About bottle-feeding
If your baby can’t always feed directly from the breast, you might choose to bottle-feed withexpressed breastmilk. Or you might need to feed your babyinfant formula, which is the only safe alternative to breastmilk.
Before you bottle-feed your baby, it’s important to knowhow to clean and sterilise bottle-feeding equipment, as well ashow to prepare, store and warm bottles of formula. This will help to keep your baby safe from infection and make sure your baby is getting the right nutrition.
Getting the right flow when bottle-feeding
Totest 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 your baby is having trouble getting formula or breastmilk from the bottle, try a faster teat. If your baby doesn’t seem to be swallowing quickly enough, try a slower teat. You might need to try a few different teats before you find one that suits.
Giving your baby the bottle
Make yourself comfortable. Cuddle your baby close to you, holding them gently but firmly and on a slight incline.
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 that it’s filled with formula or breastmilk and so that small air bubbles can rise through the milk as your baby drinks. This will help to reduce the amount of air your baby swallows and might help with burping. If you don’t see air bubbles rising, try loosening the ring a little.
When your baby stops sucking strongly or when about half of the formula or breastmilk has gone, gently remove the bottle and see whether your baby wants to burp. Once you’ve triedburping your baby, you can offer the bottle again.
Paced bottle-feeding
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 your baby develop and grow. Feeding is also a great opportunity tobond with your baby.
When your 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 your 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 your baby doesn’t finish all the formula or breastmilk, throw it away within one hour. When your baby drinks from the bottle, bacteria from your baby’s mouth get into the milk. These bacteria can make your baby sick if you give your baby the same bottle again later.
When your 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 the bottle to your baby. This can help if you usually breastfeed your baby.
- Check the flow of formula or breastmilk. If the flow is too slow, this can frustrate your baby. You might need to try a different teat.
- 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, speak to your child and family health nurse for advice.
If you think your baby is refusing the bottle because they’re unwell, treat your baby’s symptoms ortake 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’sno 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. Some babies have predictable feeding patterns, whereas other babies change their feeding times each day.
Feed your baby whenever they’re hungry. You’ll seebaby 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 weight gain, 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: risks
Bottle-feeding in bed has several risks for your baby. So it’s important to put your baby to bed without a bottle or to take the bottle away after your baby has finished feeding.
Here are risks of bottle-feeding in bed.
Choking and chest infections
Babies who fall asleep flat on their back while bottle-feeding can draw liquid into their lungs. They might then choke on it. Or they might get a chest infection.
Ear infections
If your baby drinks while lying flat, milk can flow into the ear cavity, which can causeear infections.
Tooth decay
Bottle-feeding in bed can increase your baby’s risk of tooth decay. This is because there’s less saliva in children’s mouths during sleep, and saliva protects teeth from the sugar in milk.
Sleep associations
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 baby to settle for sleep independently.
Prop feeding is risky and isn’t recommended. Prop feeding is using a rolled-up blanket, pillow or other prop to keep the bottle in the baby’s mouth. Prop feeding can increase the risk of choking, suffocation, ear infections and tooth decay.
Using a feeding cup
When your baby is around 6 months old, you can help your baby startlearning to drink from a cup. It’s best to wean your baby off the bottle by the time your baby is 12 months old.
It’s important to continue to thoroughly wash and sterilise feeding cups containing infant formula or breastmilk until your baby is 12 months old.
