If your baby can’t always feed directly from your breast, you might choose to bottle-feed with expressed breastmilk. Or you might need to feed your baby infant formula, which is the only safe alternative to breastmilk.
Before you bottle-feed your baby, it’s important to know how to clean and sterilise bottle-feeding equipment, as well as how to prepare, store and warm bottles of formula. This will help to keep your baby safe from infection and make sure baby is getting the right nutrition.
Getting the right flow when bottle-feeding
To test the flow of the formula or breastmilk, hold the bottle upside down when it’s filled with liquid at room temperature. The liquid should drip steadily from the teat but not pour out.
If you have to shake the bottle vigorously to see the drip, the flow is too slow. Your baby might go to sleep before drinking what they need.
When you feed your baby, you might see a little leakage at the corners of your baby’s mouth. This doesn’t mean the flow is too fast. It’s nothing to worry about. It will stop as your baby gets older.
If you have trouble finding a teat with a flow to suit your baby, try a faster teat rather than a slower one. You might need to try a few different teats before you find one that suits.
Giving baby the bottle
Make yourself comfortable and cuddle your baby close to you, holding baby gently but firmly. It’s better for your baby to be on a slight incline so any air bubbles rise to the top, making burping easier.
Put the teat against your baby’s lips. Your baby will open their mouth and start to suck. Keep the neck of the bottle at an angle so it’s filled with formula or breastmilk.
When your baby stops sucking strongly or when about half of the formula or breastmilk has gone, gently remove the bottle and see whether baby wants to burp. Once you’ve tried burping your baby, you can offer the bottle again.
Babies who are normally breastfed might find it hard to pace themselves when bottle-feeding, particularly if they’re premature. This is because they’re used to controlling the flow of breastmilk. Sometimes these babies can drink too much too quickly.
Paced feeding can sometimes help. This involves holding your baby in an upright position and letting them rest every few minutes. If you’re interested in paced bottle-feeding, it’s best to get help from your child and family health nurse or a lactation consultant.
Holding, cuddling and talking to your baby during feeding will help baby develop and grow. It’s also a great opportunity to bond with your baby.
When baby doesn’t finish the bottle or goes to sleep while feeding
Don’t worry if your baby doesn’t finish the bottle. Babies are very good at judging how much they need, so you can let your baby decide when they’ve had enough formula or breastmilk.
If your baby goes to sleep during a feed, put baby over your shoulder, rub their back, and stroke their head, legs and tummy. This can help your baby to wake up. A nappy change is a good way to wake up your baby if that doesn’t work.
Wait until your baby is properly awake before offering the rest of the formula or breastmilk.
If there’s any formula or breastmilk left in the bottle, throw it away after one hour. When your baby drinks from a bottle of formula or breastmilk, bacteria from their mouth get into the milk. The bacteria can grow and make your baby sick if you give your the baby the half-finished bottle later.
When baby refuses the bottle
Babies sometimes refuse a bottle altogether. Here are things to try if this happens:
- Try a new feeding position or change the feeding environment. For example, move around while you’re feeding, find a quieter place to feed, or play some relaxing background music.
- Try again later when your baby is more settled. For example, give your baby a bath and then try again.
- Ask your partner or another family member to give your baby the bottle.
- Try using a different teat. If the flow of formula or breastmilk is too slow, it might frustrate your baby.
- Let your baby open their mouth for the bottle when they’re ready, rather than putting the teat into their mouth.
- Offer the formula or breastmilk from a small cup or spoon. To do this, sit your baby up and offer them small sips.
If your baby is regularly refusing the bottle, you could try adjusting your routine.
If you think your baby is refusing the bottle because they’re unwell, treat your baby’s symptoms or take your baby to see your GP.
How much do bottle-feeding babies drink?
Newborn babies commonly have 6-8 feeds every 24 hours, but there’s no set amount of food or number of feeds your baby should have. Different babies drink different amounts of formula or breastmilk. Some might have feeds close together and others further apart. And it can change from day to day.
Just feed your baby whenever they’re hungry. You’ll see baby cues that say ‘I’m hungry’ – for example, your baby will make sucking noises or start turning towards the breast or bottle. If your baby stops sucking or turns their head away from the bottle, you’ll know they’ve had enough.
As your baby eats more and more solid food, the total amount of breastmilk or formula they take in a day will decrease. The amount of breastmilk or formula will also decrease as your baby starts to drink from a cup instead of a bottle.
Some babies never drink the ‘recommended amount’ for their age and size, and others need more. Plenty of wet nappies, consistent healthy weight gains, and a thriving, active baby mean all is well. If you’re concerned about how much breastmilk or formula your baby is taking, talk to your child and family health nurse or GP.
Bottle-feeding in bed: issues and risks
If your baby gets used to falling asleep with a bottle in bed, they might depend on it to get to sleep. This can make it more difficult for your child to fall asleep or settle for sleep independently.
Bottle-feeding in bed also has several risks for your baby.
Babies who fall asleep while bottle-feeding can draw liquid into their lungs. They might then choke on it or inhale it.
Babies have less saliva in their mouths to protect their teeth during sleep. If your baby falls asleep with a bottle, the lactose in the milk can build up on your baby’s teeth, putting your baby at risk of tooth decay.
If your baby drinks while lying flat, milk can flow into the ear cavity, which can cause ear infections.
It’s best to put your baby to bed without a bottle or to take the bottle away after your baby has finished feeding.
Using a feeding cup
When your baby is around 6 months old, you can help your baby start leaning to drink from a cup. It’s best to stop using bottles by the time your baby is 12 months old.
You should continue to thoroughly wash and sterilise feeding cups containing infant formula or breastmilk until your baby is 12 months old.