Bottle Feeding Your Baby

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1 Bottle Feeding Your Baby The American Academy of Pediatrics or AAP recommends breast milk (human milk) for the first year of life and beyond. Pumping breast milk for bottle feeding is an option. If there are medical reasons to use an ironfortified infant formula to feed baby, your doctor will help you to choose a product. Getting Started 1. Wash your hands well with soap and water for 20 seconds or use an alcohol based hand sanitizer before feeding your child or handling formula. 2. Feed your baby when there are signs of hunger, such as putting hands to mouth, or tongue moving. This may be every 2 to 4 hours. If your baby sleeps for longer than a 4 hour period, wake baby to feed. Plan to feed your baby at least 8 to 12 times in 24 hours. Babies who are given breast milk may be hungry faster than babies using infant formula. Breast milk is easier to digest. Your baby is taking milliliters every hours today. If you are now sure how much your baby is eating talk with your doctor or nurse. 3. Relax, sit down and make yourself comfortable. Hold your baby in a semi-upright or side lying position while feeding. 4. To get your baby's attention, stroke the upper lip or cheek with your finger or with the tip of the bottle s nipple. Your baby's head will turn and mouth will open in response to the stroking. When you place the bottle nipple in your baby s mouth, your baby should begin sucking. Learn more about your health care. More on next page Copyright May 24, The Ohio State University Wexner Medical Center - Upon request all patient education handouts are available in other formats for people with special hearing, vision and language needs, call (614)

2 Page 2 5. Hold the bottle at a slight incline so the top of the bottle fills completely with breast milk or formula to prevent baby from swallowing air. Once baby starts to drink a bottle of mixed formula, throw away the uneaten portion of the bottle in 1 hour. It should not be refrigerated or reused. 6. Burp your baby every ½ to 1 ounce from the bottle. Try burping if your baby wants to stop eating too soon. Burping helps your baby get rid of the extra air in the stomach. Air causes a baby to feel full and uncomfortable. A small amount of breast milk or formula may come up when burping and this is normal. Read the handout, How to Burp Your Baby, for more information. 7. Allow your baby to decide when he or she has had enough to eat. Do not force your baby to finish a bottle. Towards the end of a feeding, baby may fall into a light sleep. You may still notice some sucking movements. This is just a reflex and does not mean that the baby is still hungry. Let your baby suck on your finger or a pacifier. Hold your baby close and talk softly during the feeding. Skin to skin contact can be done during feeding by partially undressing yourself and your baby. Your baby will enjoy the warmth and feel of your skin. Read the handout, Skin to Skin Contact with Baby, for more information. Common Questions about Formula How long is breast milk or formula needed for a healthy diet? It is needed at least the first year of life. Do not add anything to the bottle formula, including honey, sugar, cow's milk or cereal unless directed by your doctor. The doctor will advise when to start solid foods and cow's milk. What types of formula should I give my baby? Your baby s doctor will recommend a formula best for your baby. Regardless of type, check the expiration date on the label. Do not use expired formula. Ready-to-Use Formula This formula comes in ready-to-feed 2 ounce or 4 ounce bottles or cans (in several sizes). If you buy the cans, pour the formula into a sterilized bottle. You need to supply your own

3 Page 3 sterilized bottle nipples. They do not come with ready to use products. Use within 48 hours and throw away unused formula. Liquid Concentrate Formula Concentrate will cost you less but you must read the mixing directions on the label. Mix the concentrate with equal amounts of water. For example, if you want 4 ounces of formula use 2 ounces of concentrate and 2 ounces of water. You will need sterilized bottles and nipples ready after mixing formula. Use within 48 hours and throw away unused mixed formula. Powder Formula Powder formula costs less than ready to use or liquid concentrate, but it takes the most time to prepare. Mix 1 scoop of powder for every 2 ounces of water, or as directed by your doctor if baby has special nutrition needs. For example, if you need to make 4 ounces of formula, use 4 ounces of water and add 2 scoops of formula. You will need sterilized bottles and nipples ready to fill after mixing formula. Use within 24 hours of mixing and throw away unused mixed formula. Can I use tap water to mix formula? The type of water used depends on baby s age and health. Until the age of 3 months, the Centers for Disease Control and Prevention (CDC) recommends boiled city or tap water for 1 minute or using bottled water. The goal is for water to be sterile and safe for baby. If using well water, have the well checked for safety. Boil water as directed by doctor for baby s health or use bottled water. Can I change formula if my baby does not like it? Treat formula like a medicine. Call your baby's doctor for advice on changing the brand of formula. Do not change the brand because of an advertisement or coupon for another brand. If you think your baby does not like the formula or your baby has problems digesting it, call your baby's doctor. Common signs to watch for when babies have problems with formula: Vomiting right after the feedings Recurring diarrhea or constipation Frequent bouts of crying after feedings

4 Page 4 Signs of colic with a firm, enlarged and tender tummy right after a feeding Fussy behavior and/or waking at night A rough, rash on the face and around the rectum (opening for bowel movements) Frequent colds and/or ear infections Talk to your baby s doctor if you see any of these signs. What type of bottles and nipples should I use to feed my baby? No one type of bottle or nipple is better than another. Your baby will help you decide which one is best by how they are able to use it. There are several you may want to try. All infants should be on a low flow or slow flow nipple unless medically needed. Do I need to sterilize bottles and nipples? Yes. Health care providers recommend sterilizing bottles and nipples by placing them on the top rack of your dishwasher. If a dishwasher is not available, check with your health care provider on sterilizing bottles and nipples. Read the handout, How to Sterilize Baby Bottles and Nipples, for more information. What is the safest way to heat a bottle of formula? The safest way to heat a bottle of formula is to run warm water over it. Do not place a bottle in a pan of water on the stove and bring it to a boil. This destroys the protein in the formula and is too hot for baby to drink. Do not microwave formula. Microwaving causes uneven heating. The bottle may feel cool to you, but the formula inside can be very hot and burn your baby. Always check the temperature first before giving a bottle to your baby. Shake a few drops on your inner arm. Formula is ready when it no longer feels hot or too cold.

5 Page 5 Other Safety Tips Do not let baby drink a bottle of formula lying flat. Feeding a baby in this position increases the chance of ear infections and choking. Decay of baby teeth and jaw problems are also common if you feed in this position. Do not lay a baby down with a propped bottle. Propped bottles increase the risk of choking. Know how to use a bulb syringe. Sometimes babies choke when you are feeding them. Your nurse will show how to use the bulb syringe to suction your baby's mouth and / or nose. Read the handout, How to Suction Your Baby s Nose with a Bulb Syringe, for more information. Do not give your baby homemade formula. Formula made from cow's milk (fresh or evaporated) does not have the same nutrients as commercially made formula. Babies cannot digest cow's milk. Talk to your doctor or others on your health care team if you have questions. You may request more written information from the Library for Health Information at (614) or

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