Infants
Feeding and Nutrition
Breast and Formula Feeds
The amount of formula taken during a feed will vary from one infant to the next. The table below is a general resource on typical feeding amounts. Paying attention to your infant’s signals to help figure out when he/she is hungry, or becoming full during a feed, will help you understand how best to handle your baby’s nutritional needs.
| Age | Average amount taken each feed | Frequency |
| Newborn | 2-3 ounces (60-90 ml) | Every 2-3 hours |
| 1 months old | 4 ounces (120 ml) | Every 3-4 hours |
| 2 months old | 5 ounces (150 ml) | Every 4-5 hours |
| 4 months old | 6 ounces (180 ml) | Every 4-5 hours |
| 6 months old | 6-8 ounces (180-240 ml) | Every 4-5 hours |
**As your baby grows and settles into higher feeding volumes, he/she should not drink more than 32 ounces (960 ml) in a twenty-four-hour period.
Starting Solids
Before too long, you will begin to wonder about when and how to introduce solid/puréed foods into your child’s diet. Current guidelines from the American Academy of Pediatrics suggests introducing solids at about 6 months old. However, infants as young as 4 months old may start to show signs of readiness and interest in experiencing solid foods.
Knowing the signs of readiness is an important part of introducing purées at an appropriate time. Some indicators that your child may be developmentally ready for solids include:
- Doubling of their birth weight to reach a minimum weight of 13 pounds. This usually occurs around 4 months old.
- His/her ability to sit with little to no support.
- He/she opens their mouth and can lean forward to receive food.
Once you’ve determined that your child is ready to start solid foods, deciding on what to feed them and how much will naturally be your next questions. In the recent past, parents could count on receiving very specific instructions on what color sequence, food type, and order of flavors to introduce. Guess what, you’ll be glad to know that according to updated guidelines offered by the American Academy of Pediatrics, introducing solids can be done with a lot more flexibility and fun.
Here are some tips to help get you and your baby started on your food adventures:
- Tip #1: It does not matter which solids you introduce first. Though single grain cereals were the go-to food to start solid introduction in the past, ultimately it is more important to start with single-ingredient foods. Introducing a single ingredient will allow you to monitor how your child tolerates that particular food. If there are no signs of an allergic reaction, voilà! After your child has tolerated that food type, you may go ahead and start building his/her menu by adding new foods. It is important to wait at least 3 days between each new food you decide to add.
- Tip #2: You don’t need to wait until after 1 year old to introduce foods that are considered highly allergic. These foods include eggs, wheat, soy, peanuts, fish, and dairy. Once your baby has tried a few solids, it is fine to include these foods into the diet. Remember that it is still important to integrate allergy-associated foods, in a texture-appropriate form (for example, dissolve peanut butter puffs in breastmilk or infant formula). Of course, if there is a family history of food allergies or your infant has eczema (a severe dry skin condition), it is best to be guided by your pediatrician as you introduce these foods. Please call our office immediately if you notice any signs of allergic reaction, such as rash, diarrhea, or vomiting.
- Tip #3: Feed your baby all solid foods using a spoon. Do not put cereals into bottles for feeding. This can present a risk for choking.
- Tip #4: Avoid the introduction of honey until your child turns 1 year old. Honey isn’t an allergic food, however, it can be extremely unsafe for children under a year. There is a certain type of bacteria that can contaminate honey, leading to a potentially life-threatening condition called botulism.
- Tip #5: Wait to introduce juices (and definitely no sodas) until after 1 year old. It is acceptable to offer juices as early as 6 months old but let’s face it, juice has no true nutritional value. It simply adds extra sugars and calories to your child’s diet and increases the risk of early tooth decay and childhood obesity. Once you do start introducing juice into your child’s diet, offer your toddler no more than 4-6 oz of 100% fruit juice daily.
** Special note: Cow’s milk introduction before 1 year old is not recommended. However, you may introduce processed dairy products such as yogurt into your baby’s diet before their first birthday.
Sleep
Ensuring that your infant is getting adequate rest is an important part of his/her growth and development. Just like older children and adults, there will be some variation in the amount of time spent sleeping. Most young infants require somewhere between 14-16 hours of sleep over a 24-hour period. During the first few months of life, you will notice that your baby will only sleep for periods of about 2-4 hours, mostly due to the need to wake for feeds. These “blocks” of sleep will gradually lengthen, and sometime between 4-6 months old, this will become 6-8 hour periods of sleep. Naps will still be a part of your daily routine and for those infants over 6 months, anywhere from 2-4 naps will be required up until a year old.
Over the first two to three months, your infant should start to normalize their sleep-wake cycle, developing a pattern similar to our own. To promote this transition, maximize interactions with your baby when he/she is awake during the day. Providing stimulating playtime, for example, in a well-lit environment will help you achieve this. At night, focus on predictably soothing bedtime routines. Given enough time, the natural sleep rhythm will take shape.
By the time your infant is 6 months old and likely sleeping for longer stretches at night, it is not unreasonable to begin teaching him/her how to self soothe. To start developing this ability, get in the habit of putting your baby to bed while drowsy. Placing your infant in his/her crib while drowsy but still awake will help to break the association that someone is needed in order to settle himself/herself back to sleep.
After conquering these initial milestones, you may feel as if you are on cruise control, when all of a sudden, nighttime wakings resurface. There is a simple explanation for this seemingly inconvenient situation. Around 9 months old (may be earlier for some infants), babies develop the understanding that objects continue to exist even when they cannot be seen. In other words, they realize that when you leave a room, you are not gone forever; all they need to do is summon you with a cry. The good news is that this sleep milestone won’t last forever and there’s a healthy way to get through it all. First, continue to maintain nurturing bedtime routines. Then, if your infant does awaken during the night, simply check in and help settle him/her back to sleep. Over time you will notice that your child will develop the ability to return to sleep independently.
SIDS
Just as much as it is a priority to establish regular routines for good sleep hygiene, it is even more important to ensure a safe sleep environment. Sudden infant death syndrome (SIDS) claims the lives of a significant number of infants each year in the United States. SIDS is the sudden and unexpected death of a baby younger than 1 year old. Placing your infant on his/her back to sleep (for naps or at night) on a firm mattress with well-fitted sheets, is one of the most important things you can do to reduce the risk of SIDS. The American Academy of Pediatrics (AAP) has developed a list of recommendations that has been shown to reduce the risk of sleep-related deaths in this age group.
Please familiarize yourself with these recommendations and do share them with anyone who helps you care for your infant:
- Place your infant on his/her back to sleep.
- Use a firm surface/mattress for sleep.
- Room share for at least the first six months of life. Place your infant in a nearby sleep space (a crib or bassinet) in your room, but do not share the same bed.
- Do not swaddle your baby after the age of 2 months old.
- Do not place blankets, toys, bumper pads, or other items in the crib with your infant.
- Offer (but don’t force) a pacifier during naps and nighttime sleep.
- Fully immunize your infant.
- Breastfeed when possible.
- Do not smoke during pregnancy.
- Make supervised tummy time a regular part of your baby’s playtime. This will help strengthen motor skills.
Development
Watching your baby develop new skills and abilities while exploring the world around them comes with lots of anticipation and excitement. Keeping up with routine well-child visits and discussing any concerns you may have with your pediatrician will help your child achieve their maximum potential each step of the way.
Every child develops at their own pace. However, there are generally accepted timeframes for which certain abilities are expected to emerge. These abilities are known as developmental milestones. Interacting with your child regularly to help promote growth in the areas of social, language, cognitive/thinking, and motor skills will help with their progress. Additionally, identifying “red flags” in their development is very important. A red flag signals that a child may be at risk of not achieving an expected milestone. Early referrals and evaluations are key steps in addressing any possible delays. In fact, obtaining a baseline developmental evaluation for any concerns is as simple as contacting your state’s early intervention program. It does not require a referral. For patients of our clinic, we welcome you to discuss your concerns with us and utilize the link below to initiate an evaluation of your child’s development at anytime:
Nevada’s Early Intervention Programs
Please use the checklist links below in conjunction with routine visits to your pediatrician to help monitor your child’s progress: