If your baby can't always feed directly from your breast, you might choose to bottle-feed her expressed breastmilk. This will keep up your milk supply and make sure baby gets the benefits of breastmilk. Or you might need to feed your baby infant formula, which is the only safe alternative to breastmilk.Before you bottle-feed your baby, it's important to know how to clean and sterilise bottle-feeding equipment, as well as how to prepare, warm and store bottles of formula. This will help to keep your baby safe from infection and make sure he's getting the right nutrition.
Getting formula or milk to flow when bottle-feeding
To test the flow of the formula or breastmilk, hold the bottle upside down when it's filled with liquid at room temperature. The liquid should drip steadily but not pour out.
If you have to shake the bottle vigorously to see the drip, the flow is too slow. Your baby might go to sleep before she drinks what she needs.
A little leakage at the corners of baby's mouth while he feeds is nothing to worry about - as he gets older this will stop.
If you have trouble finding the perfect teat, go for a faster teat rather than a slow one. It's normal to have to try a few different teats before you find one that suits you and your baby.
Giving baby the bottle
Make yourself comfortable and cuddle your baby close to you, holding her gently but firmly. It's better for her to be on a slight incline so any air bubbles rise to the top, making burping easier.
Put the teat against baby's lips. He'll open his mouth and start to suck. Keep the neck of the bottle at an angle so it's filled with formula or milk.
When your baby stops sucking strongly or when she has drunk about half the formula or breastmilk, gently remove the bottle and see whether she wants to burp. Once you've tried burping your baby, you can offer the bottle again.
It's a good idea to change the direction your baby is facing for part of the feed or at different feeds. This helps to stimulate your baby's senses equally.
Babies who are normally breastfed might find it hard to pace themselves when bottle-feeding. This is because they're used to controlling the flow of breastmilk. Sometimes these babies can end up drinking too much too quickly.
To help make bottle-feeding more like breastfeeding, you can try paced feeding. This involves holding your baby in an upright position and letting him rest every few minutes.Holding, cuddling and talking to your baby while she's feeding will help her develop and grow. It's also a great opportunity to bond with your baby.
When baby doesn't finish the bottle
If your baby goes to sleep during a feed, put him over your shoulder, rub his back, and stroke his head, legs and tummy to wake him up. A nappy change is a good way to wake him up if that doesn't work.
Wait until your baby is properly awake before offering her the rest of the formula or breastmilk.
Let your baby decide when he's had enough infant formula or breastmilk. Babies are very good at judging how much they need, so don't worry if he doesn't finish the bottle.
Always throw away any leftover infant formula or breastmilk after one hour. Storing half-empty bottles for future use is risky because they get contaminated quickly once they've been sucked on.
How much do bottle-feeding babies drink?
Babies commonly have 6-8 feeds every 24 hours, but there's no set amount of food or number of feeds your baby should have. Different babies drink different amounts of formula or breastmilk. Some might have some feeds close together and others further apart. Just feed your baby whenever she's hungry.
The following is a general guide for formula-fed babies:
- Your baby needs around 150 ml of formula per kilogram of body weight per day until he's three months old. Some babies might need up to 200 ml of formula per kilogram of body weight per day, especially preterm babies. So a one-month-old baby who weighs 4 kg might have between 600-800 ml of formula.
- When your baby is aged 3-6 months, she needs around 120 ml of formula per kilogram of body weight. So a five-month-old baby who weighs 7 kg might have 840 ml of formula a day.
- When your baby is aged 6-12 months, he needs around 90-100 ml of formula per kilogram of body weight. Your baby can also be introduced to solid food when she's ready at around six months, but not before four months.
You can use the chart on the formula tin to see how much infant formula to give, but information about quantity for age on formula tins is just a guide. It mightn't necessarily suit your baby.
Breastfed babies take an average of 750-800 ml of breastmilk per day from one month until about six months. But this can vary a lot between babies.Some babies never drink the 'required amount' for their age and size, and others need more. Plenty of wet nappies, consistent but not excessive weight gains, and a thriving, active baby mean all is well.
Dangers of bottle-feeding in bed
If your baby gets used to falling asleep with a bottle in bed, she might depend on it to get to sleep. This can make it more difficult for your child to fall asleep or settle herself independently.
Bottle-feeding in bed also has several risks for your baby.
Babies who fall asleep while bottle-feeding can draw liquid into their lungs. They might then choke on it or inhale it. This is like what happens when you have something 'go down the wrong way'.
It's more dangerous for your baby than it is for you, because your baby isn't as good at waking up if something interferes with breathing.
Although it's more likely that your baby will cough and be uncomfortable, you might want to avoid the risk altogether.
If your baby falls asleep with a bottle of infant formula, formula might slowly drip into your baby's mouth, soaking your baby's teeth and putting him at risk of tooth decay.
Risk of ear infections
If your baby drinks while lying flat, milk can flow into her ear cavity, which can cause ear infections.
Using a feeding cup
When your baby is around six months old, you can start using a feeding cup to teach your baby how to sip drinks from a cup. You should continue to thoroughly wash the feeding cups containing infant formula or breastmilk until your baby is 12 months old.