How to Bottle-Feed

Newborns need nutrition and plenty of loving. These are both things you can supply while bottle-feeding. Both breast milk and formula can be given to your baby in a bottle.

You don't need to heat breast milk or formula before offering it to your baby. Never use a microwave if you want to heat breast milk or formula. A microwave heats unevenly. Hot milk might burn your baby's mouth. Instead, warm the bottle by putting it in a bowl of warm (not hot) water. Using hot water to heat formula or breast milk can burn your baby's mouth or throat. Too much heat can also destroy parts of breast milk that are healthy for your baby. Test the temperature of the milk by dripping a few drops on your wrist. Make sure it's not hot before giving it to your baby.

No matter if you use breast milk or formula, the bottles, nipples, and tools you use to get the formula ready must be clean. Below are suggestions for bottle care. But talk with your doctor about how to care for bottles:

• Wash your hands with clean, running water before you mix formula, fill a bottle, or offer a bottle. Do this every time. Use an alcohol-based hand cleaner if soap and water aren't available.
• Clean glass bottles and nipples in the dishwasher. Use the hot water setting with a hot drying cycle. Or wash the bottles and nipples with hot, soapy water. Be sure to rinse both completely. If you don't have a dishwasher, sanitize them by boiling them for 5 minutes. Cool them before using.
• Make sure all bottle parts are completely dry before putting them together to store. This will prevent mold.
• You will still need to make sure the bottles and nipples are clean if you use plastic bottles with disposable liners.
• Store clean, unused bottles with the cap on. This will keep the nipples clean.

Most infant formulas are made from cow's milk. All formula used should include iron. Make sure to look for one with iron. Discuss your choice of formula with your baby's doctor. This is to make sure it's the best fit for your baby.

Ready-to-feed formula is the easiest to use, but it also costs the most. Brand names cost more than store-brand formulas because these companies spend more money on advertising.

• Pour the desired amount of ready-to-feed formula into the baby's clean bottle. Ask your doctor how much formula to offer your baby at each feeding.
• Use opened, prepared formula quickly or store it safely. It can spoil if left out at room temperature. You should discard any unused formula after 2 hours of being left unrefrigerated or after 1 hour of beginning feeding. Or, if unused, store it in the refrigerator.
• You can fill bottles with the formula up to 24 hours ahead of time. You must keep them refrigerated until you use them.

Concentrated liquid formulas need to be mixed with water before using. Follow the directions on the can closely. Using too much or too little water may harm your baby. Follow these tips:

• Use tap water that has been boiled and then cooled. Or use distilled bottled water.
• Pour the whole can of concentrated liquid formula into a clean pitcher.
• Fill the can with water to the top and add it to the pitcher. Mix well.
• Pour the desired amount of formula into your baby's clean bottle.
• Store the pitcher of mixed formula in the refrigerator. Keep it for only 24 hours. If not refrigerated, the formula is only safe at room temperature for 1 hour. After that, it must be thrown out.
• Ask your doctor how much formula to offer your baby at each feeding.

Powdered formulas must be mixed with water before using. Liquid formulas have no germs (sterile). But powdered formula can get germs (bacteria) in it when you make it or when you store it. Follow these tips to protect your baby from getting sick from these germs:

• Concentrated powder formulas need to be mixed with clean water from a safe source. This can be distilled bottled water or boiled tap water. If you're not sure if your tap water is safe to use for preparing infant formula, call your local health or water department.
• Wash and dry the top of the formula can before you open it. Make sure the can opener, spoons, scoops, and other tools you use to make the formula are clean.
• Don't mix the formula with water until right before you are going to feed your baby.
• Add the right amount of water to the bottle. Then add the right amount of powdered formula. It's important to add the water to the bottle first. Using too much water can cause your baby to not get enough nutrients. Using too little water can cause the formula to be too concentrated. This can be hard on your baby's kidneys and digestive system and can cause constipation or dehydration.
• Mix the water and formula well.
• To prevent spoiling, use prepared infant formula within 2 hours of preparation when kept at room temperature and within 1 hour from when feeding begins. If you don't plan to use the prepared formula right away, put it in the refrigerator and use it within 24 hours.
• It's important to keep the dry powder in the formula can in a clean, dry, place to prevent bacteria from growing. Do not store the can in the refrigerator.
• Ask your doctor how much formula to offer your baby at each feeding.

To hold your baby and feed them with a bottle, follow these tips:

• Hold baby in side lying position with head elevated slightly higher than body.
• Using the correct position can lower the chance that your baby will choke.
• Stroke your baby's lower lip. When your baby's mouth opens, aim nipple towards roof of mouth and feel them pull the nipple into the mouth.
• Hold the bottle horizontal, tip either up or down to adjust the flow. Your baby should then suckle to remove the milk from the nipple. If your baby is choking or having trouble "keeping up" with the flow, tilt the milk out of the nipple. This will give your baby a chance to breathe and "catch up" to pace the bottle-feeding. It's important that the feeding happens at the baby's pace, and not too fast.
• For safety's sake, never prop the bottle. Your baby can choke if you leave them alone with a propped bottle. Propping bottles can also raise your baby's risk for ear infections.
• Feeding your infant can be a time of bonding and building trust. Hold your baby close to your body, make eye contact, and talk to your baby. These are important ways to help them develop.

If your baby seems hungry but isn't eating well, you can try a different-shaped nipple. You might also check the nipple opening. Some babies prefer a faster flow of milk. They can get frustrated when the flow is too slow. If your baby is gagging and choking, you might need a nipple with a smaller hole. The smaller hole slows the flow.

Experiment with bottle nipples. Let your baby choose which bottle nipple is best for them. If your baby is struggling to feed from a bottle, seek follow-up care with a doctor.

It's easy for babies to swallow air while bottle-feeding. Burping helps your baby get rid of that air. Tips on burping your baby include:

• Burp your baby when they act restless, try to turn away from the nipple, or slow their sucking. This is usually about halfway through the feeding and when they are finished feeding.
• Your baby can be burped sitting up while you hold the baby's jaw, lying face down across your lap, or upright with their belly against your shoulder.

Follow these tips for not overfeeding your baby:

• Feedings can last 5 to 20 minutes depending on the child. Newborn babies feed around 8 to 12 times a day.
• Don't overfeed or force your baby to finish the bottle if they show signs of being full. This can lead to your baby eating more than needed and can cause fussiness. Burp your baby several times during and after feeding. This will allow the passage of gas. This will also space out the feeding and allow time to digest.
• Keep your baby in an upright position during feeding and for 20 to 30 minutes after each feeding.
• Wait at least 2 to 3 hours between feedings so your baby's stomach can empty. Or give smaller amounts more often.

• Don't wait for your baby to cry before feeding. Crying is a late hunger cue.
• Your baby is ready to feed when your baby moves their hands to the mouth as they wake up and turns their head side-to-side looking for a nipple.
• Respect cues that your baby is finished. These include letting go of the bottle, turning the head away, looking sleepy, or stopping feeding.

Offer a pacifier if your baby acts like they want to suckle after finishing the amount of formula your doctor advised. Babies enjoy sucking. But bottle-fed babies may feed so fast that they don't get enough suckling time.