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Bottle Feeding Advice

Breast milk is the best choice for babies. Sometimes it is not possible for infants to exclusively feed directly from the breast and the use of bottles may be required to feed expressed breast milk or an infant formula.

Some mums choose to combine breast with formula feeding (mixed feeding). Others find that expressing breast milk and feeding using a bottle can be handy and can give their partner the chance to get involved with feeds. And some mums will (for whatever reason) switch to an infant formula completely.

Whatever you choose, this section will help you prepare yourself and your baby for the introduction of a bottle and explain why introducing formula feeding can be a decision that is difficult to reverse. We'll also look at the practical considerations, like what equipment you'll need, how to sterilise and prepare bottles and how much and how often your baby should feed.

  • Mixed breast and bottle feeding

     
    • Many mums who choose mixed feeding say it offers the best of both worlds. Their baby still gets the benefits of breast feeds, yet it gives mums more freedom to bottle feed if they need to be away from their babies.

      Many women will express and store enough breast milk to give to their babies via a bottle for when they are unable to breast feed.

      For women who are unable to express and store enough breast milk to meet their baby's requirements, they may choose to combine breast feeding and some formula feeding.

      Mixed feeding can also enable your partner to be more involved in feeding, especially with night feeds. However dads can be more involved in many other aspects of baby care.

      It's important to realise that the less your baby breastfeeds, or if you do not express breast milk, the less breast milk your body will produce and it can be difficult to switch back to breast feeding once you've introduced formula.

      If milk is not regularly removed from the breast and remains static, your body will produce less milk. Babies are also more effective at removing milk than most commercial pumps or hand expressing, although these are still workable solutions. The point is, that to ensure good supply there is nothing better than a baby put to the breast and allowed to feed on their individual hunger cues.

      Mixed feeding is a big decision and one that should not be taken without consulting your health care professional first.

  • When to start mixed feeding

     
    • Mixed feeding should not be considered until breast feeding is well established - as a guide, this is usually around six to eight weeks but some women will have to introduce a bottle earlier, in which case it is advised to avoid introduction until your baby is 3-4 weeks old. This is because it takes several weeks for your supply to build up and demand feeding an infant is the best way to ensure a good milk supply is established.

      If feeding from a bottle is introduced before you've established breast feeding, you can reduce your milk production and your baby may develop a preference for bottle feeding and give up on breast feeding altogether.

      Introducing a bottle after three months of age may be met with bottle refusal by some babies. While many of these babies can adjust after a period of time to taking a bottle, some may not and alternate means of feeding (i.e. cup) will be necessary. Most health care professionals agree however that overcoming bottle refusal is easier than the potential problems that can arise if a bottle is introduced too early.

      Preparing to introduce formula

      Introducing formula is a big decision both physically and emotionally. For some infants it can be difficult to introduce a bottle as they are used to being breast fed. Once babies are on formula and the change has been made, it can be difficult to reverse, particularly if breast milk is not being expressed to maintain supply. Make sure you have spoken with your health care professional about the decision to move from breast feeding to formula feeding first.

      • If you wish to reduce breast feeding, the approach to weaning will be dependent on how old your baby is, whether you want to completely wean or mix feed your baby, and what your individual milk supply is like. Your health care professional is the best person to help suggest suitable approaches to weaning, or contact one of our experts. For an older baby, dropping one feed every few days or each week may help minimize breast discomfort. Hand expressing to alleviate breast fullness and discomfort associated with milk stasis should also be considered as this may help prevent breast engorgement or leaking.
      • Your body will soon learn to stop producing breast milk at the time you choose to drop a feed from the breast and formula feed instead. For example, if this is at night, you'll begin to stop producing milk for this feed.
      • Changing one feed at a time may give your breasts time to adjust to the reduced milk requirements and stop them becoming painful or engorged. If your breasts feel as if they're full or uncomfortable, you can express some milk - just enough to relieve the pressure. This is important to help reduce any risks associated with blocked ducts or engorgement.
      • Some women may notice that their overall supply becomes affected with the introduction of formula feeds. In this instance putting the baby back onto the breast frequently and expressing following breastfeeds (in some cases up to eight times or more in 24 hours to increase a reduced supply) may be helpful in boosting your milk supply again. Other women will find that their body regulates around the formula feed and they still produce sufficient quantities of milk. The more reliant on formula feeds, the less your body will begin to produce. Once you've made the step it can be difficult to switch back.
      • Think carefully about which feeds you'd like from the breast and which with the formula. Sticking to a regular routine will get your breasts used to producing the right supplies of milk at the right time. Just remember to go slowly and give your body time to adjust.
      • If you have concerns about your supply contact one of our advisors or your health care professional who may be able to refer you to a lactation consultant.

      It can take time to work out a mixed feeding routine that both you and your baby are comfortable with, so try to be patient. If you'd like some advice on mixed feeding speak to your health care professional, or give one of our team a call on 1800 438 500 or contact us on LiveChat.

  • Bottle feeding with expressed breast milk and formula

     
    • Getting your baby used to bottles

      Whether you are bottle feeding with expressed breast milk or formula, not all breast fed babies switch to bottles easily in the beginning. If your baby is not taking to the bottle, try:

      • Warming your baby's milk before feeding.
      • Letting someone else feed your baby (leave the room so your baby can't see you or smell your breast milk).
      • Try holding them in a different position, such as propped up against your front and facing away from you.
      • Experiment using different types of teats or warming the teat first.
      • Allow your baby time to "play" with the teat - to chew and lick it. This is part of their way of familiarizing themselves with the new teat and often occurs prior to learning how to suck from it.

      Choosing the right time to introduce a bottle

      • You're advised to wait until breast feeding is firmly established before introducing a bottle of expressed breast milk or formula - as a guide, that's around six to eight weeks. This is because it takes this long to encourage a good supply of milk and introducing bottle feeding before this time may make it difficult to establish a good supply.
      • Because the mechanics of sucking milk from a bottle are different than from a breast, it may take your baby some time to get used to the change.
      • If you are returning to work, give yourself at least two to three weeks prior to your start date to work through any new challenges you may face, such as how to sterilise bottles, baby accepting milk from a bottle, and how to bottle feed.

      Be prepared

      Make sure you have all the equipment you need: bottles, teats, sterilisers etc, and carefully read the instructions for making up your feeds.

      Helping your baby adjust to bottle feeding

      Some babies take longer to adjust to bottle feeding than others but there are things you can try, such as:

      • Try offering the bottle a bit earlier than regular feeding time so baby is hungry but not so hungry that they will become frustrated with the change of nipple.
      • Try feeding your baby milk (expressed breast milk or formula) at different temperatures - some babies prefer body temperature (like breast milk) while others prefer it cooler.
      • Experiment with different teats.
      • Ask someone else to feed your baby and leave the room so they can't see or smell you. Your baby may be less confused if someone else is feeding them instead - just for the introduction phase.
      • Use a toy or music to distract them while they feed.
      • Try feeding your baby using a sipper cup if they are over six months old and finding a bottle difficult to get used to.
      • Express some breast milk to bottle feed with - the familiar taste may help your baby get used to feeding from a bottle.
      • Let your baby play with the teat to get familiar with it. They may lick or chew on it which is their way of understanding it. The sucking may start after that.
      • If your baby has a pacifier, then try using a teat that is similar. Sometimes warming the teat first may make it more easily accepted.
      • Try feeding your baby in a different position until they are used to taking a bottle and then you can hold your baby as you usually would for a feed.
      • Stay relaxed - if you're relaxed it will help them settle down too.
      • Be patient. It may take time, but your baby should get used to feeding from a bottle eventually. It's normal for many babies to push a bottle away and protest initially. With comfort and perseverance babies adjust in time, but the last thing you want is a battle or negative associations with a bottle. If after a few attempts baby refuses, leave it for a day and then try again.
      • Don't breastfeed immediately after but delay it around 10 minutes or so and do something else before giving the breast so your baby doesn't associate bottle refusal with breast gain.

      Bonding with a bottle fed baby

      Be sure your baby gets the same amount of one-to-one, nurturing and cuddly time with you and a bottle as they did with you and the breast. Babies love the closeness of breast feeding. So if you're bottle feeding, you can encourage bonding by giving your baby lots of skin contact when feeding. Talk to them, sing to them and make plenty of eye contact with them too.

      It can take time to work out a mixed feeding routine that both you and your baby are comfortable with, so try to be patient. If you'd like some advice on combination feeding speak to your health care professional, or give one of our team a call on 1800 438 500 or call us on LiveChat.

  • Bottle feeding equipment

     
    • Before you begin bottle feeding you'll need to buy:

      Baby bottles

      • Four to six baby bottles generally suffice alongside regular sterilization of equipment. The amount of times a baby feeds is dependent upon its age so ensure you always have enough bottles on hand.
      • Baby bottles come in a variety of sizes and widths. When choosing your baby's bottle, it may come down to what you and your baby prefer. It may be worth buying the larger sized bottles as your baby will grow out of the small ones.

      Teats

      • Four to six teats.
      • Teats are available in a variety of shapes, sizes, flow rates and materials. The right type of teat for you and your baby will depend on what milk you are using and your baby's preference. For newborns, it's best to start with slow flowing teats, increasing the flow speed as your baby grows and gets used to sucking.
      • If your baby chokes, splutters or leaks milk from their mouth during feeding it may be a sign that the flow is too fast - try a slower flowing teat. Again, if you think your baby is struggling with bottle feeding, switch to a different type or make of teat. Teats don't last forever and may wear over time and may need replacing, particularly if your baby has teeth and bites. So be sure to check them regularly and make sure you pick a size to suit your baby's stage of growth.

      Equipment for sterilising

      Your baby's immune system is still immature, especially if your baby is under six months old. Sterilising feeding equipment is therefore important. The equipment required depends on the sterilising method you have chosen. There are three ways to sterilise your baby's feeding equipment:

      • Boiling
      • Steam sterilising - using an electric steam steriliser or microwave sterilising
      • Cold water sterilising - sterilisation tablets

      A bottle brush for cleaning bottles

      Before you sterilise bottles and teats, ensure you clean the bottles and teats thoroughly using warm soapy water and scrub them with a bottle-cleaning brush (you could also put them through the dishwasher).

      Your choice of infant formula

      If you choose to formula feed your baby, there are many formula choices available from different brands. Whilst each provides adequate nutrition for infants there are differences between the types and amounts of ingredients used. Consult your health care professional before introducing a formula and talk about how to choose an appropriate formula for your baby.

      If you have any questions about bottle feeding equipment, give our expert team of health care professionals a call on 1800 438 500. Or chat to us online with our instant messaging service, LiveChat.

  • Preparing Formula

     
    • Making up a bottle feed isn't difficult but, as with doing anything new, it can take a bit of practice. That's why we've put together our step-by-step guide to preparing a bottle feed. Have a read through online or print it out and keep it to hand, so you can refer to it until you've got the hang of things.

      Remember, if you'd like any more help on preparing a bottle feed, you can always give our advisors a call on 1800 438 500.

      • Wash bottles and teats thoroughly.
      • Wash your hands and wipe clean all surfaces to prevent the spread of germs.
      • Sterilise all utensils by boiling or using an approved steriliser.
      • Measure required amount of cool, boiled water (refer to on-pack instructions) into a sterilised bottle or a sipper cup.
      • For accuracy, always use scoop provided and level off powder with built-in leveller.
      • Alternatively, level with a clean, dry knife.
      • Do not press extra powder into scoop.
      • Add correct measure of powder to water.
      • Adding too many or too few scoops can be harmful.
      • The feeding instructions on the pack will give you an indication of the number of feeds your baby may need per day.
      • Screw cap on bottle or sipper cup and shake well to dissolve powder in water.
      • Test temperature of milk by allowing some drops to fall on your wrist. If it feels comfortable, it should be just right for your baby.
      • Use made-up feeds immediately.
      • Discard any leftover milk, wash bottles and teats, ready to be sterilised for next feed.

      Important considerations when preparing formula

      • Check expiry date of formula on base of can or back of sachet.
      • Hands should always be washed and dried before expressing milk or preparing formula and bottles.
      • Always use sterilised bottles and teats for babies up to 12 months of age.
      • Always use the scoop provided with the formula because different formulas may have different scoop sizes.
      • Always keep formula in its original can and cover with the plastic lid to prevent contamination of the powder. Do not transfer the powder to another container because there is a high risk of contamination.
      • Follow manufacturer's instructions when preparing feeds and don't add more or less powder than recommended. It is important that the formula is made up correctly so the infant gets the correct amount of nutrients.
      • The cooled, boiled water should always be put in the bottle first and then the powder added.
      • Bottles containing the sterilised water can be refrigerated for up to 24 hours.
      • Prepared formula should be used immediately. Make up each feed fresh as needed. Do not store prepared formula for later use.
      • Once an infant has had some formula from the bottle, the feed should be used within one hour, and then any leftovers discarded.
      • Do not leave prepared formula sitting at room temperature or in a warm place.
      • Once a can of powdered formula has been opened, it can be safely kept for four weeks if stored in a cool dry place (always check manufacturers' instructions on can).
  • Sterilising equipment safely

     
    • Your baby's immune system is still developing so keeping your baby's feeding equipment clean and sterile is very important. There are a number of safe ways to sterilise infant feeding equipment. Bottles and teats should always be cleaned first to ensure no traces of milk or milk residue remain.

      Steam

      Electric steamers sterilise bottles in 8-12 minutes. They leave no unpleasant smell or taste but are not suitable for all equipment (check the manufacturer's instructions before sterilising in an electric steamer). It is important to ensure the openings of the bottles and teats are facing downwards in the steriliser and that the manufacturer's instructions are followed.

      Microwave

      Steam sterilising units create steam in the microwave which sterilises bottles and teats in 8-10 minutes.

      It is important to follow the manufacturer's instructions, especially concerning the correct amount of water to use.

      This method is not suitable for glass bottles, as glass retains heat and can become extremely hot in the time it takes to sterilise. Teats should be placed upright not laid flat, as this allows the steam to circulate to all areas of the teat.

      Boiling

      To sterilise a bottle by boiling, completely submerge all the feeding equipment in boiling water for five minutes. The water should cool before taking the equipment out and then shake off excess water.

      Cold water

      Using an approved sterilisation tablet (prepare the sterilising solution according to the manufacturer's instructions) takes about 30 minutes and is highly effective. The solution should be made up in a plastic container. It is important that the bottles and teats are fully submerged in the container (no air gaps). The bottles can stay sterilised in the water for up to 24 hours.

      If you'd like any more tips on sterilising your equipment safely, feel free to give our advisors a call on 1800 438 500 or call us on LiveChat.

  • How much you should formula feed

     
    • The table below provides a guide to how much and often you should feed your baby, relative to their age. If your baby is premature or was born at a low birth weight, their feeding requirements will be different. Your health care professional will be able to advise you if you are at all unsure.

      AgeApproximate quantity of formula per feedNumber of feeds per day
      Up to 1 week 50mL 7 - 9
      1 week to 1 month 100mL 6 - 8
      1 to 2 months 150mL 5 - 6
      2 to 4 months 200mL 5
      4 to 6 months 250mL 4 - 5
      6 to 9 months 250mL 3 - 4
      9 to 12 months 200mL 3 - 4

      Important

      • The feeding guide is a general guide ONLY; your baby may need more or less than shown.
      • ALWAYS REFER TO THE BACK OF THE CAN OF YOUR SPECIFIC FORMULA FOR GUIDANCE.
      • Always use the scoop provided in the can and follow manufacturer's instructions for preparation.

      How to time feeds

      If you're trying to gauge how long your baby is feeding for, and how long they are going between feeds, time feeds from the moment they start until the beginning of the next feed.

      If you have any questions about your baby's feeding habits, you can call our expert team on 1800 438 500. Or chat to us online with our instant messaging service, LiveChat .

AptaNutrition ® 2016