Mixed type of feeding newborns. How to organize mixed feeding of newborns

Mixed feeding of newborns is not an alternative to artificial feeding. This is mother's milk for the most part, and the missing amount of nutrition is compensated by purchased mixtures. This is an acceptable method of feeding a newborn baby with insufficient amounts of breast milk.

It is completely inappropriate to compare artificial feeding and mixed, always giving preference to the second. The purchased mixture cannot be compared with mother's breast milk in any way, but it can serve as an excellent addition to the baby's diet with limited opportunities for the wet nurse.

The principle of breastfeeding

The best specialists of the Association of Natural Feeding Consultants (AKEV) recommend developing and adhering to several principles of feeding with artificial mixtures:

These steps will naturally help eliminate mixed feeding from your infant's diet. Established lactation of the required amount of mother's milk in a few weeks will make it possible to refuse supplementary feeding.

If you think that feeding your baby is easier than breastfeeding, you are in for a disappointment. The mixture must be prepared in advance. and maintain its temperature. Must be warmed up before feeding. Dishes must be sterilized after each use. Before transferring an infant to such a diet, one should ask oneself the question: is the transition to artificial feeding of a child a necessity or a whim?

How to determine the need for feeding

Lack of confidence in yourself and your abilities is a common cause early use in the child's diet of artificial mixture. There are three main reasons for a nurse to worry about having enough milk in her breasts:

1. For a long time after feeding, the breast remains soft.
2. Unable to express milk, there is none.
3. The baby is restless while eating.

AKEV specialists approve t: such experiences have no basis. The condition of the mammary glands, expressed milk and the motor skills of the child during feeding are not an indicator of the level of lactation in the mother.

If the breast does not fill up for a while and remains soft, this is an indicator of an excellent feeding regimen for the baby, and this regimen is well suited to the mother's body. Milk begins to arrive at the moment when the baby is applied to the nipple, excellent mature lactation has just such indicators. During the early stages of breastfeeding it is really difficult to express milk from the breast, but we put the baby on - and the milk flowed in a stream. The mobility of the baby during the meal has nothing to do with the amount of milk, it's just fiction.

Baby is naughty and turns away

The baby touches the mother’s breast not only to get enough, there are other reasons for bodily contact: the need to feel safe, feeling the beat of the mother’s heart, plunge into the warmth of her body, and the children want to eat out of schedule. The absence of these factors can cause excessive nervousness, resentment and anxiety in the baby, which will certainly affect the behavior at the next feeding.

It hurts to feed the baby and he throws his chest

There are often situations when the baby does not grasp the nipple correctly, this is just such a case. This happens as a result of improper attachment of the child to the breast. He feels difficulty and inconvenience while eating, emptying the mammary gland incompletely. Discomfort is felt not only by the child, the mother also feels inconvenience, up to painful sensations.

It is easy to change the created situation: it is necessary to master the technique of proper breastfeeding. With the right use of this technique, the process itself becomes painless.

Indirect signs

Let's say baby during the first two months Gained weight according to pediatric norms, and in the third month the weight gain was small. Such a standard situation may be the reason for the introduction of additional feeding.

Or the child does not let go of the breast at all, but this does not help him sleep normally at night. Becomes restless, sleeps poorly and cries often.

It is necessary to recommend additional feeding after finding out the reasons that cause dissatisfaction with the baby. If it so happened that your doctor did not find anything that causes dissatisfaction in the child, there is always the right to turn to another pediatrician.

The main thing is to find the cause of the violation of the feeding regimen and remove it.

Domestic pediatrics recommends the introduction of artificial nutrition, based on the weight gain of the baby, making control weighings. In international practice, such a decision is made on the basis of an insufficient daily amount of urination.

Parents have to decide how many times the child goes to pee in a day. Normal nutrition forces a three-month-old baby to go small 12 times a day. Making the calculation is easy: just change diapers for diapers.

In case of insufficient urination, we transfer the baby to mixed feeding. In all other cases, there is no reason to talk about additional nutrition.

The rule of mixed feeding

Mixed feeding of newborns takes place without any special rules. The only thing is that they do not give an artificial mixture at night.

Required amount of additional food is divided into five equal parts. Starting from the first morning feeding, stretch the feeding until the evening. The baby is fed without a schedule, for any reason they offer to eat. Every mother is interested in adding milk and increasing lactation levels.

Amount of additional power

The main question in the organization of proper feeding is how to determine how much mixture the child needs.

Procedure for determining the amount of additional power, our pediatrics is simple:

1. The baby was weighed before feeding.
2. After feeding, they also weighed.
3. The difference was calculated - the amount of food received.
4. Compared with the volume required for this age.

International pediatrics has long abandoned control weighing, the probability of incorrect data is too high. The thing is that at different times of the day, for various reasons, babies can eat different amounts of milk.

In the morning, before waking up, he can drink a little milk and fall asleep again. At lunch, after an active pastime, he will drink twice as much as in the morning.

A more accurate determination of the amount of missing nutrition helps to give the above method with diapers, b thanks to which parents determined the need for additional feeding.

For each missing urination, the baby needs to add:

• Aged three months– 30 ml of nutrition.
• Four months - 40 ml.
• Five months - 50 ml.
• Six months - 60 ml.

Example:

A three-month-old baby peed 8 times, four are missing: 4 * 30 \u003d 120 ml. How much food should be added per day.

A four-month-old child urinated 10 times, missing 2: 2*40=80 ml. So much mixture should be given additionally the next day.

Utensils for additional feeding

It is good to feed with a nipple, the baby quickly eats up, and there is less hassle. There is only one but: taking additional nutrition from the nipple, the baby can quickly refuse the breast. On the principle of least resistance.

Spoon

A soft silicone spoon works well. Having collected half a spoon, you should pour the baby by the cheek. After he swallows a portion, pour more into his mouth and so on until the last drop.

Pipette

Take a small amount of the mixture into the pipette, inserted into the corner of the lips and poured food over the cheek.

Cup

A teaspoon and a pipette are used for small children with small portions. If the dose is larger, you can use a cup or glass. Many kids love it.

In cases where a large amount of the mixture is required, a spoon and a pipette will take a lot of time. It is advised to use a nipple with a very small opening. Such a nipple is very tight and the child will have to make considerable effort in order to empty the bottle.

Proper feeding

Mixed breastfeeding This is a simple and uncomplicated job. Check out the recommendations of professional nutrition consultants:

• Feeding begins with the mother's breast. Apply to both mammary glands.
• After breastfeeding, we feed the baby with a mixture.
• We complete the process of breastfeeding again. This will help the child fall asleep peacefully after a little stress.
• Feeding should take place in conditions that are comfortable for the baby. All reasons for his dissatisfaction must be eliminated.
• No force feeding. The baby should eat when he wants and how much he wants. If he's full and doesn't want to eat, don't force him to add leftovers to his next meal. Feed only when the child asks for food, open your mouth and do not turn away from food.
• Lactation test (wet diaper) should be done once a week. It is possible that after two to three weeks it will no longer be necessary to feed.

A simple method of restoring and increasing lactation is to constantly have close contact with the baby. Hold in your arms, apply to your chest, sleep together, stroke and caress the child in every possible way. The warmth of the mother's body, affection and attention help the baby overcome fears and discontent caused by laborious natural feeding.

Rumors and speculation

Mixed feeding often does not find understanding among young mothers, this is due to numerous prejudices.

Newborn chair

Mixed feeding makes the baby's stool unstable, and there may be difficulties with the tummy. Also, artificial nutrition can cause flatulence and constipation. But you should not blame mixtures for all sins. The common cause of all troubles not the food itself, but an improperly prepared or poorly selected mixture.

The child may experience diarrhea and constipation, not only as a result of feeding. Most importantly, each mother can independently minimize the likelihood of a digestive disorder in a baby.

A few tips from consultants:

• Choose the right artificial mixture.
• Prepare according to the attached recipe.
• Divide the missing volume by several times.
• Continue breastfeeding.

Violation of immunity

On mixed feeding, the immune system does not receive the necessary trace elements. Of course it is. breast milk baby receives everything necessary not only for the immune system, but also for the development and growth of the entire child's body. Formula does not provide an immune factor, so formula-fed babies get sick more often and grow weaker.

When it comes to mixed feeding, everything is different. Mixed nutrition cannot provide the baby with the necessary elements; it only supplements the caloric content and mass of the food itself. The mother's breast creates the environment necessary for the body. These children grow up healthier and stronger than children who are on full artificial feeding.

Mother's goals

The introduction of mixed feeding fraught with the transition to a complete artificial.

If the nurse is faced with a lack of milk in her breasts, mixed feeding will not last long. You can restore lactation in the coming weeks.

Switching to mixed feeding is necessary only as a result of severe indicators of lack of milk and malnutrition of the infant. Before switching to it, you need to think carefully about this decision, it is not enough to suspect a lack of milk.

Be sure to test with diapers, accurately determine the amount of missing nutrition. Consult with your pediatrician and choose the mixture together.

Do not let everything take its course, make every effort to increase or restore lactation. We can safely, without exaggeration, say: the natural nutrition of a baby is his future health!

The most valuable food for a baby is the mother's breast milk!

A mixture, which can be ordinary or medicinal, is given based on the missing amount of food. Usually the amount of supplementary feeding is from 10% to 30%, but not more than 50%. The exact volume of the mixture is calculated by the pediatrician. If the mother does not plan to transfer to breastfeeding, and the child is less than 4 months old, then the volume of the mixture administered is increased weekly. If the mother's lactation has returned to normal, then the mixture is gradually canceled.

When and how to feed

They are usually supplemented after breastfeeding, first they give the child both breasts, then they offer supplementary feeding. The mixture is given either from a bottle that mimics breastfeeding as much as possible, or from a spoon. If your goal is to keep breastfeeding, give up standard bottles that allow milk to flow freely. The child should not have similar associations when he suckles and when he receives supplementary food. When a baby suckles, he clearly regulates the flow of milk and his breathing, the rubber nipple does not pause and gives out milk all the time - this is uncomfortable, provokes swallowing of air and coughing.

Supplementary feeding is distributed according to the number of feedings, trying to maintain intervals of 3 hours. That is, they are supplemented at 6, 9, 12, 15, 18, 21 hours or at 6, 12, 18 hours, depending on the amount of supplementary feeding required. At night and between feedings, the baby should eat only breast milk. Night feeds stimulate lactation, and the absence of “easy milk” encourages the baby to suckle more actively. In the event that the mother goes to work and is absent for part of the day, if possible, they adhere to the same scheme, giving supplementary feeding after feeding with expressed milk. Expressed milk is also offered either from a spoon or from a bottle imitating sucking.

The mixture should be prepared strictly according to the instructions, and the cooking utensils, spoons and bottles should not only be washed, but also sterilized.

How to introduce supplement

Any mixture is a potential allergen; a quickly introduced supplement can provoke constipation, intestinal colic and dermatitis. They begin to supplement with a volume of 5-10 ml, gradually increasing the volume of the injected mixture to the required level. The main criterion for the correctness of your actions is the good health of the child, the absence of disruption of the intestines and the absence of a rash.

Do not forget that a mixed-fed baby needs additional supplementation. Offer him periodically boiled water from a spoon or from a drinker.

Is the child eating?

If there is never a lot of breast milk and the child can breastfeed as often as he wants, then this is a forced measure, where overfeeding is much worse than underfeeding. The criterion for the effectiveness of mixed feeding is a stable, albeit small, weight gain, good health of the child and a sufficient amount of liquid excreted. If the child urinates more than 6-8 times a day, then the volume of food is enough for him. And, of course, the main criterion of effectiveness is the improvement of lactation and a gradual decrease in the volume of supplementary feeding.

Non-objective reasons for supplementation

You should only supplement a hungry baby and when the baby really does not have enough breast milk. If it seems to the mother that there is not enough milk, since the breast does not pour, and the child adds well and actively urinates, supplementary feeding is not needed. The lack of milk when expressing is also not an argument - for some women it is quite difficult to express, although the child is full and feels calm. "Blue" milk - this is how mothers call upper milk, it is really almost transparent, since it contains mainly water, vitamins and milk sugar, the baby receives the main part of the nutrition at the end of feeding. Lactation crises associated with rapid growth and unsettled lactation can often be misinterpreted and the baby is switched to formula.

If the transfer to mixed feeding is a necessary measure and you want to breastfeed only, contact your pediatrician for help.

The main communication between the mother and the baby occurs precisely during the feeding sessions. And such sessions, like nothing else, establish an invisible connection between the parent and the baby. Therefore, pediatricians prioritize breastfeeding.

But there are situations when a parent has to combine natural breastfeeding with the use of infant formula. What is mixed feeding of newborns, how to properly feed a child in this case, what schedule will be optimal for mom and baby? We will look into these important issues together.

There is breastfeeding - this is when you feed your baby exclusively with your breast milk. Artificial feeding is when the little one eats a special milk formula. It is prepared most often from cow or goat milk, taking into account the daily need of the child for nutrients, micro and macro elements.

Mixed feeding is a combination of the first and second options. In this case, the child receives both mother's milk and bottled food. Only in turn, following a strict schedule. It turns out that the baby seems to get all the best from his mother, and the amount of food eaten per day is “catching up” due to the mixture. Often this type of food is called supplementary feeding.

Manufacturers try to adapt the composition of the mixtures as much as possible for breast milk. But in the end, you still get products that are fundamentally different for the digestive system. The stomach and intestines of a newborn is forced to adapt to two types of food at once - you want to eat something. This is not easy, because the introduction of supplementary food needs good reasons.

Reasons for mixed feeding

The main reasons why a mother may need help in feeding her baby include:

1. . There are women who are genetically programmed to produce enough milk. And there are those whose body is not designed for this. And then there is stress, which even a large number of milk cancels out.
2. Life and society. Sometimes a mother needs to deal not only with a newborn, but also with study / work. But you can’t drag a baby with you either to university or to work.
3. Health Issues. If a parent feels unwell, there are problems with the heart or blood vessels, kidneys, lungs or some other organs, where can we go before breastfeeding.
4. Milk quality. If the baby develops poorly, malnutrition or anemia is recorded in him, the reason may be that the mother has a lot of milk, but in composition it is almost water, and does not satisfy the needs of the growing body for nutrients.

Mixed feeding rules

The fundamental principles of supplementary feeding include several theses:

1. Breast milk is the best thing you can give a baby. An adapted mixture in this regard should be exclusively an assistant to make up for the lack of this food. And in no case should it be pushed into the background.
2. Supplementation is a temporary phenomenon. Supplementary feeding is introduced only for a few months. In six months it should be replaced.
3. Lactation must be maintained and extended. To do this, it is important to put the baby to the breast as often as possible, for this you can even neglect the feeding regimen.

In addition to principles, there are also rules. They will help to pass supplementary feeding without prejudice to your lactation and as correctly as possible from pediatrics:

1. Supplementary feeding is given only after the mammary glands are completely devastated, even if your cat has cried milk.
2. Ideally, supplementary feeding should be given from a spoon - so the baby will not refuse to "work" at your breast.
3. Once a feeding regimen has been established, it is very important to follow it at all times.
4. If you do give formula from a bottle, you should choose a nipple with a very small opening. All children's utensils must be kept clean and sterile.
5. The temperature of the finished “artificial” food should not exceed 38 ° C, but liquids cooler than 37 ° C should not be given either.

Calculation of milk/mixture ratio

This is the most main question mixed feeding. Milk you give everything, no matter how much it is produced by your breast. It remains to determine how much mixture with your amount of milk you need to give the newborn. Very often, this issue is approached empirically - first they give the baby a breast until it is completely empty, and then they supplement it with a mixture from a spoon or bottle until the newborn is full. And often this method really works.

But if you want to know the daily amount of formula needed by a newborn, ideal method calculation is considered all the same "wet diapers". Normally, the baby should write at least 12 times a day. From how many urination is not enough to this rate, and calculate the required milliliter of supplementary feeding.

Thus, for each missing wet diaper of the finished mixture, you need:

• at 3 months - 30 ml;
• at 4 - 40;
• at 5 - 50;
• in 6, respectively, 60 ml.

For example, if a child urinated 9 times at three months, he needs 90 ml of supplementary food per day, and if a five-month-old toddler spoiled only 7 diapers, he lacks 250 ml of food.

If you have ever been on a diet, then you know exactly what BJU is, and how much protein, fat and carbohydrates you need per day for happiness. These are the main ingredients of any food.

Babies up to 4 months with mixed feeding per day must receive:
3-3.5 g of protein, 5.5-6 g of fat and 12-14 g of carbohydrates per kilogram of weight.

That is, a newborn with a body weight of 4 kg needs, on average, 12 g of protein, 24 g of fat and 48 g of carbohydrates. After 4 months, the daily requirement for protein increases to 4, and fat - up to 6 grams per day. The amount of carbohydrates does not change.

Using this data, you can get confused and calculate whether your newborn is getting everything he needs. But if the baby is sleeping soundly and steadily gaining height and weight, it simply does not make sense to worry and do accurate calculations. The baby will still ask to eat exactly as much as he needs, no matter what you calculate with a calculator, the baby’s body knows better what he needs and how much.

How to choose formula and bottle

If there is very little milk, spoon-feeding a newborn on the recommendation of a pediatrician from a spoon can be inconvenient, long, and generally problematic. Therefore, the question arises about the choice of bottle. Today they are:

1. glass. This is the best option, since the glass does not affect the contents of the bottle in any way. But if the baby has already grown up and moves its arms quite actively, such a vessel will easily fly to the floor and may simply break.
2. Plastic. This is the most practical and durable of all that is. But one caveat - you can buy such a bottle only in a specialized store by checking the appropriate certificate. Only high-quality plastic will not affect the contents of the bottle in any way, a cheap one will release harmful substances into a slightly warm liquid.

In addition to the dish, it is important to choose the right "nozzle" for it. Nipples are:

• silicone;
• latex.

And here the choice is solely for the child. Some children do not care what the nipple is made of, others refuse to drink from silicone, and others do not like latex. It is difficult to recommend something here, only trial and error will help. But it's up to you to choose the form. In this sense, an orthodontic nipple will be ideal for a newborn, which in the baby's mouth feels the same as the mother's nipple. In addition, it would be useful to pay attention to the hole - it should be minimal, the child should work on eating the mixture in the same way as when sucking the breast. It would be useful to ask a question about the anti-colic valve, it provides normal sucking without swallowing excess air.

As for the mixture, the choice today is quite large. But to say which of them is good and which is not is simply impossible, since different mixtures are perceived differently by different newborns. The first one will most likely be advised by your pediatrician. Just do not immediately buy a large package, choose a small one for testing. If the product fits the little one, fine. If not, you will have to choose another option, following the same trial and error method.

Did you know? If a young mother at one time was artificially or mixed-fed, it makes sense to check with her grandmother with which mixture. In 80% of cases, it is ideal for a grandson.

Constipation in infants with mixed feeding

Constipation in a newborn with mixed feeding is not much more common than in a natural one, if the mother violates. Too many factors affect the baby's digestive system. Therefore, you will have exactly the same amount of constipation as if the baby were exclusively a baby or an exclusively artificial one.

The only rational point in this is when artificial feeding meals are on schedule. Therefore, between feedings, if necessary, the newborn is supplemented with warm boiled water. With mixed feeding, water, as a rule, is out of the question, but if supplementary feeding is 50% of the total diet of an infant or more, constipation may be the result of a banal lack of fluid in the body. It may also be a sign that the mixture simply did not fit the newborn.

Other Possible Problems with Mixed Feeding

The most common problems, oddly enough, are exactly the same children's troubles as with any other type of feeding:

• loose stools in infants on mixed, and indeed on any feeding, manifest themselves, either when the mother has the wrong diet during breastfeeding, or when there is a failure in the peristalsis of the intestines of the newborn;
• colic, but this is a standard problem for most babies, regardless of the type of feeding;
• allergy to cow's milk, which may occur due to the use of the mixture, provided that the child is initially allergic.

But the green stool in a mixed-fed baby is just the result of digestion of the mixture. At the same time, you can notice yellow blotches in it - this is already a product of the digestion of your milk.

Mixed feeding of newborns - video

In this video, a specialist talks about feeding a baby with breast milk in combination with bottle feeding.

Mixed feeding for a newborn is a real way out when for some reason you have little milk, but you still want to keep lactation to the last. There is nothing wrong with the fact that the baby will eat two different foods at the same time, no.

The opinion that children on mixed feeding suffer more than on any one is fundamentally wrong. With the right bottle, nipple, and mixture, colic, diarrhea, and constipation occur at exactly the same frequency as other newborns. And all these troubles will completely disappear after 4-5 months of a newborn's life. The main thing is to follow the rules of such feeding, and give the baby as much attention as possible.

Do you have experience with mixed feeding a newborn? Which formula is right for your baby? Share your experience in the comments, it will be very helpful for those young mothers who are faced with the issue of supplementary feeding for the first time. Healthy children and good appetite!

When deciding which method of feeding is preferable, mixed or artificial, it is undoubtedly worth making a choice in favor of the first. The adapted mixture is still far from real breast milk, and mixed feeding makes it possible to feed the baby with unique mother's milk. The newborn receives all the benefits of breast milk, which is supplemented with a small amount of supplementary nutrition.

If a mother has the opportunity to supplement her baby with breast milk at least a little, she should do it. Even the best artificial mixture cannot fully recreate unique composition mother's milk

Principles of mixed feeding

Maria Gudanova, AKEV Association Expert and Breastfeeding Consultant, suggests the following principles that will be relevant when supplementing your baby with an adapted formula:

• The best "food" is breast milk. The mixture should be an assistant in making up for the lack of mother's milk, but never completely replace it. Only breast milk is able to fully satisfy all the needs of the child's body, and not even the most expensive mixture is able to do this.
• The mixture is temporary. The introduction of supplementary feeding is carried out only for a few months. When the baby reaches the age of 6 months, the artificial part of the diet is replaced with complementary foods. In addition to mother's milk, the baby receives vegetable purees, cereals and juices.
• Maintain and prolong lactation. Mom needs to make sure that milk in the breast constantly arrives. The most effective remedy is frequent applications. Active stimulation of the mammary glands will help produce more milk. In this case, non-compliance with the regimen is possible in order to prevent lactation from fading away. The baby needs to be breastfed at any time: before bedtime, after sleep, and also when he is actively looking for an object to suck. Don't replace breasts with a pacifier. Feed more often at night, and especially after 3 a.m. - at this time, the hormone prolactin is gaining strength, whose task is to increase lactation.

The process of mixed feeding is more complex and energy-intensive compared to the natural type. There should always be a ready-made warm mixture at hand, the bottles have to be constantly sterilized, so before giving up full-fledged breastfeeding, you should once again weigh and think everything over.

When to mix?

Dear reader!

This article talks about typical ways to solve your questions, but each case is unique! If you want to know how to solve your particular problem - ask your question. It's fast and free!

Lack of breast milk in the mother (hypogalactia) is the main reason for switching to mixed feeding. Hypogalactia can be primary (occurs immediately after childbirth) and secondary (manifests itself on more later dates). Having not achieved positive results from measures aimed at increasing milk production, doctors recommend starting to supplement the child with an adapted mixture (we recommend reading:). This is done in order to make up for the lack of food, lack of vitamins and minerals.

The lack of breast milk is determined by the following signs:

• The child behaves restlessly during sucking or immediately after eating.
• During suckling, the mother feels that the breasts are completely empty.
• Small amount of urination: you can find out with the help of the “wet diaper” test. A well-nourished three-month-old baby should, on average, pee 12 times a day. It is this number that will be the control.
• The child is not gaining weight well, and there are also noticeable delays in physical plane and in mental development (we recommend reading:).

Having established the presence of these signs, you should not immediately buy the mixture. It is better to first consult with a pediatrician who would support ideas. breastfeeding or seek help from a lactation specialist. Experienced doctors will always suggest the right way to solve the problem and answer the question of how to maintain lactation.

Sometimes the idea to start the process of mixed feeding of newborns visits young mothers during periods of "milk crises". Such time intervals are characterized by low milk production compared to the needs of the child. The problem is solved by one sure and reliable means - private attachments to the chest. After 2-3 days, lactation will again become sufficient. Make no mistake, do not rush to introduce the mixture.

Feeding technique

Mixed feeding of newborns involves a free feeding schedule. This has its pros and cons. The baby receives a breast on demand at any time - this is necessary to increase milk production.

The amount of the adapted mixture, designed for the whole day, is divided into 5 "doses" - in portions, the mother feeds the baby during the day, and at night only the breast is offered to the baby. Thus, the baby's diet will be carried out with mixed feeding.

The child does not need extra food - the baby eats the mixture five times a day in approximately equal amounts. His mother must calculate in advance, but there is no need to cook food for the future - a fresh portion is made each time

How to determine the amount of the mixture?

One of the main issues in the organization of mixed feeding is the volume of the mixture needed by the child. Russian pediatricians adhere to the method of weighing the baby before and after breastfeeding. The amount that the baby ate should be subtracted from the total amount required for one complete feeding.

Doctors from other countries consider this method uninformative. They explain this by the fact that each time a child can eat a different amount of breast milk. To find out how much mixture a baby needs with mixed feeding, again, the “wet diaper” test will help.

The following volume of the mixture can compensate for one missing urination:

• 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.

The scheme will help to calculate the required amount of the mixture per day. For example, a baby pisses 10 times at 3 months - you need to supplement him with 60 ml of the mixture per day. A 4-month-old baby who has wet diapers 8 times needs supplementary feeding with a mixture of 160 ml per day.

How to choose a mixture?

If the child feels well and there are no contraindications, you can choose any of these mixtures: Humana, NAN, Nestozhen, Nutrilon, Hainz, Hipp or Mamex (we recommend reading:,). A child with severe symptoms of constipation, colic, irregular stools or at risk of developing infections should be fed with Nan Sour Milk 1, which is intended for children under 6 months.

Intolerance to cow's milk in one of the parents or the risk of it in the baby justify the use of the mixture "Nan hypoallergenic", "Hipp hypoallergenic" or "Nutrilak hypoallergenic", in which there is a partially hydrolyzed protein. The presence of an identified allergy to cow protein determines the choice of hydrolytic adapted mixtures, in which the main potential allergens are destroyed by hydrolysis. In this case, parents can choose Frisopep, Pregestimil, Nutramigen, Nutrilon Pepti MSC, Damil Pepti, Nutrilak Pepti SCT and the like. Before you start feeding the selected product, be sure to consult a pediatrician and find out which mixture will be optimal for your baby.

What to feed?

Due to the risk of mixing breastfeeding being crowded out, we recommend that you take your time to switch to bottles. It is quite possible to introduce small portions of supplementary food in other ways:

• Spoon. Feed your baby with a soft silicone spoon. Take a mixture of 0.5 tablespoons and gently pour the crumbs into your mouth. To set up the correct technique, you can watch the training video.
• Pipette. With it, you can easily feed your baby with a small amount of formula. Bring the filled pipette to the corner of your lips and pour into your mouth.

If you need to introduce a large amount of supplementary feeding, options with a spoon and a pipette will be inconvenient. In this case, find a bottle with the tightest nipple and a small hole. The process of sucking the mixture should be as laborious as the process of natural breast sucking. A baby receiving "easy prey" will refuse breastfeeding.

The introduction of supplementary feeding does not necessarily mean the use of a bottle with a nipple, which can cause further rejection of the mother's breast. A soft silicone spoon is perfect - even the smallest will master it

Rules

What are the features and rules for introducing the mixture in the combined type of feeding? GV experts recommend adhering to the following principles:

• Breast first, then supplements. Every feeding should start with breastfeeding. First, attach the crumbs to one breast, then to the other - as soon as both are empty, you can proceed to supplementing from a spoon or bottle.
• Mom after the mixture. At the end of the introduction of supplementary feeding, be sure to attach the baby to the breast again, so he can calm down and fall asleep.
• Convenient feeding. The baby should be comfortable while eating. The lack of mother's milk should not be the cause of unrest and worries of the baby with mixed feeding.
• Don't feed. Seeing that the baby does not want to eat the mixture after the breast, do not insist. It is important not to overfeed - it is very harmful. Always focus on the needs of the child. He asks for more, opens his mouth - supplement, no - do not be zealous and do not add uneaten to future doses of daily feeding.

Dr. Komarovsky argues that it is important to organize frequent bodily contact between mother and child, which will help stimulate the production of the required amount of milk. Light massage, co-sleeping, frequent carrying on the hands and regular breastfeeding will help to improve lactation. A pleasant environment, love and care will help the baby to be convinced of the need for natural feeding. Other mothers confirm the words of experts with their personal experience.

myths

The modern view of mixed feeding gives rise to a number of prejudices:

• From mixed feeding one step to artificial. Go to combined type nutrition due to unwillingness to establish lactation will definitely bring the transition to an artificial type of feeding closer. If the mode is introduced as necessary, mommy can keep lactation.
• A child on a mixed type of food receives less immune protection. The presence of breast milk in the diet satisfies the body's needs for protective substances. Formula-fed babies are much more likely to become weak and sickly than babies who receive valuable mother's milk at least in a small dose.

A mother who feels that there is not enough milk for the crumbs should never make a decision about supplementary feeding on her own and thoughtlessly. Be sure to consult with experts.

If a child receives both mother's milk and formula at the same time, such feeding is called mixed. With this type of feeding, the proportion of the mixture in the baby's diet is from 20% to 50%.

In the case of this type of feeding, feeding can be organized in two ways:

1. First give the breast, and then supplement the mixture.
2. Completely replace any feeding with a mixture.

Since there is nothing better for a baby than breast milk, choose a feeding method in which he will receive more of your milk.

Causes

• Most often, mixed feeding is switched to with insufficient production of breast milk. Often, the lack of milk is a far-fetched problem, caused either by the subconscious reluctance of the mother to breastfeed, or by the woman's low awareness of the lactation process. However, there are also objective reasons for hypogalactia, forcing the mother to resort to supplementary feeding.
• The second reason for combining breastfeeding and bottle feeding is when the mother goes to work or school. Often, the mother leaves expressed milk for the duration of the absence, but more often, while the mother is working, the child is fed formula milk.
• The doctor recommends a mixed type of feeding when the baby is not gaining enough weight or was born prematurely. In this case, this type of feeding is a temporary measure - gradually feeding becomes completely breastfeeding.
• Also, mom can start bottle feeding the baby to free up some time for herself. In this case, the child can be left for a while with her husband or another adult, without worrying that the baby will remain hungry.
• Another important reason for supplementing a baby with a mixture is the presence of diseases in the mother in a compensated form.

Breastfeeding allows close contact with the baby and provides him with the necessary substances for development. Even with an acute shortage of milk, do not refuse partial breastfeeding

pros

• With this type of feeding, the mother can be temporarily replaced by another adult, but at the same time she will be able to maintain closeness with the baby during breastfeeding.
• The baby retains all the benefits of breastfeeding.
• The mother may be away from the child for some time.
• Mixed feeding can help dad bond more closely with the baby.

Minuses

First of all, due to the skipping of feeding, the mother may experience problems with the breasts (stagnation, milk flow, chest pains and even mastitis) and lactation. Also, the mother may suffer psychologically from the fact that the time of breastfeeding has decreased.

At the same time, it can be difficult for a child to adapt to two types of feeding at once:

• He may refuse bottle feeding and act up. His appetite may be reduced.
• Having started to easily get the mixture from the bottle, the baby will not want to "work", extracting milk from his mother's breast. This happens with a very early transition to mixed feeding (in the first 6 weeks of a baby's life).
• Often, having received less breast during the day, the child begins to demand more breast milk in the evening and at night.

Which is better: supplementing with formula or completely switching to it?

The baby's digestive system is tuned to breast milk, and when the mixture enters it, various unforeseen reactions are possible. Therefore, you need to carefully monitor the reaction of the baby.

It is important to understand that the mixture, even if it is expensive and most best quality is not equal to breast milk. Therefore, it is not necessary to refuse breastfeeding in any case. It is not easy to treat supplementary feeding with a mixture; you should not choose a mixture without consulting a doctor. Also, the decision of the mother to supplement the crumbs with goat's milk or kefir can only harm the health of the baby.

Mixed feeding is much better than artificial. If there is not enough milk, try to increase lactation

Rules

• If the mixture and breast milk are given in one feeding, then the baby is first applied to the breast (even if the mother has very little milk), and when the child completely empties it, they give the mixture. The reason for this approach is the presence of a greater appetite in the infant at the beginning of feeding. If you give the mixture first, it will be difficult for the mother to calculate the right amount, and the child will not want to suck on the breast to get milk, since he has already satisfied the first hunger.
• In situations where the mother will be temporarily absent during the day, the child is transferred to such a mixed feeding regimen, in which two or three times a day the baby will receive only the mixture, and in other feedings - only mother's milk.
• If the volume of supplementary feeding is small, it is recommended to give the mixture from a spoon, since due to the easier intake of the product from the nipple, there is a risk of the baby not sucking at the breast. If formula is given in large quantities, it is important to choose a firm nipple that has small holes so that the baby makes an effort to obtain formula from the bottle.
• The diet with this type of feeding can be free, but if the mother decides to feed the baby according to the schedule, then the number of feedings can be reduced by one.
• It is important to carefully monitor the sterility of bottles and nipples.
• If the mother goes to work, the first attempts to bottle feed the baby should not be put off for last days. In most cases, babies do not immediately put up with bottle feeding. It is optimal to start supplementing the baby with a mixture 2-3 weeks before the moment when the mother begins to leave home for a long time.
• With mixed feeding, a baby can start complementary feeding two to three weeks earlier than a baby who receives only breast milk.

With mixed feeding, it is necessary to follow many rules and monitor the reaction of the child when introducing the mixture.

Demand calculation

If you have the opportunity to provide the baby with the required amount of milk for one feeding (while cutting their total amount), use this opportunity and give the mixture only in one of the feedings. In this case, only the amount of formula needed for the current formula feeding of the baby can be calculated.

To determine the baby's needs for additional nutrition, you should consider the age of the crumbs and the type of mixture used.

First, the total daily nutritional requirement of the infant is calculated:

• a baby under the age of 10 days weighing less than 3200 g to calculate the required amount of nutrition should be multiplied by 70 by age in days (weighing over 3200, multiply 80 by age in days);
• a child under 2 months old is given food in the amount of 20% of his body weight;
• children from two to four months require food in the amount of 1/6 of their weight;
• babies older than 4 months to 6 months of age need food in the amount of 1/7 of their body weight;
• children aged six months to one year require a daily intake of food in the amount of 1/8 to 1/9 of their weight.

We divide the total volume by the number of feedings and find out the approximate amount of food needed by the baby in one feeding.

The amount of sucked milk can be measured by control weighing: Weigh your baby before feeding and then after. After subtracting these values, you will find out the amount of milk drunk. Now it remains only to subtract the volume of breast milk received by the baby from the total volume - so the mother will know how much the baby will need the mixture.

By simple calculations, you will find out how much you need to give the mixture to the child

To make sure that the baby has enough for the growth and full development of all nutrients, you need to calculate how much the child receives daily proteins, carbohydrates and fats. The calculation is based on the norms of entry into the child's body of essential nutrients, as well as the approximate content of these substances in human milk.

First, they calculate how much the baby receives in total breast milk per day, and then how many proteins, carbohydrates, and fats he receives with this food. Further, the content of nutrients in the resulting volume of the milk mixture is also calculated. Having calculated the needs of the baby, depending on the age, it is determined whether the food received is enough for the crumbs.

At the same time, it should be taken into account that the need for protein in the transfer to mixed feeding in an infant increases. A baby under 4 months old needs 3 grams of protein for every kilogram of weight if supplementary feeding is carried out with an adapted mixture, and 3.5 grams if the mixture is not adapted. A child older than 4 months needs 3.5-4 grams of protein.

What are they feeding?

For supplementary feeding, choose the same mixtures that are recommended to feed infants on artificial feeding. Preference is given to an adapted mixture.

The mixture must be exclusively adapted and selected by the pediatrician based on the needs of your child.

What can't be fed?

The baby should not be given a medicinal mixture unless recommended by a pediatrician. There are strict indications for the use of mixtures with a therapeutic effect, for example, a soy mixture is given for allergies to milk protein, and a lactose-free mixture is used in crumbs with a lack of lactase. Kefir, cow's or goat's milk can significantly harm the body of the crumbs.

If the child does not like the bottle

Many babies do not want to switch from breastfeeding to bottle feeding. To make this transition more successful, mom is recommended:

• Try putting pacifiers on a bottle different kind so that the baby can choose "his".
• At first, bottle feed with expressed human milk.
• Bottle feed during the period when the baby wants to eat, but the baby is not yet too hungry.
• Let someone else, not the mother, offer the baby a bottle with the mixture for the first time.
• When the baby will be fed with a mixture, let the baby be in a different position in which he is used to receiving his mother's breast.
• The liquid that is given to the baby should be warm, as the baby is used to receiving warm milk from the mother's breast.
• Don't expect your baby to drink all the formula from the bottle right away.
• In extreme cases, the mother will have to not give the baby a breast all day, so that the baby still agrees to try the mixture from the bottle.
• If the baby persists and he is already 6 months old, it makes sense to plan feeding the baby with complementary foods during the absence of the mother.