20
www.hrh.ca Page 1 English: This information is important! If you have trouble reading this, ask someone to help you. Italian: Queste informazoni sono importanti! Se ha difficoltà a leggere questo, chieda aiuto a qualcuno. Spanish: ¡Esta información es importante! Si tiene dificultad en leer esto, pida que alguien le ayude. What’s Inside: Breastfeeding your Baby..................................................... 2 Breastfeeding and You......................................................... 7 Daily Feeding Diary .............................................................. 9 Feeding your Baby When You Cannot Breastfeed ...10 Expressed Breast Milk..................................................... 10 Baby Formula .................................................................... 12 Notes ........................................................................................ 18 Maternal and Child Program Feeding Baby From Birth to 6 months Form # 002051 © 2013_09 REV 2019_06 The Canadian Paediatric Society, Dietitians of Canada, Health Canada, and the World Health Organization recommend exclusive breastfeeding for the first 6 months of life. At about 6 months of age, you may begin to introduce foods that are rich in iron. Continue to breastfeed until age 2 or older. Breast milk: • Is the ideal food you can give your new baby • Is uniquely designed by you for your own baby’s needs • Has the right amount and quality of nutrients for your baby. Why should I breastfeed my baby? The following are just some of the reasons to breastfeed your baby: Your breast milk: Breastfeeding: 1. Helps protect your baby from getting sick or infections 2. Has all the nutrition your baby needs to grow and develop - Breast milk changes as your baby grows 3. Is easy to digest 4. Protects your baby from developing allergies 5. Gives your baby “brain power” - Research shows that breastfed babies have higher academic performance 6. Is convenient - It is always ready, safe, fresh and exactly at the right temperature. 7. Strengthens the bond with your baby 8. May help protect you from developing breast and ovarian cancer, and weak bones later in life 9. Helps you lose weight gained during pregnancy 10. Saves you money. Breastfeeding is good for your baby, for you and the environment! You make human milk and deliver it to your baby without any pollution, unnecessary packaging or waste.

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Page 1: Feeding Babyhrccatalog.hrrh.on.ca/InmagicGenie/DocumentFolder/002051... · 2019-08-09 · 8. May help protect you from developing breast and ovarian cancer, and weak bones later in

www.hrh.ca

Page 1

English: This information is important! If you have trouble reading this, ask someone to help you.

Italian: Queste informazoni sono importanti! Se ha difficoltà a leggere questo, chieda aiuto a qualcuno.

Spanish: ¡Esta información es importante! Si tiene dificultad en leer esto, pida que alguien le ayude.

What’s Inside:

Breastfeeding your Baby ..................................................... 2

Breastfeeding and You ......................................................... 7

Daily Feeding Diary .............................................................. 9

Feeding your Baby When You Cannot Breastfeed ...10

• Expressed Breast Milk .....................................................10

• Baby Formula ....................................................................12

Notes ........................................................................................18

Maternal and Child Program

Feeding BabyFrom Birth to 6 months

Form # 002051 © 2013_09 REV 2019_06

The Canadian Paediatric Society, Dietitians of Canada, Health Canada, and the World Health Organization recommend exclusive breastfeeding for the first 6 months of life.

At about 6 months of age, you may begin to introduce foods that are rich in iron. Continue to breastfeed until age 2 or older.

Breast milk:

• Is the ideal food you can give your new baby

• Is uniquely designed by you for your own baby’s needs

• Has the right amount and quality of nutrients for your baby.

Why should I breastfeed my baby?The following are just some of the reasons to breastfeed your baby:

Your breast milk: Breastfeeding:

1. Helps protect your baby from getting sick or infections

2. Has all the nutrition your baby needs to grow and develop - Breast milk changes as your baby grows

3. Is easy to digest

4. Protects your baby from developing allergies

5. Gives your baby “brain power” - Research shows that breastfed babies have higher academic performance

6. Is convenient - It is always ready, safe, fresh and exactly at the right temperature.

7. Strengthens the bond with your baby

8. May help protect you from developing breast and ovarian cancer, and weak bones later in life

9. Helps you lose weight gained during pregnancy

10. Saves you money.

Breastfeeding is good for your baby, for you and the environment! You make human milk and deliver it to your baby without any pollution, unnecessary packaging or waste.

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Humber River HospitalPage 2

What is colostrum?Colostrum is the first milk you make. It is a golden-yellow color and thick. It is very rich in antibodies, which help to protect your baby from infections. You may or may not notice this milk coming from your nipples during your pregnancy – this is normal. Colostrum slowly transitions to mature milk within a few days to a couple of weeks.

How do I know it is time to feed my baby?Feed your baby when she shows early signs of hunger. This is the best time to feed your baby because she will latch to the breast easier and feed better. Crying is a late sign of hunger – if she is crying she may be too upset to latch properly.

Common infant hunger cues include:

Early • Smacking or licking lips

• Opening and closing mouth

• Sucking on lips, tongue, hands, fingers, toes, toys, or clothing.

Active • Rooting around on the chest of whoever is carrying her

• Trying to position for nursing, either by lying back or pulling on your clothes

• Fidgeting or squirming around a lot

• Hitting you on the arm or chest repeatedly

• Fussing or breathing fast.

Late • Moving head frantically from side-to-side

• Crying.

If your baby is crying, first try to calm him down. Try gentle rocking, skin-to-skin, swaying or make a “shhhh”ing sound.

BREASTFEEDING YOUR BABY

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How do I breastfeed my baby?There are different positions that you can hold your baby. Use whatever position works best for you and feels most comfortable. As you gain confidence, you can use different positions that work for you and your baby.

Step 1: Sit comfortably using pillows. You may use pillows behind your back, under your arms, and/or across your lap. Use a footstool to rest your feet.

Step 2: Allow your breast to fall naturally. Removing your bra and extra clothing is helpful. Ideally remove the baby’s clothing as well for skin-to-skin contact.

Step 3: Bring your baby to your breast, with his hips flexed, so that he does not have to turn his head to reach your breast. His mouth and nose should face your nipple.

Step 4: You may need to support your breast with your free hand. Attach or latch baby onto your breast when his mouth is opened wide. Pull him into you breast by supporting his back or shoulders (rather than the back of his head). His head should be tilted back slightly and his chin should be well in against the breast. His nose should be away from the breast.

If you are feeling pain or discomfort, try to reposition your baby until you feel comfortable. You and your baby will find a technique that works for you after some practice.

What is skin-to-skin?Skin-to-skin means holding your baby (only wearing a diaper) against your bare chest or tummy. This is a perfect place for your baby to smell you, hear you, feel you and get to know you, and to adjust to life outside your womb.

Babies held skin-to-skin stay warmer, calmer and breastfeed better than babies who are swaddled or wrapped in blankets.

Did you know? Babies held skin-to-skin have better heart rates, better blood sugar levels, breathe better, cry less, and stay warmer. Skin-to-skin contact helps you make more milk.

BREASTFEEDING YOUR BABYBREASTFEEDING YOUR BABY

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What are some ways to breastfeed my baby?There is a variety of different positions that you can use to breastfeed your baby.

Here are some examples:

Type of hold How is it done?

Cradle hold

This is an easy, common hold that is comfortable for most mothers and babies.

1. Hold your baby with his or her head on your fore-arm and his or her whole body facing yours.

Cross Cradle

Useful for premature babies or babies with weak suck because it gives extra head support and may help babies stay latched.

1. Hold your baby along the opposite arm from the breast you are using.

2. Support your baby’s head with the palm of your hand at the base of his or her neck.

Football or Clutch hold

Useful for mothers who had a caesarean section (c-section) and mothers with large breasts, flat or inverted nipples, or a strong letdown reflex. It is also helpful for babies who prefer to be more upright. This hold allows you to better see and control your baby’s head and to keep the baby away from a c-section incision.

1. Hold your baby at your side, lying on his or her back, with his or her head at the level of your nipple.

2. Support the baby’s head by placing the palm of your hand at the base of their head. In this hold, your baby is almost under your arm.

Side-lying

Useful for mothers who had a c-section or to help any mother get extra rest while the baby breastfeeds.

1. Lie on your side with your baby facing you.

2. Pull your baby close so your baby faces your body.

Image Source: Office of Women’s Health, U.S. Department of Health & Human Services (womenshealth.gov)

BREASTFEEDING YOUR BABY

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Type of hold How is it done?

Laid-back

Laid-back breastfeeding, or Biological Nurturing, means getting comfortable with your baby and encouraging your own and your baby’s natural breastfeeding instincts. For more information, see www.biologicalnurturing.com

1. Dress yourself and your baby as you wish.

2. Find a bed or couch where you can lean back comfortably and be well-supported. You should not be lying down. When you put your baby on your chest, gravity will keep him in position.

3. Have your head and shoulders well-supported. Let your baby’s whole front touch your whole front.

4. Since you are leaning back, you do not have a lap, so your baby can rest on you in any position you like. Just make sure her whole front is against you.

5. Let your baby’s cheek rest somewhere near your bare breast.

6. Help her as much as you like; help her do what she is trying to do. You are a team.

7. Hold your breast or not, as you like.

8. Relax and enjoy each other.

How do I know if my baby is getting enough breast milk?Signs your baby is getting enough breast milk include:

• Hearing swallowing sounds when your baby is breastfeeding

• Baby has wet and soiled diapers (peeing and pooing)

• Baby is growing and gaining weight

• Baby is content (happy or comfortable) after feeding.

Does my baby need anything else to drink besides breast milk?

Breast milk is the only fluid your baby needs until they are 6 months old.

Do not give your baby any other fluids such as water, tea, honey, sugar-water, herbals.

See the “Daily Feeding Diary” on page 9.

BREASTFEEDING YOUR BABY

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Can I feed my baby other types of milk?

Does my baby need vitamin D?

Everyday your baby drinks: Give your baby this much vitamin D each day:

Only breast milk 400 IU (International Units)

Less than 500 mL of formula 400 IU

Between 500 mL to 1000 mL of formula

200 IU

(Or you can give baby 400 IU every other day)

1000 mL or more of formula You do not need to give additional vitamin D.

Babies who are born premature may need extra vitamins and iron. Your baby’s doctor or dietitian will let you know which extra vitamins to give your premature baby.

At about 6 months of age, your baby should be ready to eat solid foods (baby food). For more information on feeding your baby solid foods, see the HRH handout, “Starting your Baby on Solids” Continue to breastfeed until your child is 2 years of age and beyond.

DO NOT feed your baby:

• Whole fat cow's milk (homogenized / 3.25% M.F.)

• Pasteurized, full-fat goat milk

• Full-fat evaporated milk.

Wait until your baby is 9 months to 1 year old to feed these to your baby.

DO NOT feed your baby:

• Soy milk

• Rice drinks / milk

• Nut milks

• 2% milk, 1% milk or skim milk

• Chocolate milk

Wait until your baby is 2 years old to feed these to your baby. At that time, ask your baby’s doctor or dietitian for advice on feeding your older child these types of milk. Too much milk for a toddler is not healthy.

Why? These milks and drinks do not give your baby the nutrition, energy, vitamins or minerals to grow and be healthy.

Why? Cow’s milk protein may cause unseen bleeding in your baby’s intestine. The protein and minerals in cow’s milk are also hard for a baby’s kidneys to handle. Cow’s milk contains a very small amount of iron, which can cause your baby to have low iron.

If you are partially breastfeeding your baby, the recommended amount of vitamin D supplement your baby should have depends on the amount of formula you are giving your baby. This is because infant formula contains some vitamin D.

BREASTFEEDING YOUR BABY

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What is engorgement?Engorgement is fullness in the breast due to combination of milk staying in the breast and edema (swelling due to your body retaining water). It usually appears on third or fourth day after delivery. You can prevent engorgement by getting the baby latched on to your breast well from the very beginning or removing milk often if your baby is not latching.

Engorgement goes away within 1 or 2 days even without any treatment, but can be uncomfortable during that time. Continue to breastfeed the baby. Make sure he gets on the breast well and nurses well - the engorgement will resolve. However, if your engorged breast makes it difficult for your baby to take your breast, try to squeeze some milk out to soften your areola. By expressing some breast milk before putting baby on your breast, you can help relieve the pressure and make latching on easier. For more information, see the section, “Expressed Breast Milk” on page 10.

More than mild engorgement in the breasts is usually a sign that breastfeeding is not going well. If you have moderate to severe engorgement, use the leaves of the common green cabbage as a compress on the breast. If the skin on your breast is broken, place the cabbage leaves around the breast, without covering irritated skin.

If you are allergic to SULFA, DO NOT USE cabbage leaves as a compress.

When should I seek help?If the engorgement lasts for two or more days, ask your doctor or lactation consultant for help.

When should I seek help?Contact a health professional, such as your doctor, lactation consultant, and/or public health nurse, if you have:

• Cracked or painful nipples, nipple sores or blisters

• A lump in your breast

• Pain in your breast

• Swelling of the breast, with soreness and possibly fever – this is a sign of breast infection (called mastitis).

Do not stop breastfeeding.

BREASTFEEDING AND YOU

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Can I still breastfeed if I am sick?If you are sick, ask your doctor for information about nursing your baby. You can still breastfeed even if you are taking most prescription drugs. Only small amounts will pass through breast milk, and there are usually no problems for the baby. There are only a few exceptions, such as:

• Cyclosporine (such as Apo-Cyclosporine®)

• Methotrexate (such as Rheumatrex®, Trexall®)

• Bromocriptine (such as Parlodel®, Cycloset®)

• Cyclophosphamide (such as Endoxan®, Cytoxan®, Procytox®, Revimmune®, Neosar®)

• Doxorubicin (such as Doxil®)

• Ergotamine (such as Cafergot®, Ergomar®)

• Phencyclidine (PCP)

What should I eat when I am breastfeeding?Eat nutritiously when you are breastfeeding. Expect to be more hungry and thirsty than usual - satisfy your hunger and thirst with nutritious foods and drinks.

• Follow Canada’s Food Guide (https://food-guide.canada.ca/en/) and enjoy an extra 2 to 3 servings of food guide servings each day.

• Enjoy healthy, nutritious meals and snacks every day and drink plenty of fluids.

• Try to have at least 150 grams (5 ounces) of omega-3 rich cooked fish each week.

• Carry easy-to-eat snacks and water with you when you are out.

• Avoid dieting or fad diets.

Do I need to take a vitamin when I am breastfeeding?Food is the ideal source for vitamins and minerals. While breastfeeding, your body needs extra nutrition such as vitamin A, folic acid, vitamin C, zinc and some B vitamins. It may be difficult to get all the vitamin and mineral requirements by food alone. This is why you need to take a complete multivitamin and mineral supplement each day.

If you are not sure the medicine you are taking is safe while you are breastfeeding, you may contact MotherToBaby at 1 (866) 626-6847.

If you smoke (including marijuana) or drink alcohol, consider cutting back.

If you are receiving long-term chemotherapy, or you have HIV disease, your doctor may advise you not to breastfeed. If this applies to you, talk to your doctor.

For more information on healthy eating while breastfeeding, including which foods and drinks you should limit while breastfeeding, refer to the HRH handout, “Nutrition during Breastfeeding” (001169).

BREASTFEEDING AND YOU

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What do I feed my baby if I cannot breastfeed?If you cannot breastfeed:

1. Expressing your breast milk is the next best choice. For more information on how to feed your baby expressed milk, see the section, “Expressed Breast Milk” below and talk to your health care professional such as your nurse, lactation consultant, dietitian or doctor.

2. Giving pasteurized donor human milk from a milk bank (if it is available for your baby) is the next best option to give to your baby.

3. The following infant (baby) formulas are acceptable supplements to breast milk:

• Store-bought iron-fortified infant formula - It should be cow’s milk-based

• Soy-based formulas only if your baby cannot have milk products for health, cultural or religious reasons

For more information on feeding your baby formula, see the section “Baby Formula” on page 12.

Expressed Breast Milk

Should I express my breast milk?Expressing your breast milk can help if:

• You are not feeding your baby at your breast.

• Your breasts are engorged (very full and sore) and your baby is having difficulty latching on. Expressing can relieve the pressure and make latching on easier.

• You are going to be away from your baby during feeding times.

Before expressing your milk, wash your hands. You can express some milk manually by gently squeezing your breast with your hands or with a breast pump. You can feed your baby this milk from a cup or a bottle.

Donor milk processing follows strict guidelines set out by the Human Milk Banking Association of North America

If you are feeding your baby formula, it is very important that you make it safely.

If you think your baby has a problem with the formula she is drinking, do not switch formula without talking to your baby’s doctor or dietitian first. Switching formulas often can be hard on your baby’s digestion.

If you choose not to breastfeed or if you have not been successful in breastfeeding, giving your baby expressed breast milk is the next best thing you can do.

If you have too much breast milk and would like to donate your extra milk, please contact http;//www.milkbankontario.ca Tel: (416) 586-4800 ext. 3053

FEEDING YOUR BABY WHEN YOU CANNOT BREASTFEED

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How should I store expressed breast milk? Store expressed breast milk in a clean, sterile glass or BPA-free plastic bottle or container. Mark the date and time on the bottle or container.

For a healthy, full-term baby, you can store your expressed breast milk:

For up to...

At room temperature 4 to 6 hours

Thawed, previously frozen 24 hours (1 day)

In your refrigerator Up to 5 days

* Frozen (freezer compartment in refrigerator) 2 weeks

* Frozen (separate door freezer of refrigerator) 2 to 3 months

* Frozen (deep freezer (chest-type) at a temperature below -20°C [-4°F])

6 months

* Freeze expressed breast milk within 24 hours of collection.

How do I prepare expressed breast milk for a feeding?1. Wash your hands with soap and water.

2. Prepare clean bottles and bottle nipples.

3. Thaw frozen milk in the refrigerator and keep it there until you are ready to use it. Do not use a microwave to thaw or warm frozen expressed milk. The milk can contain hot spots that can harm your baby. The quality of the milk may also change if it is too hot.

4. When it is time for feeding, put the thawed milk into a feeding bottle.

5. Warm the milk by placing the bottle of expressed milk into a container of warm water before the actual feeding.

6. To mix, gently swirl the bottle of thawed expressed breast milk well.

7. Test the temperature of the milk on your wrist to make sure it is room temperature and not too warm or too cold.

8. After each feeding, throw away any leftover prepared milk.

9. Throw away thawed milk after 24 hours. Do not feed to baby.

When you are freezing breast milk, do not add warm expressed milk to milk that has been already chilled or frozen. This may encourage bacteria to grow.

For guidelines on storing expressed breast milk for premature babies, speak to your health care provider.

Make sure you wash all equipment with water and dish soap after every use. You will need to sterilize your equipment once a day by using a sterilizer or boiling parts for 2 to 5 minutes.

If you have a premature baby, please talk to your nurse in the hospital.

FEEDING YOUR BABY WHEN YOU CANNOT BREASTFEED

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Baby Formula

Does baby formula come in different ways?Baby formula comes in 3 different ways. All 3 ways give your baby the same nutrition, vitamins and minerals. The main differences are how they are prepared and how much they cost.

Health Canada recommends that high-risk infants (that is, infants who are premature, have a low birth-weight or weakened immune systems) drink sterile liquid infant formula if they are not breastfed to prevent food-borne illnesses. However, if you cannot get liquid infant formula, or when a suitable liquid infant formula is not available, you can use powdered infant formula if it is prepared safely and properly.

For healthy, full-term infants, it is preferable to use sterile liquid infant formula if they are not breastfed. However, if sterile liquid infant formula is not available, then you can use powdered infant formula if you prepare it safely and properly.

How much formula should I feed my baby?

Ready-to-use liquid

• Use directly out of the can. Do not add water.

• This is the most expensive type of formula.

Concentrated liquid

• You must add water as directed on the formula label.

Powder • You must add water as directed on the formula label.

• Powdered formula is the cheapest form

• Not a sterile product.

Give your baby iron-fortified infant formula. Instructions are different for each kind of formula. Be sure to read the directions on the label.

Age of Baby How many times should I feed my baby formula a day?

How much baby formula should I give per feeding?

At Birth 6 to 10 times per day 15 to 60 ml per feeding (1/2 to 2 oz)

2 weeks 6 to 10 times per day 60 to 120 ml per feeding (2 to 4 oz)

1 month 6 to 8 times per day 60 to 120 ml per feeding (2 to 4 oz)

2 months 5 to 7 times per day 60 to 120 ml per feeding (2 to 4 oz)

3 to 4 months 5 to 7 times per day 150 to 180 ml per feeding (5 to 6 oz)

5 to 6 Months 5 to 7 times per day 180 to 240 ml per feeding (6 to 8 oz)

FEEDING YOUR BABY WHEN YOU CANNOT BREASTFEED

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*Adapted and reprinted with permission from the Toronto Public Health.

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FEEDING YOUR BABY WHEN YOU CANNOT BREASTFEED

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Humber River HospitalPage 14

How do I prepare formula?

Ready-to-Feed Infant Formula*

Liquid Concentrate Infant Formula*

1

5

9

Tightly cover open can and put in refrigerator. Use within 24 hours.

Run cold water for at least 2 minutes. Boil water for 2 minutes. Let it cool and use water within 30 minutes.

Shake can.Open with sterile can opener.

Put bottles in refrigerator.Use within 24 hours.

Pour boiled water into glass measuring cup.

Pour amount of infant formula for one feeding into each bottle

(use glass if possible).

Pick up nipples, rims and caps with sterile tongs and put on bottles. Then tighten with your hands.

Wash hands and counter with soap and water.

Have sterilized items ready on a clean paper towel

(see How to sterilize equipment).

Read the label. It will tell you how much formula and water to use.

Wash top of can with warm water.

2 3

1211

Shake bottle well. Cool bottle under cold running water.

8Add an equal amount of liquid

concentrate formula to the boiled water. Be sure to measure carefully.

Stir well with sterile fork.

76

10

2 minutes

4

5

1

Shake can.Open with sterile can opener.

Put bottles in refrigerator.Use within 24 hours.

Pick up nipples, rims and caps with sterile tongs and put on bottles.Then tighten with your hands.

Tightly cover open can and put in refrigerator.

Use within 24 hours.

4

7 86Pour amount of infant formula for

one feeding into each bottle (use glass if possible).

DO NOT ADD WATER.

Wash hands and counter with soap and water.

Have sterilized items ready on a clean paper towel

(see How to sterilize equipment).

2 3

Read label. Wash top of can with warm water.

FEEDING YOUR BABY WHEN YOU CANNOT BREASTFEED

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Humber River Hospital Page 15

Powdered Infant Formula*

If you do not have a refrigerator, put nipple rims and caps on empty sterile bottles. Make each bottle fresh as needed using boiling water.

Read the label for how much powdered formula and water you need. Usual dilution is 1 scoop of infant formula powder added into 60 mL (2 oz) of sterile, lukewarm water. Be sure to measure the water first, THEN add the powder.

*Adapted and reprinted with permission from the Toronto Public Health.

1

5

9

Throw away what your babydoes not drink within 2 hours.

Have sterilized equipment readyon a clean paper towel (see How

to sterilize equipment).

Pour the amount of boiled water needed into a sterilized bottle.

Feed baby (see How to feedyour baby with a bottle)

Fill scoop from can with powder.Level with a sterilized knife. Add

the powder to the water.

Shake bottle to mix. (If there isclumping, use sterilized utensils to

stir the formula.)

Quickly cool bottle under coldrunning water or in a container

of cold water.

Disinfect counter and wash hands with soap and water.

Run cold tap water for at least 2 minutes. Bring water to a rollingboil for 2 minutes. Let it cool and

use within 30 minutes.

Read the label. It will tell you howmuch water and powder to use.

Wash top of can with warm water.

2 3

1211

Check temperature on your wrist.It should feel lukewarm.

8

Pick up nipple, rim and cap withsterilized tongs and put on bottle.

Then tighten with your hands.

7

4

10

6

2 minutes

FEEDING YOUR BABY WHEN YOU CANNOT BREASTFEED

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Humber River HospitalPage 16

What are some tips for using baby formula?

Checking the cans of formula

• Check “use by” dates on the can. Do not use after that date.

• Make sure the cans are clean and have no dents.

Mixing Formula

• Wash your hands before you start.

• Wash the top of a liquid formula can before you open it.

• Clean and dry the counter top, and make sure your equipment is sterilized.

• Read the directions on the label and measure carefully. It could harm your baby if you add too little or too much water.

• Fill the bottles with about 30 mL (1 ounce) more than your baby usually drinks.

• Make just enough bottles to last one day.

Using Water

• Use water from the cold water tap. Until your baby is 4 months old, boil the water for 2 minutes.

• Do not use an electric kettle that switches off as soon as the water boils. Instead, boil the water in a pot. Be sure the water boils 2 minutes.

• Let the water cool to lukewarm before you add it to powder formula or liquid concentrate.

• Do not use carbonated water or mineral water for your baby’s formula.

Storing Baby Formula

• Use prepared bottles within 24 hours.

• Keep open cans of powder formula covered with the lid. Use within one month.

• Keep open cans or tetra boxes of ready-to-feed or liquid concentrate in the refrigerator. Use it within 48 hours after opening.

• Do not freeze any kind of infant formula. Freezing changes the fat in infant formula.

Warming Your Baby’s Bottle

• If the bottle of formula is too cool, warm under hot water for a few minutes, or hold it under warm running tap water. Test the temperature by putting a few drops on your wrist.

• Do not heat bottles in the microwave oven.

Giving Formula to Your Baby

• Hold your baby when giving a bottle.

• Make sure the hole in the nipple is the right size. When you hold the bottle upside down, about one drop per second should come out.

• Hold the bottle so the nipple is always full of formula.

• Never force the nipple into your baby’s mouth.

• Look for signs that your baby has had enough to eat, such as sucking slows down, turns his head away, falls asleep.

• Throw out formula left in the bottle within one hour after feeding begins.

• Do not put your baby to bed with a bottle.

• Do not add anything extra (such as cereal) to your baby’s bottle unless your baby’s doctor has told you otherwise.

Changing Formula

• Talk to your baby’s health care professional.

Going Away from Home

• Store boiled water from home in a tightly closed sterilized container for 2 to 3 days in the refrigerator or 24 hours at room temperature.

• Ask your doctor or a health care professional about the safety of the water where you will be visiting.

FEEDING YOUR BABY WHEN YOU CANNOT BREASTFEED

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Humber River Hospital Page 17

How do I feed my baby with a bottle?*

*Adapted and reprinted with permission from the Toronto Public Health.

Tip bottle slightly so there is no air in nipple.

8

Put bottle in warm water for no more than 15 minutes.

1

Shake bottle well.

3

Check temperature on your wrist. Let cool if too hot.

4

Watch your baby swallow. Allow baby to rest.

10

Wait for your baby to open her mouth.

7

Burp your baby as needed. Stop feeding when your baby

shows signs of being full.

11

Throw away what your baby does not drink within one hour.

Rinse bottle and nipple.

12

Watch your baby for early feeding cues (see Tips for Feeding).

6

Always hold your baby close in an upright position.

9

Check for one drop per second.

5

2

Do not heat bottles on stove or in the microwave.

FEEDING YOUR BABY WHEN YOU CANNOT BREASTFEED

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Humber River HospitalPage 18

NOTES

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Humber River Hospital Page 19

NOTES

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Humber River HospitalPage 20

Breastfeeding is the natural way to feed your baby and child. Sometimes feeding can be overwhelming for a new family and may not come easily to you. Do not be afraid to ask for help.

If you have questions about breastfeeding or feeding your baby, please contact:

Humber River Hospital Maternal and Child Program Web: http://www.hrh.ca

Prenatal Outpatient Clinic Tel: (416) 242-1000 ext. 21450

Registered Dietitian Tel: (416) 242-1000 ext. 21416

Lactation Consultant Tel: (416) 242-1000 ext. 21450

Breastfeeding Walk In Clinic at HRH Monday, Wednesday, Friday 12:30 p.m. to 3:30 p.m. (except holidays)

UnlockFood.ca Web: http://www.unlockfood.ca Tel: (866) 797-0000 (via Telehealth Ontario)

La Leche League Canada Breastfeeding line for a referral to someone in your community Toll-free: 1 (800) 665-4324 Web: http://www.lllc.ca

Medications & More During Pregnancy and Breastfeeding Tel: 1 (866) 626-6847 Web: https://mothertobaby.org

Telehealth Ontario Breastfeeding support 24/7 Toll-free: 1 (866) 797-0000 Web: https://www.ontario.ca/page/get-medical-advice-telehealth-ontario

Toronto Public Health Tel: (416) 338-7600 Web: https://www.toronto.ca/community-people/health-wellness-care/

For Breastfeeding Videos, go to Global Health Media Project:

https://globalhealthmedia.org/videos/breastfeeding/