to suck, he will not get milk. An empty chest is a deceptive impression.
In addition, such soft breasts are the absolute norm with established lactation.

6. The child gains little weight. Normally, babies in the first months of life gain from 600 grams per month. But even 500 grams is the absolute norm. If in the first month the child gained less than 500 grams, but at the same time looks healthy and developed by age, the mother must first try to increase her milk production. And only if nothing comes of it, think about mixed feeding of newborns and children of the first year of life. As practice and statistics show, if a mother wants to breastfeed her child, everything will work out. If something inside her opposes this, artificial feeding is not far off.

7. Very little milk is expressed. Getting it right is not easy. Many women simply "pull" the nipples, hurting themselves. Milk does not go, and from this they conclude that there is not enough milk or it is not enough. But how much milk is expressed is by no means an indicator of its amount in the mammary glands. It takes skill to express well. An average of 10 days of daily pumping.

8. Small amount of urination. 8 or less per day. This is one of the rather specific signs of nutritional deficiencies. Usually, along with this, the child has a rare and dense stool, and the urine itself has a pungent odor similar to acetone.

9. Control weighing showed that the child sucked milk less than the norm. If the baby eats on demand, not on schedule, then he can suck out different amounts of milk. This calculation will be informative only if the child is weighed after each feeding during the day. Then it will be clear how much exactly he sucked milk.
You can find out how much milk your baby needs per day from your pediatrician. There are different formulas for calculating.
Tentatively, by the end of the first month of life, this is 90 grams per 1 feeding. By the end of the second - 120 grams per 1 feeding. By the end of the third - 150 grams. At the same time, the larger the child was born, the more milk he needs. However, a child younger than 6 months should not drink more than 1 liter per day. And a child of 6-12 months - more than 1.1 liters per day.

If there is even a drop of milk in your breast, this means that you can try to establish lactation. Be sure to breastfeed your baby. And preferably more often. The chest should come first. The mixture - after the child sucks for 15-20 minutes one breast and the same amount on the other. During this time, saturation should occur. Offer formula after breastfeeding. Make it a small amount. For example, 40-60 grams for the first time and see how much the child sucks.

It will be possible to more accurately calculate the mixture for mixed feeding if, within 1-2 days, the control weighing of the child is carried out, and the exact amount of sucked milk is calculated. Then subtract this amount from the average rate. And the resulting number of grams divided by the number of feedings. For example, 7 or 8. At the same time, it is very desirable that more than half of the diet, at least 70 percent, is still breast milk. Lactation with mixed feeding should be maintained. And ideally, if the mother is constantly with the child, gradually you need to completely return to the Guards.

It is very important to choose a good bottle nipple. The liquid should flow out of it not in a trickle, but in droplets. The baby will suck out the mixture slowly, which is comparable to sucking on a "half-empty" breast. And thus the risk of complete refusal of the breast will be reduced.

It is highly undesirable to supplement with a mixture with mixed feeding at night. If the child wakes up at night from hunger - give him a breast. After all, it is during night feedings that the hormone of lactation, prolactin, is most actively produced.
And during the day, breastfeed as often as possible. It is undesirable to establish a diet with mixed feeding, as this will further reduce the amount of milk from the mother. In addition, a mixed-fed baby must suckle at the breast. If not necessary, express breast milk should not be given. Of course, it is easier to control the amount of food eaten, it is clear how much to give the mixture, but the amount of breast milk is becoming less and less.

Is it necessary to give water when mixed feeding? Suggesting is a must. It is believed that a child does not need water only in the first 28 days of life. And then, if the air temperature in the room is normal, moderate humidity, and the baby is healthy and does not have a temperature. Constipation in a newborn with mixed feeding, by the way, is often the result of a lack of moisture in the body. You can give the baby to drink boiled water or the so-called "raisin" (steam a tablespoon of washed raisins in a glass of water). It is believed that such water is healthier than simply boiled water, since raisins enrich it with useful microelements. Including potassium - a positive effect on the baby's intestines.

The first complementary foods with mixed feeding are given at 6 months. Usually by this age, children can already sit and have a food interest. If the baby is not gaining weight well, then dairy-free cereals become the first complementary foods - rice, buckwheat and corn are introduced within a month. You can give boxed cereals from the department of ready-made baby food or cook it yourself from cereals ground in a coffee grinder, flour of the corresponding cereal or just grind ready-made porridge with a blender and (or) grind through a sieve.
If the child is gaining weight normally, then you need to start complementary foods with one-component vegetable purees - from zucchini, cauliflower or broccoli. You can cook your own vegetables. Blend with a blender before serving. Or buy ready-made purees in jars.

After the introduction of vegetables and cereals, the child is given meat (usually at the age of 8 months), then cottage cheese and fruits. Well, closer to the year, the child's menu is supplemented with fish and kefir.

Advantages and disadvantages of mixed feeding

Let's start with the benefits.

1. You can feed anywhere at any time of the year. If in the summer this is not of fundamental importance, since the clothes are light, open, you can quietly feed somewhere in the park, but in the fall or winter in a public place only a bottle will help out.

2. Sleep better at night. When the child ate well, and the mixture is very nutritious, he sleeps longer at night without waking up.

3. There is absolute certainty that the child is not hungry. And therefore, if he cries, then the parents begin to look for the reason for this and do not attribute everything to hunger.

4. You can leave the house. If in the case of exclusive breastfeeding, you need to at least express a bottle of milk, then in the case of supplementary feeding with a mixture, there is no need to express, because you can give the baby artificial nutrition.

And these are the cons of mixed feeding, and there are much more of them than the pros.

1. Fading lactation. The more mixture the mother gives to the child, the less he suckles, and the less milk she comes. And if you do not immediately make an effort to return to exclusive breastfeeding, the amount of formula will most likely increase every week until the mother's milk disappears. Practice shows that almost all mothers who feed in a “mixed way” sooner or later switch to completely artificial feeding.

2. Atopic dermatitis. Cow and goat milk, soy - the basis of all artificial mixtures, these are allergens. Many children cause a rash on the face and body. Unlike breast milk. The child will not be allergic to it if the mother herself often and in large quantities does not eat allergens.

3. Colic. Children who eat formula are more likely to experience abdominal pain. Even in the case of using an expensive adapted mixture. However, over time, the child's body adapts to this type of diet.

4. Inconvenience and waste of time for formula preparation, washing and boiling bottles. At least not at first until they get used to it. Although moms on the forums are actively sharing tips on how to speed up the process of preparing the mixture at night, pouring the right amount of the mixture in the evening and leaving warm boiled water in a thermos. These simple steps can save you a lot of time.
Well, the bottles can not be boiled from the second month of a child's life. It is enough to wash them using safe baby products.

5. Rejection of the breast. If a baby suckles formula from a bottle, there is a high risk that he will not want to suckle later. Therefore, if the amount of supplementation is not large, it is better to give it from a spoon or syringe without a needle.

6. Financial costs. If you buy an expensive mixture, then you will have to spend more than one thousand rubles a month. True, with the introduction of complementary foods, the need for breast milk and formula will decrease, and in parallel with this, the money spent.

7. Constipation. It often occurs in children who are supplemented with unadapted or partially adapted milk formula. To prevent constipation from tormenting your baby, when choosing a mixture, be guided by the following rules:

  • buy a mixture by age (one for babies up to 6 months, deuce - from 6 to 12 months);
  • the protein index is not higher than 1.6 g / 100 g for children of the first six months of life and 2.5 g per 100 g for those older;
  • fat content - 3.5% (partially milk fats are replaced by vegetable ones);
  • the ratio of calcium to fluorine is 2 to 1, so they are better absorbed;
  • replacing cow protein (casein) with whey, the best ratio is 40% casein to 60% whey.

The advantages of mixed feeding are much less than the disadvantages, but this is in comparison with breastfeeding. However, if there is no way out, it is better to leave the child at least partially on breastfeeding, and not completely transfer to artificial feeding.

We figured out how to properly feed a newborn with mixed feeding. And in the end, one more piece of advice - in no case do not supplement your child with whole or diluted cow's milk! Or water with semolina diluted in it. Yes, women used to do this, but only because there were no infant formula in the stores. Unadapted cow and goat products can cause serious digestive disorders and negative skin reactions in infants. Whole milk can only be used when preparing cereals for children over 6 months old. A whole drink - after a year. In an amount of not more than 200 grams per day.

Kefir can be given to children in the same amount of no more than 200 grams per day from 8 months.

  1. Supplementary feeding (artificial mixture) should be given only after the child is attached to the mammary glands and after their complete emptying, even with a minimum amount of milk. This is done due to the fact that at the beginning of feeding, the child has the most pronounced appetite and he actively sucks at the breast. If you give an artificial formula first, then, firstly, you don’t know how much to give it, and secondly, after satisfying the appetite, the child will not want to suckle, since it is much more difficult than eating from a bottle.
    In the case of social conditions, when the mother is forced to be absent for a certain amount of time or in the treatment of certain diseases, the mother can resort to the following method of feeding. The child during the day receives an artificial mixture 2-3 times, and the rest of the feeding is breast milk;
  2. Supplementary feeding is better to give from a spoon (if its volume is not very large), since an easier intake of the mixture from a bottle can help the child refuse gud. With a large amount of supplementary feeding, as a rule, a bottle is used. The bottle should have a sufficiently elastic nipple with small holes (so that the child makes an effort while sucking);
  3. Diet. The most optimal is the free mode of feeding. But you can also feed the baby on a schedule, in which case the frequency of feeding can be reduced by one feeding compared to natural feeding;
  4. Mixture, bottles, nipples must be sterile. The temperature of the finished mixture is 37-38 degrees;
  5. Complementary foods with mixed feeding are introduced 2-3 weeks earlier than with natural feeding.

To calculate the child's needs for food ingredients, the following are taken into account: the age of the child, what type of feeding the food is close to (artificial or natural), the type of mixture used (adapted, non-adapted).

Daily requirement of children for the main ingredients

ingredients g/kg age months type of feeding
natural mixed artificial
squirrels up to 4 2,0-2,5 3.0 (adaptive) 3.0 (adaptive)
3.5 (non-adaptive) 4 (non-adaptive)
4-12 3-3,5 3,5-4 3,5-4
fats up to 4 6,5-6
4-9 6-5,5
9-12 5,5-5
carbohydrates 0-12 12-14

Example: Baby is 3 weeks old. Birth weight 3000 g, currently 3100 g. Mom worries that the baby often cries, wakes up after feeding after 1-1.5 hours, calms down if he sucks at the breast. The child is outwardly healthy, stool 1-2 times a day, dense feces. Feeds 7 times a day.

  • Due body weight 3000 g + 400 \u003d 3400 g;
  • Body weight deficit 3400 - 3100 \u003d 300 g (8%);
  • Daily amount of food needed = 3100:5 = 620 ml;
  • Volume per feeding = 620:7 = 88.5 (90) ml.

During the control weighing, it was found that for each feeding the child sucks out 30-40 ml of milk. During the day, he receives 35 * 7 = 245 ml of milk. When comparing the required amount of food (620 ml) and the milk received (245 ml), it can be seen that the mother has hypogalactia. Supplementary feeding is required (transfer to mixed feeding).

Feeding calculation: for one feeding, the mother has about 35 ml of milk, and 90 ml is needed. In the form of supplementary feeding there will be a mixture of "Detolact" in the amount of = 90-35 \u003d 55 ml (each feeding give breast milk -35 ml, a mixture of "Detolact" -55 ml)

Calculation of the child's need for ingredients:

  • proteins - 3.0 g * 3.1 kg \u003d 9.3 grams;
  • fats - 6.5 * 3.1 \u003d 20.1 grams;
  • carbohydrates - 14 * 3.1 \u003d 43.4 grams.

The number of ingredients received by the child:

  • proteins - from breast milk (V = 245 ml) - 2.45 * 1.5 = 3.6 g;
  • from the mixture "Detolact" (V=385 ml) 3.85*1.8=6.9;
  • fats - from breast milk - 2.45 * 3.5 \u003d 8.5 g; from a mixture -3.85 * 3.7 \u003d 14.2 grams;
  • carbohydrates - from breast milk 2.45 * 7.0 \u003d 17.1 g; from the mixture - 3.85 * 7.3 \u003d 28.1 grams.

Conclusion: with this feeding, the needs of the child are fully satisfied.