Feeding Guide: 0-5 Months

Feeding your new baby is an important decision. Carefully consider breastfeeding versus formula feeding during pregnancy.

Please note: This information primarily focuses on nutrition for the healthy, full-term baby. Consult with a WIC Health Professional for more detailed and advanced information particularly for preterm, low-birth weight, or special needs infants or those with medical conditions.

*Source: WIC Works Infant Nutrition and Feeding Manual.

Breastfed Baby

There are two types of breastfeeding:

• Exclusive breastfeeding is when a mother only provides breast milk to her infant. No formula or other liquids are offered. It is recommended by the American Academy of Pediatrics (AAP) to exclusively (only) breastfeed for the first 6 months of life when complementary foods are added and to continue breastfeeding through 2 years of age and beyond as mutually desired by mom and baby. 
• Partial breastfeeding is when a baby receives breast milk and formula. Mothers who partially breastfeed may have a hard time maintaining milk supply.

The longer a mother exclusively breastfeeds, the more benefits seen by mom and baby.

Supply & demand

Breastfeeding is a supply and demand way to feed. The more often a baby nurses, the more milk mom will produce. Supplementing with formula may reduce milk supply for this reason. If mom offers formula instead of the breast for a feeding, the body will assume the baby did not need to eat and will start to produce less milk because the baby is eating less.

It is always important to feed babies ‘on demand’. This means letting them eat when they are hungry and stop when they are full—not by the clock or how much is left in the bottle. 

It can be helpful to know what an average baby eats each day:

• Newborns will nurse about 8-12 times in 24 hours for about 20-30 minutes each feeding. Newborn babies have tiny stomachs, so they need to eat small amounts many times during the day.
• 5 week to 3 month olds will nurse less, about 6-10 times in 24 hours and the length of time for feedings will continue to go down as baby gets older and becomes more efficient at removing milk from the breast.

Is my breastfed baby getting enough milk?

Mothers who are nursing can’t see how much milk their baby is getting and sometimes worry if they are getting enough.

Here are ways to know that your baby is likely getting enough milk:

• Gaining weight consistently. This is the most important indicator. It is normal for a newborn to lose weight immediately after birth, but the weight should be gained back by 2 weeks of age.
• Frequent breastfeeding (see chart above for how often) and is satisfied after each feeding
• Waking to feed
• Can be heard swallowing constantly while breastfeeding in a quiet room
• Plenty of wet and dirty diapers (see below for how many) with pale yellow or nearly colorless urine. The urine should not be deep yellow or orange (Baby should not be given any extra fluids besides human milk).

Breastfeeding moms can also tell on their own body if baby is getting enough:

• Tingly feeling during milk let-down. This sensation needs to happen at each feeding.
• Breasts feel less full after a feeding.
• Feel cramping in the lower abdomen which indicates uterine contractions in the first few weeks after delivery. Hormones produced and released during breastfeeding also helps the uterus to contract and return to its pre-baby form.

Growth spurts

During growth spurts, baby may need to breastfeed more often. This does not mean that mom’s milk supply has decreased! The growth spurts typically happen at 2 to 4 weeks, 6 weeks, 3 months, and 6 months and may last one to two days. When baby nurses more often, mom’s body will produce more milk which is just what baby is requesting during these growth spurts!

Wet & dirty diapers

A breastfed baby should have 6 to 8 wet diapers in 24 hours. A breastfed baby may have a bowel movement once per day or once with each feeding.

Each baby will have its own schedule. During times of growth, baby may go several days to a week without a bowel movement; this is not constipation if the stool is soft when the bowel movement is made.

Supplements

Breast milk contains the right amount of nutrients for your baby and the nutrients change as your baby grows and develops.

• Vitamin D is the only nutrient not adequately supplied in breast milk. Supplement your baby with 400 IU of vitamin D per day starting soon after birth OR the breastfeeding mom can supplement herself with 6,400 IU per day of vitamin D.
• Supplements can be purchased at most retailers and pharmacies without a prescription. Visit with a doctor about supplementing with vitamin D.
• Talk with your doctor about an iron supplement for your baby at 4 months of age until the baby is starting to eat foods with iron.

Get more great breastfeeding information here!

Formula-Fed Baby

Iron-fortified formula is the next best choice after breast milk. Formula is made to be as close to breast milk as possible, but cannot provide the anti-viruses, anti-allergies, anti-parasites, antibodies, hormones, enzymes, growth factors, and more that is naturally found in breast milk. 

Formula is fortified with iron because it is very important for brain development and helps to prevent anemia. Read more about iron here.

Please note: Low-iron formula is not recommended because it does not contain enough iron to prevent anemia and it is not the right treatment for constipation.

Supply & demand

It is always important to feed babies on demand—not by the clock or how much is left in the bottle. Let them eat when they are hungry and stop when they are full. See Feeding On Demand for more information on the signs of hunger and satiety (fullness).

Growth spurts

During growth spurts, baby may need to eat more often. 

The growth spurts may occur at 2 to 4 weeks, 6 weeks, 3 months, and 6 months and may last one to two days. Watch for signs of hunger and fullness to decide if you should prepare more or less formula for feedings.

Wet & dirty diapers

Baby should have 6 to 8 wet diapers in 24 hours. Formula fed babies will develop their own pattern of soiled diapers. Watch for your baby’s pattern.

Feeding Other Liquids

Never give cow’s milk before 12 months. Why?

• Cow’s milk has too much protein, calcium, phosphorus, sodium, chloride, and potassium.
• Cow’s milk lacks key nutrients like vitamin C, vitamin E, linoleic acid, iron, and copper.
• Too much protein and minerals are hard on your baby’s kidneys, can cause dehydration, and it is hard for a baby to digest.
• Cow’s milk can cause bleeding from the intestinal tract.
• Bleeding caused by cow’s milk increases your baby’s chance of becoming anemic (or low in iron).

Never water down formula or breast milk. Why?

• You might be saving money, but you’re harming your baby’s health!
• Adding extra water decreases the nutrients your baby will get, slowing down their growth and development.
• Extra water also disrupts the electrolyte and mineral balance in your baby’s body which can lead to severe health problems, including seizures.
• Always mix formula according to manufacturer instructions.

Never make your own baby formula. Why?

• In the US, we have laws and regulations to make sure that infant formula sold in stores meets certain standards. Each formula must have a certain amount of each nutrient to help your baby grow healthy and strong.
• When making your own, you can’t be sure that you have enough of all of the right nutrients in the mixture OR you might end up with too much of a certain nutrient.
  • You might miss vital components like iron or vitamin C
  • You might have too much of a nutrient like salt which can harm your baby’s kidneys and liver.
• If your baby isn’t getting the right nutrients in the right amounts, they could have serious health issues for the rest of their life.

Never give honey, syrup, kool-aid, pop, juice, or any sweetened drink to an infant.

Solid Foods

Introduce solid foods around 6 months of age when showing signs of readiness. Look for these signs to let you know the baby is ready:

• Holds neck steady
• Sits without support
• Opens mouth when food is offered
• Draws in lower lip when spoon is removed from mouth
• Keeps food in mouth and swallows it
• Reaches for food showing they want some

See Feeding Guide: 6-12 Months for information on starting baby food once showing these signs of readiness.

Please note: WIC does not provide baby food until 6 months. At this age most babies are developmentally ready to try solids.

Source: AAP Policy Statement: Breastfeeding and the Use of Human Milk, AAP: Why Formula Instead of Cow's Milk, AAP: How to Safely Prepare Formula, AAP: Is Homemade Baby Formula Safe.