Breastfeeding is the best way to nourish your baby, but when that is not possible, formula feeding is the preferred method. This pamphlet talks about giving your baby pumped mother’s milk or formula in a bottle.
Why stop breastfeeding?
There are many reasons not to breastfeed. Perhaps you do not have enough milk for the baby, or it is your choice not to breastfeed for various reasons. Perhaps the problems you experience breastfeeding are too much, and you decide to stop. Once you have decided to bottle feed the baby, you have to choose if you want to feed expressed milk, or formula milk.
Expressed mother's milk
You can express your milk by hand or by pump. If the milk will not be used immediately, pour it into a bottle, close it and store it in the refrigerator or freezer.
Pumped breastmilk storage:
- Refrigerate at maximum 5C up to 3 days
- Freeze at -18C up to 6 months
- Regular freezer up to 3 months
Children under 6 months should not be given regular dairy products such as yoghurt and cow’s milk.
In choosing a formula for your baby you should keep the following in mind:
Many different companies make formula, which you choose is not of importance, as long as you choose formula that is marked ‘birth to 4 months’.
Ready to feed formula and powdered formula have the same properties. Ready to feed is generally more expensive.
Your health visitor can give you advice about choosing the formula.
How do I prepare the formula?
Always follow the directions on the package; if you reconstitute the formula properly, the baby will get the right nutrients intended. If you reconstitute with too little powder, your baby will not get the needed nutrients. If you reconstitute with too much powder, the baby will not get enough fluid and risks constipation.
Always use good hygiene to prevent your child from getting sick. Wash your hands prior to making the formula. Always use clean bottles, a measuring spoon, and a nipple. You can find more good advice about cleaning bottles at the end of this pamphlet.
The first 4 months you’ll need to boil the water before preparing the formula.
- Bring cold water to a boil.
- Cool to room temperature.
- Mix the powder into the water.
- Shake the bottle carefully. The bottle is now ready to feed.
How much can I prepare at a time
It is recommended that you prepare one bottle at a time for the first two months or longer if your baby is compromised in any way or born premature. This prevents contamination of potential harmful bacteria.
After the first two months you can prepare bottles for up to 24 hours at a time. If you prepare for 24 hours at a time, you must cool the water to 5C, before adding the powder. If you do not use the bottle immediately, cover it and store in the refrigerator until use.
What do we do if we are going out somewhere?
Bring a clean bottle, nipples, and water that has been boiled previously. Add the powder only right before the baby is ready to eat.
How do I heat up the formula?
You can heat up the formula or expressed breastmilk by:
- Water bath
- Microwave, however this method heats up the bottle unevenly, and the bottle should be carefully shaken during the heating process to avoid ‘hot pockets’. The formula should be 37C. Test the temperature of the milk on your underarm before feeding the baby.
When heating the milk up keep in mind:
- Breastmilk that is defrosted quickly should be used immediately, after 1 hour discard the unused milk.
- Once heated, milk cannot be reheated.
- Frozen mothers milk should be defrosted slowly in the refrigerator, once defrosted it can stay in the refrigerator for 24 hours.
- Do not refreeze defrosted milk.
How to give a bottle:
When giving a bottle it is important to sit comfortably, as you would sit if you were nursing your baby. The close contact between you and your baby is as important as the meal itself. Do not allow the baby to lie alone in bed while feeding from the bottle.
Feed your baby alternating sides to prevent the baby from developing a misshapen head. The baby’s skull is soft and pliable.
When feeding, make certain the nipple is filled with milk during the feeding, to avoid that the baby swallows excessive air. Burp the baby after s/he has eaten half the meal, or if s/he lets go of the nipple her/himself.
How do I know my baby is thriving?
Babies who are on formula have soft, brownish bowel movements. Babies who get mothers milk have yellowish bowel movements which have a sweet/sour smell.
Your baby is thriving when he or she is:
- Awake and interested in contact
- Wants to eat during meals
- Eats a minimum of 6 times in 24 hours
- Produces 6-8 wet diapers in 24 hours
- Farting and has a bowel movement once daily if only formula feeding
Cleaning of Bottles
Bottles should be cleaned between each feeding. Here is some advice on how to wash and keep your bottes clean.
Check the nipple
Always make sure that the rubber from the nipple is intact. If broken, you risk that the rubber will break while the baby feeds, dislodging and risking that the baby will choke on the components.
Cleaning of the bottle
The bottle is rinsed after each use with running cold water.
Wash the bottle with clean warm water and a little dish soap, using a bottle brush. Rinse all parts so all soap residue is gone. Boil the bottle parts in a big pot once daily for 5-10 min and air dry or dry with a clean towel. Store in a clean, dry place free from contamination.
Cleaning of the nipple
The nipple is rinsed in running cold water The nipple is cleaned inside out using friction and sea salt.
Clean the nipple with the bottlebrush and rinse carefully; all remains of salt should be removed Place the nipple in cold water and bring to a boil for 2-3 minutes.
Any questions not addressed in this pamphlet should be directed to the staff on postpartum 426 or 412. Once discharged from the hospital you can contact your health visitor or doctor