bottle feeding

    Formula Feeding

    Breastfeeding is known to be the best food for babies for the first six months. However, some mothers cannot or decide not to breastfeed. For these babies, infant formula is the safest alternative. You must make the best decision for you and your baby regarding feeding. You will get support to formula feed your baby if you choose, and provided the education you need while you are in hospital.

    If you choose to mixed-feed your baby (supplementing your breastfed baby with formula), you may experience a reduction in breastmilk production. However, this may be reversible. If you are also breastfeeding your baby, they will not need the same amount of formula as an exclusively formula-fed baby. Please seek professional advice if you feel that you do not have enough breastmilk.

    Which brand of formula?

    When a baby does not receive breastmilk, the only suitable and safe alternative is a commercially available infant formula. Please seek professional advice before using an infant formula. Newborn formulas contain the ingredients needed to meet the nutritional requirements of infants up to the age of 6 months. The Infant Nutrition Council regulates all infant formula sold in Australia. They are also required to comply with the Australia and New Zealand food standards. Please check that your chosen formula meets your relevant national standards18.

    What about speciality formulas?

    There are many speciality formulas on the market today. These are generally more expensive than generic “normal” formulas. Still, most of these formulas do not have thorough research proving that they are better than standard formulas. Also, simply adding ingredients to the recipe does not mean that they benefit the baby as much as breastmilk does. Types of speciality formulas include Hypoallergenic (HA), Lactose-free, Probiotic, Anti-reflux (AR), Goat and Organic (there may be many more).

    How much milk does my baby need18?

    The amount of milk a baby drinks differs for each baby. Sometimes they will want more than usual, others less. Sometimes their feed times will be closer together, others longer apart. This pattern is all dependent on variables such as weight, age, development, and external factors like an over-stimulating day.

    Just know that it is normal for baby’s feeding to vary from day-to-day. If they don’t finish the bottle occasionally, there’s no need to be concerned. However, if it continues, please seek medical advice and reassurance. Formula cans indicate babies milk requirements by their age. This guide is NOT the case; it really should be determined by their weight.

    There isn’t a set amount. However, please use this example as a guide:

    • Day 5 – 3 months: 150ml/kg/day
    • 3 months – 6 months: 120ml/kg/day
    • 6 months – 12 months: 100ml/kg/day

    Your baby mightn’t drink it all or may require more. You should expect to see plenty of wet and dirty nappies and regular weight gain.

    What do I need to bottle feed18?

    • Formula (infant)
    • Bottles with teats and lids
    • A flat-edged knife for levelling
    • Cooled boiled water
    • Sterilising equipment
    • Bottles and teats

    You will need approximately three large bottles (250 ml), that are leak-proof and come with lids and teats. It’s best to choose one with clear measurement indicators on the side.

    Flow rates for teats vary. There are specific flow rates for each age. The smaller the hole, the younger the baby.

    • Slow flow – for newborn to three months
    • Medium flow – for three to six months
    • Fast flow – six months and above

    Your baby may have other requirements; if you are unsure, ask your health professional to assist you. It is common to need to trial different teats to find one which your baby likes. If you are still breastfeeding still and supplementing with formula, please use a LONG neck teat. Although wide-neck teats look more like a breast, they are not similar at all. You may also choose to use an orthodontic teat. The long neck teat stimulates your baby’s palate and tongue mimicking the nipple much better than a wide-neck bottle.

    How do I make a bottle of formula?

    Please use the World Health Organization’s recommendations for Formula Feeding at Home19. This document shows a simple step-by-step guide to cleaning, sterilising, preparing and storing infant formula and bottles. These recommendations guide health facilities and workers globally in the development of their educational resources and policy.

    How do I bottle feed18?

    • Firstly, sit somewhere comfortable, and hold baby close to you – don’t leave your baby unattended with a bottle.
    • Feed your baby in an upright (or semi-upright) position.
    • The bottle should be tilted, make sure the neck and teat fill with formula. This method helps baby not to swallow too much air.
    • If your baby isn’t firmly holding the teat in their mouth, you can apply gentle pressure to baby’s chin with your thumb. You can then assist your baby to move their jaw rhythmically to prompt your baby to suck independently.
    • Make sure your bottle is flowing well. If you were to tip the bottle upside-down milk should DROP steadily, not pour out or spray.
    • Babies swallow air, even when you have followed all these previous steps. You must allow your baby to have a break. Sit them up on your lap halfway through the feed to allow them the chance to burp and bring up their wind. You can do this by gentle circular rubbing on the back, or gentle patting.
    • Your baby will show you signs that they are finished. These signs could be falling asleep, milk spilling from their mouth or them refusing to take more. Each feed will vary, so it’s essential not to force-feed your baby. If they didn’t take as much in one feed, they would likely make up for it the next and vice versa.

    Things to remember:

    • Always use boiled water to make formula, make sure it has cooled to lukewarm before giving to baby.
    • Always prepare according to the recommendations on the tin. Never add or subtract amounts of formula or water.
    • Never estimate formula or water – exact measurements always!
    • Use the knives flat edge to level the scoop (heaped scoops are not ok, neither are tightly packed scoops).
    • Make one bottle at a time. Throw out leftovers and clean the bottle immediately.
    • Always add water BEFORE formula.
    • Your newborn baby requires feeding 2-4 hourly both during the day and at night – this is important for meeting their nutrition, energy and growth requirements.
    • Orthodontic teats are not evidence-based, meaning there is not enough research to show that they affect later tooth development.
    • Cow’s milk is not suitable for babies under 12 months.
    • Never leave baby unattended with a bottle.
    • Don’t rush baby, make feed time a time for connection.

    Nikki-Lee Rossiter (BMid), Registered Midwife
    Photo by kryzhov used under license from Shutterstock.com


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