Bottle-Feeding

Overview

A lot of people bottle-feed their babies. Sometimes it's a personal decision. Sometimes there's a medical reason, like HIV infection or certain cancer treatments. Many adoptive parents bottle-feed. You can bottle-feed using breast milk or formula.

Formula can provide all the calories and nutrients your baby needs in the first 6 months of life. Several types of formula are available. Most babies start with a cow's milk–based formula. Talk to your doctor before trying other types of formula, which include soy and lactose-free formulas.

Your newborn baby probably will want to eat every 2 to 3 hours. Don't worry about the exact timing for the first few weeks, but feed your baby whenever they are hungry. In general, your baby should not go longer than 4 hours without eating during the day for the first few months. Sit in a comfortable chair with your arms supported on pillows.

Does your baby need extra vitamins or minerals?

Doctors sometimes prescribe vitamin or iron drops for newborns. These drops help babies get the nutrition they need.

It's fairly common for a baby to need:

• Extra iron. Babies born early haven't had enough time to build up an iron supply before birth. So they usually get extra iron for the first few months after birth.
• Extra vitamin D. Breast milk does not have a lot of vitamin D. Many doctors prescribe vitamin D drops for babies who are breastfed. And formula-fed babies who might not be eating enough may also get vitamin D drops.

If you have questions, talk with your doctor about what is right for your baby.

How to Bottle-Feed

Getting ready to bottle-feed

• Prepare your supplies for bottle-feeding before your baby is born, if you can.
  • Have a supply of small bottles (usually 4 ounces) for your baby's first few weeks.
  • You may want to buy a variety of bottle nipples so you can see which type your baby likes.
  • Before you use bottles and nipples the first time, wash them in hot water and dish soap. Then rinse them with hot water.

Using infant formula

• If you plan to use formula, ask your doctor which kind to use. You can buy it as a liquid concentrate or as a powder that you mix with water. Formulas also come in a ready-to-feed form. Always use formula with added iron unless the doctor says not to.
• Make sure you have clean, safe water to mix with the formula. If you aren't sure if your water is safe, you can use bottled water. Or you can boil tap water.
  • Boil cold tap water for 1 minute, then cool the water to room temperature.
  • Use the cooled boiled water to mix the formula within 30 minutes.
• Wash your hands before you prepare the formula.
• Read the label to see how much water to mix with the formula. If you add too little water, it can upset your baby's stomach. If you add too much water, your baby won't get the right nutrition.
• Cover the prepared formula, and store it in a refrigerator. Use it within 24 hours.
• Soak dirty baby bottles in water and dish soap. Wash bottles and nipples in the upper rack of a dishwasher. Or you can hand-wash them in hot water with dish soap.

Using breast milk

• If you plan to use a bottle to feed breast milk to your baby, you can safely store pumped milk in plastic bottle liners, small freezer bags, or glass bottles.
• Wash your hands before you touch the containers. If you use bottles, make sure they are clean.
• Thaw frozen breast milk carefully. Run warm water over the container. You can also thaw breast milk overnight in the refrigerator. Don't refreeze thawed milk.
• You can keep breast milk at room temperature for 6 to 8 hours if the milk was collected under clean conditions. This means using properly washed hands and properly cleaned pump parts and containers.

How to bottle-feed

• Warm the formula or breast milk to room temperature or body temperature before feeding. The best way to warm it is in a bowl of heated water. Do not use a microwave oven. It can cause hot spots that can burn your baby's mouth.
• Before feeding your baby, check the temperature of the formula or breast milk by dripping 2 or 3 drops on the inside of your wrist. It should be warm, not cold or hot.
• Place a bib or cloth under your baby's chin to help keep clothes clean. Have a second cloth handy to use when burping your baby.
• Support your baby with one arm, with your baby's head resting in the bend of your elbow. Keep your baby's head higher than their chest.
• Stroke the center of your baby's lower lip to encourage the mouth to open wider. A wide mouth will cover more of the nipple and will help reduce the amount of air the baby sucks in.
• Angle the bottle so the neck of the bottle and the nipple stay full of milk. This helps reduce how much air your baby swallows.
• Do not prop the bottle in your baby's mouth or let them hold it alone. Avoiding those things can reduce your baby's chances of choking or getting ear infections.
• During the first few weeks, burp your baby after every 2 ounces of formula or breast milk. This helps get rid of swallowed air and reduces spitting up.
• You will know your baby is full when they stop sucking. Your baby may spit out the nipple, turn their head away, or fall asleep when full. Newborn babies usually drink from 1 to 3 ounces each feeding.
• Throw away any formula or breast milk left in the bottle after you have fed your baby. Bacteria can grow in the leftover formula or breast milk.
• To reduce spitting up, try holding your baby upright for about 30 minutes after they eat.

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When to Feed Your Baby

From birth, babies follow their internal hunger and fullness cues. They eat when they're hungry and then stop eating when they're full. Experts agree that newborns should be fed on demand. This means that you bottle- or breastfeed your infant whenever they show signs of hunger, rather than setting a strict schedule.

How often your baby needs to eat will depend on your baby's age and how hungry they are at that moment. Here are some things to expect or try as your newborn grows.

Managing feedings

At about 3 weeks, you can try to delay feeding for a short time by cuddling or talking with your newborn. Your newborn's nervous system is mature enough that they can wait longer between feedings and interact with you more at this age. But take cues from your baby. Don't force your baby to interact when they are not engaging with you or seem very hungry.

You might be able to limit nighttime feedings if you avoid socializing with your baby and lingering after they have finished eating. Your baby will feed and go back to sleep easier if they are calm.

• As your baby wakes up for feeding, try to respond before they start to cry a lot.
• During the feeding, keep the light off and use a soft voice.

If you want to give your baby more attention during nighttime feedings, plan for a time you can rest the following day to avoid fatigue.

By age 2 months, many babies start to eat less often at night.

At age 3 to 4 months, babies become more and more interested in the world around them. Babies often interrupt feedings by looking around, smiling, cooing, and reaching for a parent's face. This is a normal attempt to turn feeding times into a more social event. It's a good time to interact with your baby.

Adding solid foods

At about 6 months, most babies can start to eat solid foods. Some babies may be ready for solid foods at 4 or 5 months. Solid food is given along with breast milk or formula.

• Ask your doctor when you can start to feed your baby solid foods. Follow your doctor's advice on when and what to feed your baby.
• Try to be patient as your baby experiments and learns new skills like chewing and using a spoon.

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When to Call a Doctor

Call your health care provider if your baby:

• Is not growing and gaining weight as expected. About a 2 lb (1 kg) weight gain per month is usually expected for the first few months after birth.
• Is constipated or has stools that are hard and/or dry.
• Is vomiting forcefully and seems to be uncomfortable. When vomiting occurs, all or most of a feeding is thrown up.
• Has diarrhea or a skin rash or is vomiting or crying and can't be consoled. Your baby may have developed a cow's milk intolerance or food allergy.
• Has gas, bloating, cramps, or diarrhea after drinking milk or eating dairy products. Your baby may have lactose intolerance.
• Has dark areas on the teeth or other signs of tooth decay.