HEALTH INSIGHTS

How to Bottle-Feed

April 30, 2017

How to Bottle-Feed

Newborns need nutrition and plenty of loving—2 things you can supply while bottle-feeding. Both breastmilk and formula can be given to your baby in a bottle.

Mother feeding newborn baby with bottle.

Safety tip: Never heat breastmilk or formula in a microwave. This can result in uneven heating. The hot formula 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 breastmilk can burn your baby's mouth or throat. Test the temperature of the formula by dripping a few drops on your wrist. Make sure it is a warm temperature before giving it to your baby. 

Bottle care

No matter if you use breastmilk 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 healthcare provider about how to care for bottles:

  • Wash your hands before you mix formula, fill a bottle, or offer a bottle. Do this every time. If soap and water aren't available, use an alcohol-based hand cleaner.

  • 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. Boil them for 5 minutes and cool them.

  • If you use plastic bottles with disposable liners, you will still need to make sure the bottles and nipples are clean.

  • Store clean, unused bottles and nipples with the nipple end facing into the bottle (inverted). Put the bottle caps on the bottles to keep the nipples clean.

Facts on formula

Baby formula is made from cow’s milk or soybeans. Formula made from cow’s milk is more commonly used. But you may need to use formula made from soybeans. Your baby’s healthcare provider may tell you to use soybean-based formula if your family has a history of allergies or your baby has certain health conditions. All formula used should include iron.

Ready-to-feed formula

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.

  • Once you open the container of formula, it must be stored in the refrigerator. It can only be stored for 24 hours.

  • If not refrigerated, the formula is only safe at room temperature for 1 hour. After that, it must be thrown out.

  • You can fill bottles with the formula up to 24 hours ahead of time. You must keep them refrigerated until you use them. 

  • If your baby does not finish drinking a bottle within 2 hours, throw away the unfinished formula.

  • Ask your healthcare provider how much formula to offer your baby at each feeding.

Concentrated liquid formulas

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 water that has been boiled and then cooled.

  • 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 healthcare provider how much formula to offer your baby at each feeding.

Concentrated powder formulas

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, boiled water before using.

  • 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.

  • Use very hot water to mix with the formula powder. This means water that is 158°F (70°C).

  • Don’t mix the formula with water until right before you are going to feed your baby.

  • Add the right amount of hot water to the bottle. Then add the right amount of powdered formula. It’s important to add the water to the first. Adding the formula first may make it too strong and cause diarrhea.

  • Mix the water and formula well.

  • Test the temperature of the mixed formula by shaking a few drops on your wrist. If it is too hot, cool it by running the bottle under cool tap water. Or put the bottle in an ice bath. Make sure the cooling water does not get into the bottle or on the nipple.

  • If you don’t plan to use the prepared formula right away, put it in the refrigerator and use it within 24 hours.

  • It is important to keep the dry powder in the formula can clean to prevent bacteria from growing.

  • Ask your healthcare provider how much formula to offer your baby at each feeding.

Holding baby and bottle

To hold your baby and feed him or her with a bottle, follow these tips:

  • Cradle your baby in your arm, holding your baby’s head slightly higher than his or her bottom.

  • 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, place the nipple on the tongue and feel him or her pull the nipple into the mouth.

  • Tip the bottle so the nipple fills with milk. For safety's sake, never prop the bottle. Your baby can choke if you leave him or her alone with a propped bottle.

  • 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.

  • Don't let your baby fall asleep while sucking on a bottle. This can lead to tooth decay when he or she is older.

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 him or her.

Burping your baby

It is 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 he or she acts restless, tries to turn away from the nipple, or slows his or her sucking. This is usually after eating every 1/2 to 1 ounce of formula and when he or she is 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 his or her belly against your shoulder.

Feeding cues

  • Don't wait for your baby to cry before feeding. Crying is too late of a sign that your baby is ready to eat.

  • Your baby is ready to feed when your baby flutters his or her eyes and moves his or her hands to the mouth as he or she wakes up.

  • Don't force your baby to finish the bottle. This can lead to obesity.

  • Respect cues that he or she is finished. These include letting go of the bottle, turning his or her head away, looking sleepy, or stopping feeding.

Offer a pacifier if your baby acts like he or she wants to suckle after finishing the amount of formula your healthcare provider recommended. Babies enjoy sucking. But bottle-fed babies may feed so fast that they don’t get enough suckling time.

Updated:  

April 30, 2017

Sources:  

Bhatia, J., Use of Soy Protein-Based Formulas in Infant Feeding, Pediatrics (2008) 121(5); 1062-1068, Hancock, ME., Formula-feeding safety: What nurses need to teach parents who choose to formula-feed, Nursing for Women's Health (2010) 14(4); 302-309, Redmond, EC., Contamination of bottles used for feeding reconstituted powdered infant formula and implications for public health, Perspectives in Public Health (2009) 129(2); 85-94, Shloim, N., Looking for cues - Infant communication of hunger and satiation during milk feeding, Appetite (2017); 108; 74-82

Reviewed By:  

Freeborn, Donna, PhD, CNM, FNP,Godsey, Cynthia, MSN, APRN, MSHE, FNP-BC,Image reviewed by StayWell art team.