本文发表在 rolia.net 枫下论坛Cuddles, kisses, and consistency. To baby, these are a few of his favorite things. Add in proper nutrition and you are on the path to parenting success. Whether the nourishment comes from a bottle of breast, only you can choose. Both are discussed here for your knowledge and heartfelt deliberation. No matter what your choice, know that successful lactation alone, like raindrops on roses, will not deliver perfection in parenting. There is much more to good mothering than just bringing a baby to breast.

Feeding your baby is perhaps the most basic task of managing your infant. Since a baby’s sucking and rooting reflexes are well developed at birth, he will satisfy those reflexes by rooting and sucking on anything near his mouth. Whether feeding is accomplished by a bottle or the breast is not nearly as important as the gentle, tender cuddling you give him during feeding. Your decision to bottle or breastfeed must be free of any coercion or manipulation. Guilt or a quest for approval is never in line with clear thinking. Instead, confidently base your decision on accurate, honest information.

Nothing beats breastfeeding for physiological benefits to baby. That is plain fact. Mother’s milk is the complete and perfect food-nothing short of miraculous. Easily digested, it provides excellent nutrition and contains the right balance of proteins and fats. It also provides additional antibodies necessary for building your baby’s immune system.

According to the American Academy of Pediatrics, there is strong evidence that breast milk decreases the incidence and/or severity of diarrhea, lower respiratory infection, bacterial meningitis, and urinary tract infection. The Academy also points out various studies demonstrating breast milk’s protection against Sudden Infant Death Syndrome, allergic diseases, Crohn’s disease, ulcerative colitis, and other chronic digestive disease.

There is more good news. Unlike formula, which needs to be prepared, stored, warmed, and packed for every outing, breast milk is always ready whenever and wherever you go. And you never need to wonder about the milk’s freshness. Inside mother, it won’t go bad. Breastfeeding is also known to speed the return of mother’s uterus to its normal size and shape which is another healthy consideration for a postpartum mom.

BREASTFEEDING TRENDS
Despite numerous benefits to breastfeeding, the American Academy of Pediatrics notes that the number of mothers opting to breastfeed is lower than expected. “Although breastfeeding rates have increased slightly since 1990, the percentage of women currently electing to breastfeed their babies is still lower than levels reported in the mid-1980’s and is far below the Healthy People 2000 goal.” says the AAP.

Why do nearly half of all mothers choose against the nourishment, convenience, and physical closeness of breastfeeding? Why do over a half of all mothers initially choosing breastfeeding opt out so early on? Are they simply callous women, cold to the nourishment and nurture of their babies, who are more concerned with freedom than baby’s physical well-being? Of course not. There is more to their choice and change of heart than is perceived on the surface. Possibly, the decision to quit breastfeeding is actually a disturbing necessity for distraught and fatigued moms unable to cope with endless demands.

The PDF moms reveal an interesting twist on the breastfeeding story. A convenient sampling of over 240 mothers following the PDF principles demonstrated that 88% of mothers who start with the program breastfeed, and 80% of those moms breastfeed exclusively with no formula supplement. And while the national average was 21.6% of mothers breastfeeding into the fifth month, a full 70% of PDF mothers continued into the fifth and six month. On average PDF moms breastfeed 33.2 weeks. Add to these statistics the benefits of uninterrupted nighttime sleep, and you will better appreciate the wonderful benefits of a flexible routine.

For PDF mothers, there is no questioning or second-guessing what will happen next and when. The routine for these moms provides greater understanding of their babies’ needs, helping them connect with their babies sooner. If problem occur, they typically fall so far outside a baby’s normal pattern of behavior that mother quickly picks up on this distress. Breastfeeding under these conditions is delightful, not demanding.

But even with these wonderful statistics, transforming a woman into a good mother is one thing breastfeeding cannot do. There is not “good mother” hormone, and much more is required than just bringing a baby to breast. While strong support for breastfeeding does exist, no one should choose breastfeeding at all costs. The well-being of your entire family is also a critical consideration. Although breast milk is a significant link to the physical well-being of a baby, the act of breastfeeding itself is not the genesis of baby’s psychological health. It is not a silver bullet assuring a love attachment or security.

If you want to ensure optimal development, provide a predictable routine for your baby. It will best complement baby’s overall advancement and attachment in all critical areas of development. Combine this with breastfeeding and your truly can offer a total package for your baby.

IS THERE REALLY A DIFFERENCE?
Demand-feeding’s more standard, moderate approach, as used by Julia and Barbara, instructs parents to feed their babies every two to three hours based on the baby’s hunger signals. On the other hand, PDF parents will feed their babies on a flexible routine every two to three hours. In terms of nutrition, both methods are the same. But as demonstrated earlier, the physiological outcomes are drastically different because one method is child-led and the other parent-directed.

Preparation for Parenting offers an alternative to hyper-scheduling at one extreme and AP style of nursing at the other. It has enough structure to bring security and order to your baby’s world, yet it has enough flexibility to give mom freedom to respond to any need at anytime. PDF moms feel comfortable handling this freedom to assess and decide need and offer her baby guidance.

Some moms rely too heavily on watching and waiting for their babies to signal a desire to nurse. They may be discouraged when their babies nurse so irregularly or want to nurse every hour. These mothers may worry about their babies getting enough food. The expectation that a baby should nurse whenever usually leads to frustration for both mother and baby and may be the single greatest reason mothers give up breastfeeding so quickly.

Waiting on the baby’s signal for food may also compromise the child’s health. Some newborns may not cry to signal hunger readiness for five to six hours, and crying is not always a signal of hunger. Weak and sickly babies may not have the energy to cry, so the advice of sit back and let the baby direct the show could allow serious medical problems to go unnoticed that would otherwise be picked up through routine feedings. It is the predictability within the routine that helps PDF moms pick up any deviation from the norm. Deviation cues stand out because there is a pattern of norm cues.

“Just listen to your baby’s cues” is common breastfeeding advice and good advice if you know what to listen and look for. Babies provide parents two sets of response cues-those that are immediate need (e.g. hunger, sleep, and messy diaper cues) and those that represent a parenting style. Behavior patterns can be attributed to parenting styles as much as temperament. For example, the three-month-old baby who has a pattern of waking two, three, or four times in the middle of the night to nurse is responding to his mother’s parenting style. In this case, the need cue for food may be legitimate, but the greater question centers on the greater parenting style cue-why is a child of this age repeatedly hungry at night? Mothers will say, “But my baby is waking for comfort nursing, not just food.” We would still ask the same question at this age. A baby nursing for comfort so many times during the night is a cue that your parenting style during the day is causing too much discomfort.

A baby nursing every hour is another double cue. It’s telling you two things. It may signal that your baby is not getting the rich, high-chloride hind milk and, equally important, that your baby is not getting enough healthy sleep. Healthy sleep facilitates healthy nursing. Fatigue is another parenting style cue. If mom is continually waking up each morning fatigued and discouraged from her middle-of-the-night experience, that is her body’s and emotion’s way of telling her that what she is doing is not working.

In contrast, the babies who are growing and sleeping contently and securely through the night are also responding to a parenting style. This is a healthy response signaling that their tummies are content and their hearts are secure in mom and dad’s parenting. What about the mom who wakes in the morning feeling rested? That sense of restedness is a positive response cue to what she is doing. Parents must learn how to distinguish between immediate need cues and parenting style cues. Both are important. One is for short-term benefit and one is for long-term gain.

MILK PRODUCTION
If breastfeeding is your choice, there are a few basic principles you must understand. The most important one is that breastfeeding success is based on demand and supply. The supply of milk produced by the glands is proportional to the demand placed on the system. The greater the demand, the greater the supply. But how do you define demand?
Steven’s mother heard that milk production is directly related to the number of feedings offered. The more feedings she gave, the greater her milk production would be. While there is some truth here, the statement is greatly misleading. Certainly a mother who takes her baby to breast seven times a day will produce more milk than the one who offers only two feedings; however, there are limits. A mother who takes her baby to her breast twelve, fifteen, or twenty times a day will not necessarily produce any more milk than the mom who takes her baby to breast eight or nine times a day.

The problem is not the amount of milk overall, but the quality of the milk taken in by baby. First, babies on a routine of fewer feedings will take in more calories at each of those set feedings than babies who feed ad lib. The difference here is qualitative feeding, as with a baby on routine, versus quantitative feeding, meaning more feedings of lesser quality.

With qualitative feeding, you eliminate the need for continual snacking. Many feedings become exactly that. Baby feels like a little something to tide her over. No meal is desired. Such snack feeding provides baby only a partial meal consisting of the lower-calorie foremilk and not the higher-calorie hindmilk essential for growth. Mom thinks she is doing more for baby through endless breast availability. In actuality, she’s delivering less than her best. Baby often quits suckling before optimum nourishment is offered. How disheartening for both.

Part of a mother’s ability to produce milk is tied to the demand placed on her system. Several factors are associated with the demand side of breast milk production, with two specific to this discussion. First, there is the need for appropriate stimulation at each feeding. That means the strength of the infant’s suck must be sufficient. A second factor for the PDF baby is the correct amount of time between feedings. Without proper stimulation, no matter how many times an infant goes to the breast, milk production will be limited. Too many snack feeding with too little time in between may reduce proper stimulation. Thus, baby gets only foremilk which is much lower in calories than the most desirable hindmilk. Too few feedings, which allow too much time in between feedings, reduce mother’s milk production. Both proper time lapse and stimulation are needed for breastfeeding success.

References to breast stimulation refer to the intensity of baby’s sucking. The urgency of a baby’s hunger drive will consistently influence the sucking reflex. This drive for food is related to the time needed for milk digestion and absorption into baby’s system. An infant fed on a basic 2.5- to 3-hour routine and whose digestive metabolism is stable will demand more milk. In turn, this stimulates greater milk production than the infant demanding less milk more often. Here then lies your key to efficient milk production. Work on getting full feedings.

THE LET-DOWN REFLEX
When a baby begins to suckle on his mother’s breast, a message is sent to the mother’s pituitary gland which in turn releases several hormones. The hormone prolactin is necessary for milk production and the hormone oxytocin is required for milk release. The most important factor in the continued release of prolactin is proper nipple stimulation. Without this stimulation, milk will not be produced no matter how many times an infant goes to the breast, because a consistent routine will help maximize milk production.

Before the milk is let down, you baby will receive a milk substance stored in the ducts under the areola (the flesh encircling the nipples). This foremilk, as it is called, diluted and limited in nutritional value. Oxytocin then causes the cells around the milk glands to contract, forcing milk into the ducts. When that happens, the milk is said to have been “let down”. For some mothers, this experience includes a tingling or pressure sensation. Without let-down, the milk would remain in the glands. In the absence of any sensation, the most reliable sign of let-down is your baby’s rhythmic swallowing of milk. The milk released is called hindmilk or mature milk. This high-protein and high-fat-content milk is rich in calories (thirty to forty per ounce).

Mothers following PDF have little or no problem with the let-down reflex. There are two reasons for this. First, routine plays an important part in proper let-down. Not only does the mind need a routine to maintain order and efficiency, but the body does as well. The very nature of inconsistent feeding wears on a woman’s body. A second reason is the high confidence level of the mother who follows a routine. There is no worrisome fear or anxiety for moms who know what happens next. Mother is confidant and her confidence aids the successful working of her let-down reflex.

BREAST MILK AND BABY’S DIGESTION
An empty stomach does not trigger the hunger drive. Efficient and effective digestion and absorption of food does. This is where the various food groups get broken down into proteins, fats, and carbohydrates. After the break-down, the nutrition is assimilated into the body via the blood. Absorption, which takes place primarily in the small intestine, is the process by which broken-down food molecules pass through the intestinal lining into the bloodstream. As absorption is accomplished, the blood-sugar level drops sending a signal to the hypothalamus gland. The red alert is triggered: Baby now needs food. So, it is blood-sugar dropping, not the empty tummy, which signals feeding time.

Breast milk is digested faster than formula, but that doesn’t justify unlimited breastfeedings to try and play catch-up. Rather than comparing breast milk to formula, it is more useful to look at the amount of breast milk consumed at each feeding. The AP Style of demand-feeding does not distinguish between snack time and mealtime. For these mothers, a feeding is a feeding. The child who nurses frequently and takes in fewer ounces, especially of foremilk, will naturally be hungry more often. PDF moms look to deliver full meals at each feeding.

PROPER POSTION FOR NURSING YOUR BABY
During the first few days of nursing, find a comfortable position for baby and you. This may be a matter of personal preference or an eclectic assortment based on situational needs. A pillow may be helpful under your supporting arm to lessen stress on your neck and upper back. Correct positioning of your precious bundle is imperative in successful lactation. How comfortable you are with this experience is also directly affected by the angles you impose on baby and yourself.

With your nipple, stroke lightly downward on your baby’s lower lip until she opens her mouth. Take care not to touch her upper lip as this creates confusion for baby. A her mouth opens wide, center your nipple and pull her close to you so that the tip of her nose is brushing slightly against your breast and her knees are resting on your abdomen. With baby correctly latched on, nursing should not be painful. Successful latching is made difficult if the baby’s head is toward the breast, but the body is allowed to turn away. If there is discomfort, remove her and try again. Patience in the process pays off as you discover what is best for you both.

When the baby nurses, she should take both the nipple and all or much of the areola into her mouth. Encourage the baby to latch on the areola, though she ay seem satisfied with only the nipple. Also, see that your baby’s entire body is facing you (head, chest, stomach, and legs). She will not latch on correctly if her head is facing you but the rest of her body isn’t. While this may sound awkward and impossible, baby has only one thing in mind when approaching the breast. Ideal positioning is not an issue for her consideration. You need to take charge here. To further assist in achieving successful feeding, there are three correct and interchangeable nursing positions: cradle, side-lying, and football hold.

Cradle Position
Cross Cradle Position
This position works well: · If you are learning to breastfeed · If you have a small baby.
Cradle Position
This position works well: · After you are comfortable with breastfeeding

The cradle position is most common. Sitting in a comfortable position, place your baby’s head in the curve of your arm. You may desire to place a pillow under your supporting arm to lessen the stress son your neck and upper back. When the baby nurses, he should take both the nipple and all or much of the areola courage and assist the baby in latching on the areola. With this approach, your baby’s entire body should face you (head, chest, stomach, and legs). Again, he will not latch on correctly if his head is facing you but the rest of his body is not. With your nipple, stroke lightly downward on his lower lip until he opens his mouth. When his mouth opens wide, center your nipple and pull him close to you so the tip of his nose is touching your breast and his knees are touching your abdomen.

Side-lying Position (above left)
Side-Lying Position
This position works well: · If you find it too painful to sit · If you want to rest when you breastfeed · If you have large breasts · If you had a caesarean birth

This position is commonly used by moms recovering from a cesarean delivery. Your stomach and your baby’s stomach should be facing each other, and your baby’s head should be near the nipple. With your nipple, stroke lightly downward on his lower lip until he opens his mouth. When his mouth opens wide, center your nipple and pull him close to you so the tip of his nose is touching your breast.

Football Hold Position (above right)
Football Position
This position works well: · If you are learning to breastfeed · If you have a small baby · If you have large breasts · If you have flat or sore nipples· If you had a caesarean birth

When using this position, place one hand under the infant’s head pulling him close. The breast is lifted and supported by the other hand. With the fingers above and below the nipple, introduce the baby to the breast by drawing him near.

A nursing baby often has a remarkably strong suck. If you try to pull the nipple away, she will just suckle harder. Just once, suddenly interrupt a feeding to answer the door and you quickly will discover baby’s intensity in this area. To remove her without hurting yourself, slip your little finger between the corner of her mouth and your breast. That will break the intense suction, allowing you to take her off easily.

HOW OFTEN SHOULD I NURSE MY BABY?

How often you should feed your baby depends on baby’s age. As a general rule, during the first two months you will feed your baby approximately every 2.5- to 3-hour from the beginning of one feeding to the beginning of the next. Sometimes it may be less and sometimes slightly more, but this time frame is a healthy average. In actual practice, a 2.5-hour routine means you will nurse your baby 2 hours from the end of the last feeding to the start of the next, adding back in 20 to 30 minutes for feeding to complete the cycle.

A 3-hour routine means you will nurse your baby 2.5 hours from the end of the last feeding to the start of the next. When you add 20 to 30 minutes for the actual feeding time, you will complete your 3-hour cycle. With these recommended times, you can average between 8 to 10 feedings a day in the early weeks. These times fall well within recommendations of the American Academy of Pediatrics.

While 2.5- to 3-hour routines are a healthy norm, there may be occasions when you might feed sooner. But take heed; consistently feeding exclusively at 1.5- to 2-hour intervals may wear a mother down. Extreme fatigue reduces her physical ability to produce a sufficient quantity and even quality of milk. Add postpartum hormones to the mix and it isn’t any wonder some women simply throw in the towel. Bear in mind, the word consistently is operative. As stated, there will be times when you might nurse sooner than 2.5 hours, but that should not be the norm. At the other extreme, going longer than 3.5 hours in the early weeks can produce too-little stimulation for successful lactation.

THE FIRST MILK
The first milk produced is a thick, yellowish liquid called colostrums. Colostrum is at least five times as high in protein as mature milk with less fat and sugar. As a protein concentrate, it takes longer to digest and is rich in antibodies. Some mothers experience tenderness in the first few days before mature milk comes in. This is due to the thickness of the colostrums and the infant sucking especially hard to remove it. A typical pattern is suck, suck, suck, then swallow. When mature milk becomes available, your baby responds with a rhythmic suck, swallow, suck, swallow, suck, swallow. At that point, the hard sucking is reduced and the tenderness should dissipate.

A clicking sound and dimpled cheeks during nursing are two indicators that your baby is not sucking adequately. Take the following test yourself. Curl your tongue and place it near the roof of your mouth, and then pull it away. You should hear a clicking sound. When your baby is nursing, you should not hear that sound nor see dimpled cheeks. It means your baby is sucking his own tongue not the breast. If you hear clicking, remove baby from breast and then re-latch him. If this continues, contact your pediatrician.

Even with a complete understanding of how the breast works and the many benefits of colostrums, mothers may still wonder if their babies are getting enough food in that first week. Consider these important clues. One sign that your baby is receiving adequate nutrition is his stooling pattern. Newborn stools in the first week transition from meconium, greenish black and sticky in texture, to a brownie batter transition stool, to a sweet odor, mustard yellow stool. The yellow stools is a totally breast milk stool and a healthy sign. After the first week, two to five or more yellow stools along with seven to eight wet diapers daily are healthy signs that your baby is getting adequate milk to grown on. Healthy baby growth indicators are discussed in Chapter 5. A bottle-fed baby will pass firmer, light brown to golden or clay colored stools strong in odor.

AFTER YOUR MILK COMES IN
Unless specified by your pediatrician, normally a baby does not need additional water or formula prior to mother’s milk coming in because your baby is getting colostrums. Once your milk is in, your nursing periods will average fifteen minutes per side. As mentioned, some babies nurse faster, and some nurse slower. Studies show that in established lactation, a baby can empty the breasts in seven to ten minutes per side, providing he or she is sucking vigorously. This astounding truth is not meant to encourage less time at the breast. Rather, it’s a clear demonstration of a baby’s ablity for speed and efficiency.

Under normal circumstances, baby takes what is needed within thirty minutes. The idea that non-nutritive sucking beyond this time enhances a baby’s security or heightens a baby’ sense of love is interesting but lacks serious scientific support. Security and love result from the overall parent-child relationship not one isolated factor. If you feel your baby has a need for non-nutritive sucking, a pacifier can meet the need without compromising your routine. But even with this, be careful not to over use the pacifier.

Usually a woman’s milk comes in between three and six days. During that period, some weight loss (up to 10% of birth weight) is normal and expected but should be regained by ten to fourteen days. We recommend that babies be weighted between ten and fourteen days. If there is a problem, it will show up on the scales. Catching it early allows for correction and is obviously much safer. Weight gain, as well as three to five or more yellow stools daily for the first month and five to seven wet diapers per day after the first week, are good indicators that your baby is getting enough milk for healthy growth.

NURSING PERIODS
Current wisdom governing the length of nursing periods for the first few days is fairly consistent. We suggest the following:

The Very First Nursing Period
If possible, nurse your baby soon after birth. This will be sometime within the first hour-and-a-half, when newborns are usually most alert. We suggest you strive for fifteen minutes per side or a minimum of ten minutes per side. Remember to properly position the baby on the breast. If your baby wants to nurse longer during this first feeding, allow him or her to do so. In fact, with the first several feedings, you can go as long as the two of you are comfortable. Both breasts need ot be stimulated at each feeding and the initial time frame mentioned above will allow for sufficient breast stimulation.

The First Five Days
For the next three to five days, maintain your basic 2.5- to 3- hour routine, nursing fifteen to twenty minutes on each breast. This means your average nursing period falls between thirty and forty minutes per feeding during this first week. Babies are usually sleepy during the first several days after birth. As a result, some will fall asleep right at the breast after a few minutes of nursing. That means you may have to work on keeping your baby awake at the breast. You can rub his feet, stoke his face, change a diaper, talk to him, or remove his sleeper, but he must eat. Keeping him awake will help him take in full feedings as opposed to snacking. It’s your key to success both in terms of early lactation and establishing a healthy routine. In our experience, mothers who work to get a full feeding during the first week have a baby who naturally transitions into a consistent 3-hour routine within seven to ten days. Keep this goal in mind when putting in the extra effort. The payoff is the confidence and comfort for both baby and you.

Some mothers nurse fifteen to twenty minutes from each side, burping their baby before switching breasts. Other mothers find it helpful to employ a ten-ten-five-five method. They alternate between each breast after ten minutes (burping the baby between sides) and then offer each breast for five additional minutes. This second method is especially helpful when you have a sleepy baby. This disruption prompts your baby to wakefulness and assures that both breasts are stimulated. Please note that these figures are goals based on averages. Some newborns nurse faster and more efficiently. Others nurse efficiently but slightly slower. If your baby wants to nurse longer, let him do so.

JAUNDICE IN NEWBORNS

A mild degree of jaundice is common in most newborns. This is not a disease, but a temporary condition characterized by a yellow tinge to the skin and eyes. Jaundice, caused by the pigment bilirubin in the blood, is usually easily controlled. However, it could develop into a dangerous situation when ignored or left untreated. If the condition appears more pronounced after the second day, frequent blood tests are done and conservative treatment is initiated.

Babies with moderately raised levels of bilirubin are sometimes treated with special fluorescent lights that help to break down the yellow pigment. Also, part of the treatment is an increase in fluid intake. In this case, your pediatrician may recommend other liquid supplements, although exclusive breastfeeding is usually the best way to correct this condition, even feeding as often as every 2 hours. Because bilirubin is eliminated in the stool, make sure your baby has passed his first stool (meconium). Your doctor will determine the program of treatment best suited for your baby. Because a newborn with jaundice will tend to sleep more, be sure to wake your baby for feeding at least every 3 hours.

BREAST VERSUS BOTTLE
We know there is substantial nutritional and health-benefit disparity between breast milk and formula during the first twelve weeks of baby’s life. By six months of age, the disparity is still present but to a lesser degree than in the first twelve weeks. According to the American Academy of Pediatrics, this six-month term is the minimum recommended duration. Between six and nine months, the difference between what is best and what is good continues to narrow. That is partly due to the fact that other food sources are now introduced in your baby’s diet. Between nine and twelve months, the nutritional value of breast milk drops and food supplements are usually needed. In our society, breastfeeding beyond a year is done more out of a preference for nursing than an absolute nutritional need.

When it comes to nourishing baby, mother’s milk is clearly superior to formula. Now for the stickier issue of nurturing. Is breast superior to bottle? In times past, experts said yes. Stressing the value of breastfeeding, they associated bottle-feeding with child rejection. Considered to be lacking warmth, a bottle-feeding mom was accused of renouncing her biological role as a woman and her emotional role as a mother. Others considered bottle-fed children to have less of an advantage in life than those who were breast-fed. In truth, studies over the last sixty years which attempted to correlate methods of infant feeding with later emotional development failed to support any of these conclusions. A mother’s overall attitude toward her child far outweighs any single factor, including manner of feeding.

BOTTLE-FEEDING
Bottle-feeding is not a twentieth-century discovery, but a practice that has been in existence for thousands of years. Our ancestors made bottles out of wood, porcelain, pewter, glass, copper, leather, and cow horns. Historically, unprocessed animal’s milk was the principal nourishment used with bottle-feeding. Since this milk was easily contaminated, infant mortality was high.

During the first half of this century when bottle-feeding was vogue, selection was relatively limited. Not so today. Your grocer’s shelves are filled with options. Besides that standard glass and plastic bottles, there are those with disposable bags, designer imprints, handles and animal shapes. All of these come in a clever range of colors and prints. This perhaps is more for mother’s amusement than baby’s. Adding to the confusion is a varied selection of supposedly proper nipples. You can find everything from a nursing nipple that is most like mom to an orthodontic nipple. There are juice, formula, water and even cereal nipples, so baby can suckle her table food. With so many choices, do not go to the store without adequate rest.

In truth, the most important consideration when buying nipples is making sure you purchase one with the right-size hole. With too large a hole, the child drinks too fast. Excessive spitting up and projectile vomiting can be signs of too rapid a fluid intake. Remembering this simple tip can save you many midnight mop-ups. Conversely, a hole which is too small creates a hungry and discontented child. Imagine the frustration! These simple tips will prevent what could be major feeding problems for your baby and you.

FORMULA
Take time to sit and hold your baby while feeding with a bottle. What better time to sneak in the rest you deserve, not to mention the cuddling your baby requires. Holding your baby at this time also will help prevent your child from becoming attached to the bottle. You control the feeding with the bottle in your hands-not baby.

Generally, avoid feeding baby while he is lying completely flat, such as when the mother is nursing in the lying-down position. Swallowing while lying down may allow fluid to enter the middle ear leading to ear infections. For the same reason, avoid propping up the bottle. Putting a child six months and older to bed with a bottle is a no-no. This is true not only for health factors relating to ear infections but also for oral hygiene. When a child falls asleep with a bottle in his mouth, the sugar in the formula remaining in the mouth coats the teeth resulting in tooth decay.

Most important in bottle-feeding is what goes in the bottle. Sometimes the choice may be made for you, either by the hospital where you deliver or by your pediatrician. If either your husband or you have a history of milk allergies, mention that to your doctor. It may influence the type of formula your pediatrician recommends. Formulas today have properties closely matched to those of breast milk, including the proper balance and quantity of proteins, fats, and carbohydrates. Cow’s milk and baby formula are not the same. Formula is designed for a baby’s digestive system; cow’s milk is not. Cow’s milk is not suitable for children less than one year old. For more specific information regarding the different manufacturers of formula, check with your pediatrician.

The amount of formula taken at each feeding will vary with the baby’s age. On average, as with breast-fed babies, it is anywhere from one-and-a-half to three ounces per feeding in the first several weeks. This amount gradually increases as baby grows. If you prepare a four-ounce bottle for each feeding and allow your baby to take as much as he or she wants, the baby will tend to stop when full. While a larger baby might take more formula, that is not always the case. As with breast-fed babies, the feeding routine or lack of routine is the primary influence on the establishment of predictable hunger patterns not the substance or the amount of food offered.

Again, we cannot overstate breast milk’s advantage in infant nourishment. However, if you choose not to nurse, you can’t nurse, or if you decide to discontinue nursing within the first twelve months, the decision will not make you an unloving mother. Just as breastfeeding doesn’t make you a good mother, bottle-feeding won’t make you a bed one.

BURPING YOUR BABY
Baby needs to burp. Initially, formula-fed babies must be burped every one-half ounce. By the time your baby is four to six months old, he or she will probably be able to consume six to eight ounces before burping. Both breastfeeding and bottle-feeding offer a certain amount of spitting up. You’ll learn to expect it. (Spitting-up is covered in Chapter 10.)

1. Place the palm of your hand over baby’s stomach. Now hook your thumb around the side of your baby, wrapping the rest of your fingers around the chest area. Your hand should be your baby’s only support. Rest his bottom on your knee, but allow all of his weight to be placed on your support hand. Next, lean the baby over your hand. If the baby is wiggling or needs further support, hold his or her hands in your supporting hand. Cup your hand and begin patting your baby’s back.

NOTE: Whenever you pat your baby’s back as described here, do so firmly but without excessive force.
2. Place your baby high on your shoulder with your shoulder placing direct pressure on his or her stomach. The baby’s head and arms should freely dangle over your shoulder. Remember to hold on tightly to one leg so your baby doesn’t wiggle away from you. Pat the baby’s back firmly.
3. In a sitting position, place your baby’s legs between your legs and drape the baby over your thigh. While supporting the baby’s head in yor hands, bring your knees together for further support and pat the baby’s back firmly.

Sitting up. Hold your baby in a sitting position on your lap, supporting her head and back with one hand and her chin and chest with the other. Gently pat her back. Over your shoulder.Hold your baby upright with her head on your shoulder and chest against yours. With one arm supporting your baby’s bottom, gently pat her on the back with your other hand, or rub her back upward. Across your lap. Lay your baby down across your lap. Support her head with one hand, and gently rub or pat her back with your other hand.
4. Cradle the baby in your arm with his or her bottom in your hands. (The baby’s head will be resting at your elbow.) Wrap one arm and leg around your arm. Make sure the baby is facing away from you. This position allows one hand to be free at all times.

NOTE: At times air will become trapped in the intestines of your baby. Most babies don’t like to expel gas. They will tighten their bottoms and resist the normal expulsion of gas making them very uncomfortable. One way to assist your baby in releasing gas is to place him or her in a knee-chest position. Place your baby’s back next to your chest and pull his or her knees up to the chest. This will help to alleviate your baby’s discomfort.更多精彩文章及讨论，请光临枫下论坛 rolia.net

本文发表在 rolia.net 枫下论坛If you have come this far, chances are you feel convinced. You understand the need for routine feedings within a pre-set, flexible time frame. You may be willing, if not determined, to breastfeed your baby that most miraculous of foods-mother’s milk. Indeed, one of many advantages of parent-directed feeding is the success mothers have with breastfeeding. Knowing her baby’s nutritional needs are being met in an orderly fashion gives any woman greater confidence in her role as mother. In addition, establishing a routine gives mother the freedom to maintain relationships outside motherhood.

So, you have a content baby and motherhood feels good. You are rested and complete. The confidence is positive, but guard against carelessness. Be aware that routine alone won’t eliminate every potential lactation problem. Other variables come into play. Factors affecting your routine and attempts to breastfeed include the amount of sleep a mother receives; her diet, nutrition, state of mind, and age; whether this is her first child or her sixth; her desire and physical capacity t breastfeed; her nursing techniques; and the baby’s ability to latch on properly.

If you are breastfeeding, monitoring your baby’s growth is a vital concern to us and should be to you. Your baby’s life depends on it. How do you know if your baby is getting enough food to grow on? There are a number of objective indicators to assist you in the evaluation process. These indicators provide mom with guidance and feedback as to how well she and her baby are doing.

As a new mom and dad, knowing what to expect in the first week and having objective markers can make all the difference in the world for your sense of confidence and future direction. At the same time, observing these indicators will help alert you to conditions that may not lead to healthy growth. Poor starts and tragedies can be avoided by monitoring your baby for signs of adequate and inadequate nutrition. If you start to notice the unhealthy indicators, call your pediatrician and report your objective finding.

Included in the back of your book is a series of healthy baby growth charts developed to assist you in monitoring your baby’s growth. Chart One was designed specifically for your baby’s first week of life. Chart Two is for weeks two through four. Chart Three will be used for weeks five and beyond. Using these charts accordingly will provide important benchmarks signaling healthy or unhealthy growth patterns.

What indicators should you look and listen for? Consider the following:

WEEK ONE: Healthy Growth Indicators
1. Under normal circumstances, it takes only a few minutes for your baby to adjust to life outside the womb. His eyes will open, and he will begin to seek food. Bring your baby to breast as soon as it is possible, and certainly try to do so within the first hour-and-a-half after birth. One of the first and most basic positive indicators is your baby’s willingness and desire to nurse.
2. It is natural to wonder and even to be a little anxious during the first few postpartum days. How do you know if your baby is getting enough food to live on? The release of the first milk, colostrums, is a second important encouraging indicator. In the simplest terms, colostrums is a protein concentrate ideally suited for your baby’s nutritional and health needs.

One of the many benefits of colostrums is its effect on your baby’s first bowel movement. It helps trigger the passage of the meconium, your baby’s first stools. The meconium stool is greenish black in color with a tarry texture. Newborn stools in the first week transition from meconium, to a brownie batter transition stool, to a mustard yellow stool. Three to five soft or liquid yellow stools each day by the fourth or fifth day is a totally breast milk stool and a healthy sign that your baby is getting enough nutrition. A bottle-fed baby will pass firmer light-brown to golden or clay colored stools that have an odor similar to adult stools.
3. During this first week, frequent nursing is necessary for two reasons: First, your baby needs the colostrums and second, frequent nursing is required to establish lactation. The fact that your baby nurses every 2.5 to 3 hours and a minimum of eight times a day are two more positive indicators to consider.
4. Just bringing your baby to breast does not mean your baby is nursing efficiently. There is a time element involved. In those early days, most babies nurse between thirty to forty-five minutes. If your baby is sluggish or sleepy all the time or not nursing more than a total of ten minutes, this may be an unhealthy indicator.
5. As your baby works at taking the colostrums, you will hear him swallow. A typical pattern is suck, suck, suck, then swallow. When mature milk becomes available, your baby responds with a rhythmic suck, swallow, suck, swallow, suck, swallow. You should not hear a clicking sound or see dimpled cheeks. A clicking sound and dimpled cheeks during nursing are two indicators that your baby is not sucking efficiently. He is sucking his own tongue not the breast. If you hear clicking, remove baby from breast and then re-latch him. If this continues, contact your pediatrician.

Summary of Week One Growth Indicators
1. Your baby goes to the breast and nurses.
2. Your baby is nursing a minimum of eight times in a 24-hour period.
3. Your baby is nursing over fifteen minutes at each nursing period.
4. You can hear your baby swallowing milk.
5. Your baby has passed his first stool call meconium. (Make sure you let the nurses know that you are tracking your baby’s growth indicator.)
6. Your baby’s stooling pattern progresses from meconium, greenish black, to brownie batter transition stools, to yellow stools by the fourth or fifth day. An increased stooling pattern is one of the most positive signs that your baby is getting enough milk.
7. Within 24 to 48 hours, your baby starts having wet diapers (increasing to two or three a day). By the end of the first week, wet diapers are becoming more frequent.

Unhealthy Growth Indicators for the First Week
1. Your baby is not showing any desire to nurse or has a very weak suck.
2. Your baby fails to nurse eight times in a 24-hour period.
3. Your baby tired quickly at the breast and cannot sustain at least fifteen minutes at the breast.
4. Your baby continually falls asleep at the breast before talking a full feeding.
5. You hear a clicking sound accompanied by dimpled cheeks while baby is nursing.
6. Your baby’s stooling pattern is not progressing to yellow stools within a week’s time.
7. Your baby has not wet any diapers within 48 hours of birth.

At this point, please turn to the back of the book to look at Chart One. Review it and remember to bring the book with you to the hospital. If you desire to make additional copies of these charts for your own use, please feel free to do so.

WEEKS TWO THROUGH FOUR: Healthy Growth Indicators
After the first week, some of the healthy growth indicators begin to change. Here is the check list for the next three weeks.
1. Your baby is nursing at least eight times a day.
2. Your baby over the next three weeks has two to five or more yellow stools daily. (This number will probably decrease after the first month.)
3. Your baby during this period should start to have six to eight wet diapers a day (some saturated).
4. Your baby’s urine is clear (not yellow).
5. Your baby has a strong suck, you see milk on the corners of this mouth, and you can hear an audible swallow.
6. You’re noticing increasing signs of alertness during your baby’s waketime.
7. Your baby is gaining weight and growing in length. We recommend your baby be weighed within a week or two after birth. Weight gain is one of the surest indicators of growth.

Unhealthy Growth Indicators for Weeks Two through Four
1. Your baby is not getting eight feeding a day.
2. Your baby in the first month has small, scant , and infrequent stools.
3. Your baby does not have the appropriate amount of wet diapers given his age.
4. Your baby’s urine is concentrated and bright yellow.
5. Your baby has a weak or non-productive suck, and you cannot hear him swallow.
6. Your baby is sluggish or slow to respond to stimulus and does not sleep between feedings.
7. Your baby is not gaining weight or growing in length. Your doctor will direct you in the best strategy to correct this problem.

WEEKS FIVE AND ABOVE: Healthy Growth Indicators
The major difference between the first month indicators and the weeks to follow is the stooling patterns. After the first month, your baby’s stooling pattern will change. He may pass only one large stool a day or as infrequently as one in every three to five days. Every baby is different. Any concerns regarding elimination should be directed to your pediatrician.

Parents are responsible for seeing that their baby’s health and nutritional needs are recognized and met. For your peace of mind and your baby’s health, we recommend regular visits with your pediatrician and use of the charts in back to monitor and record your baby’s progress. Any two consecutive days of deviation from what is listed as normal should be reported to your pediatrician.

Take the charts out of this binder and post them in convenient location, such as on the refrigerator, above the crib, or any location that will serve as a convenient reminder. If your baby exhibits any of the unhealthy growth indicators, notify your pediatrician and have your baby weighted

WEIGHT GAIN CONCERN
With the conservation practice of PDF, weight gain should be steady and continouous. We routinely monitor the progress of prep babies and continue to find wonderful result. In 1997, our retrospective studies tracked and compared the weight gain of 200 Preparation for Parenting infants (group A) and 200 demand-fed infants (group B). Pertinent growth information (weight gain and length) was taken directly from the patient charts of four pediatric practices.

The study’s purpose was to determine if faster weight gain can be attributed to a particular method of breastfeeding (routine or demand). Weight and length of each infant was charted at birth, 1 week, 2 weeks, 1, 2, 4, 6, 9 months, and 1 year. Statistical comparisons were made between five weight groups. Babies born between 6.5 and 7.0 lbs; 7.1 and 7.50 lbs; 7.51 and 8.0 lbs; 8.1 and 8.50 lbs; and 8.51 and 9.0 lbs. Two methods of analysis were used to compare growth: weight gain ratios (comparing weight gained at each visit as a percentage of birth weight) and Baby Mass Index (BMI).

Here are three major conclusions.
1. While there was no significant difference between the two groups, group A did gain weight slightly faster than group B at each weight category.
2. Even when group A began sleeping 7 to 8 hours at night, there was no significant change in weight gain performance.
3. While breastfeeding initially was the preferred method for both sets of parents, group B moms gave up breastfeeding significantly sooner than group A.

You can take comfort in the fact that a basic routine will not detract form proper, healthy weight gain. What it will do is facilitate breastfeeding comfort and success. Even low birth-weight babies do well on a conservative routine. Although some newborns start off at the low end of the national norm, they continue to gain weight in proportion to the genetic potential for stature inherited form their parents. That is, smaller parents usually give birth to smaller babies, thus weight gain will usually be proportionately less. Add to these weight-gain benefits for baby the pleasure of a solid night’s sleep for everyone, and the greater benefits of PDF are obvious. If you have a low weight-gain baby, seek your physician’s specific recommendations as to how often your baby should be fed.

NORMAL WEIGHT GAIN GUIDE

Birth to Two Weeks
Approximate average: Regain birth weight plus.

Two weeks to Three Months
Approximate average: Two pounds per month or one ounce per day.

Four to Six Months
Approximate average: One pound per month or one-half ounce per day. (Doubles his or her birth weight by six months).

One Year
Approximate average: Two-and-a-half to three times his or her birth weight.

BABIES WHO FAIL TO THRIVE
There is a difference between slow weight gain and failure to thrive. With the first , weight gain is slow but consistent. “Failure to thrive” describes an infant who continues to lose weight after ten days of life, does not regain his or her birth weight by three weeks of age. Or gains at an unusually slow rate beyond the first month. It’s estimated that in the United States more than 200,000 babies a year experience failure to thrive. The cause can be attributed to either mother or child.

Mother-Related Causes
Here are some matters specific to mother that can contribute to slow or no weight gain.
1. Improper nursing technique. Many women fail at breastfeeding because the baby is not positioned properly on the breast. As a result, he or she latches on only to the nipple and not to all or much of the areola. The end result is a hungry baby.
2. Nature of lifestyle. Insufficient milk production can be a result of nature (insufficient glandular tissue or hormones) or a mother’s lifestyle (not getting enough rest or liquids). The mother simply doesn’t produce enough milk, or in some cases, milk of high enough quality. If you suspect this is the case, try:
a) Using a breast pump to see what quantity of milk is being produced,
b) Discovering if your baby will take any formula after he or she has been at your breast for the proper amount of time. Report your findings to your pediatrician.
3. Poor release of milk. This indicates a problem with the mother’s let-down reflex.
4. Feeding too frequently. There is an irony here, because one would think many feedings ensure adequate weight gain. Not necessarily! In some cases a mother can be worn out by too many ineffective feedings. When we first met Jeffrey, he was six weeks old and had gained only one pound. His mom offered him the breast each time he cried, approximately every one to one-and-a-half hours. Jeffrey was properly latched on to his fatigued and frustrated mother.

Although he was failing to thrive, the only counsel this mother received was to feed more often. Furthering her exhaustion, she was told to constantly carry Jeffrey in a sling. Immediately, we put Jeffrey’s mother on a 3-hour routine. To improve Jeffrey’s poor health, he was given a formula supplement. Within a few days, the starving child started to gain weight. After just a week, he was sleeping through the night. Jeffrey’s mother successfully breast-fed his subsequent siblings on the PDF plan with no weight-gain problems.
5. Feeding too infrequently. This problem can be attributed to either hyper-scheduling or AP demand-feeding. The mother who insists on watching the clock to the minute lacks confidence in decision-making. The clock is in control not the parent. The hyper-schedulist insists on a strict schedule, often nursing her baby no more often than every four hours. Enslavement to the clock is almost as great an error as a mother who is in bondage to thoughtless emotions.

Another side to the problem of infrequency is that some demand-fed babies demand too little food. As a result, the mother’s breast is not sufficiently stimulated for adequate milk production. Routine feedings with a time limitation between feedings eliminate this problem. That’s why neonatal and intensive care units stay close to a 3-hour feeding schedule. It’s healthy.
6. Not monitoring growth signs. Many moms simply fail to notice their baby’s healthy and unhealthy growth indicators. The Healthy Baby Growth Chart will assist you with this vital task.
7. Physical nurturing, holding, and cuddling, or the lack of it, can impact a child’s ability to thrive. It is more important that moms cuddle, hold, and talk to their babies frequently throughout the day. Your routine will help provide these periods, but mom should not be the only one cuddling the child. Dad, older siblings, grandma are few of your baby’s favorite people. More people, more love.

Infant-Related Causes
Slow weight gain or an absence of weight gain also may be directly related to your infant. Here are several possibilities.
1. Weak sucking. In this case, the child doesn’t have the coordination or the strength to suck properly, remain latched on, or activate the let-down reflex. As a result, the baby receives the low-calorie foremilk but not the high-calorie milk.
2. Improper sucking. This can result from a number of different conditions:
a) Tongue thrusting. When going to breast, sometimes a baby thrusts his or her tongue forward and pushes the nipple out of his or her mouth.
b) Protruding tongue. This condition is described as the tongue forming a hump in the mouth, interfering with successful latching on.
c) Tongue sucking. The infant suckles on his own tongue.
3. An underlying medical problem. A weak or laborious suck (for example, one in which the child tires to the point of giving up after a few minutes of nursing) can be a symptom of cardiac or neurological failing. If you suspect this may be the case, do not wait for your baby’s next scheduled checkup. Call your pediatrician immediately. There are many variables involved in successful breast milk production, and fortunately, your baby’s routine is a healthy one.

GETTING THE NECESSARY HELP
Contacting a Lactation Consultant
Even with all the classes we take, the plans we make, and books we read, sometimes nursing just doesn’t go well. It can be very frustrating in those first few days or weeks. There you are holding a crying, wiggling, red-faced (but cute), little bundle who can’t or won’t nurse. And all your interventions seem of no avail.

You may need help from a lactation consultant. These are professionals skilled in identifying and correcting lactation difficulties. Your pediatrician’s office, hospital, or clinic will often have a consultant on staff or can refer to one. We highly recommend you choose one who is licensed and board-certified. Be aware that those who practice independently tend to have higher fees than those who are affiliated with a medical practice. Check with your insurance company to find out if the cost is covered under your plan.

If you can, schedule you initial visit near a feeding time. Your consultant usually will want to observe the baby nursing. She will also weigh the infant and check to see that his suckle is correct. Next, a history will be taken, including questions about the length of labor, birth, birth weight of the baby, your diet, how often you are nursing the baby, and more. The information logged on your Healthy Baby Growth Chart is useful to the consultant. It provides an overall picture of how your infant is doing. Certain conditions like inverted or flat nipples, which can make nursing difficult, may be modified or corrected prenatal. If this is your situation, you might benefit by making an appointment with a consultant early in your third trimester.

Unfortunately, as a result of their training, many within the lactation, industry are heavily biased in favor of the attachment parenting theories and thus against any type of routine feeding. PDF is a new and major paradigm shift for the industry and not all consultants have a working understanding of routine breastfeeding dynamics. While some consultants are open and sensitive to you as a consumer and want to work with you as a mother to help facilitate your goals, others unfortunately are less receptive to your efforts. As a result, do not be surprised if the concept of putting a nursing infant on a “flexible routine” is question. Openly share actual feeding times and precisely what you are doing. Cite all the sources for feeding time recommendations found in Chapter Four.

Although parenting philosophies will differ, any technical lactation intervention is applicable whether you demand-feed or use a routine. If you hear something that does not sound right or seems extreme, consider getting a second opinion, keeping in mind what is normal for attachment parenting babies is not necessarily normal for PDF babies. Likewise, if you are told to feed your baby every hour-and-a-half, carry him in a sling, and sleep with him, consider looking elsewhere for a solution.

In some cases intervention and correction are immediate. In others, such as those infants who have a disorganized or a dysfunctional suckle, re-training the infant to suckle correctly will take some time and patience on your part. Depending on the circumstance, the lactation consultant might suggest using devices such as a syringe (minus the needle), finger-feeding, or a supplemental feeding device to help your infant learn to nurse. Sometimes these are effective. Other times they are not. They also can be time consuming to use. Discuss the choices with your husband and make your decision together. If you use a device, at some point reevaluate its effectiveness.

Breastfeeding proficiency is usually a matter of standard review in childbirth classes. For additional help, consider taking a breastfeeding class at your local hospital or renting a “how to” video. You can attend a class and learn proper techniques of breastfeeding without accepting the instructor’s personal parenting philosophies that sometimes accompany such classes. Remember to keep the issue of nursing in balance. Going the “extra mile” to correct a nursing difficulty or deciding to stop and bottle-feed instead, is not a positive or negative reflection on your mothering. What is important is that your husband and you decide what is best for your baby.

INSUFFICIENT MILK PRODUCTION
Regardless of which feeding philosophy you follow, you cannot add to what nature has left out. The anxiety created by the fear of failure is a contributor to milk deficiency. Because so much guilt is placed on mothers who are not successful at breastfeeding, many of them go to extremes to become milk-sufficient.

In most cultures, five percent of nursing mothers during peacetime and up to ten percent during wartime will not produce enough milk to satisfy their infant’s needs. Some mothers may initially be milk-sufficient but become insufficient by the third month. This sometimes happens even though baby is cooperative and sucking frequently and mom is using correct nursing techniques, receiving adequate food and rest, and has sufficient support from her husband and family.

If You Question Your Milk Supply
If at any time you question the adequacy of your milk supply, observe routine fussiness after every feeding, or your baby is having difficulty going the appropriate duration between feedings, review the external stresses in your life. Eliminate what you can, This is true whether baby is four weeks or four months old.

Ask yourself the following: Are you too busy or not getting enough sleep? Are you drinking enough liquids? Is your intake of calories adequate? Are you dieting too soon, or are you on birth control pills? Are you following your doctor’s recommendation for supplemental vitamins during lactation? Also consider the technical aspects associated with feeding. Is the baby positioned properly and latched on correctly? Is your baby taking a full feeding from both breasts?
1. If You Question Your Milk Supply in the First Two Months:
For a baby between three and eight weeks old, consider feeding on a strict 2.5-hour routine for five to seven days. If your milk production increases (as demonstrated by the baby becoming more content and sleeping better), work your way back to the 3-hour minimum. If no improvement comes, work back to three hours with the aid of a formula complement for the benefit of your baby and your own peace of mind.
2. If You Question Your Milk Supply in the Fourth Months:
The same basic principles apply to this age category. If your baby is between four and six months of age and you question your milk supply, try adding a couple of feedings to your daytime routine. One of our mothers, also a pediatrician, felt she was losing her milk supply at four months. She did two things. She added a fifth feeding to her day, and she stopped dieting. In less than one week her milk supply was back to normal.

Other mothers found success by returning to a fairly tight 3-hour schedule. Once their milk supply returned to normal, they gradually returned to their previous routine. If no improvement comes after five to seven days, consider a formula complement. Adding a few extra feedings during the day is not a setback in your parenting but is necessary to insure a healthy balance between breastfeeding and the related benefits of PDF.

THE FOUR DAY TEST
You may also want to consider the four-day test. This involves offering a complementary feeding of one to two ounces of formula after each nursing period. Then express your milk with an electric breast pump ten minutes per side. (Manual pumps are not effective for this purpose.) Keep tract of how much extra milk you are producing. If your milk is plentiful, then the problem lies with your baby. He or she is either not latching on properly or is a lazy nurser. If your milk supply increases as a result of pumping, which will be indicated either by milk expressed or by your baby not wanting the complementary feeding, then return to breastfeeding only, maintaining a 3-hour routine.

If additional stimulation from breast pumping doesn’t increase you milk supply and you have reviewed all of the external factors and found them compatible with nursing, then you may be among the five percent of moms who can’t provide a sufficient milk supply. Are you ready to give it up? Before you say, “That’s me” and quit for good, consider calling your pediatrician for advice, Ask if he or she knows of an older mother in the practices who was able to reverse this situation. You may also be referred to a lactation consultant. One final caution: Avoid extreme recommendations that can worsen your condition. Remember, different opinions abound. Learn and discern what is best for your family. Then make a commitment with no excuses needed.更多精彩文章及讨论，请光临枫下论坛 rolia.net

本文发表在 rolia.net 枫下论坛Day one. There’s no better time to begin thinking about your baby’s routine. While all the pieces may not fall into place for another three or four days, you should still be thinking about your long-term strategy now. Whether you have just one baby or a whole bushel, consistency of care will establish peace for all. At the heart of this plan lie three basic activities. Baby is fed. Baby is awake. Baby sleeps. With the exception of the late-night and the middle-of-the-night feedings when waketime is not necessary, this order shall not be altered.

For the first week, consistently achieving this sequence with your newborn may seem an insurmountable task. Let’s face it. Newborns are sleepyheads. You may find that after many of your feedings, baby drifts determinedly back to sleep. Attempts to keep this sweet bundle awake are simply not successful. This is okay. Wakefulness is a goal to strive towards. Exercise the effort now towards giving full feedings and by week two your baby will most likely fall into a predictable feed/wake/sleep routine. When this happens, you are off and running. With parent-directed feeding, your baby wins the ribbon of confidence knowing you, indeed, are in control.

How you first meet your baby’s nutritional needs says a world about your overall parenting philosophy. These moments of nurturing do far more than fill a little belly. With feeding, you are integrating life into your child and your child into life. Shouldn’t such a significant a process require a fully developed plan? Whether nourishment is provided by breast of by bottle, the guidelines which follow will assist in your success.

YOUR LIFESTYLE AND YOUR BABY
Rod and Colleen are a disciplined couple. They are neat, orderly, precise, and systematic in everything they do. There is a place for everything and everything is in its place. This couple would never dream of leaving a pair of muddy loafers at the back door. As early risers, they have jogged two miles, showered, and are prepared to sit down for breakfast by 6:30 a.m. Dinner is typically served at precisely the same time each evening, and the activities of the day are fairly predictable. Their lifestyle represents a tight routine.

If you feel Rod and Colleen have life just a bit too together, maybe you lean more towards the lifestyle of Dave and Kim. This couple seems comfortable with a little more flex in their lives. They appreciate things which are neat, orderly, precise and systematic but consider some types of confusion to be an art form. If the day doesn’t turn out as planned, it is no big deal. Sometimes they rise at 6:30 a.m. while other days they sleep longer. Perhaps they even daydream about an entire Saturday spent lounging in bed. Mealtime are anything but rigid but are easily worked in around the day’s activities. This lifestyle represents a loose routine.

Look at your spouse and you as a couple. Which of the two personal styles named above best represents your duo? Is life very predictable or are you comfortable with variations in routine? If you view life most like Rod and Colleen, you will have a tendency to establish for baby a tighter routine. In contrast, being a couple more like Dave and Kim mean feeding periods will have some flex to them. For example, some days Kim’s baby will receive his first feeding at 6:30am. Another day it may be 7:00am before baby gets food. When this happens, Kim automatically adjusts the baby’s morning routine based on this feeding. Regardless of either parenting style, your baby soon learns to fit with your personal style.

Whether you are a Rod and Colleen, a Dave and Kim, or any combination in between, flexibility is basic to your success. But what is flexibility? Many times we hear new moms say they want to be flexible. What does this look like? The word flexibility means the ability to bend or be pliable. When you think of a flexible item, you think of something with particular shape that can bend and then return to its original shape. Returning is perhaps the most crucial element of flexing. During the critical first weeks of stabilization, you are giving your baby’s routine its shape. Too much “flexibility” in these weeks is viewed by a baby as inconsistency.

Routine must first be established. After that, when necessary deviations are made, baby will bounce back to the original routine. Doing so, however, may require your firm guidance. The flexibility your desire will come, but give yourself time to develop your child’s routine. And remember, true flexibility is not a lack of routine but a temporary alteration of what you normally do.

YOUR BABY’S FIRST YEAR

Your baby’s first year is divided into four basic phases:

Phase 1: Stabilization. Birth through week eight
Phase 2: Extended Night. Weeks nine through fifteen
Phase 3: Extended Day. Weeks sixteen through twenty-four
Phase 4: Extended Routine. Weeks twenty-five through fifty-two

In this chapter, our focus is confined to feeding times and activities related to feeding. In the next chapter, we will focus on waketime activities and naptime.

PHASE ONE: STABILIZATION

Birth through Eight Weeks

During the first four or five days, a daily routine for most new mothers will be a continual repeat of a 2.5 to 3 hours cycle from the end of one feeding to the beginning of the next. Feeding times and sleep times initially will be more constant than waketimes. That again is due to the natural sleepiness of your baby during the early postpartum days. By the end of the first week, waketimes will start to become predictable and constant.

Both baby and mom need to achieve a few basic goals during this phase. For the breastfeeding mother, the establishment of stable milk production is the main objective. For baby, the stabilization of hunger metabolism as well as stabilized sleep/wake cycles are primary goals. An additional goal may be teaching your baby how to nurse. Between the end of the eighth or ninth week, 87% of PDF (Parent-Directed Feeding) girls and 77% of PDF boys begin sleeping through the night (7-8 hours). By twelve weeks both groups reach 97% success.

As a new parent, stay mindful of your newborn’s sleepiness. A newborn tends to fall asleep at the breast before he is done nursing; baby only wants to snack. The parents must keep him awake until a full feeding is over. Rub his toes, change his diaper, or share your deepest thoughts. Baby is a good listener and will enjoy the sound of your voice. Truly strive to keep him awake until after the feeding period is completed. Remember, exerting the extra energy will pay off soon enough. Plus, it’s a health issue. Babies who love snacking at the breast too often fail to get crucial hind milk rich in calories.

General Guidelines
Don’t underestimate the following six guidelines. Although simple, they will bring order to your life and make you a confident, more competent parent.

1. Understand how to calculate time between feedings. As previously mentioned, the time between feedings should be measured from the beginning of one feeding to the beginning of the next. In every feeding cycle, plan approximately 0.5 hour for feeding. For example, two-week-old Ryan was on a 3-hour routine. He received a feeding at 7am, when his mom nursed him 30 minutes up to 7:30. If Ryan receives his next feeding in 2.5 hours at 10am, then 3 hours will have elapsed from the start of one feeding to the start of the next. Keep in mind that the clock is only your guide. If your baby shows signs of hunger before her next scheduled feeding time, feed her.
2. Between weeks one and four, nurse your baby every 2.5 to 3 hours. Any combination within these time frames is acceptable. During these early weeks, stay close to these recommended times. These routine feedings will help to establish and stabilize both lactation and your baby’s metabolism. You want to average 8 to 10 feeding in a 24-hour period.

NOTE: If you need to awaken your baby during the day to prevent him or her from sleeping longer than the three-and-a-half-hour cycle, do so! Such parental intervention is necessary to help stabilize the baby’s digestive metabolism and help him organize his sleep. If you find that your baby just won’t wake up enough to feed, then give him an extra 30 minutes sleep and try again. The exception to this guideline comes with the late-evening feedings. After the late-evening feeding, usually 10 or 11pm, let the baby sleep as long as he will, but never more than five hours if your are breastfeeding. When he does wake, feed him and put him right back to bed.

3. After the first week, starting with the early morning feeding and continuing through the mid-evening feeding, all three activities will take place-feeding time, waketime, and naptime. During the late evening and nighttime segment, there should be no extended wake periods. Feed your baby and put him or her right back to bed.
4. Between weeks five and eight, starting with your early morning feeding and continuing through the mid-evening feeding, you will feed your baby every 2.5 to 3.5 hours. Any time increment between those two times is acceptable. Even with an increase in time flexibility, plan an average of eight feedings a day. Understand that some babies may need to feed more often, other less. One question commonly asked is “At this age, my baby is doing well with only seven nursing periods a day. Should I try to force an eighth feeding?” Some babies do well with seven feedings by this age. Remember, the premise of PDF is that you, the parent, are directing feedings based on your assessment of your baby’s needs. Regardless of what number you think is right for your baby, stay mindful of all healthy baby indicators.
5. When you establish your baby’s routine, first consider all your activities such as grocery shopping, work, exercise, household chores, and church attendance. There will be times when your baby’s routine will change to fit into your schedule. Other times, you will plan your activity around your baby’s needs simply because it is more practical to do so. With a routine, you are subject to the irregular needs of the child.
6. Determine the time of your day’s first feeding. This time will be fairly consistent each day and may initially be set by both your baby and you. Make certain you establish one. This, too, will help organize your baby’s feed/wake/sleep cycles.

Summary of Phase One
By the end of eight weeks, the stabilization phase is usually complete. By this time, your baby should be sleeping through the night on a regular basis or very close to achieving the skill. If she is not, don’t worry. Approximately 15% of PDF babies will start sleeping through the night between weeks ten and twelve. At this point, they catch up to all the other PDF babies.

The number of feedings in a 24-hour period will be seven to nine before your baby is sleeping through the night, and seven to eight feedings afterwards. Although you will be dropping the nighttime feeding at this point, you will not be reducing your baby’s caloric intake, just rearranging feeding times. Babies tend to compensate for the one lost nighttime feeding by consuming more milk during other periods.

You may need to maintain a seventh or eighth feeding period for four to five days after your baby initially begins sleeping through the night. Sticking close to a 2.5 to 3 hours routine will help facilitate that goal. Some mothers find those times more in line with their comfort zone and stay there several weeks. Most PDF moms are comfortable alternating between a 2.5 and 3.5 hours routine, getting in six good nursing periods.

Feeding at Intervals Less Than Two and One-half Hours
As previously stated, your baby’s normal feeding periods fall between 2.5 and 3.5 hours intervals. But there are times when you may feed sooner than those time increments. For example, the late afternoon for many nursing mothers is usually when their milk supply is at its lowest point quantitatively and qualitatively. That is usually due to mother’s busy day. As a result, there may be an early evening feeding as soon as two hours since the last.

There may be medical reasons for feeding a child more frequently. For example, some premature newborns or very small full-term infants, such as those with intra-uterine growth retardation, may need to feed as often as every two hours initially. In addition, if your child has jaundice and requires the use of phototherapy lights, he will lose more fluids from exposure. Therefore, he may need to feed more frequently. Your doctor will direct you in this area.

Your late evening feeding, falling somewhere between 8:30 pm and midnight, is another example of when you might drop below the 2.5-hour mark. Some mothers feed their babies at 8:30pm and then again at 10:30pm. Here the decision to feed within two hours is a practical one. Now both mom and baby can go to bed earlier. The point is that it is okay to deviate from the 2.5 to 3 hours feeding norm, but do not deviate so often that you establish a new norm.

What should you do if your baby sleeps through the night only to awaken at 5am when his normal routine does not officially start until 6:30am? You have three choices. First, you may wait ten to fifteen minutes to make sure he is truly awake. He may be passing through an active sleep state to deeper sleep. Second, you can feed your baby and then put him back down. You can then awaken him at 6:30 or 7am and feed him again. Although that is less than three hours and he may not take much at that feeding, the advantage will be that your baby stays on his morning routine. Finally, a third option is to offer a feeding at 5am, treating that as your first feeding of the day. In that case, you would adjust the rest of the baby’s morning schedule so that by early afternoon he is back on his daily routine.

CONSIDERING CONTEXT AND BEING FLEXIBLE

Earlier we talked about being flexible. What does it look like and how do you know what circumstances call for flexibility? Most notable in a person who lacks flexibility is his or her rejection of context. Responding to the context of a situation does not mean suspending the principles of PDF. Rather, you are able to focus on the right response in the short term without compromising your long-term objectives. As stated above, there will be times when a situation dictates a temporary suspension of the guidelines. Remember you are the parent, endowed with experience, wisdom, and common sense. Trust these attributes first not an extreme emotion or the rigidity of the clock. When special situations arise, allow context to be your guide.

Here are some examples of context and PDF flexibility:

1. Your two-week-old baby boy was sleeping contentedly until his older brother decided to make a social call. Now, big brother notifies you that baby is awake and crying. Another thirty minutes is left before his next scheduled feeding. What should you do? First, you can try settling the baby back down by patting him on the back or holding him. Placing him in his infant seat is a second option. A third option is to feed him and rework the next feed/wake/nap cycle. (Also, instruct the older brother to check with you before he visits his sleeping sibling.)
2. You are on an airplane and your infant daughter begins to fuss. The fussing grows louder. You fed her just two hours earlier. Yet, failure to act will stress you, not to mention the entire jet fll of people. What should you do? Your solution is simple; consider others. Don’t let your baby’s routine get in the way of being thoughtful toward others. You can either attempt to play with your baby and entertain her, or you will feed her. Although you normally would not offer food before three hours have passed from your last feeding, the context of the situation dictates that you suspend your normal routine. When you arrive at your destination, get back to basics. There’s your flex!
3. You have been driving for 3 hours which is your baby son’s normal time between feedings. Your baby is still asleep, and you have another forty minutes to travel. As a parent in control, you may choose to awaken your baby and feed him (pull over first) or wait until you get to your destination.
4. You just fed your baby daughter and dropped her off at the church nursery or with your babysitter. You are planning to return within an hour and a half. Should you leave a bottle of breast milk or formula just in case? Most certainly, yes. Babysitters and nursery workers provide a valuable service to young parents. Because their care extends to other children, they should not be obligated to follow your routine exactly as you do. If your baby fusses, you will want the caretaker to have the option of offering a bottle (even though it will have been less than three hours). It won’t throw your child off her routine to receive early feedings a few times each week.

Most of your day will be fairly routine and predictable, but there will be times when you may need more flexibility due to unusual circumstances. Your life will be less tense if you consider the context of each situation and respond appropriately for the benefit of everyone. Right parental responses often determine whether a child is a blessing to others or a source of discomfort.

SAMPLE SCHEDULE

Below we have provided a sample schedule which can be personalized for you and your baby. Remember our basic suggestions. There is feeding time and waketime, followed by naptime. After the first couple of weeks when life settles down from the newness of having a baby around the house, your schedule will begin to take shape. The following is an example of what life might look like for you in a couple of weeks or sooner. The various activities listed alongside the waketimes are suggestions. This work sheet is based on eight feedings in a 24-hour period and is a guide for your first six to eight weeks.
TIME WHAT TO DO
Early Morning______am 1. Feeding and diaper change.2. Waketime: Rock your baby and sing; place your baby on his or her back in the crib to watch a mobile.
Mid-morning_______am 1. Feeding and diaper change.2. Waketime: Take a walk with your baby, run errands, or visit neighbors.3. Put your baby down for a nap.
Afternoon________pm 1. Feeding and diaper change.2. Waketime: Bathe your baby and place him or her in an infant seat near a window.
Mid-afternoon________pm 1. Feeding and diaper change.2. Waketime: Play with your baby; have him or her by your side as you read or sew.3. Put your baby down for a nap.
Late Afternoon________pm 1. Feeding and diaper change.2. Waketime: Family time.3. Put your baby down for a nap.
Early Evening________pm Feeding, diaper change, possible waketime, then put your baby back to bed.
Late Evening________pm Feeding and diaper change, then put your baby back to bed. NOTE: For many babies, this feeding is the last scheduled feeding of the day. If this is the case with your baby, do not wake him for his next feeding. Let him wake up naturally. (If you’re breastfeeding, we do not recommend that you let your baby go longer than five hours at night for the first four or five weeks.)
Nighttime________am Feeding and diaper change, then put your baby back to bed.

When a breast-fed baby initially begins sleeping through the night, mom may experience some slight discomfort for the first couple of mornings. For some of these moms, it may take a couple of days for their bodies to make the proper adjustments to the longer nighttime sleep. If you feel uncomfortable after the first morning feeding, pump until you are comfortable. This will be temporary. Within a week’s time, both mom and baby should have adjusted to their new sleep/wake patterns.

PHASE TWO: EXTENDED NIGHT
Weeks Nine thorough Fifteen

During this second phase, a breast-fed baby can gradually extend his nighttime sleep to nine to ten hours and a bottle-fed baby can go eleven hours. Remember that breastfeeding mothers must stay mindful of their milk production. Letting your baby sleep longer than nine or ten hours at night may not allow you enough time during the day for sufficient stimulation. That is not true for all mothers, but it is for some. Therefore, if you are breastfeeding and are concerned about a decrease in your milk supply, we recommend that you not let your baby sleep longer than ten hours at night during this phase.

Bedtime during this phase will be adjusted closer to the early-evening feeding. By the end of the thirteenth week, your baby should average five to six feedings a day but never fewer than four.

PHASE THREE: EXTENDED DAY
Weeks Sixteen through Twenty-four

Usually between the sixteenth and twenty-fourth weeks, you will introduce your baby to solid foods. Your pediatrician will direct you in this area. Along with solid foods, continue with four to six liquid feedings per day. During phase three, most babies are sleeping ten to eleven hours. Again, Breastfeeding mothers must continually monitor their milk supply. If you feel you need to add an additional feeding during the day, do it.

By the twenty-fourth week your baby’s mealtimes should begin to line up with the rest of the family’s breakfast, lunch, and dinner, with a fourth, fifth, and for some a sixth liquid feeding at bedtime. As you begin introducing solids to your baby’s diet, please note that you are not adding more feeding periods, just additional food at breakfast, lunch, and dinner. If you are breastfeeding, nurse first and then offer some cereal. If you are bottle-feeding, offer some formula, then offer cereal, followed by formula. Do not offer cereal alone with a supplemental liquid feeding two hours later. That would mean you are feeding every two hours which is not a healthy habit. Introducing solid foods is a topic discussed in detail in Preparation for the Toddler Years. As a breastfeeding mother, try to maintain four to six feeding periods as long as you are nursing; any fewer may decrease your milk supply.

PHASE FOUR: EXTENED ROUTINE
Weeks Twenty-five through Fifty-two

Between the ages of six months and twelve months, your baby will continue to feed on three meals a day. Each meal will be supplemented by baby food with an optional fourth liquid feeding before bed. At this age, your baby should be taking two naps averaging from 1.5 to 2.5 hours in length. Continue with four to five nursing periods during the day. This same general rule applies to formula-fed babies.

SUMMARY OF FIRST-YEAR FEEDING

For easy reference, the following summary of your baby’s first year of feeding is provided.

Phase One: Weeks One through Eight
Start with eight or more feedings for the first two to three weeks. After that, you may average eight feedings daily over the course of the next six weeks. The number of feedings will depend on whether you begin with a flexible 2.5- to 3-hour routine or a strict 2.5- to 3-hour routine. By the end of this phase, you should be averaging seven to eight feedings in a 24-hour period and most likely will not have a middle-of-the-night feeding.

Phase Two: Weeks Nine through Fifteen
From the beginning of this phase until the end of it, most PDF moms transition from seven or eight feedings down to five to seven feedings in a 24-hour period. (Please note these are averages not absolutes. Between weeks twelve and fifteen, most babies easily go to a combination 3- to 4-hour routine and drop the late-evening feeding.)

Phase Three: Weeks Sixteen through Twenty-four
Your baby will maintain four to six liquid feedings in a 24-hour period, three of which will be supplemented with baby food.

Phase Four: Weeks Twenty-five to Fifty-two
The process of moving a child to three meals a day should be nearly completed by the beginning of this phase. Remember that at each meal there needs to be a time of nursing plus a fourth nursing period just before bed.

HOW TO DROP A FEEDING

By dropping a feeding, we do not mean your baby will take in less food over a 24-hour period. Actually, the amount of food will gradually increase, but the frequency of feedings will decrease. As your baby begins taking in more food at each feeding and his metabolism stabilizes, you will begin dropping a feeding period. Three common ways to do this are as follows:
1. Change from a 3-hour to a 3.5-hour schedule or from a 3.5-hour to a 4-hour schedule. If you have to consistently wake your baby for his or her daytime feedings, this is a strong indication the baby can go longer between feedings. Generally, your baby will be capable of moving to a flexible 3- to 4-hour routine by three month of age.
2. Drop the middle-of-the-night feeding. Many babies drop this feeding on their own between the seventh and ninth week. One night they simply sleep until morning. Some babies gradually stretch the distance between the 10pm and the 6am feedings.

There are some little ones whose internal clocks get “stuck” at the nighttime feeding. Parental guidance can help reset that clock. If you have a digital timepiece and notice that your baby is waking at nearly the same time each night, that’ s a strong indicator that his or her biological clock is stuck. To correct the problem, wait for a weekend when no one has to get up early for work. (You may want to sleep in if your sleep is disturbed by your baby’s crying during the night.) When your baby awakens, don’t rush right in to him or her. Any crying will be temporary, lasting from five to forty-five minutes. Remember, this will be temporary! Some parents fear that failing to respond right away will make their baby feel unloved or insecure. On the contrary, it’s cruel not to help your child gain the skill of sleeping through the night. Taking the baby into bed with you will delay the learning process. Generally, it takes three nights to establish a new routine that allows for continuous sleep for both mom and baby.

3. Drop the late-evening feeding. This process occurs anywhere from two months of age on and is usually the trickiest feeding to eliminate. Having grown accustomed to sleeping all night, some parents are reluctant to drop the late-evening feeding for fear that the baby will awaken in the middle of the night starving.

Sometimes, in the process of eliminating feeding, bending a guideline may be necessary. If we assume your baby is on a 4-hour schedule (6am, 10am, 2pm, 6pm, and 10pm) and you think he or she is ready to drop the last feeding, then instead of eliminating the 10pm feeding completely, try backing it up fifteen minutes per day until you arrive at the time you desire. For a while, your baby’s last two feedings of the day may be less than three hours apart which is permissible during this transition time. The rest of the day’s schedule may need to be adjusted so that you end up with a new 4-hour format which looks like this: feedings at 8am, 12pm, 4pm and 8pm (or whatever times best suit your family).更多精彩文章及讨论，请光临枫下论坛 rolia.net

本文发表在 rolia.net 枫下论坛In this chapter we will examine the last two activities in your baby’s routine-waketime and naptime. Much of what is discussed in this chapter deals specifically with a child who is at least one week old. That statement is not to suggest that parental guidance is not necessary in the first week, but that a baby is better able to respond to your leadership starting in week two when life begins to settle for both of you.

One of the most common mistakes made when following a routine is to reverse the order of these last two activities by putting the baby down for a nap right after his or her feeding. This will be one of your greatest challenges during the first week. Babies are usually sleepy during the first several days causing some to fall asleep right at the breast after a few minutes of nursing. That means you have to work on keeping your baby awake to take a full feeding. (You can rub his feet, stroke his face, change a diaper, talk to him, or remove his sleeper, but he must eat.) Snacking five minutes every hour is not a full feeding. Mothers who work to get a full feeding during the first week have a baby who naturally transitions into a consistent 3-hour routine within seven to ten days. Keep this goal in mind when putting in the extra effort. The payoff comes in confidence and comfort for both baby and you.

Even with all this encouragement, there may be a meal or two that your baby will not wake up sufficiently to take a full feeding. What will you do in those times? If your attempts to keep him awake fail, then put your baby down to sleep; but work on feeding him again in an hour or two or anytime your baby signals hunger readiness. The newness of parenting can bring about some anxious moments, especially if you have a sleepyhead on your hands. But rest assured, in a few days life will become more predictable for you and your baby, and your planned pattern of routine feedings, with your baby completely participating, will begin to take shape.

Waketime activities include times when you and your baby will be together and times when your baby will explore his or her new world alone.

MOM, DAD, AND BABY TOGETHER

Feeding: Whether bottle- or breastfeeding, you will spend much of your baby holding your baby while feeding him or her.

Singing: At birth, a baby responds to his or her mom’s and dad’s voices. Talk and sing to your baby during waketimes, remembering that learning is always taking place.

Reading: It’s never too soon to read to your baby or to show the baby colorful picture books (especially cardboard or plastic ones that the baby can explore more on his or her own). Your infant loves to hear the sound of your voice and inflections. Read your Bible devotions out loud to your baby.

Bathing: This is another pleasant routine for you and your baby. You can sing, tell your child which part of his or her body you are washing, or just have fun splashing.

Walking: Taking time for a stroll outside is great for you and your little one. You can sing or talk while you are walking, and the fresh air is good for both of you.

Playing: Initially, you can’t play much with a newborn. A few early play activities are flirting, smiling, talking, gently moving his or her arms and legs, and, of course, cuddling with your newborn. This is more than fun; it is a necessary way to express physical love to him or her.

BABY ALONE

Pictures: Putting bright pictures and patterns around the nursery is a great way to stimulate your baby visually.

Mobiles: Moving, musical mobiles help your baby learn to track with his or her eyes.

Gym: Crib gyms and objects that dangle over your baby and rattle when he or she bats at them help to develop hand-eye coordination. Batting is the necessary preparation for reaching out and holding objects. (For safety’s sake, the crib gym should not be dangled over the baby once the child learns to sit up.)

Swing: Putting a baby in a swing allows your infant to watch what is going on around him or her. Swings are especially helpful for calming fussy newborns; however, don’t get into the habit of letting you baby fall asleep in a swing since the child needs to learn to fall asleep without this prop.

Infant Seat: This item provides another way you can help your baby sit up and take notice of the world. Sometimes toys or books can be hung from an overhead handle.

Playpen: Start at one month of age with the playpen. A four-week-old baby can spend some waketime in an infant seat placed inside the playpen in view of a mobile. Also, allow the child to take a nap in the playpen once a while.

Having some of this equipment-whether new, used, or borrowed-is helpful, but it is certainly not a necessity. In addition to feeding, changing, and bathing your baby, you might have at least one playtime a day when the baby has your full attention for fifteen minutes or so. Dad also needs to spend time each day with the baby in addition to possible feeding times.

NAPTIME

Naps are not an option based on your baby’s wants. When naptime comes, the baby goes down. It is that simple. For optimal development, infants need daytime rest. While following your feed, wake, and sleep routine for your newborn, you should plan that the last 1 to 1.5 of your 2.5-hour cycle will be for a nap. When moving a 3-, 3.5-, and in time a 4-hour routine, your baby’s naps will range anywhere from 1.5 to 2.5 hours.

NOTE: If your baby during the first two months is not napping well, try cutting back on his waketime by 15-minute increments. Some babies become over-stimulated during waketime and have difficulty settling in for a nap. The fatigued or over-stimulated child becomes hyper-alert, fighting off sleep through crying. If this is a regular problem for your baby, shorten his waketime.

There may be a brief period of fussing or crying when you put the baby down for a nap. Don’t be deterred from doing what is best for the child. Some crying is normal part of a baby’s day and some babies will cry a few minutes in the process of settling themselves to sleep. The future trade-off will be a baby who goes down for a nap without fussing and wakes up cooing.

When settling for a nap, crying for15-20 minutes is not going to hurt your baby physically or emotionally. Your baby will not lose brain cells, experience a drip in IQ, or have feelings of rejection that will leave him manic-depressive at age 30. You do not undo all the love and care of the waking hours with a few minutes of crying. On the other hand, if you want a fussy baby, never let him cry; hold, rock, and feed him as soon as he starts to fuss. We guarantee you will achieve you goal.

SLEEPING PATTERNS

Unlike feeding patterns, infant sleep behavior has more variation due to individual differences. Remember, stable sleep patterns are based on stable feed/wake patterns. When there are a number of changes in these two activities, there will be corresponding changes in his sleep patterns.

Newborns
Newborns can sleep 16 to 20 hours per day, including the periods of sleep between each feeding. With the parent-directed feeding approach, this sleep will come in six to eight naps (depending on the number of daily feedings). When your baby has been up for the appropriate amount of time (which may only be a total of 45 minutes including feeding time) and he begins to show signs of fussiness, it is time for a nap.

Two Months
If you follow the principles of PDF, this will be the period when your baby drops his or her nighttime feeding and begins sleeping seven to eight hours continuously. Naps during the day should be at least 1.5 hours long. Eighty percent of PDF babies begin sleeping through the night on their own without any further parental guidance apart from routine feedings. It just happens. Some periods of night crying were experienced for the remaining 20% of children. Most of this took place over a three-day period and the crying bouts averaged between five and thirty-five minutes in the middle of the night. On average it took three to five days for a nine-week-old to establish unbroken sleep cycles at this age.

NOTE: It’s not unusual for two- or three-month-old PDF babies to awaken at around 5 or 5:30am and talk to themselves for up to an hour. Afterward, they usually go back to sleep for another hour or so. This quirky phase can go on for a week or up to a month. If you start to respond each time you hear a noise from the cradle, then 5am will become your baby’s waketime-and yours, too.

Three to Five Months
During this period, your baby will drop his or her late-evening feeding, leaving four to six feeding periods during the day. Nighttime sleep will average ten to twelve hours. The baby will have three daytime naps between one-and-a-half and two hours in length, resulting in a longer waketime. Once the third nap is dropped, both waketimes and the remaining naptimes will increase in duration.
Six to Sixteen Months
Your baby will drop his late-afternoon/early-evening nap at around six months of age, leaving two naptimes: one in the morning and one in the afternoon. The naps are usually each about one-and-a-half to two hours long. (For more information on this period of development, please read Preparation for the Toddler Years.)

Sixteen Months and Older
Between 16 and 20 months, the morning nap is dropped. Your baby should be sleeping ten to twelve hours at night and two to three hours during one afternoon nap.

WAKING UP HAPPY

Between four and six months of age, infants generally develop a wakeup disposition that you highly influence. Your baby’s disposition can be happy and content when you follow three basic rules for naps.
Rule 1: Mom, not baby, decides when the nap starts.
Rule 2: Mom, not baby, decides when the nap ends.
Rule 3: If your baby wakes up crying and cranky, it’s most often because he or she has not had sufficient sleep. Other factors to consider are a dirty diaper, a noise neighbor, sickness coming on, or an arm or leg stuck between the crib slats.



After having been put down for a nap, your baby will move from an active sleep state to relaxed sleep in 30 to 45 minutes. In the next 30 to 45 minutes, he or she will move from relaxed sleep back to active sleep. At the end of that cycle, your baby may begin to stir and cry. Parents often interpret this to mean naptime is over. Going in to pick up the baby, they assume the child’s crankiness is his or her natural way of waking up, but that is not the case.

If your baby is waking up cranky or crying, he or she is most likely not getting enough sleep. Even though he or she may cry, your baby will probably go right back to sleep in ten minutes for another 30 to 40 minutes of rest. When your baby gets enough sleep, you will notice a happy disposition; the baby will make happy, cooing sounds, letting you know it’s time to get him or her up.

SUMMARY

When your baby starts to sleep through the night, people will invariable say, “You’re just lucky” or “You’ve got an easy baby.” Neither statement is true. Your baby is sleeping through the night because you trained him or her to do so. You can take the credit for your success. Remember, getting your baby to sleep through the night is not the final goal of parenting, but we believe it does represent a right beginning.更多精彩文章及讨论，请光临枫下论坛 rolia.net