Infant Feeding: Lessons from a Pediatrician and Mom
By Dr. Anjana Trivedi, DO, FAAP, Pediatrician and Sakhee Advisor
A compassionate guide to the unpredictable realities of infant feeding - what’s normal, what’s not, and practical tips to navigate breastfeeding, supplementation, and support with confidence.
As a pediatrician, I thought being a new mom was going to be easy. I had learned everything I needed to know in medical school and residency. I even read a few extra books before my first baby was born, so I would know even more about the newborn period and breastfeeding.
Well, my baby was born, and I quickly realized how little I knew!
Feeding an infant was not as natural a process as I had anticipated. One of the biggest lessons I learned is that things don’t go as planned. You cannot keep a strict schedule or expectations. Instead, you need to learn to listen to not only what your baby is telling you, but also what your own body is saying. As moms, if we are not feeling well physically or psychologically, it will be harder to feed our baby.
Normal vs. Worry: What We Look for in the Office
I like to see new babies and moms frequently in the office to check in emotionally and physically. During these visits, in addition to many things, I am especially looking at weight gain, feeding issues, jaundice, and your emotional state.
Here is a quick guide to what is normal and when we start to pay closer attention:
Weight Gain: Babies normally lose weight within the first few days of delivery. We worry more if they lose 10% from their birth weight or do not get back to their birth weight by 2 weeks old.
Wet & Dirty Diapers: I always like to know how many wet diapers your baby has had in the past 24 hours and how many times they’ve pooped.
The “Poop” Transition: I will also check the color of the poop and consistency. Poop usually starts as a dark, sticky color and slowly transitions to a yellow, watery, seedy color. People often think it looks like diarrhea, but that is actually normal.
Bilirubin: It is also routine for hospitals to check bilirubin levels, and we may need to recheck these levels in the office to monitor for jaundice.
Navigating the Latch
Poor latch is a common issue at the start - breastfeeding is not as “natural” as it should be! Most often, babies simply need to be repositioned to help them feed better. Here are a few common breastfeeding positions you can try.
There is a lot of information on social media these days about tongue and lip ties. In practice, this is not always a concern, and often a different feeding position solves the issue without additional procedures. If you are worried about this, please ask your pediatrician or a lactation consultant.
When Supplementing is Necessary
When I see that babies are losing too much weight or have issues with jaundice, I usually recommend supplementing with formula or pumped breast milk. I never want moms to give up on nursing if that’s what they want to do, but giving a little extra formula can go a long way.
Syringe Feeding: I generally recommend a mom-nurse and then feed a small amount of formula (or pumped milk) via a syringe after the nursing session.
Avoiding Nipple Confusion: I suggest syringe feeding because sometimes babies can get nipple confusion. Bottles are much easier to feed out of than the breast, and we want to be careful the baby doesn’t get too used to the bottle early on. Dad or another family member can help with this part.
Grace for Exhaustion: That being said, if you are exhausted and syringe feeding is not going well, a bottle is okay!
The Struggle with Sleepy Babies
Babies can be very sleepy, and it can be hard to keep them awake for a full feed. If they don’t get a full feed in, they may wake up 20 minutes later and want to feed again, which is exhausting for everyone.
To keep them awake, try these tips:
Keep them as lightly dressed as possible.
If they fall asleep, take a break to change their diaper.
It may sound unkind, but a slight flick on the bottom of their foot or a cool washcloth on their belly while feeding can help wake them up.
It Takes a Village
Feeding a newborn can take a village - don’t be afraid to ask for help. No question is silly. Lactation consultants and support groups are amazing sources of information, and it is so helpful to be with other moms who are going through the same thing you are.
Resources for Support
Your Pediatrician: Always reach out if you have concerns about weight, jaundice, or your baby’s feeding patterns.
Sakhee Postpartum Support: Schedule a consultation for personalized guidance through the early weeks of parenthood.
Lactation Support: Reach out to an IBCLC (International Board Certified Lactation Consultant) or join a local lactation support group.