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Bottle Feeding your Baby
Choices for feeding your baby with a bottle:
You can feed your baby breast milk, formula, or both from a bottle. You can pump the milk from your breasts and put it in a bottle. You can also give your baby mostly breast milk through a bottle and give formula only when needed.
Contact your baby's pediatrician if:
- Your baby has a temperature of 100.4°F (38°C) or higher.
- Your baby has any of the following signs of formula allergy:
- A red, rough rash, usually on the face or around the rear end
- Crying after feedings
- Vomiting after nearly every feeding
- A swollen and tight abdomen after feedings
- Fussiness and waking up often during the night
- You feel your baby is not getting enough breast milk or formula.
- Your baby is 4 or more days old and has fewer than 6 wet diapers each day.
- Your baby is 4 or more days old and has fewer than 3 bowel movements each day.
- You have questions or concerns about bottle feeding your baby.
What you need to know about breast milk:
The American Academy of Pediatrics (AAP) encourages breast milk as the only source of nutrition for your baby during his or her first 6 months. They do not recommend that you add other foods to your baby's diet until he or she is 6 months old. They encourage you to give your baby breast milk until he or she is at least 1 year old.
- Breast milk has the right amount of nutrients (protein, fats, carbohydrates, vitamins, minerals) and water your baby needs. Breast milk also has antibodies that formula does not have. Antibodies help prevent your baby from getting sick.
- Breast milk may be given as soon as it is pumped. Formula needs to be mixed and may need to be warmed before you feed it to your baby.
- Breast milk does not cost anything.
- Your baby's pediatrician can give you information on how to pump and store your breast milk.
The 3 basic kinds of formula:
Baby formula has all the nutrients your baby needs to grow. Ask your baby's pediatrician which formula is best for him or her.
- Cow's milk formula is the most common kind. Most babies drink cow's milk formula. The cow's milk in formula is safe and easy for your baby to digest. You can buy it with or without iron. Some babies do not have enough iron in their bodies. Your baby's pediatrician may suggest giving your baby formula with iron until 1 year of age. Formula with iron will cause your baby's bowel movements to be black. This is normal.
- Soy formula has a different type of carbohydrate and protein than cow's milk formula. You may need to give your baby soy formula if he or she is allergic to cow's milk formula. You may also need to feed your baby soy formula for a while if he or she has diarrhea. Most soy formulas have iron and cost about the same as cow's milk formula. Your baby's pediatrician will tell you how long you should feed your baby soy formula.
- Other formulas may be needed if your baby cannot have cow's milk formula or soy formula. Premature babies or babies with health problems may need to drink special formula. Special formulas cost more money than soy or cow's milk formula. Carefully follow the instructions when you mix and prepare a special formula.
How formula is supplied:
- Ready-to-drink formula can be poured from a can into a baby bottle and is ready for your baby to drink. Ready-to-drink formula is easy to use, but is the most expensive. Always wash with soap and water, rinse, and dry the tops of formula cans before you open them. Shake formula containers well before you open them. Do not use or buy any damaged formula containers or formula with an expiration date that has passed.
- Formula that must be mixed with water comes as a liquid. It does not cost as much as ready-to-eat formula. It is very important that you add the right amount of water to this formula. Carefully follow the instructions on the package to mix the formula correctly. Water from a tap may be not be safe to feed your baby. Ask if you should mix with the formula with bottled water or if you should boil tap water before using it.
- Formula powder comes in cans or packets. You will need to mix the powder with a specific amount of water. Formula powder costs the least amount of money. A measuring scoop comes in each can. Use the scoop to measure the amount of powder you need. Formula powder is lightweight and easy to carry with you. Always use the correct amount of formula and water. If you do not add enough water, the formula may cause your baby to be constipated. If you add too much water to the formula powder, he or she will not get enough calories. He or she will not gain enough weight. Store formula powder with a tight lid.
Information about warming the formula or breast milk for your baby:
- Most babies enjoy drinking warm formula or breast milk, but you do not have to heat it. You may warm it by putting the bottle in a pan of warm water. Do not warm it on a lit stove, because it may curdle. Another way to warm the formula or breast milk is to run hot water over the bottle. Shake the bottle and then spray the liquid on the inside of your wrist before you give it to your baby. The temperature should be slightly warm and comfortable to your skin. It should not be hot.
- Do not use a microwave to heat formula or breast milk. A microwave overheats the liquid in the center of the bottle. The liquid may just feel warm when you test it, but it may be very hot in the bottle's center. The milk may burn your baby's mouth when he or she drinks it.
- Always throw away any leftover formula or breast milk. Leftover formula or breast milk that has not been refrigerated can grow germs and make your baby sick. Do not feed your baby breast milk or formula left at room temperature for more than 1 hour. Do not freeze ready-to-eat or premixed formula.
What kind of bottles to use:
- There are many types of bottles. You may use glass bottles, plastic bottles, or plastic bottles with a plastic liner. Plastic-lined bottles are easy to use and keep your baby from swallowing too much air. Do not use glass bottles when your baby is old enough to hold his or her bottle. The glass bottle may break and cause injury.
- Bottles come in many sizes. A smaller bottle may be easier to use for babies under 4 to 6 months old. Wash bottles well using a bottle brush and hot, soapy water after each use. Some bottles may be washed in a dishwasher.
What kind of nipples to use:
- There are different types and sizes of nipples that may be used in bottle feeding. Talk to your baby's pediatrician about the kind of nipple you should use to feed your baby. Your baby may need a special nipple if he or she has trouble sucking or swallowing.
- Always check the size of the hole in the nipple. Turn the bottle upside down and shake it. This will show you if the formula or breast milk is coming through the nipple at the right speed. The flow is okay if you get a little spray of liquid, and then a few drops. The liquid is flowing too quickly if it pours or spurts out. It is flowing too slowly if only a drop or two comes out.
- Your baby will give you clues about the milk flow if you watch him or her suck. He or she may choke or gulp if the nipple hole is too large. The flow may be too fast if milk leaks out of the corners of his or her mouth. He or she may have to suck harder if the nipple hole is too small. This can cause him or her to swallow a lot of air. He or she may also stop sucking or act fussy during a feeding if the nipple hole is too small.
- Carefully wash the nipples in hot, soapy water and rinse them well after every feeding.
How much formula or breast milk to give your baby:
- Your baby may want different amounts each day. The amount of formula or breast milk your baby drinks may change with each feeding and each day. The amount your baby drinks depends on his or her weight, how fast he or she is growing, and how hungry he or she is. Your baby may want to drink a lot one day and not want to drink much the next.
- Do not overfeed your baby. Overfeeding means your baby gets too many calories during a feeding. This may cause him or her to gain weight too fast. Your baby may also continue to overeat later in life. Look for signs that your baby is done feeding. Your baby may look around instead of watching you. He or she may chew on the nipple of the bottle rather than suck on it. He or she may also cry and try to wriggle away from the bottle or out of the high chair.
- Do not add cereal to the formula. Overfeeding can also happen if you add baby cereal to the formula. You can make more formula if your baby is still hungry after he or she finishes a bottle.
- Amount of formula or breast milk your baby should drink:
- Babies up to 2 months old will drink about 2 to 4 ounces at each feeding. He or she will probably want to drink every 3 to 4 hours. Wake your baby to feed him or her if he or she sleeps longer than 4 to 5 hours.
- Babies 2 to 6 months old should drink 4 to 5 bottles each day. He or she will drink 4 to 6 ounces at each feeding. When your baby is 2 to 3 months old, he or she may begin to sleep through the night. When this happens, you may stop waking up to give your baby formula or breast milk in the night. If you are giving your baby breast milk, you may still need to wake up to pump your breasts. Store the milk for your baby to drink at a later time.
- Babies 6 to 12 months old should drink 3 to 5 bottles every day. He or she may drink up to 8 ounces at each feeding. You may increase the time between feedings if your baby is not hungry. You may also start to feed your baby foods at 6 months. Ask your child's pediatrician for more information about the right foods to feed your baby.
How often to feed your baby and how long each feeding should take:
Feed your baby on demand. This means feed your baby every time he or she seems hungry. He or she may be more alert, make sounds with his or her lips, move around more, or stick out his or her tongue. He or she may also place his or her fist in his or her mouth and suck on it. Crying is a late sign of hunger. Your baby should eat on demand about every 2 to 3 hours or 8 to 12 times a day. Each feeding should take about 20 minutes. Feedings may take longer if your baby has a medical problem or has trouble sucking or swallowing.
How to hold your baby during feedings:
Feeding time is a special time for you and your baby to enjoy and get to know each other. It should be a time for you to relax and to show love to your baby. Talk, smile, touch, or sing to your baby while you feed him or her.
- You may be comfortable feeding your baby while sitting in a rocking chair or an armchair. Put a pillow under your arm for support. Gently wrap your arm around your baby's upper body, supporting his or her head with your arm. Be sure your baby's upper body is higher than his or her lower body.
- You may need to help your baby open his or her mouth to grasp the nipple. Do this by stroking the nipple against his or her cheek near his or her mouth. To keep your baby from swallowing air, hold the bottle so that liquid fills the bottle neck and covers the nipple.
- Do not prop a bottle in your baby's mouth or let him or her lie flat during a feeding. He or she may choke. The milk may also flow into his or her middle ear and cause an infection.
- Do not let your baby sleep with a bottle. If he or she falls asleep while drinking, the milk will pool around his or her teeth and may cause tooth decay.
How to burp your baby:
- Babies tend to swallow air while drinking from a bottle. The air in his or her stomach may cause him or her to feel full before he or she has had enough milk. It may also make him or her cry or be fussy. Burp your baby after he or she drinks 2 to 3 ounces of formula or breast milk. Burp him or her more often if he or she seems to be unhappy or is spitting up.
- If your baby does not burp, feed him or her more, and gently try to burp him or her again. Your baby may not burp every time you try to burp him or her. This is normal. Your baby may also spit up a small amount of breast milk or formula when he or she burps. It may smell strong and look curdled. This is normal. You may try any of the following positions to burp your baby:
- On your shoulder: Put a clean cloth on one of your shoulders to catch milk that he or she spits up. Hold your baby against your shoulder. Put one of your hands under your baby's bottom. Gently rub or pat his or her back with your other hand.
- Sitting up: Sit the baby on your lap with his or her head leaning forward. Support his or her chest and head with your hand. Gently rub or pat his or her back with your other hand. Your baby's neck may not be strong enough to hold his or her head up. Until his or her neck gets stronger, you must always support his or her head while you hold him or her. If your baby's head falls backward, he or she may get a neck injury.
- Face down across your lap: Put a cloth or towel on your lap. Put your baby face down on your lap. His or her head should rest on one leg while his or her stomach rests on the other leg. Gently rub or pat his or her back with your hand.
How to know if your baby is getting enough formula or breast milk:
Your baby will show you signs that he or she is full. He or she may turn his or her head away from the bottle or close his or her mouth. He or she may fall asleep, or his or her face, arms, and hands may look relaxed. He or she should seem calm and satisfied after a feeding. The following can also help you know your baby is getting enough breast milk or formula:
- Your baby has several wet and soiled diapers each day. He or she should have 6 or more wet diapers and 3 to 4 bowel movements each day.
- Your baby is gaining weight. Your baby's pediatrician will check his or her weight at each visit to see if he or she is gaining weight as he or she should. Your baby may lose weight in the first 3 days after birth. By 4 to 5 days old, your baby should start to gain weight.
- Your baby feeds 8 or more times each day. Your baby may let you know when he or she is hungry. If he or she does not, you may need to wake him or her up to feed him or her.
Signs that your baby may be allergic to formula:
- He or she acts fussy or cries after a feeding.
- He or she has diarrhea or trouble having bowel movements. The bowel movements may be small and very hard.
- He or she has a red rash on his or her face or around his or her rear end. The rash may feel rough when you touch it.
- His or her stomach feels full or tight after a feeding. He or she may cry and pull his or her legs up to his or her stomach because he or she is in pain.
- He or she vomits after almost every feeding.
- He or she wakes up often during the night.
Do not give your baby anything else to drink:
Your baby does not need any other liquids besides formula or breast milk for the first 12 months. Formula and breast milk have the right amount of nutrients that your baby needs and are easy for him or her to digest. Do not give your baby other types of milk, such as cow's milk, goat's milk, or soy milk, until he or she is at least 1 year old. It does not provide the nutrients he or she needs and is hard for him or her to digest. It may also cause him or her to develop allergies or other health problems. Your baby does not need juice or extra water during the first 12 months of life. Your baby is getting all the water he or she needs from his or her breast milk or formula.
Extra vitamins or minerals:
Some babies may need vitamin D, iron, fluoride, or other vitamins and minerals. Ask your baby's pediatrician if he or she needs any extra vitamins or minerals.
Follow up with your baby's pediatrician as directed:
Write down your questions so you remember to ask them during your visits.
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