Breastfeeding or bottle feeding


During the pregnancy, feeding the child will be discussed. Some will already have made their choice for bottle feeding already, though our midwife would still like to explain why breastfeeding is so important. However, it’s up to you if you don’t want to (or can’t) breastfeed. Of course we will respect your choice.

Our midwives advise all mothers to breastfeed because it is scientifically proven that breast milk is better than formula. Formula lacks a number of important nutrients that a manufacturer cannot add to the formula, such as antibodies and living cells that protect your baby from infections. In addition, the risk of developing allergies (e.g. asthma and eczema) is reduced by breastfeeding. Despite all the benefits of breastfeeding, we realize that breastfeeding is not always ideal. Breastfeeding can cost a lot of energy and time at first. But once you get into it, breastfeeding is the easiest (and most beautiful) thing there is. For most mothers, breastfeeding soon comes easily and smoothly. The advice is to fully breastfeed for four to six months.

To help you get started with breastfeeding, we will provide you with additional information.

In some situations, it is wise to check beforehand whether breastfeeding is possible for you, for example, if you have undergone breast surgery. Depending on the surgical techniques used, breastfeeding may be more difficult. You can inquire with your doctor what surgical techniques were used and whether you can breastfeed.

When using medication, it is important to discuss with your doctor whether you can use this medication during the nursing period. You may be able to adjust your medication (temporarily) if you would like to breastfeed.

Your body is gearing up for nursing early on during the pregnancy, more mammary glands and ducts are grown. Your breasts can gain 1 to 2 cup sizes or become heavier. This may cause you to suffer from sensitive breasts. You may also see blue veins right beneath your skin, and your nipples become larger and darker in color due to pregnancy hormones. A maternity bra can provide good support. They’re easy to adjust, so you can adapt it as your breasts are changing.

From the 6th month (the 26th week) of your pregnancy, your breasts may produce a thick yellow liquid called colostrum. This is the first breast milk. It contains many proteins, minerals and antibodies to protect your baby from infections. It also acts as a laxative to your baby and helps him or her to move their bowels for the first time. The composition of the breast milk will change as your child ages.

It’s not a requirement to leak milk during the pregnancy to have a good start with breastfeeding!

In some situations, if you want to breastfeed, it may be useful to start this preparatory process during pregnancy. It may be useful to start expressing milk during pregnancy, starting from 37 weeks. If you want to know if this may be useful to you, please discuss it with one of our midwives during the consultation hours.

Our midwives advise to lay your baby on your chest, skin to skin, during the first hour after birth. Your child can then try to find your breast, although we always try to latch your child for the first time within one hour of birth. One of our midwives can guide you. Take your time for the first time of latching, it’s important that you are relaxed and can focus all of your attention on breastfeeding. Don’t be concerned if your baby doesn’t latch on straight away, this is quite normal. A baby often needs a little time to recover after his or her birth.

Don’t underestimate the importance of skin to skin contact with your baby during the first day(s) after birth, as it has proven it eases the baby into breastfeeding and increases the chance that your child will be looking for the breast and will latch on well. But research has also shown that skin to skin contact helps your baby maintain body temperature, and helps stabilize respiratory and blood sugar. In addition, skin to skin contact is also a great for the parents, because the dad can do this too, to make contact with and to build a bond with your child. Even while your child grows older, it is good to occasionally spend some time with your child through skin to skin contact.

At first, it is important to regularly latch your baby, which will speed up breastfeeding. During the first few days, your child has to eat at least 8 times a day, so every 3 hours. Every time may take 45 to 60 minutes (including burp and diaper change). If your child does not (yet) want to breastfeed, we may advise you to start expressing milk to encourage milk production.

Breastfeeding is a natural process that requires a lot of practice particularly in the first week. It is important to get your milk production flowing and to learn how to latch your baby on properly. We will guide you through that. There is always a lactation specialist (breastfeeding expert) who can advise you. Any problems are usually easy to solve and short of nature. For more information on breastfeeding, check out the Voedingscentrum website or the GroeiGids.

Advice from our midwives:

  • Breastfeeding is a matter of supply and demand. The more often a baby eats, the more milk the mother will produce;
  • Try to latch your child every three hours, or more preferably, try to feed your child at his or her request;
  • In the first few weeks, put your child’s crib in the bedroom so you can respond directly to his or her cue for nursing;
  • By latching the baby often in the beginning, milk production will come easier. Your child will get used to a routine more quickly.
  • In the very beginning latching on may be a little painful. However, this pain has to go away: try re-attaching your child;
  • Use both breasts to feed your child in the first few days;
  • Switch sides frequently in the beginning, don’t let the baby breastfeed from one side for more than five to ten minutes;
  • When taking your baby off the breast, release the baby from the nipple by putting your little finger between your baby’s jaw;
  • Do not feed your baby formula unless it is a medical necessity.

After the first week, try a different posture while feeding, as this reduces the chance of breast inflammation.

During the first week after birth, it is common for us to advise to start expressing milk, for example, if your baby is not eating well or if your baby is losing too much weight. Expressing can help you get started with breastfeeding. It can also be desirable to start expressing during a later stage in the breastfeeding period, for example, when you go back to work.

There are a few ways to express milk, by hand, using a hand-held pump or an electric pump. Whichever way you choose, it’s always important to ensure that you’re in a calm and private space. Sit in a relaxes position and make sure you’ve got something to drink close by. Milk can come more easily when expressing if your baby is close by, if you think of your baby or look at a picture of him or her, or listen to sounds of your baby that you’ve recorded.

Before you start expressing, you can massage your breasts to improve the let-down reflex. Start gently massaging the upper side of your breast, your fingers making twisting motions. Then rub your whole hand from the upper side of the breast towards the nipple. Bend forward and shake your breasts. Heating pads on the breasts can help make your milk flow more easily.

If you start expressing milk during the first week after birth, our midwives will guide you. You can rent expressing pumps with several organizations, or you may have bought one yourself or borrowed one. You can watch this video on the website of the Voedingscentrum. If you use an electronic pump for expressing milk, it’s advisable to pump on both sides. This stimulates the production of prolactine, which helps the milk flow more easily.

You can also express by hand, this can help ease the tension in your breasts for latching on the baby, or you can empty the breast by hand.

Expressing milk by hand does require some practice, if you’d like to try this, ask your midwife to explain and help you. This video shows how expressing by hand works.

When you’re expressing milk, it’s possible to express more than your baby eats. You can create a little store of milk. If you want to store your breast milk, it’s important to chill it properly and to store it hygienically.

Storing in the fridge

  • Make sure the fridge temperature is set to 4°C (39°F). The milk will last for 3 days.
  • Store the milk in the back of the fridge where the fridge is coolest.

Storing in the freezer

  • Store your milk in the freezer right after expressing. The milk will last for 6 months, provided that you own a freezer with 3 (***) or 4 stars (****).
  • Store your milk in small portions, for instance, in ice cube bags. That way you only have to defrost the amount you need.

If you want to use frozen breast milk, it’s best to take it from the freezer and let it defrost in the fridge. In case you want to use the milk sooner, heat it up using flowing lukewarm water. Use the defrozen milk within 24 hours.

During the period that you’re breastfeeding, it’s important to eat a healthy and varied diet. However, your body requires more nutrients and energy than usual. Nutrients are proteins, carbohydrates, fats, vitamins and minerals. Increase variety in vegetables and fruits to get all those nutrients – eat different kinds of veggies and fruits throughout the week. Additionally, it’s good to alternate between fish, legumes, meat and egg. Your body will also require more hydration so make sure you stay hydrated.

Tip: make sure you have a glass of water for yourself whenever you’re feeding your baby.

When you’re breastfeeding we advise against dieting, because you won’t get all the nutrients you need. Also make sure you’re not drinking too much caffeine and avoid alcohol, unless there is 3 hours between drinking alcohol and the next time you’re feeding.

Have you already given thought to how you would like to combine breastfeeding and work? For many moms, expressing is the solution, but sometimes it’s also possible to continue feeding your baby yourself, for instance, when child care is close to where you work. Make sure that you’re aware of all your legal rights regarding breastfeeding and work before you get back to work. Legally speaking, you have the right to feed your child or express milk during work hours for the first nine months of the child’s life, you’re allowed to take extra break time. You’ll be paid for the time you spend breastfeeding or expressing, up to a quarter of your working time. If you’re expressing at work, you would do that as often as your child would need to feed. Your employer is also required to provide a proper space where you can breastfeed or express.

Whether you’re expressing at work or continue to breastfeed, inform your employer and colleagues of what you’re doing. It will give your employer time to arrange the necessary measures, and your colleagues will know why you leave work occasionally or have a moment to yourself. Moreover, your employer also needs to be aware of your rights. You can find more information about breastfeeding and work in this brochure of the Voedingscentrum.

Bottle feeding

It’s important to consider during the pregnancy how you want to feed your baby once he or she is born. Our midwives will discuss this choice with you during our consultation hours. If you’ve chosen to feed your baby formula it’s good to already prepare for this during the pregnancy, for example, by buying the formula, bottles, teats beforehand. We will give you more information regarding bottle feeding for babies between 0 and 6 months.

Are you still in doubt about whether you want to breast or bottle feed your baby? Consider the pros and cons of both choices, and find more information here. Discuss your doubts during consultation hours and perhaps we can guide you in making the right decision.

The composition of formula

Standard formula is formula that can be given to babies that are developing normally. The designation is usually Standaard 1, 2, 3, et cetera. Standard formula contains all nutrients for proper growth and development. Most formula is based on cow’s milk. Cow’s milk doesn’t naturally contain all the nutrients a human baby needs. For standard formula, the composition of cow’s milk is changed. Some nutrients are removed from the cow’s milk (like carbohydrates and certain proteins), and some are added to it (such as vitamins D and K, iron and fibers).

In The Netherlands, legislation stipulates what should be in artificial nutrition, so it doesn’t matter what brand you choose or what the product costs. Trying a different brand won’t hurt. If you compare several brands of formula, you’ll see that ingredients still differ per brand. That’s because many of the manufacturers are allowed to add some substances to the formula, next to the ones that are mandatory. These substances too are stipulated by legislation and aren’t bad for your baby, but according to the European Food Safety Authority (EFSA) they don’t add anything to the health of your child either.

Choice of formula

In case some direct family members have suffered from allergies, it’s advisable to start with hypoallergenic formula straight away.

In addition, different types of formulas are available, for example, for hungry babies or for babies with cramps. Usually it’s not necessary to use these kinds of different formulas. The advice is not to use these formulas during the first week after birth. If you get the idea later on that your child may need different kind of formula, please consult with the midwives before you switch.

Recently formula based on goat’s milk has become available. You can find information on the internet, or ask any of the midwives during the consultation hours.

Choice of bottles and teats

You’ll notice that there’s a huge range of types and sizes of bottles. It actually doesn’t matter what bottle you pick, although it’s important that you can see how much there’s left in the bottle. The teat you choose can matter more, as every baby has his or her own preference. Some babies prefer one kind of teat whereas another will eat better from a different kind. Teats also have different sizes of holes, small or large. For big eaters, you’ll want a teat with a small hole, but for slow eaters, you’ll want one with two or three holes. You may find that your baby doesn’t accept all teats, so feel free to try a few.

Formula during the first week after birth

During the first few days after birth, your baby’s stomach and bowels have to get used to the nutrition he or she gets, so it’s good to start with small amounts. In the womb, the baby received nutrition through the umbilical  cord and the gastrointestinal system didn’t have to process anything yet, so it’s not used to processing food yet. It’s possible that your baby will be a little nauseated during the first few days after birth. Usually people start with 10 to 20 ml of formula after birth, six to seven times every 24 hours. Every day 10 ml is added, and by the end of the first week, the baby will eat 80 to 90 ml of formula. Depending on the birth weight of your baby this can be more or less, the midwife will guide you in increasing the amount of formula. It will also say on the packaging of the formula how much your baby can eat at his or her weight.

To check if your baby is getting enough nutrition, keep an eye on dirty diapers, whether he or she grows well enough and is satiated. If this is all the case you can safely assume that your baby is getting enough.

Skin to skin contact

Skin to skin contact is often associated with breastfeeding. However, skin to skin contact is important or all babies, also babies who get formula. Don’t underestimate the importance of skin to skin contact with your baby during the first day(s) after birth, as it has proven it eases the baby into breastfeeding and increases the chance that your child will be looking for the breast and will latch on well. But research has also shown that skin to skin contact helps your baby maintain body temperature, and helps stabilize respiratory and blood sugar. In addition, skin to skin contact is also a great for the parents, because the dad can do this too, to make contact with and to build a bond with your child. Even while your child grows older, it’s good to occasionally spend some time with your child through skin to skin contact.

Preparing and storing formula

It’s important to always prepare the bottle in a hygienic way and keep it clean. The midwife will teach you during the first week after birth how to prepare formula. It’s important to heat water first, then add the formula. Always use the scoop provided with the package to measure the formula. Carefully measuring the formula is important so that your baby receives the right amount of nutrients. In case you prepared the bottles of formula beforehand you can store these in the fridge, no longer than 8 hours. When you’ve heated a bottle, never reheat it again. Always throw out left-overs.

In The Netherlands, tap water is safe to use for preparing formula. It’s not necessary to boil it beforehand. However, abroad water isn’t always safe to use. If you doubt the quality of the tap water you can boil it beforehand or use bottled water instead. The bottle will say whether it’s suitable to use for formula.

Switching formula

It’s important to consistently buy the same brand of formula. This way cramps are prevented. On average, babies need three weeks to get used to new formula. When your child appears to suffer from cramps or throws up a lot after a few weeks, never change immediately change formula. It’s possible something else is the cause. Always discuss with your GP before you switch formula. You can find more information about bottle feeding on the website of Voedingscentrum.

Standaardvoeding is voeding die gegeven kan worden aan baby’s die een normale ontwikkeling doormaken. De aanduiding is meestal Standaard 1, 2, 3 enzovoorts. Standaardvoeding bevat alle voedingsstoffen voor een goede groei en ontwikkeling. De meeste kunstvoeding is gemaakt op basis van koemelk. Koemelk bevat van nature niet alle voedingsstoffen die een baby nodig heeft. Voor standaardvoeding wordt de samenstelling van de koemelk aangepast. Bepaalde voedingsstoffen worden uit koemelk gehaald, zoals bijvoorbeeld koolhydraten.  Bepaalde eiwitten en andere voedingsstoffen worden toegevoegd (vitamine D en K, ijzer en vezels).

In Nederland is in de wetgeving (Warenwet) vastgelegd wat er in kunstvoeding moet zitten. Het maakt dus niet uit welk merk je kiest of hoe duur het product is. En wil je eens een ander merk uitproberen? Dan kan dat geen kwaad. Als je verschillende merken kunstvoeding met elkaar gaat vergelijken, zie je dat de inhoud van de voeding per merk wel kan verschillen. Dat komt, omdat veel fabrikanten vanuit de Warenwet nog extra stofjes aan de voeding mógen toevoegen, naast de verplichte voedingsstoffen die er al in zitten. Ook deze extra stofjes zijn vastgelegd in de wet en niet slecht voor je kindje, maar volgens de Europese autoriteit voor voedselveiligheid (EFSA) voegen deze stofjes niets toe aan de gezondheid van je kindje.

Indien er in de directe familie een of meerdere familieleden last hebben (gehad) van allergieën, dan is het raadzaam om direct hypoallergene voeding in huis te halen.
Daarnaast zijn er verschillende typen voedingen verkrijgbaar, bijvoorbeeld voor hongerige kindjes of voor kindjes met krampjes. Meestal is het niet nodig om deze verschillende voedingen te gebruiken.
Het advies is om tijdens de eerste week deze voedingen nog niet te gebruiken. Heb je later het idee dat je kindje toch andere voeding nodig heeft? Overleg dan eerst met het consultatiebureau voor je overstapt.
Er is sinds enige tijd ook kunstvoeding op basis van geitenmelk. Informatie hierover vind je op internet, maar vraag onze verloskundigen hier ook gerust naar tijdens het spreekuur.

Je zult merken dat er flessen in alle soorten en maten verkrijgbaar zijn. Het maakt eigenlijk niet uit welke fles je kiest, wel is belangrijk dat je op de fles goed kan zien hoeveel erin zit.
De keuze voor de speen kan wel van belang zijn, ieder kindje heeft zijn eigen voorkeur. Sommige kindjes vinden spenen met een ronde top fijner, andere kindjes drinken beter uit een speen met een platte top. Daarnaast zijn er spenen met verschillende gaatjes: er zijn spenen met een klein of een groot gaatje of met meerdere gaatjes. Voor gulzige drinkers is een speen met een klein gaatje geschikt. Is je kindje een langzamere drinker, kies dan voor een speen met twee of drie gaatjes. Mogelijk merk je dat je kindje niet alle spenen accepteert, probeer gerust verschillende spenen uit.

Tijdens de eerste dagen na de geboorte moeten het maagje en de darmen van je kindje wennen aan de voeding die hij of zij krijgt. Het is daarom goed om met kleine beetjes voeding te beginnen. In de baarmoeder kreeg je kindje zijn of haar voeding via de navelstreng. Het maagdarmstelsel kan nog niet verteren, waardoor het dus nog niet gewend is om voeding te verwerken. Mogelijk merk je tijdens de eerste dagen na de geboorte ook dat je kindje wat misselijk is.

Meestal start je na de geboorte met 10 tot 20 ml per voeding, 7 a 8 keer per 24 uur. Iedere dag hoog je de voeding op met 10 ml. Aan het einde van de kraamweek zal je kindje dan 80 tot 90 ml per voeding drinken. Afhankelijk van het geboortegewicht van je kindje kan dit wat meer of wat minder zijn. De kraamverzorgende zal jullie begeleiden in het ophogen van de hoeveelheid voeding. Op de verpakking van de kunstvoeding staat ook altijd aangegeven hoeveel je kindje mag drinken aan de hand van zijn of haar gewicht.

Om na te gaan of je kindje voldoende voeding binnen krijgt, is het goed om in de gaten te houden of je kindje wel voldoende plasluiers heeft, goed groeit en voldaan is. Is dit het geval dan kun je ervan uit gaan dat je kindje voldoende krijgt.

Huid op huid-contact wordt vaak geassocieerd met borstvoeding. Echter huid op huid-contact is belangrijk voor alle kindjes, ook kindjes die kunstvoeding krijgen. Onderschat daarom tijdens de eerste dag(en) na de geboorte van je kindje niet het belang van huid op huid-contact. Uit onderzoek is namelijk gebleken dat het je kindje helpt om zijn temperatuur op peil te houden. Het stabiliseert ook zijn ademhaling en bloedsuikerspiegel. Daarnaast is huid op huid-contact ook een hele goede manier om als ouder contact te maken en een band op te bouwen met jullie kindje. Ook als je kindje ouder wordt, is het goed om af en toe een moment te kiezen om huid op huid te gaan zitten met hem of haar.

Het is belangrijk om de fles altijd op een hygiënische manier klaar te maken en de fles goed schoon te houden. De kraamverzorgende zal je tijdens de kraamweek leren hoe je kunstvoeding moet klaarmaken. Belangrijk is om eerst het water op te warmen en daarna de voeding toe te voegen. Gebruik altijd het schepje wat bij de verpakking zit om de hoeveelheid voeding af te meten. Zorgvuldig afmeten van de hoeveelheid voedingsstoffen is nodig om te zorgen dat je kindje de juiste hoeveelheid voedingsstoffen binnenkrijgt. Heb je een fles kunstvoeding vooraf klaargemaakt? Bewaar deze dan goed gekoeld en niet langer dan 8 uur. Als je een fles opgewarmd hebt, mag je deze nooit opnieuw opwarmen voor een latere voeding. Gooi restjes kunstvoeding dus altijd weg.
In Nederland is kraanwater veilig om te gebruiken voor het bereiden van kunstvoeding, het is niet nodig om het vooraf te koken. Maar in het buitenland is kraanwater niet altijd veilig te gebruiken. Als je twijfelt aan de kwaliteit van het kraamwater kun je het vooraf koken of mineraalwater gebruiken. Op de verpakking van mineraalwater staat meestal aangegeven of deze geschikt is voor het bereiden van kunstvoeding.


Verder is het belangrijk om steeds hetzelfde merk kunstvoeding te kopen. Hiermee beperk je de smaakwisseling en darmkrampjes bij je kindje zoveel mogelijk. Kinderen hebben gemiddeld 3 weken nodig om aan een andere voeding te wennen. Indien je kindje na het kraambed last blijkt te hebben van krampjes of veel spuugt, dien je in geen enkel geval meteen over te gaan op andere voeding. Er kan namelijk een andere oorzaak zijn. Overleg altijd even met je huisarts of consultatiebureau voor je wisselt van voeding.
Voor meer informatie over kunstvoeding kun je terecht op de website van het Voedingscentrum.