Nutrition and Feeding
Breastfeeding
Colostrum is small in volume and sufficient. Feed on cues 8–12 times per 24 hours - not by the clock. Assess latch (wide gape, flanged lips, chin to breast, audible swallow, no nipple pain) and output: at least one void and stool on day 1, rising to six or more voids by day 5–6. Weight loss up to 7–10% by day 3–5, with regain to birth weight by 10–14 days. Frequent early feeding is the main defense against hyperbilirubinemia and hypoglycemia.
Supplementation and support
Indications include hypoglycemia unresponsive to feeding, weight loss over 10%, inadequate output with delayed lactogenesis, maternal illness or medication, galactosemia (absolute contraindication), and an active herpetic lesion on the breast. Supplement with expressed milk or formula - never water or cereal. Teach pumping when separated and human milk storage limits (fresh at room temperature up to about 4 hours, refrigerator up to 4 days, freezer up to 6 months). Exclusively breastfed infants need vitamin D 400 IU daily and iron from about 4–6 months.
Formula feeding
Standard term formula is 20 kcal/oz. No cow's milk or water before 12 months. Use paced, cue-based bottle feeding and correct dilution - over-concentrated formula causes hypernatremia, over-diluted formula causes water intoxication.
Traps
"Feed every 4 hours," "give water between feeds," "supplement so the baby sleeps," and treating nipple confusion as an absolute rule. A jaundiced, sleepy infant is not a reason to skip feeds.