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What can I do myself?

If you breast feed, it is essential that you consume an adequate diet. Typically a nursing mother needs to consume about 2,200 to 2,400 calories per day, and more if she is very active herself. She should also consume adequate fluids, 10 to 12 glasses per day, to make milk. Following are the minimum numbers of servings from the basic food groups that are recommended for a nursing mother:

• Protein - 3 servings.
• Dairy foods -4 servings.
• Starches - 4 or more servings.
• Fruits/vegetables — 4 or more servings.
• Fats/oils - 2 tablespoons.

The baby's nursing stimulates the mother's body to
produce milk. As the baby
requires more food, the
mother's body responds by
making more milk. The
woman should alternate
breasts from feeding to feeding, and "burp" the baby at
intervals during feeding and
afterwards to get rid of any
swallowed air that may later
produce painful gas.

If a bottle is used, the caregiver should hold the baby rather than prop the bottle. This promotes parent-baby bonding and also ensures that the bottle is in the proper position and that the baby does not choke. Since a bottle-fed baby is more apt to swallow air than one who is breast fed, burping is even more important and may have to be done several times during a single feeding.

When should I see my doctor?

You should consult your doctor if your baby does not seem to be growing at the proper rate. Typically, a baby should grow

Although breast milk provides all the nutrition a baby needs for the first 6 months or so, solid foods can be introduced, one at a time, when the infant is 4 to 6 months old. Bottle-fed babies may need solid foods earlier than breast-fed babies. If a food does not agree with the baby, or if the baby dislikes it, don't worry. Offer a substitute and try the food again in a few months.

at a steady rate, gaining a few ounces every week and doubling his or her birth weight in the first 4 or 5 months of life. There may be periods of accelerated growth, during which a baby is more hungry than usual, interspersed with a slow down during which the baby eats less. This is normal. What is important is that the baby progresses at a steady rate within his or her general percentile on the growth chart. Any marked change in either direction may be cause for concern and you should consult your doctor.

Bladder and bowel function also indicate whether the baby is getting enough to eat. In general, a newborn baby should produce 6 wet diapers a day. Bowel movements vary from baby to baby. In the first few weeks, breast fed babies tend to have more bowel movements than those that are bottle fed. Their stools are generally odorless or slightly sour smelling, pale yellow to dark green in color, and soft to watery in consistency. In contrast, a bottle fed baby may have less frequent bowel movements, and may even be constipated. The stools tend to be smellier and darker in color than those of a breast-fed baby.

After 6 to 8 weeks, the baby's bowel pattern is likely to change. Some babies may go for several days without a bowel movement. Frequency is not important so long as the stool is soft and passed without straining. In contrast, diarrhea in a baby can be serious, and warrants a call to your doctor if

it persists for more than a day or if there are other symptoms such as a fever or a rash.

Excessive intestinal gas or distress after eating is also an indication to see your doctor, especially if the baby is bottle fed. He or she may be sensitive to cow's milk and require a special formula. Or if you are breast feeding, something in your diet may disagree with the baby's digestive system.

What will the doctor do?

The doctor weighs the baby and examines him or her for any sign of nutritional deficiency. If a food sensitivity is suspected, a special formula (or diet for the mother) may be recommended. Diarrhea should be treated to prevent dehydration. If the baby is not getting enough to eat, a supplement may be recommended, or more frequent feedings may be advised.

If the baby is gaining too much weight, the doctor may recommend cutting back a bit on feeding. Obesity often begins with instilling faulty eating habits in a baby. For example, many new parents resort to feeding as a means of quieting a crying baby. Parents should not assume that every cry means the baby is hungry. Some babies cry because they want to be held or want other attention. Parents should learn to recognize a hungry cry from others, and avoid giving food simply to quiet a fussy baby. This practice can lead to overfeeding, obesity, and a life-long weight problem.

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