Feeding My Baby – Advice for Families 317
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both breasts during the first days. Initially, the
breast produces colostrum, which is rich in anti-
b o d ie s t hat w i l l c ont r ibute to prote c t i ng you r ch i ld
from infections; a larger amount of milk, with in-
creasing protein and fat content, will be produced
a few days after birth. Temporary supplementary
feeding with water or other liquids should only be
offered if it is deemed necessary by the pediatri-
cian or other health care professionals.
Breastfeed your baby whenever it wishes to
suckle, also at night. In the first weeks, most in-
fants take 8–12 meals within 24 h. Breastfeeding
promotes a gradual loss of the mother’s body
weight and the extra body fat stores that were de-
posited during pregnancy. The amount of fat loss
increases with the duration of full breastfeeding.
Additional active weight reduction during breast-
feeding with the use of restrictive diets is not rec-
ommended because it may have undesirable ef-
fects on milk composition.
Breastfeeding women should consume a var-
ied diet and plenty of liquids. A good supply of
iodine (iodized salt, supplements with 100–150
μg/day) and long-chain n–3 fatty acids (200 mg
docosahexaenoic acid/day, provided by 1–2 week-
ly meals of sea fish including fatty fish) is recom-
mended. Breastfeeding women should refrain
from smoking and the consumption of signifi-
cant amounts of alcoholic drinks. Only very few
mothers of babies with proven food intolerances
are advised to exclude allergenic foods from their
own diets upon individual advice from their pe-
diatrician or dietitian. However, the preventive
exclusion of certain foods from the maternal diet
to reduce the risk of allergies in infants is not jus-
tified and not recommended.
I n f a n t F o r m u l a
If breastfeeding is discontinued before 1 year of
age, a commercial infant formula should be used.
In the first months of life, only infant formula
should be used, which can be continued through-
out the first year of life. Follow-up formulas are
only appropriate after the timely introduction of
complementary feeds into the infant’s diet.
In infants who are not fully breastfed and who
have a parent or sibling suffering from allergic
diseases, the pediatrician should be consulted re-
garding the preventive use of infant formula
based on hydrolyzed protein during the first 4–6
months of life.
Manufacturers’ recommendations on the prep-
aration of bottles should be carefully followed.
Both too low and too high concentrations of for-
mula are detrimental. Milk bottles must always be
freshly prepared and fed within approximately 2 h.
Leftovers should be discarded to prevent an in-
creased risk of bacterial infections. Frozen and
then defrosted breast milk must be handled simi-
larly. It is important to keep bottles and nipples
clean and dry. Powdered formulas must be pre-
pared with fresh and clean drinking water. The
use of water filters is not recommended. If the wa-
ter contains high levels of nitrate (>50 mg/l; found
particularly in domestic wells) or water pipes made
of lead a re used (fou nd i n some old bu i ld i ngs), bot-
tled water suitable for preparing infant formula
should be used. The suitability of water from do-
mestic wells should be assessed in each case.
Infant formulas based on soy protein as well as
so-called special formulas are only indicated un-
der limited special conditions and should only be
used upon the recommendation of a pediatrician
or other qualified health care professional. Self-
prepared bottle feeds from cow’s milk, the milk
of other animals (goat’s, mare’s, and sheep’s milk)
and other sources (such as almond milk) pose se-
rious risks and should not be used.Feeding Solid Foods (Complementary Foods
or ‘Beikost’)After 6 months, breast milk alone does not ade-
quately meet the nutrient requirement of a healthy
baby. For their optimal development, all infantsKoletzko B, et al. (eds): Pediatric Nutrition in Practice. World Rev Nutr Diet. Basel, Karger, 2015, vol 113, pp 316–319
DOI: 10.1159/000375275