Either glass bottles or plastic bottles with collapsible liners can be used for nursing. Plastic bottles with collapsible liners are, however, particularly beneficial because the baby does not swallow as much air as is possible with the glass type.
If you have chosen to use the traditional glass bottles, you will need eight 8-ounce (240ml) bottles, at least two 4-ounce (120ml) bottles, and various nipples, caps, and hoods.
You can use the aseptic method of making up the bottles or the terminal method. (1) Aseptic method (sterilized formula poured into sterilized bottles): First, prepare a clean work surface. Then wash your hands thoroughly. Remove bottles and other equipment from the sterilizer. Place them on clean paper towels. Boil some water, then let it cool for a few minutes.
The formula can be made up in bulk (a 24-hour supply), mixing milk powder or evaporated milk with the boiled water in a sterilized pitcher. Or one bottle at a time can be prepared by measuring the ingredients directly into the bottle. For storing in the refrigerator, invert the nipples in the bottle. (Handle the nipples by the rims only.) At the same time make up two 4-ounce (120ml) bottles with plain, boiled water.
(2) Terminal method (formula sterilized at the same time as bottles): Make up the formula as directed by the physician. The water does not have to be boiled first. Pour the formula into clean bottles, then place the bottles in the sterilizer.
Burping a Baby. All babies swallow air when they suck, whether nursed at the breast or on the bottle. The air collects as a bubble in the baby's stomach, causing discomfort and sometimes pain. The baby stops nursing and begins to cry. Many physicians advise a pause about halfway through the feeding in order to burp the baby.
The amount of air a baby swallows depends on both the flow of milk from breast or bottle and on the baby's sucking ability.
It is important that all air bubbles are expelled at the end of the feeding as well, or the baby will cry soon after being put to bed.
There are many different kinds of nipples available for baby bottles. Some are long, some short; some are made of hard rubber, some are soft. The nipples can have a small, medium, or large hole. Buying a selection allows a mother to find the one that is most comfortable and most effective in her baby's mouth. The ability to suck also varies according to the baby's age and whether he or she is hungry. A one-week-old baby who is slightly jaundiced and sleepy, for example, needs a medium-hole or large-hole nipple. A baby who is in this condition, sucking through a small hole, swallows a lot of air in an effort to get the milk, then falls asleep exhausted and uncomfortable. But if the hole is too large, the milk gushes through so fast that the baby may choke immediately or vomit afterward.
Spitting. A baby who nurses too quickly may vomit slightly after the feeding. Throwing up a small amount of milk is often called spitting and is nothing to worry about. Even if the baby occasionally throws up the entire feeding, there is no need for alarm. If the vomiting occurs repeatedly, however, consult a physician.
When burping a baby in the upright position, rest the baby's chin on your shoulder and be sure to protect your clothing in case the baby should spit or vomit.
Gas Pains. A baby who has swallowed too much air may be unable to expel the bubbles by burping immediately after being fed. The resulting discomfort can last for a few days and demands a great deal of patience. Be aware of a reliable sign that indicates gas: the baby may take two or three gulps of milk, draw away from the breast or bottle, and arch the back.
Nurse the baby slowly and try to relax. Walking slowly round the room with the baby in your arms sometimes helps to start him or her nursing again. Another method is to change the baby to a different nursing position, so that he or she sits upright or lies flat, for example. When the condition improves, make sure that the baby returns to the usual feeding position.
Inexperienced parents or baby sitters commonly try to bring up a baby's gas by striking him or her sharply on the back. But this only makes the baby tense and even less able to release the bubbles. Sometimes such patting may actually cause the baby to throw up some milk.
Reluctant Nursers. Because the liver does not work at full capacity for some time after birth, some babies may become slightly jaundiced. This condition makes a baby sleepy and disinclined to suck during the first week, when it is important that a baby drinks enough. To encourage a baby to nurse, push gently and rhythmically with the forefinger under the baby's chin. But be patient, because the baby may fall asleep again.
Restless Nursers. Older babies who for one reason or another feel insecure tend to be restless at nursing time. They wave their arms about, scratching at the bottle or hitting the breast. Such a baby should be held close to the body and wrapped in a blanket from the waist down. The baby's arms may be left free if they are kept out of the way. One arm can be tucked behind the feeder's back, while the other hand can be held. Hold the baby firmly, but not roughly, because this may make the baby struggle even more.
Hospitalization - Admission Procedures
The procedures you follow on admission to a hospital vary from one hospital to another, but basically the process is the same in most institutions in the United States.
Care of the Dying - Reaction of Children
A child's reaction to death depends on many factors. A child's first experience with death is often the death of a pet. A child under the age of eight cannot understand that death is irreversible and may expect the mother or father to bring the pet back to life. After the age of eight or nine, the child's understanding is usually as rational as an adult's understanding.
Care of the Dying - Moment of Death
Do not be alarmed if the patient's breathing makes a groaning or croaking sound. It does not mean that he or she is in pain. When a dying patient slips into a coma, the position of the neck and body produces the noise, which can be reduced by gently turning the patient's shoulders or body.
