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Newborn and Infant Care

Concern about my 6 week old niece

02/12/2008

Question:

Hi, my niece is 6 weeks old, she cries alot even after feeding,.she is on breast feed as well as we give 2oz formula feed twice a day becasuse she was not satisfied by only mother feed.but when she starts crying no one can handle her.Her weight was 2.9kg on birth and now she is 3.5kg,her sleeping time is also very short just 9-10hours in a day.i want to ask some basic question as she is the first child in our home after a long long time so everybody is very much concerned for her. 1: what are the possible reasons for her crying except bieng wet,hunger or gas trouble and what remedy should we used? 2: is her weight ok? 3: quantity of formula feed correct ? 4: use of feeder safe or spoon feeding is better? 5: can we give a little bit of water through spoon with a drop of honey? 6: do children of this little age cries with tears? 7: what is the best way to clean her ears and nose? pls guide me in detail about the children of this age

Answer:

You seem to have a great concern about you niece- how lucky she is to have you for an aunt. I will now try to address the questions you've asked.

Breastfeeding is always best for a baby. Milk supply is based on the amount that the baby demands, so the more the baby nurses; the more milk will be produced. By feeding her artificial breast milk (formula) daily, she has less desire to nurse, so she will decrease the time she actively sucks at the breast there by decreasing the amount of milk made. Artificial breast milk is not the same composition as breastmilk. It has more protein (and a changing ratio of whey and casein, based on infant age, which is stagnate in artificial breast milk), a different source of some fats, and a different source of carbohydrates. In addition there are difference in trace elements and vitamins (linoleic acid, calcium, phosphorus, iron, copper, Vitamins D, E, K and Folate). All of these differences could be causing some of her crying and perhaps discomfort as she tries to digest breast milk and the artificial breast milk.

As for a remedy, I would suggest exclusively breastfeeding, and allowing her to nurse as long and as often ask she wants to build up the supply. Also, mom might want to keep a food diary, and compare it to the baby crying. Some babies are very sensitive to some of the foods that mom's eat. Gassy foods, in addition to milk products are frequent culprits. It may take a week or more to remove all traces of the culprits from mom. Mom could consult a lactation consultant once she has record of at least a week.

On an average an infant will gain ½ ounce (15 grams) per day for the first 6 months if breast fed, and one ounce (30 grams) if fed artificial breast milk. Her average has been 13.75 grams, based on 48 days.

Babies should NEVER be given honey for the first year. Honey is NOT pasteurized, and as a result they can contract infant botulism. Prior to giving her any Honey be sure to consult with her health care provider, the general rule is they must be well over a year of age. I'm not sure what a feeder safe is, but I assume you are talking about a method for giving artificial breast milk, and I would recommend discontinuing this. Infants likewise do not need water when exclusively breastfed.

The newborn is often tearless, as the lacrimal structures (the tear producing part of the eyes) are immature at birth, and may not be fully functional for the first couple of months. If she is not producing tears by the third month, consult her health care provider. As for cleaning her ears and nose, NEVER stick anything into them to clean them out. It is possible to push thing further into the ear canal, and damage the eardrum. You can use a cloth wrapped around your finger to clean the external ear, and behind it. If the baby's nose is clogged or runny you can use a nasal aspirator to remove mucus.

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Response by:

Tina   Weitkamp, RNC, MSN Tina Weitkamp, RNC, MSN
Associate Professor of Clinical Nursing
College of Nursing
University of Cincinnati