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Bottle feeding

We all know "breast is best" for babies, and that it's recommended we exclusively breastfeed our babies until they're six months old. But if breastfeeding isn't working for you and you feel you need to bottle-feed or supplement with formula, here are some things you should know.

Infant formula is made for babies up to 12 months who are not breastfed Health professionals recommend mothers try to maintain some breastfeeding if possible, even if they are using infant formula
Formula milk is produced from cows’ milk, but its general make-up has been altered
Talk to your nurse or midwife about which formula is best for your
baby Soy formula should only be used when advised by a health professional
Drinks other than infant formula and breast milk can make your baby sick
Babies over seven months may be offered water to drink

Preparing the formula

Formula milk comes as a powder and you mix it with boiled, cooled water Always wash your hands before preparing bottle feeds You must wash and sterilise all feeding equipment until baby is at least 3 months old (including any items used with breast milk) When baby is older, thorough washing and rinsing is
enough(For more information about sterilising, talk to your nurse or chemist)
It is best to make a bottle up fresh for each feed if possible When preparing formula, follow the instructions on the packet Use only level measures and the exact volume of water Never add more powder or less water than directed as this could make your baby very sick, and never add anything else into the formula
Heating formula
Formula should be warmed gradually by placing the bottle in a container of hot water It is best not to put the bottle of formula in a microwave as it can easily overheat or heat unevenly If you do microwave formula to warm it, shake and let it sit for 2–3 minutes Shake again before testing temperature is right for baby
Before feeding baby, always check the temperature of the formula by putting some on the inside of your wrist It should feel just warm
Storing formula
The Ministry of Health recommends that you prepare just one meal at a time to avoid bacteria developing When milk is kept warm for any length of time, bacteria multiply dramatically putting your baby at risk so it’s important to store made-up formula properly It can be stored at room temperature for no more than two hours and in the fridge for no more than four hours Never re-heat used formula – throw out what your baby doesn’t drink
If you are going out somewhere, you need to bring a clean, sterilised bottle with cooled boiled water, and only add the powdered formula when it is time for the baby’s feed If you must make a bottle up beforehand, keep it cold in a chilly bin or insulating bag and use within two hours Never let your baby drink alone in their car seat – they could choke Stop to feed them
How much to feed
Age, weight, time of day, activity levels, illness and rate of growth can all affect a baby’s formula needs The tin of formula will have general guidelines on it Babies are usually fed on demand, so learn your baby’s hungry signals
Most formula-fed newborns will need around six to eight feeds in 24 hours for the first few weeks Some may stop a night feed after about six weeks
Gradually increase the quantity of feeds during the day At about two months, there will probably be 3–4 hours between feeds

You can tell if enough formula is being fed if your baby :
• is content and settles for a couple of hours after a feed
• is gaining weight at a steady rate
• has six or more very wet nappies every day

In hot weather or if your baby is unwell they may need extra feeds
Continue using breast milk or formula as the main drink until baby is one year old (There is no need to change to a follow-on formula at 6 months, which is usually when baby will be ready to start solids)
Condensed and evaporated milks should not be used for babies If baby is hungry and demands more, give more to drink at each feed or add an extra feed Do not alter the strength
After 7–8 months your baby can have small amounts of cows’ milk in cooking or as yoghurt, custard or cheese
After 12 months, the main milk for toddlers can be whole homogenised cows’ milk(dark blue lid)

Bottle-feeding position
It’s important you hold your baby close to you when you are bottle-feeding so that they feel safe and loved while they are feeding Holding your baby also ensures they are safe from choking and that the bottle is at the correct angle to prevent ear infections Do not leave your baby lying with a bottle to suck on – if babies fall asleep with milk in their mouth, their teeth can be damaged

If you need advice and support with breastfeeding or formula feeding, you can ask for help from:
• Your family doctor or practice nurse
• Your midwife or a lactation consultant
• Community or private practice dietician
• Parents Centre
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