We all know "breast is best" for babies, and that it's recommended we exclusively breastfeed our babies until they're six months old. But if breastfeeding isn't working for you and you feel you need to bottle-feed or supplement with formula, here are some things you should know.
Formula milk is produced from cows’ milk, but its general make-up has been altered.
Talk to your Plunket nurse or midwife about which formula is best for your
baby. Soy formula should only be used when advised by a health professional.
Drinks other than infant formula and breast milk can make your baby sick.
Babies over seven months may be offered water to drink.
Preparing the formula
Formula milk comes as a powder and you mix it with boiled, cooled water. Always wash your hands before preparing bottle feeds. You must wash and sterilise all feeding equipment until baby is at least 3 months old (including any items used with breast milk). When baby is older, thorough washing and rinsing is
enough.(For more information about sterilising, talk to your Well Child nurse or chemist.)
It is best to make a bottle up fresh for each feed if possible. When preparing formula, follow the instructions on the packet. Use only level measures and the exact volume of water. Never add more powder or less water than directed as this could make your baby very sick, and never add anything else into the formula.
Formula should be warmed gradually by placing the bottle in a container of hot
water. It is best not to put the bottle of formula in a microwave as it can easily overheat or heat unevenly. If you do microwave formula to warm it, shake and let it sit for 2–3 minutes. Shake again before testing temperature is right for baby.
Before feeding baby, always check the temperature of the formula by putting some on the inside of your wrist. It should feel just warm.
The Ministry of Health recommends that you prepare just one meal at a time to avoid bacteria developing. When milk is kept warm for any length of time, bacteria multiply dramatically putting your baby at risk so it’s important to store made-up formula properly. It can be stored at room temperature for no more than two hours and in the fridge for no more than four hours. Never re-heat used formula – throw out what your baby doesn’t drink.
If you are going out somewhere, you need to bring a clean, sterilised bottle with cooled boiled water, and only add the powdered formula when it is time for the baby’s feed. If you must make a bottle up beforehand, keep it cold in a chilly bin or insulating bag and use within two hours. Never let your baby drink alone in their car seat – they could choke. Stop to feed them.
How much to feed
Age, weight, time of day, activity levels, illness and rate of growth can all affect a baby’s formula needs. The tin of formula will have general guidelines on it. Babies are usually fed on demand, so learn your baby’s hungry signals.
Most formula-fed newborns will need around six to eight feeds in 24 hours for the first few weeks. Some may stop a night feed after about six weeks.
Gradually increase the quantity of feeds during the day. At about two months, there will probably be 3–4 hours between feeds.
You can tell if enough formula is being fed if your baby :
• is content and settles for a couple of hours after a feed
• is gaining weight at a steady rate
• has six or more very wet nappies every day
In hot weather or if your baby is unwell they may need extra feeds.
Continue using breast milk or formula as the main drink until baby is one year old. (There is no need to change to a follow-on formula at 6 months, which is usually when baby will be ready to start solids.)
Condensed and evaporated milks should not be used for babies. If baby is hungry and demands more, give more to drink at each feed or add an extra feed. Do not alter the strength.
After 7–8 months your baby can have small amounts of cows’ milk in cooking or as yoghurt, custard or cheese.
After 12 months, the main milk for toddlers can be whole homogenised cows’ milk(dark blue lid).
It’s important you hold your baby close to you when you are bottle-feeding so that they feel safe and loved while they are feeding. Holding your baby also ensures they are safe from choking and that the bottle is at the correct angle to prevent ear infections. Do not leave your baby lying with a bottle to suck on – if babies fall asleep with milk in their mouth, their teeth can be damaged.
If you need advice and support with breastfeeding or formula feeding, you can ask for help from:
• Your family doctor or practice nurse
• Well Child nurse and Plunket Karitane Family Centre
• Your midwife or a lactation consultant
• La Leche League (breastfeeding advice and support only)
• Community or private practice dietician
• Parents Centre.
The Ministry of Health has a very informative ‘Feeding Your Baby Infant Formula’ brochure available on-line from www.healthed.govt.nz