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Feeding your baby infant formula by bottle: Information for parents

Patient information

What infant formula to use

If you are giving your baby infant formula, first infant formula (whey-based) is the only formula they will need for the first year of life.

What infant formula should I use?

It doesn't matter which brand you use, they're all very similar. It doesn't matter if you choose a cows' or goats' milk based formula, but talk to your midwife or health visitor before choosing a soya based formula.

What about all the other milks that claim to help hungry babies, prevent colic, wind, reflux or other allergies?

There is no evidence that most of these "special" milks do any good, and they might not be safe for your baby. Ask your GP or other health professional if you think your baby might need a different milk.

Should I move on to follow-on formula when my baby is six months old?

There is no need for follow-on formula. Stick to a first infant formula throughout the first year.

How long do I need to use infant formula for?

When your baby is one year old, they will be getting more of their energy, vitamins and minerals from good, and full fat cows' milk can be their main milk drink. If you have any concerns, or want to know about other milks, ask your health visitor.

Want to know more?

A simple, up to date guide on infant milks can be downloaded at firststepsnutrition.org.

Unicef UK provides a guide on different types of infant milks, available for download at babyfriendly.co.uk.

Responsive bottle feeding

The early days with your baby is a great time to get to know and love each other. This can be done by keeping your baby close to you, enjoying skin contact and feeding according to these tips. Babies will feel more secure if most feeds are given by my mum and dad, especially in the early weeks, as this will really help you bond with each other.

  • Feed your baby when they show signs of being hungry: look out for cues (moving head and mouth around, sucking on fingers). Crying is the last sign of wanting to feed, so try and feed your baby before they cry (for more details, see the Start4Life guide to bottle feeding).
  • Hold your baby close in a semi-upright position so you can see their face and reassure them by looking into their eyes and talking to them during the feed. Begin by inviting baby to open their mouth: gently rub the teat against their top lip.
  • Gently insert the teat into baby's mouth keeping the bottle in a horizontal position (just slightly tipped) to prevent milk from flowing too fast.
  • Follow baby's cue for when they need a break and gently remove the teat or bring the bottle downwards to cut off the flow of the milk.
  • Your baby will know how much milk they need. Forcing your baby to finish a feed will be distressing, and can mean your baby is overfed.

Non-urgent advice: Why is closeness and comfort important for your baby's development?

  • Helps your baby feel secure
  • It is good for your baby’s brain development
  • Cuddle and comfort your baby as much as you like – you can’t ‘spoil’ a baby with love!

Non-urgent advice: Top tips for parents in the early weeks

  • Try holding your baby skin to skin
  • Consider limiting the number of people who feed your baby
  • Look out for feeding cues in your baby
  • Hold and talk to your baby, avoid leaving them to cry
  • Keep your baby in the same room as you at night for the first six months
  • Hold your baby close and look into their eyes when they feed

How to make up a feed

Preparation and hygiene

Even when tins and packets of powdered infant formula are sealed, they can sometimes contain harmful bacteria that could make your baby ill. Although these bacteria are rare, the infections they cause can be life-threatening.

Non-urgent advice: Key fact

To reduce the risk of infection, make up each feed as your baby needs it, using boiled water at a temperature of 70°C or above. The step-by-step guide shows you how to do this. Water and this temperature will kill any harmful bacteria that may be present. Remember to let the feed cool before you give it to your baby.

A baby's immune system is not as strong nor as well developed as an adult's. This means that babies are much more susceptible to illness and infection. Therefore, good hygiene is very important when making up a feed.

All equipment used to feed your baby must be sterilised. Bottles, teats and any other feeding equipment need to be cleaned and sterilised before each feed to reduce the chances of your baby getting sickness and diarrhoea.

It is best to use drinking water from the tap that has been freshly boiled (and cooled slightly to 70°C or above) to make up a feed. Do not use water that has been previously boiled or artificially softened water.

This is because the balance of minerals in previously boiled water and artificially softened water may not be suitable for making up formula feeds.

Non-urgent advice: Key fact

Do not boil water in advance and store it in sterilised bottles in the fridge for later use. The water needs to be hot when the powdered infant formula is added, to kill any harmful bacteria that may be present.

Bottled water

Bottled water is not recommended to make up a feed as it is not sterile and may contain too much salt (sodium) or sulphate.

Water labelled as 'natural mineral water' may contain too much salt (sodium) or sulphate. If you have to use natural mineral water to make up a feed, check the label to make sure the sodium (also written as Na) level is less than 20 milligrams (mg) per litre, and the sulphate (also written as SO₄) content is not higher than 250 milligrams (mg) per litre.

Like tap water, bottled water is not usually sterile, so if you have to use you will still need to boil it before you prepare the feed.

A step-by-step guide to preparing a powdered-formula feed

Please see the downloadable document below for a handy step-by step guide on preparing a feed.

Ready-to-feed liquid infant formula

Ready-to-feed liquid infant formula is sterile. This can help reduce the risk of infections. It is suitable for high-risk infants - for example, those that are pre-term, low-birthweight or particularly vulnerable to infections.

Ready-to-feed liquid infant formula should be prepared and stored according to the manufacturer's instructions. Remember that all feeding equipment will still need to be sterilised if you are using ready-to-feed liquid formula.

Non-urgent advice: Key fact

Once opened, any unused liquid infant formula that remains in the carton to be stored at the back of the fridge on the top shelf with the cut corner turned down, for no longer than 24 hours.

Storing a feed

A feed should be freshly made up when it is needed to reduce the risk of infection that can make your baby ill. If you have no choice and need to store a feed, it should always be stored at the back of the fridge and for no longer than 24 hours.

Any infant formula left in the bottle after a feed should be thrown away.

Infant formula that has not been used and has been kept at room temperature must be thrown away within two hours.

Bacteria multiple very fast at room temperature. Even if a feed is kept in a fridge, bacteria can still survive and multiply,, although they do this more slowly. The risk of infection increases over time so that is why it is important to make up the feed each time your baby needs it.

For more information please speak with your midwife or health visitor

References

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