Bottle feeding tips for new parents

This article offers clear information on bottle feeding, how to prepare a feed, the equipment you will need and some tips for bottle feeding.

Whilst it’s widely acknowledged that breastfeeding is the best way of feeding your baby, some women are unable to successfully breast feed. For example, after breast surgery, or due to being very anaemic – and some women simply do not want to breastfeed.

Although the number of breastfed babies continues to increase in New Zealand every year, around 1/5 of all babies are exclusively bottle fed by 3 months.

These women are often left feeling guilty and this can affect their experience of parenting, leaving them with negative feelings about early parenthood.

No health professional would want to make a parent feel this way – it is a fine line between promoting breastfeeding as the best option for you and your baby and making parents feel inadequate.

It is also vital that parents are given clear information on safe preparation of formula milk. We have also included an article covering the safe collection and storage of expressed breast milk (Expressing Your Milk) as a compromise for those who cannot fully breastfeed.

What equipment will I need for bottle feeding?

• Bottles – if you are fully bottle feeding you will need around 8 bottles. Buy the large size as your baby will soon outgrow the small ones.
• Teats can be complicated! One option is to start with standard newborn teats, which have one hole, as most babies will manage just fine with these. There are also different flow rates available, which have more holes or bigger holes, as well as different shaped teats.
• Another option is to buy multiple flow teats which have the three speeds – new born, next stage and toddler. You can position them so that it is right for baby and then change the position when you need to change the flow, without it costing additional money.
• Check out your options in a baby store, but remember that most babies will suck to obtain milk when they are hungry, so don’t end up with a cupboard full of every teat and bottle on the market!
• Sterilizer – there are many option available (chemical, electric, microwave) and we have further information on these in our article Sterilizers
• Formula milk – choose one that is suitable from birth, as these are easier for baby to absorb. For further information, see table below.
• Scoop – the tin of formula milk will contain a scoop – use only that scoop for that particular milk.
• Kettle or pan to boil water (continue to use boiled water for 18 months if your water supply is from a tank or bore).
• Fridge – to store milk if you are preparing milk ahead of time
• Method of warming milk to correct temperature, such as a jug of hot water or bottle warmer. The use of a microwave is not recommended, as it warms the milk unevenly, which could scald the baby’s mouth.
• Bottle brushes – which should be used for baby’s bottles only and frequently cleaned and sterilised.

Formula – which one do I choose?

There are many different brands and types available on the market, which mostly come into 4 categories. You can try your baby on different brands and you can request samples from the companies- but most babies will settle on the formula that you choose. Be aware of the different types of milk that are designed for different stages of infancy:

Some milk companies advertise the presence of nucleotides in their formula, which are important to the development of your infant’s growth, development and immune system.

Others contain Long Chain Polyunsaturated Fatty Acids or LCPs, which are naturally present in breast milk and may be important for brain and visual development and these often are labelled as ‘gold label’ and cost a little more.

Be aware that baby milk advertising is very powerful – you should obtain individual advice from your Plunket nurse or midwife if you are unsure about which formula to choose.

There are also many other types of milk available – for example, goat’s milk or formula to prevent constipation if you baby is prone to this.

Speak with your GP or Plunket nurse if you feel your baby has special needs.

How do I prepare a formula feed?

Wash your hands!

Wash all bottles and teats in hot soapy water, squirt water through the teat holes and use a bottle brush to ensure that everything is scrupulously clean, getting into all those nooks and crannies, then rinse well.

Sterilise all equipment that will come into contact with the milk – bottles, teats, lids for the first 6 months of age.

Boil the kettle and let the water cool to lukewarm – this will allow the powder to dissolve, whilst ensuring that formula can be placed straight into the fridge. It also reduces the chance of scalding, as some bottles have a narrow neck.

Pour water into the bottle before adding the powder formula, as the powder would make it impossible to measure the correct amount of fluid, possibly leading to dehydration.

Carefully add the scoops of formula powder (levelling the powder with a clean knife) to the water, place the top on the bottle and shake gently to encourage the powder to dissolve.

If you are not feeding your baby straight away, place formula in the fridge immediately (store at 4ºc – the back of the fridge is cooler) with a cap over the teat, to prevent contamination.

It can be stored for a maximum of 24 hours, but the safest option to prevent bugs growing in the milk is to prepare bottles as you need them. Once removed from the fridge it is safe to use for up to one hour.

When you take a pre-prepared bottle from the fridge, shake it gently to remix the formula, heat the milk, then shake gently again, to distribute the heat evenly.

If you are going out, keep your milk in an insulated pack or chilli bin – but this is only safe for up to 4 hours. The best option would be to carry the water ready-measured in the bottle and the formula powder separately in a sealed container – add it to the water when baby is ready to feed.

Bacteria called Enterobacter sakazakii can contaminate infant formula. To minimise the risk of this infection harming your baby:

• keep your tin in a cool place,
• ensure the lid fits well
• discard any powder once the tin has been open for 4 weeks.

It is vital to be stringent about these safety guidelines – formula fed infants are at higher risk of gastro intestinal infections, so scrupulous hygiene is vital.

Giving a bottle…

• However you choose to feed your baby, cuddle them in close and make it a special time to rest with your baby. If people are there to help you, let them run around after your toddler, while you rest and feed your baby.
• When feeding your baby hold the bottle at an angle, so that you minimise the amount of air the baby swallows; also hold the baby semi propped rather than flat on their back to prevent the milk going into nasal and ear passages, which can make babies more prone to ear/nose/throat infections
• Most babies will inevitably take in some air during a bottle feed, and will need winding. Pop baby upright over your shoulder, pat and rub their back soothingly after feeds. Some babies also need to be winded mid way through the feed.
• You will know your baby is having enough if they settle well after a feed and produce 6-8 wet nappies each day.

Here are some tips for bottle feeding…

• If you are intending to mix breast and bottle feeding, establish your breast feeding first, then introduce a bottle – the sucking mechanism is very different, so you do not want your newborn infant to be confused.
• Do try expressing breast milk to see whether this works for you
• If you are choosing an infant formula, read the containers carefully to ensure the milk is suitable for your baby’s age and requirements
• Consult with your health professional about the right amount to put in a bottle for your baby and how often to feed them. Do not exceed the maximum number of feeds and quantity suggested on the formula without consulting your health professional, or your baby could become overweight.
• Sachets of formula are available at large supermarkets – so you can try them without investing in a whole tin.
• Talk to other parents about their experiences and products they have found suitable.
• Some formula fed babies can have harder bowel movements and become constipated (babies can go a few days without a bowel movement, this is normal if the stool is soft). Ensure you are mixing the formula correctly – never add any extra milk powder to the bottle. Try giving your baby a bit of extra water in a bottle or cup in between feeds to correct the constipation.
• The use of a microwave is not recommended as it warms the milk unevenly, causing hot spots and cold spots. If you choose to use this method, ensure you give the milk standing time of 3 minutes, as the milk continues to heat up after it has been removed from the microwave, then mix the milk well to ensure even heat distribution.
• Check the temperature of the milk on the inside of your wrist, before offering it to your baby.

Take time to make your decisions about feeding your baby. Ensure you have the information that you need and try not to be influenced into a decision that you feel is not right for you. Ultimately the most important thing is to enjoy your baby and the special (although exhausting) 12 months of baby hood.

Happy parents make the best parents!

Useful Websites and Articles on Bottle Feeding

Advice from the Ministry of Health in New Zealand on healthy nutrition for babies and toddlers

For information on the advantages and disadvantages of breastfeeding and bottle feeding see our article on Breast vs Bottle

If you require information on expressing and storing breast milk click on Expressing Your Milk

For detailed information on sterilisers, visit our Kiwi Families article Sterilisers for information on options and advice in New Zealand.