Bottle Feeding and Doing it Right!
Breastfeeding is the ideal way to feed babies. It’s the way nature designed humans to feed our young. That being said, there are many reasons why babies may need to be fed differently. The reasons are endless, including medical, separation between mother and baby, mother’s choice and more. Instead of alienating mothers that have decided to bottle feed their babies for one reason or another, nurses and other healthcare providers should be inclusive of their teaching.
That’s not usually the case in this day and age. Even though breastfeeding is not yet the norm in western society, bottle feeding isn’t either. Moms are often riddled with a ton of guilt when making the choice to bottle feed. That makes me so upset! The guilt aspect of feeding your baby is not the purpose of this post and I’m not trying to normalize bottle feeding either. I would just like to teach the proper way to prepare a bottle of formula because it’s extremely important for parents to know how to do it safely.
This post will cover how parents, who have made an informed decision to bottle feed their baby, should safely prepare and formula. The information is extracted from a new Ontario resource, developed by Best Start. They refer to formula as “breast milk substitutes”, but for convenience and understanding, I will continue to use the word formula to describe the substance we use to feed babies when they are not breastfed.
Learn more about how to bottle feed your breastfed baby at Mom Loves Best
Which Formula to Choose?
Typically, most babies can tolerate a cow milk based formula. If you think your baby isn’t tolerating it talk to your health care provider. In rare instances, babies need a soy based or hypoallergenic type of formula. This is rarer than people actually think, so before switching, talk to your pediatrician or family doctor or whoever you trust to inform you on your baby’s feeding needs.
Different types of formula are available. In Canada, all formula has to meet certain standards to be available for purchase. This varies between countries, so please talk to your health care provider about which formula to use for your baby. In Canada, we have the option of ready-made, concentrated liquid and powdered formula, which I think are the same options in most westernized countries. Ready-made requires no prep while concentrated liquid and powdered formula need to be mixed with sterile water before feeding.
All equipment used to prepare bottles, including the bottles, nipples, measuring cups and tongs (not an inclusive list, just sterilize anything that you use for the preparation) are to be sterilized for each preparation, regardless of the baby’s age. Isn’t that surprising? I think a lot of parents stop sterilizing once baby reaches a certain age, but that’s not the best practice. Note, some doctors are not aware of this so they might tell you otherwise.
The best way to sterilize equipment is to boil it in a pot for 2 minutes. The water needs to be bubbling for 2 minutes for it to fully sterilize anything inside. There are various tools out there for sterilizing, such as bottle sterilizers, but good old-fashioned pot boiling for 2 minutes is the most reliable.
It is recommended to use BPA-free or glass bottles for babies.
Sterilizing Water and Mixing Formula
Your options for water are tap, bottled and tested well water. Even if you use bottled water, it still needs to be sterilized. Just as with the equipment, water is sterilized by boiling it in a pot for 2 minutes. It has to be brought to a rolling boil, which is when the bubbles come up to the surface. Once it reaches a rolling boil, then set your timer for 2 minutes. Kettles aren’t sufficient because they turn off once the water has boiled, so you won’t reach your 2 minute boiling requirement.
First thing’s first. WASH YOUR HANDS! For concentrated liquid formula, you should cool the water before mixing. For the powder formula, it’s better to cool to just above 70 degrees Celsius before you mix the powder with the water. This will kill some harmful bacteria that may be present in the powder. Do not mix boiling water with powder. If you cool down to room temperature before mixing then use that bottle right away. With concentrated formula, you can cool the water to room temperature before mixing.
Measure both the powdered and concentrated formula according to directions on the container. Please do this VERY accurately with a measuring cup, as not to end up with the wrong amount of calories and nutrients for your baby, which can be very dangerous to their health.
This is the main reason formula is sometimes considered dangerous in third world countries. People there might not have access to safe water or are too poor to put enough powder in their babies bottles. This can lead to severe illnesses and death.
Storing Formula Over Time
It is recommended to store prepared formula bottles at the back of your fridge. This is because that is where the least temperature changes occur. Formula bottles prepared from concentrate or powder can be stored there for 24 hours and have to be thrown out after that.
The unmixed powder itself should have a tightly closed lid and stored in a cool, dry place. After it’s been opened it can be stored for one month. The concentrate and ready-to-feed can be kept covered in the fridge for 48 hours, or follow instructions on the label. Do not store bottles for more than 1 hour if the baby has drunk from the bottle, and not finished it. Never, ever freeze formula! Just don’t.
Make sure you keep the bottles in the fridge until right before you warm it for a feeding. Again, it is better to prepare the bottle and use it right away, but sometimes parents have to plan a bit in advance. Ideally, you should use warm water or a bottle warmer to heat up the formula. NEVER use a microwave. Shake the bottle a few times while warming to even out the heat throughout. Go ahead, shake, shake, shake! Don’t warm for longer than 15 mins. To test the temperature, use the classic method of putting a drop on the inside of your wrist. Your skin is thin there, and you’d feel it if the formula was too hot. Feed your baby! Never reheat partly used bottles or during a feed.
On the Go!
The best formula to use on the go is unopened ready-to-feed. If you’re using the concentrate or powder, don’t make it until your baby is ready to feed, so bring cooled sterilized water with you and prepare the formula at your destination. If your only option is to bring pre-mixed bottles, make sure to refrigerate them as soon as you can, or you can keep them in a cooler bag for up to 2 hours. The unused bottle can only be returned to the fridge if it is kept cold while travelling or is out of the fridge for less than 2 hours.
How to Bottle Feed
Your newborn can and should be kept skin-to-skin during bottle feeding, even though you are not breastfeeding. It still has all the benefits for you and your baby.
You should feed your baby on cue. There is no accurate timetable, just feed when your baby tells you they’re hungry. Obviously, they don’t talk as newborns, haha, so feed them when they show signs of hunger.
The same goes for volume. Use a paced bottle feeding method. This is where you let your baby suck the bottle nipple to get the formula out, holding the bottle horizontally, instead of making baby finish a certain amount by using gravity and essentially pouring the bottle into baby’s mouth. This helps your baby develop self-regulation and might reduce obesity in bottle-fed babies.
This post was developed using Best Start’s resource Infant Formula: What You Need to Know.