Bottle-feeding-FAQs

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To make up a bottle for your baby, you boil water, add powder and mix. Simple, right? Not necessarily so.

There are lots of considerations when it comes to formula-feeding, from finding the right equipment to how exactly to offer the bottle – and it can seem there aren’t always readily available answers. In fact, perhaps due to a lack of information, research shows up to 30 per cent of Aussie mums make mistakes when mixing their bubs’ formula feeds, and half of these involve making over-concentrated formula.

A US study also showed that over half of mums don’t always wash their hands before making up bottles (so don’t forget to lather up!) and 35 per cent heat formula in microwaves (which is a no-no, as it can create ‘hot spots’ and burn bub’s mouth). So if you’re new to bottle-feeding, worried you’re not doing it right, or are feeling confused about teat types, temperatures and transporting your little one’s milk, read on!

1. How do I choose the right bottle and teat for my baby?

When buying a bottle, check that the plastic is free from the chemical BPA (bisphenol A), says Naomi Riley, a maternal and child health nurse, midwife and lactation consultant from Finding Your Instincts (www.findingyourinstincts.com.au). She suggests using smaller-volume bottles for bubs under three months, who’ll likely drink less than 120ml per feed, and larger bottles for older babies. You may need to trial a few teats before you find the right one.

“Look for a teat that’s long, not short and stubby, as well as soft and pliable,” Naomi says. Choose a teat flow rate that suits bubs’ age and see how he goes. “If the feed seems to be taking a long time you may be better off trialling a teat with a faster flow, but if your baby is spilling milk out the corners of his mouth, the flow is likely too fast and a slower flow teat may help,” she explains. How tight you fasten the lid of the bottle can also affect the flow — looser creates a faster flow, tighter slower — so you can experiment with this too.

Related: The lowdown on using donated breastmilk

2. What type of formula should I use?

“Differences between formulas are small,” says GP Dr Megan Elliott-Rudder, so don’t stress over this point too much. Cows’ milk formulas are recommended and while breastmilk supports a baby’s immune and digestive-system development, some of the nutrients that are lower in cows’ milk have been added to particular formulas. If you think your baby is unsettled on one brand of formula, try another brand for at least few days before you decide. Formulas are different in the balance of fats and proteins, so you may find that your baby tolerates one better than another.

3. How much formula should bub be drinking?

This varies from baby to baby. Calculations made by your doctor or health nurse based on your baby’s weight and recommendations on formula packaging are just guides, says Naomi, and often quite generous. “Feed your baby to his appetite and if this means he hasn’t finished a bottle and wants more than what you offer at another time of the day, this is okay,” she reassures. If you’re concerned about the volumes of milk your baby is drinking, have a think about how hydrated he is – check bub is producing five to eight wet nappies in 24 hours in the early days and regular pooey ones, too.

4. How far in advance can I prepare formula?

According to the National Health and Medical Research Council (NHMRC), it’s best to make up a fresh bottle at the time of feeding. This isn’t always possible, though, especially when you’re out. Ideally the handiest way for your baby to eat on the go is to bring along cooled, boiled water in a bottle, plus measured scoops of formula in a separate container to be made up and warmed at the time of feeding. If that won’t work, it’s still safe to make formula in advance to be used within 24 hours, as long as it’s refrigerated to below 5˚C within an hour of being mixed. Also, when transporting cold formula, pop bottles in a cooler bag with ice bricks for no longer than two hours. Once your baby has fed, discard any formula he’s left in the bottle.

Related: Bottle feeding tips for your baby

5. What's the right temperature for formula?

Breastmilk is body temperature, so bottle milk is best served the same. The Infant Nutrition Council recommends milk no hotter than 37°C. NHMRC guidelines advise: “Test the temperature of the milk with a few drops on the inside of your wrist. It should feel just warm, but cool is better than too hot.” While the best way to warm a bottle is standing it in a pot of warm water, never in the microwave, if you do choose to use a microwave, warm for just a few seconds then shake well to avoid hot spots and potential burning.

6. Can I add anything extra to formula, such as rice cereal?

No matter what your mother-in-law or Aunty Carol tells you, thickening a baby’s bottle with rice cereal is not recommended, and it certainly won’t help bub sleep longer at night. “There are risks with introducing solids before they’re recommended,” says Dr Elliott-Rudder. This is because before the age of around six months, your baby’s stomach isn’t able to properly digest solid foods, and breastmilk or formula is the only thing he needs to nourish him. The only time thickened feeds should be given is on the advice of a paediatrician. “Even then, it’s usually for babies who’ve got swallowing problems, not normal, healthy babies,” Dr Elliott-Rudder says. Stick to straight formula, made up exactly as instructed on the tin. Don’t add extra formula, as this can lead to constipation and other issues, and don’t water it down, as this means your baby won’t get all of the nutrients he needs.

7. Is there a right way to hold my baby when offering a bottle?

Just as breastfed babies are cuddled as they eat, give your bottle-fed baby the same interaction. “Feeding is a social activity, even for a small baby,” Naomi says. “Hold your baby close to your body in a slightly elevated position where he can see your face and engage with you during the feed.”

Related: Formula feeding your baby

8. Is it possible to combine breast and bottle?

Absolutely. “There’s a warning on formula tins telling mums to think carefully about moving over from breast to bottle, saying it’s a difficult decision to reverse, but this isn’t actually the whole story,” says Dr Elliott-Rudder. “There are plenty of mums who continue breast and bottle, particularly working mums. And every breastfeed is a bonus.” Remember how supply and demand works: if your baby keeps demanding one or two breastfeeds a day, your body will adjust to supply those one or two feeds.

9. Is it OK to let my baby sleep with his bottle?

“Safe formula-feeding reduces time on the teeth,” says Dr Elliott-Rudder, who explains there’s a risk of dental decay if babies keep bottles in their mouths overnight, allowing formula to pool behind teeth and gums. “You’ve also got no control over how long your baby is going to be sucking for.” Leaving formula for hours at the incorrect temperature can encourage bacteria to grow in it, and ear infections are another risk. “We don’t normally drink and eat lying flat. If you do that with babies, there’s a risk milk can run back from the throat into the middle ear,” says Dr Elliott-Rudder.

10. When should we move from bottles to a cup?

Once your littlie hits his first birthday, his bottle can go to the fairies. “Babies should be having milk from a cup at this time,” Naomi advises. To help make the transition easier, you can practise with cups in the lead-up to a complete changeover. This is something that can begin with the offer of a cup with a sippy spout or straw alongside your child’s solid foods any time after six months, when your bub is physically able to manage it (and keeping in mind the bulk of his milk feeds will still be from the bottle or breast at this stage).

The National Health and Medical Research Council recommends babies be exclusively breastfed until around six months of age and that breastfeeding is continued until 12 months of age and beyond, for as long as mum and child desire. While breastfeeding is the ideal way to nourish your baby, we recognise not all mums are able to do so. If you have any concerns about your breastfed or bottle-fed baby, make an appointment with your child health nurse or GP.