*It is important to remember that breastfeeding is the best and most natural food for your baby. The World Health Organization and the Department of Health recommend that you breastfeed your baby exclusively for the first six months and then continue to breastfeed as you introduce weaning foods. This is the safest and best way to protect your baby's health. For a comprehensive explanation of the benefits of breastfeeding go to...
If you choose not to breastfeed, it is important that you always prepare your baby's bottle feeds safely. If you are switching from breastfeeding or introducing formula feeds for the first time, it is recommended that you ask your public health nurse for advice.
Why should I consider bottle feeding?
- Having a baby can be an extremely tiring time for everyone involved. Bottle feeding means your partner (or others) can take turns feeding the baby, giving you a rest. This is especially helpful at night-time as it allows the woman to get a few hours of uninterrupted sleep.
- Being involved in feeding may also allow your partner to develop a closer bond to the baby.
- If a woman has to go back to work or go somewhere without her baby, breastfeeding can become more difficult.
- While some women may find breast-feeding more convenient because they don't have to carry bottles or equipment when they go anywhere, others find it quite difficult to breast-feed in certain places, for example in a restaurant. They may be uncomfortable breast-feeding in public places and unfortunately the attitudes or comments of others may influence this decision.
How often should my baby be fed?
Babies should be fed whenever they are hungry. In the beginning this can mean frequent feeds. Newborns usually take seven to eight bottles a day (approximately 2oz in each bottle).
Within a few weeks they will settle down to a more regular pattern (probably one feed every three to four hours).
Newborns only take what they need so don't worry about overfeeding in the beginning. Likewise don't worry if they don't finish every bottle.
Bottle fed babies tend to be fed less frequently than breastfed babies because formula milk takes longer to digest and contains more calories, keeping the hunger away for longer.
What do I need to know about formula milk?
Powder infant formula is not sterile, and may contain bacteria that can make your baby sick. However, you can reduce the risk to your baby if your prepare and store infant formula safely.
Infant formula milk is made to be as similar to breastmilk as possible. It is necessary in the first six months of life because ordinary cow's milk is not suitable at this time.
Some vitamins and minerals are added to these formulas so that the only thing you need to add is water.
Formula milk usually comes in powder form.
If your baby does not finish a feed, do not keep the remainder for the next feed. Always make a new bottle for every feed. In some rare cases, the baby may be allergic to cows' milk. If breastfeeding is not an option, soya milk may be recommended.
How important is hygiene when bottle-feeding?
Good hygiene is absolutely essential, not only because you are dealing with a baby, but because milk is an ideal breeding ground for bacteria, especially the ones that cause stomach upsets and diarrhoea in babies.
One of the drawbacks of bottle feeding is the amount of specialised equipment required, including a special sterilising unit. However, these are easy to use.
It is very important that you clean and sterilise all the equipment you use to feed your baby such as bottles, teats and lids. Cleaning and sterilising removes harmful bacteria that could grow in the feed and make your baby sick.
To clean the equipment, wash your hands well with soap and warm water, and dry using a clean towel. Wash all feeding equipment well in hot soapy water. Use a clean bottle-and-teat brush to scrub the inside and outside of the bottles to make sure you remove any leftover milk from the hard-to-reach places. Rinse well in clean running water. You can also use a dishwasher provided the equipment is dishwasher proof. However, dishwashers clean but they do not sterilise feeding equipment.
To sterilise the feeding equipment, you can either steam it, immerse it in boiling water for at least three minutes or use a chemical steriliser. To do the latter, make up a batch of sterilising liquid such as Milton and follow the instructions.
Wash and dry your hands and clean all work surfaces before handling sterilised equipment. Ideally, you should use sterilised forceps when putting the sterilised teat onto the bottle so that it does not become dirty again. Put feeding bottles together if you remove them from the steriliser before you need them. This prevents the inside of the bottle, and the inside and outside of the teat becoming dirty again. If you put them together correctly, the bottles will remain safe to use for 24 hours if you do not open them.
To prepare a bottle feed, boil fresh tap water in a kettle or covered saucepan. When boiled, leave the water to cool in the kettle or pan. Cool it for 30 minutes, but no longer. This will ensure that the water is not too hot, but also that it is no less than 70°C. Using water warmer than 70°C to make up feeds will kill any harmful bacteria that may be present in the formula.
Clean the work surface well. Wash your hands with soap and warm water and dry. Read the instructions on the formula's label carefully to find out how much water and how much powder you need. Carefully pour the amount of boiled water you need into a sterile bottle, and add rthe exact amount of formula to the boiled water using the clean scoop provided. Reseal the packaging to protect it from germs and moisture. Remember that adding too much or too little formula could make your baby sick.
Screw the bottle lid tightly and shake well to mix the contents. To cool the feed quickly, hold the bottle under cold running water or place the bottle in a large bowl of cold water. Make sure that the cold water does not reach above the neck of the bottle.
To check the feed is not too hot, shake the bottle and place a drop of liquid on the inside of the wrist – it should feel lukewarm, not hot.
After feeding your baby, throw away any feed that your baby has not taken within two hours. If your baby is a slow feeder use a fresh feed after two hours.
Never use a microwave to re-warm feeds, as microwaves heat unevenly.
Can I store bottle feeds to use later?
It is safest to prepare a fresh feed each time you need one, and to give it to your baby straight away. This is because warm milk provides ideal conditions for bacteria to grow, especially at room temperature. If you need to prepare feeds in advance to use later, make up individual bottles, cool them quickly and place in the back of the fridge. Throw away any feed in the fridge that you have not used within 24 hours.
How do I warm up refrigerated bottle feeds?
Remove the bottle of feed from the fridge just before you need it. To warm it, place it in a bowl of warm water, making sure the level of the water is below the neck of the bottle. You can also use a bottle-warmer. Warm it for no more than 15 minutes. Check the temperature of the milk by dripping a little onto the inside of your wrist. It should feel lukewarm, not hot. Throw away any feed that your baby has not taken within two hours.
What is the best position for giving the bottle?
The person feeding the baby should be in a comfortable chair and position. The baby's head should be higher than the rest of their body. If the baby is lying flat, it is more likely that he/she will choke.
If the baby isn't aware it is time for a feed, gently stroke the cheek nearest to you with a finger or the teat of the bottle. The baby will then turn towards you and open their mouth. At this point, slip the bottle into their mouth.
Ensure that the teat is always full of milk by keeping the bottle tilted. If the teat isn't full, the baby will suck in air.
If your baby continues to suck after the feed, let them, either on the bottle or on one of your (clean) fingers. Babies need to suck and they enjoy it. It is usually not a sign that they are still hungry.
What about winding my baby?
Your baby will probably need to bring up some wind after or during the feed. Hold the baby against your shoulder. Rub or gently pat him/her on the back between the shoulder blades. The baby normally burps after a minute or two. If they don't burp after a few minutes, stop trying to wind them. They probably don't need to burp. It is completely normal for the baby to bring up some milk when they burp (possetting). Remember this if you want to protect your clothes!
How can I change from breast-feeding to bottle-feeding?
It is important that you make the transition from the breast to the bottle slowly. Offer the baby a bottle feed for their lunch. If they won't take it, don't force it. Simply try again at the same time the next day. The baby may take to the bottle if you moisten the teat with some drops of breast milk.
After the baby has taken this lunchtime bottle for three days, replace a second daytime feed with a bottle. Wait for three days again before you try to replace another bottle. The bedtime feed should be the last one to change over to the bottle.
What should I do if I am travelling?
On short journeys, you can travel with made-up bottles if the journey will be less than two hours in total and you can keep the feeds cold while travelling.
Before the journey, prepare feeds as normal, cool quickly and place in a fridge at 5º or below. Just before you leave home, remove the cold feeds from the fridge and place them in an insulated cool bag with ice packs. When you arrive, place the feeds in a fridge as soon as you can. Re-warm a feed when you need one.
If the journey is longer than two hours, or if you have no way of keeping the feeds cold, it is not safe to bring made-up bottles. Instead, use one of the following options.
- Bring the powder with you and prepare a feed as normal using water that is hotter than 70°C. Cool it quickly and feed your baby right away.
- If you will not be able to boil fresh water, bring the powder and sterile bottles of water with you. Make up the sterile bottles of water at home by boiling the kettle and pouring the correct volume of boiled water into the sterile bottle straightaway. Do not cool the water for 30 minutes. Then put the sterile teat on the bottle (using a sterile forceps if possible) and screw the lid on tightly. The bottles can be stored in a clean place for up to 24 hours. When you are out and need to feed your baby, Warm the bottle of water to feeding temperature. (To do this, stand it in a bottle warmer or a container of warm water for no longer than 15 minutes). Add the exact amount of powder to the bottle. Put the lid back on the bottle tightly, and shake well to mix the contents. Test the temperature of the milk by dripping a little onto the inside of your wrist. It should feel lukewarm, not hot. Use the feed right away, and throw away any feed that has not been taken within two hours. If your baby is a slow feeder, make up a fresh feed after two hours. If you choose to bring formula powder when travelling you can measure the correct amount per feed into a small, clean, plastic
container with a tight fitting lid or use individual sachets which can be bought in chemists or supermarkets.
- Use cartons of liquid formula. You can buy these in chemists and supermarkets. You do not need to keep them in a fridge or heat them up before feeding your baby. These are more expensive but very convenient for travelling.
Creches and childcare centres rarely prepare infant formula. Parents normally prepare all the feeds their baby will need at home and bring these to the creche each day. If you need to do this, prepare feeds using water no less than 70ºC, and cool quickly.
Place cooled feeds in the fridge until they are completely cold, but for no longer than 24 hours. The temperature of the fridge should be 5°C or less.
Bring the feeds to the crèche in a cool bag with ice-packs. Label each of your baby’s feeds carefully so they don’t get mixed up with other feeds in the crèche. Crèche staff should place the feeds in a dedicated fridge as soon as you arrive at the crèche. Feeds cannot be stored for longer than 24 hours.
The temperature of the fridge should be 5ºC or less. The fridge should have a thermometer so staff can check the temperature and adjust it if needed. Take home all feeding bottles when you collect your baby and throw away any leftover feed. Clean all bottles thoroughly at home and sterilise for the next day.
Using bottled water
Tap water is usually safe to use, but there may be times when you need to use bottled water, such as if you are on holiday, have a boil notice on your water supply or have a water softener system.
When using bottled water, only use still water, and ensure that it has a sodium content of less than 20mg/L. Always boil bottled water before making up feeds.