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 formula or milk to 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 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.
A little leakage at the corners of your baby’s mouth while feeding is nothing to worry about. This will stop as your baby gets older.
If you have trouble finding the perfect teat, go for a faster teat rather than a slow one. It’s normal to try a few different teats before you find one that suits you and your baby.
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 milk.
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.
It’s a good idea to change the direction your baby is facing for part of the feed or at different feeds. This helps to stimulate your baby’s senses equally.
Babies who are normally breastfed might find it hard to pace themselves when bottle-feeding. This is because they’re used to controlling the flow of breastmilk. Sometimes these babies can end up drinking too much too quickly.
To help make bottle-feeding more like breastfeeding, you can try paced feeding. This involves holding your baby in an upright position and letting baby rest every few minutes.
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 infant 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 to wake your baby up. A nappy change is a good way to wake your baby up if that doesn’t work.
Wait until your baby is properly awake before offering the rest of the formula or breastmilk.
Always throw away any leftover infant formula or breastmilk after one hour. Storing half-empty bottles for future use is risky because they get contaminated quickly once they’ve been sucked on.
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 some feeds close together and others further apart.
For formula-fed babies, you can use the chart on the formula tin to see how much infant formula to make up in a bottle, but information about quantity for age on formula tins is just a guide. It mightn’t necessarily suit your baby.
Just feed your baby whenever baby is 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. Your baby will also let you know when they’ve had enough by stopping sucking or turning their head away.
As the amount of solid food your baby eats increases, the total amount of breastmilk or formula baby takes in a day will decrease. The amount of formula will also decrease as your baby starts to drink from a cup instead of a bottle. By 12 months of age, when your baby is ready for cow’s milk, baby will generally be drinking around 500-600 ml of breastmilk or formula a day.
Some babies never drink the ‘required amount’ for their age and size, and others need more. Plenty of wet nappies, consistent but not excessive weight gains, and a thriving, active baby mean all is well. If you’re concerned about whether your baby is getting enough breastmilk or formula, talk to your child and family health nurse or GP.
Dangers of bottle-feeding in bed
If your baby gets used to falling asleep with a bottle in bed, baby 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. This is like what happens when you have something ‘go down the wrong way’.
It’s more dangerous for your baby than it is for you, because baby isn’t as good at waking up if something interferes with breathing.
It’s more likely that your baby will cough and be uncomfortable, but you might want to avoid the risk altogether.
Tooth decay risk
If your baby falls asleep with a bottle of infant formula, formula might slowly drip into baby’s mouth, soaking teeth and putting baby at risk of tooth decay.
Risk of ear infections
If your baby drinks while lying flat, milk can flow into the ear cavity, which can cause ear infections.
Using a feeding cup
When your baby is around six months old, you can start using a feeding cup to teach your baby how to sip drinks from a cup. You can aim to stop using bottles by the time your baby turns 12 months old.
You should continue to thoroughly wash the feeding cups containing infant formula or breastmilk until your baby is 12 months old.