1.Open milk as early as possible after delivery, insist that the first food for newborns is breast milk
【Summary
Colostrum is rich in nutrients and immunologically active substances that help the development of intestinal function and provide immune protection. After delivery, the mother should start breastfeeding as soon as possible, so that the baby can start sucking on the nipple, get colostrum and further stimulate lactation and increase milk secretion. The infant’s first food after birth should be breast milk to help prevent infant allergies and to reduce the incidence of neonatal jaundice, weight loss and hypoglycemia. In addition, allowing the infant to suckle repeatedly on the nipple as early as possible is the key to ensure successful exclusive breastfeeding. When babies are born, they have certain energy reserves in their bodies to meet their metabolic needs for at least 3 days; there is no need to worry about newborns’ hunger during the breastfeeding process, and they can pay close attention to their weight, and they should insist on exclusive breastfeeding as long as their weight loss does not exceed 7% of their birth weight. Ancillary factors such as warm environment, pleasant mood, spiritual encouragement and breast massage can help smooth and successful initiation of breast milk. Preparation for breastfeeding should start from the beginning of pregnancy.
【Key recommendation
1. Start to let your baby suckle on the nipple repeatedly as early as possible after delivery.
2.The baby’s first food after birth should be breast milk.
3.Exclusive breastfeeding should be insisted on as long as the weight loss after birth does not exceed 7% of the birth weight.
4. Babies do not need to wipe or disinfect their nipples excessively before sucking.
5.Ancillary factors such as warm environment, pleasant mood, mental encouragement and breast massage can help to open the breast smoothly and successfully.
2. Insist on exclusive breastfeeding within 6 months of age
Summary】
Breast milk is the most ideal food for infants, and exclusive breastfeeding can meet all the liquid, energy and nutrients needed by infants within 6 months of age. In addition, breast milk facilitates the establishment of a healthy intestinal micro-ecological environment and maturation of intestinal function, reducing the risk of infectious diseases and allergies. Breastfeeding creates an environment of emotional communication between mother and child, giving infants the greatest sense of security and facilitating their psycho-behavioral and emotional development; breast milk is the best nutritional support, and breastfed infants are the smartest. Breastfeeding is economical, safe and convenient, and at the same time helps to avoid maternal postpartum weight retention and reduces the risk of maternal breast cancer, ovarian cancer and type 2 diabetes. Exclusive breastfeeding should be adhered to for 6 months. Breastfeeding requires the efforts of the whole society, technical guidance from professionals, and active support from families, communities and workplaces. Make full use of policies and laws to protect breastfeeding.
[Key Recommendations
1. Exclusive breastfeeding can meet all the fluids, energy and nutrients needed by infants up to 6 months of age, and should be insisted on for 6 months. 2. Feed on demand, alternating between both breasts; breastfeed 6~8 times a day or more.
2. Insist that infants suckle directly from breast milk and do not use bottles for indirect feeding of artificially expressed breast milk as much as possible.
3.If special circumstances require the addition of complementary foods before the age of 6 months, a decision should be made carefully after consulting a doctor or other professional.
4.Conformity feeding, establish a good routine
Summary】
Breastfeeding should be in line with the infant gastrointestinal tract maturation and growth and development process, from on-demand feeding mode to regular feeding mode progression. Infant hunger is the basis of on-demand feeding. Feeding should be done promptly when hunger causes crying, not forcing the number of times and time of feeding, especially for infants before 3 months of age. Parents should clearly perceive the timing of their infant’s feeding pattern, as the infant basically establishes its own feeding pattern 2 to 4 weeks after birth. As the age of the baby increases, the volume of the baby’s stomach gradually increases, the amount of milk intake increases, the feeding interval increases, and the number of feedings decreases, gradually establishing a good eating habit of regular feeding. If the infant’s crying is obviously not in line with the usual feeding pattern, you should first rule out non-hunger causes, such as gastrointestinal discomfort. If the baby is crying for non-hunger reasons, increasing the number of feedings can only relieve the baby’s anxiety, but cannot solve the fundamental problem.
Key recommendation
1, breastfeeding should be progressive from on-demand feeding mode to regular feeding mode.
2.Feeding should be done promptly when hunger causes crying. Don’t force the number and time of feeding, but generally the number of feeding may be more than 8 times a day, and initially it will be more than 10 times after birth.
3. As the baby gets older, gradually reduce the number of feedings and establish good eating habits with regular feeding.
4.If the baby cries abnormally, non-hunger causes should be considered and active medical attention should be sought.
4.Start vitamin D supplementation a few days after birth, no need for calcium supplementation
Summary】
The vitamin D content of human milk is low and breastfed children cannot get sufficient vitamin D through breast milk. suitable sunlight exposure will promote the synthesis of vitamin D in the skin, but given the limitations of parenting, sunlight exposure may not be the most convenient way for infants to get vitamin D within 6 months of age. Daily vitamin D supplements of 10 μg (400 IU) should be started within days of birth. Exclusive breastfeeding can meet the infant’s calcium requirements for bone growth without additional calcium supplementation. Vitamin K supplementation after birth is recommended, especially for newborns born by cesarean section.
【Key recommendation
1. Infants should take a daily vitamin D3 supplement of 10 μg (400 IU) starting a few days after birth.
2. Calcium supplementation is not required for exclusively breastfed infants.
3. Newborns should receive intra-muscular injection of vitamin K1 1mg after birth.
5. Infant formula is a desperate choice when exclusive breastfeeding is not possible
Summary]
When infants cannot be fed with exclusive breast milk due to certain metabolic diseases, mothers suffering from certain infectious or psychiatric diseases, insufficient milk production or no milk production, etc., it is recommended that formula feeding suitable for infants within 6 months of age is preferred, and direct feeding of infants with ordinary liquid milk, adult milk powder, protein powder, soy milk powder, etc. is not advisable. No infant formula is comparable to breast milk and should only be used as a helpless choice after exclusive breastfeeding has failed or as a supplement to breast milk after 6 months of age. giving up breastfeeding before 6 months of age and choosing infant formula is not good for the health of the infant.
[Key Recommendations
1. No infant formula can be comparable to breast milk, and can only be used as a helpless choice after breastfeeding failure, or as a supplement to breast milk when breast milk is insufficient.
2. For the following cases, it is recommended to use formula suitable for infants within 6 months of age.
(1) Infants with galactosemia, phenylketonuria, severe breast milk hyperbilirubinemia.
(2) The mother has HIV and human T-lymphotropic virus infection, tuberculosis, varicella-zoster virus, herpes simplex virus, cytomegalovirus, hepatitis B and hepatitis C virus infection, as well as substance abuse, heavy alcoholic beverage consumption and smoking, use of certain medications, cancer treatment, and close exposure to radioactive materials.
(3) Insufficient lactation even after professional guidance and various efforts.
(3) Infants within 6 months of age should not be fed directly with regular liquid milk, adult milk powder, protein powder, soy milk powder, etc.
6.Monitor physical indicators to maintain healthy growth
Summary】
Length and weight are visual indicators that reflect the feeding and nutritional status of infants. Infants before 6 months of age should be measured every six months for length and weight, and the number of measurements can be increased during the recovery period after illness, and the World Health Organization’s “Child Growth Curve” is used to determine whether the infant is fed correctly and reasonably. Infants have their own growth pattern, too fast or too slow growth is not good for children’s long-term health. There are individual differences in infant growth, and there are also periodic fluctuations, so there is no need to compare growth indicators with each other. Breastfed children may have lower weight growth than formula-fed children, but as long as the growth curve is on a normal trajectory, it is a healthy growth state.
Key Recommendations
1. Length and weight are visual indicators of infant feeding and nutritional status.
2. Measure the length and weight of infants before 6 months of age once every half month, and increase the number of measurements during the recovery period after illness.
3.The World Health Organization’s “Child Growth Curve” is used to determine the growth status.
4.The best growth pattern of infants with normal birth weight is to basically maintain their distribution level in the group at birth.
5.Infant growth has its own pattern, it is not appropriate to pursue the reference value.