Some newborns will eat eight to twelve times a day. In this episode, Dr. Carole Keim MD talks about breastfeeding, formula feeding, pacifiers/nipple confusion, and teething/oral hygiene (also thrush). For the first couple of months, your baby should be eating at least once every 4 hours for development. Pumping can be done right after your baby is born and sometimes even before. Are you looking at formula options? She goes over different types and how to choose what’s best for your little one.Dr. Carole Keim MD goes over the benefits of breastfeeding for both mom and baby. Eventually, your baby will start to show interest in food, so it is essential to know how to introduce solid foods and approach the risk of allergic reactions. Your baby may start teething at around six months; she talks about signs to recognize, ways to help your baby during this time, and oral hygiene practices.The next few episodes will be a deep dive into certain topics that I get asked about a lot; these are also laid out just like this in my book, The Baby Manual, available on Amazon/Kindlefeeding, teething - 5/4pee/poop, gas/colic - 5/18skin - 6/1sleep - 6/15illness/red flags - 6/29vaccines 0-6mo - 7/13How often to feed: (0:54)Newborns eat 8-12x per day, need frequent feeds because their stomach is so smallBirth - stomach size of a cherry (5-10ml, or 1-1.5 tsp) - colostrumDay 2 - walnut (20-30 ml, or 0.75-1 oz) 1 week - golf ball (45-60ml, or 1.5-2oz)1 month - (80-150ml, or 2.5-5 oz)The stomach stretches like a balloonOverfeeding -> spit upsThe lower esophageal sphincter develops by 6-12mos of age8-12 feeds aren’t exactly every 2-3 hoursCluster feeding 2-6 am because prolactin is highestThis typically lasts about 2 weeks, then they learn the night/day differenceIf they sleep 4 hours you MUST wake themNewborn - 2 weeks: may eat more than 12x per day2weeks - 2 mos: typically eat every 2-3h2-6 mos: can sometimes go more than 4h between feeds if they are gaining weight and your doctor ok’s itWhat to feed them: (4:00)Breastmilk or formula ONLY for 4-6 mosContains all the protein, fat, carbs, vitamins, minerals, and water your baby needsAt 4-6 mos can start to introduce foods: will come back to this in a bitBreastfeeding: (4:29)AAP recommends exclusive breastfeeding x 6 mos, then BFing + food/water until age 1 year or laterOk to breastfeed as long as you wantEat a wide variety of foodsVitamins:A prenatal vitamin that contains iron and folic acidOmega-3 fatty acids (200-300mg per day)Calcium (1000mg per day)Vitamin D (5,000-6,400 IU per day)Ok to drink alcohol because of first-pass metabolism: an 8oz drink of 10% alcohol becomes 0.04% BAC (and 0.04% breast milk concentration - 250x less concentrated).  0.08% consumed by baby makes their BAC 0.0001% (undetectable; less than BAC after a child drinks orange juice or eats an over-ripe strawberry)When inside, your BAC = baby’s BACEach time baby eats, they are placing an order for the next feedFirst 3-5 days colostrum; need to nurse for 15-20 min per side per feed to stimulate milk productionBenefits of Breastfeeding: (9:53)Emotional: releases oxytocin, a bonding hormone, and endorphins Health: decreases postpartum bleeding, decreased risk of breast cancer and ovarian cancer, decreased risk of rheumatoid arthritis, decreased risk of postpartum depression, can help you lose baby weight because burns an additional 500 cal per dayBaby benefits: decreased risk of obesity and type 2 diabetes as adults, less chance of infection due to IgA, decreased risk of SIDS, less likely to develop atopic and autoimmune diseases Extra benefits nobody really talks about: poop won’t smell bad and is water-soluble, you always have it on hand, the composition changes as your baby grows, it’s freeTricky things about breastfeeding: (12:40)Takes babies up to 2 weeks to get a hang of itCan be painful for the first 2 weeksAggressively moisturize your nipplesTongue-tie: only class 4 needs repair. Lip and cheek ties do NOT need to be repaired.Pumping: (14:37)Can start as soon as the baby is born; pumping while pregnant can induce laborChoosing a pump: manual vs. electric, how much suction, how portable, single or doubleGetting the best return: Early morning (prolactin peak)One side while baby latches on the other side, or within 15 mins of baby finishingIf at work, look at photos/videos of babyStay hydratedCan try herbal teas, lactation cookies, dietary supplements; these are not proven to be effective and are unlikely to be harmful outside the US: domperidone Pumped milk lasts 6 mos in the freezer, 6 days in the fridge, 6 hours at room tempGiving bottles to a breastfed baby: (17:11)Allows partner and other family members to bond with baby Can allow mom a little more sleep at nightAlways pump while your baby gets a bottle to keep supply upBrush baby’s cheek and let them latch on; don’t put the nipple into baby’s mouthStart with it horizontally, angle up after 1-2 secondsUse a preemie flow nippleChoosing a formula: (19:07)All brands are fairly equal in the US; choose based on the type of formula and look at the ingredients!Regular (cow’s milk-based) - best mimics breast milkGoat milk formula is ok; goat milk is NOT (nor is any animal milk other than human)Preemie formula - has extra iron, calcium, and calories because the last month is when babies store Fe/Ca/fatSoy-based - for vegan families or babies with galactosemia; NOT for milk protein allergy because tend to cross-reactSensitive formulas - more simple sugars, corn syrup-based - I hate these but they do have their place; more info in the next episode (gas/reflux/colic/spit-ups)Anti-reflux formula - has added rice starchHydrolyzed formulas (partially digested, amino acid-based) - protein, fat, and/or carbohydrates are broken down and easier to digest; for babies with milk protein allergy To prepare the formula: (21:38)Ok to mix up to 1 day’s worth (24-30oz) and keep in the fridge Can get ready-to-feed (liquid) formula; do NOT water it downPowdered formula - follow instructions on the package exactly Can mix with drinking water if the clean source Temp should be lukewarm / room tempReminder: let baby latch onto the bottle, always hold baby and bottle while feeding (don’t prop)Burp halfway through and at the endAny leftover in the bottle must be thrown away Baby cues: (9:05)Hungry - eyes open, looking around; rooting; cryingDone - falls asleep, sucks slowly, or turns awayCan offer pacifierStarting solids: (23:03)4-6 mos of age in the US; 6 mos elsewhereSigns of readiness: sit with support, loss of extrusion reflex, watching you eat, bringing hands/objects to mouthOne food every 3-4 days; watch for signs of allergyFood order doesn’t matter; can have anything other than honey and animal milkPuree method: rice cereal, green veg, orange veg, fruit BLW: give babies mashed up foods that they can swallow, or pieces too big to fit in their mouth for them to suck onStart water with solids, 1oz per each 1-2oz of foodFood allergies: (26:46)Signs - blood in stool, rash, vomitingMust discontinue food and wait until after 1st bday with your doctor’s approvalTop 8: peanuts, tree nuts, fish, shellfish, dairy, wheat, egg, soyRisk factors: family member with asthma, eczema, or allergy (likely to something different), a baby with severe eczemaIntroducing peanut proteinNipple confusion: (18:27)Not a real thing, but flow preference isIf you’re going to give bottles ever, start early Pacifiers don’t cause nipple confusion and can soothe the baby and decrease SIDS riskTeething: (29:28)Average 6 mos of age; anytime in the first yearTeeth order; 20 total baby teeth (for tooth-fairy planning)Signs: fussiness, drooling, low-grade fever, pink cheeks, chewing on hands/toys, tooth buds, diarrheaHow to help: teething toys, frozen washcloth, frozen fruit in a mesh bag, topical medications, Tylenol Oral hygiene: (33:12)Pre-teeth: don’t need anything specialAs soon as teeth emerge, brush 2x/day with water or fluoride-free toothpasteStart fluoride at 6mos of age if it’s not in your drinking water; the size of a grain of riceDentist at 1 year of ageThrush: (34:41)Yeast infectionThick white coating on the tongueDoesn’t wipe offNystatinCan spread to breasts - pills for mom The next episode will be gas, colic, spit-ups, and refluxResources discussed in this episode:The Baby Manual - Available on Amazon--Dr. Carole Keim MD: linktree | tiktok | instagram Hosted by Simplecast, an AdsWizz company. 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