Part one – newborns
I will start the discussion with infants. Breast feeding is clearly best for numerous reasons, and we are strong advocates. That having been said, if breast feeding is not for you, for whatever reason, in America today you will not be harming your child if you use formula. If you are unsure whether you want to breast feed or not, start off doing it, as you can always switch to a bottle later, while it is hard to do this the other way around.
To establish breast feeding, frequency is probably the most important factor. Feeding for shorter periods every 2 hours is more helpful at getting milk flowing than marathon feeds every 4. We recommend trying to feed 10-12 times per day (every 2-2.5 hours), 10 minutes per breast, and then ‘topping off’ for a few more minutes if the baby is still hungry.
Breast milk does not come in for a few days, during which time your baby will lose weight, up to 10 % or so in many cases. This is normal, and not a cause for concern. Well-meaning family and friends may suggest giving a bottle to the baby ‘just in case’. This is not necessary, and can interfere with breast feeding. There are some medical indications for supplementing, but let us help decide that.
If you choose formula, there are a wide variety from which to choose, for gas/fussy/spit up and so forth. All of the formulae nowadays are nutritionally complete (low-iron ones are no longer out there), and I am not convinced that there is much more than marketing, rather than science, that goes into these. I therefore do not recommend any particular brand. Along those lines, I have no problem with generic formula, which is often made by the company that produces brand names, and can be the same, except for the label.
Lastly, a word about gas and spitting up. Just about all babies spit up some. We may suggest changing formula, or the maternal diet, to see if that helps, as this is simple enough, and safe to do. However, it will usually not work. Most spitting up is due to the baby themselves, not the diet, and one waits for it to be outgrown. As long as the baby is comfortable and gaining weight (a ‘happy spitter’), this is a laundry problem and not a medical one.