Feedings should be initiated as soon after birth as possible, depending on the infant’s ability to tolerate enteral nutrition. This helps maintain normal metabolism during the transition from fetal to extrauterine life and also promotes bonding between the mother and infant. Most infants can start breast-feeding immediately after birth, almost always within 1–4 hr. Mothers who wish to initiate breast-feeding in the delivery room should be supported in doing so, provided there is no question about the infant’s tolerance of enteral feeding. If so, feedings should be withheld until the infant is carefully evaluated. It if appears that feedings must be withheld for some time, parenteral fluids should be administered.
The successful feeding of infants requires practical interpretation of specific nutritional needs and the wide variability among normal infants in appetite and behavior regarding food. The time required for an infant’s stomach to empty may vary from 1–4 hr or more during a single day. Thus, the infant’s desire for food will vary at different times of the day. Ideally, the feeding schedule established should be based on this reasonable “self-regulation” by the infant. However, this “self-regulation” is not established immediately; considerable variation in the time between feedings and in the amount taken per feeding is to be expected during the 1st few weeks of life. Most infants will have established a suitable and reasonably regular schedule by 1 mo of age.
By the end of the 1st wk of life, most healthy infants will be taking 60–90 mL/feeding and want 6–9 feedings/24 hr. Some will take enough at 1 feeding to be satisfied for as long as 4 hr, but others will want to be fed as often as every 2–3 hr. Breast-fed infants prefer shorter feeding intervals than formula-fed infants. Feeding can be considered to have progressed satisfactorily if the infant is no