There are lots of reasons why parents choose to formula feed their babies.
Whatever the reasons, the following information is a guide to help you get started with formula feeding.
But firstly, just in case you're introducing formula for top up feeds or low supply without an official diagnosis, please read our article on low milk supply first, as well as the article not enough milk? — both written by an International Board Certified Lactation Consultant (IBCLC).
It's very important not to self diagnose before switching to formula, as there are many myths about milk supply and quantity.
The best person to properly diagnose a breastfeeding problem is an IBCLC. Other medical professionals receive minimal breastfeeding training (just a few hours for most medical professions). You can also call the Australian Breastfeeding Association’s helpline on 1800 686 268.
So, let's get started!
Formula Essentials #1: Must-Have Items for Formula Feeding
If you are planning to formula feed your baby, you will need:
- Six or more bottles
- Six or more teats
- Sterilising equipment
- Bottle and teat brush
Formula Essentials #2: Choosing the Right Bottles and Teats
There are a number of bottle types available on the market. The best ones to start with are the standard bottles, these are relatively cheap and easy to find. As your baby grows, you may find that experimenting with different bottles helps you to find the perfect fit. If you choose plastic bottles, always make sure you buy the ones labelled “BPA free”.
For a newborn baby, you should use the teats with the smaller holes. These allow the milk to flow slowly, preventing the baby from getting too much milk at once. As your baby (and his appetite) grows, you may find he needs a larger hole to enable him to get the right amount of milk.
The best teats to start off with have long nipples which gradually widen. These teats allow the baby to pull the nipple to the back of their mouth (as they would a breast). The shorter, wider nipples cannot be taken to the back of the baby's mouth as easily, and as a result the baby often ends up sucking the end of the nipple like a straw. This can lead to gaps at the corner of the baby's mouth, and an increase in air swallowed and milk leaked.
Formula Essentials #3: How to Sterilise the Bottles
Before you can sterilise the bottles, you must make sure they are properly cleaned. As soon as possible after each feed, you should use warm, soapy water to clean the bottle and teat using your bottle and teat brush. Take cake to clean off all of the milk residue.
There are a number of different ways to sterilise your baby bottles, including:
- Boiling – for this you will need a large pan with a lid. It is best to buy a pan specially for this purpose. Fill the pan with water and fully submerge all of the feeding equipment. Cover and boil for at least 10 minutes.
- Electric steam sterilising – bottle sterilisers are an expensive but convenient option for sterilising feeding equipment. The sterilisers vary between brands, but most can sterilise six bottles (plus an assortment of teats) at once. If you choose to use a bottle steriliser, make sure you follow the manufacturer's guidelines for use.
- Chemical sterilising – bottles can be sterilised in cold water if accompanied by a non-toxic chemical sterilising tablet. These dissolvable tablets added to cold water can sterilise bottles and teats. Follow the manufacturer's instructions for use. It takes about half an hour to sterilise a bottle with this method.
- Microwave sterilising – sterilisers for use in the microwave are widely available. These are convenient and do not leave a funny taste or smell on the sterilised equipment. If you buy a microwave steriliser, make sure you follow the manufacturer's guidelines for safe use.
- Dishwasher sterilising – a wash cycle of at least 80 degrees celcius will sterilise feeding equipment. However, the bottles must be used immediately as they are no longer sterile once the dishwasher has been opened.
Formula Essentials #4: Making up a Feed
#1. You should leave the feeding equipment in the steriliser until you need it. Hygiene is very important, so make sure you wash your hands and thoroughly disinfect the work surface before making up a bottle.
#2. Boil enough water for one bottle. If using a kettle, let the water boil until the kettle switches off. If using a pan, allow a rolling boil before switching off the heat.
#3. Let the water cool slightly, but do not let it go below 70 degrees celcius (formula powder is not sterile, so it must be hot to sterilise the powder). Then pour the correct amount of water into the sterilised bottle.
#4. Follow the preparation instructions listed on the formula packaging. Add the correct number of scoops to the bottle.
#5. Assemble the bottle, and then swirl and gently shake to mix the formula together.
#6. The bottle will be too hot to give to your baby, so you will need to cool it down. Hold the bottle under a running cold tap, or immerse in ice water until cooled.
#7. Check the temperature of the milk by pouring a few drops on the back of your hand. If it feels okay, you can feed your baby. If not, repeat step 6 until cooled.
If you choose to make up bottles in advance, these must be stored at the back of the fridge for no longer than 24 hours. The fridge temperature must be no higher than 5 degrees celcius.
To reheat the stored bottle, you must gently heat the bottle for 10 minutes. Longer than 10 minutes could allow harmful bacteria to multiply inside the bottle. To reheat, you should place the bottles in a pan of warm water over a low heat for 10 minutes. Alternatively, you can use a bottle warmer to heat the bottles. Always check the temperature of the milk on the back of your hand before offering it to the baby.
Formula Essentials #5: Feeding Your Baby
You should hold your baby close during feeds. Skin to skin during feeds can help with both bonding and digestion. Tilt the bottle so that the teat is full of milk, this will reduce the amount of air your baby swallows).
If your baby is wriggling or crying during the feed, he may have wind. Try sitting the baby up to get rid of any wind. You may find that rubbing your baby's back helps to clear it.
Never leave your baby unattended with a bottle. Do not prop the bottle up during feeds, you should hold the bottle at all times so that you can ensure it is in the right position and there is no risk of choking.
Do not put your baby to sleep with a bottle at night. Unlike breasts, bottle continues to release milk when not actively sucked, and this can cause milk to pool around the teeth of sleeping babies. This can lead to tooth decay.
Formula Essentials #6: How Much Formula to Give
As with breastfeeding, you should feed your baby when he is hungry. Do not try to feed your baby according to a schedule, simply follow his natural cues. Some days he may be hungrier than others, for example during growth spurts, and other days he may not take as much milk, for example if he is feeling under the weather.
Never force your baby to finish a bottle. Your baby is best placed to judge his hunger levels. Always throw away unfinished bottles of formula within one hour.
If your newborn hasn't asked for a feed, offer a bottle every two to three hours, and let her dictate the length of the feed. Learn to recognise your baby's hunger cues so that you can respond in good time.
If you are worried that your baby is getting too much or too little formula, speak to your healthcare provider.