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Childrens Health: How to Bottle Feed Safely  Previous Next

How to Bottle Feed Safely

by: Anne Stiller, RNC, IBCLC

If your baby is not breastfed, or if you must supplement feedings with additional milk, there are important facts you need to know to make bottle feeding safe for your baby.


According to the American Academy of Pediatrics, babies under 12 months of age should be fed either breastmilk or infant formula. No other type of milk provides all of the nutrients in the right amounts to support optimal growth. Formula companies use human milk as a standard and produce a product, usually based on cows’ milk, which contains proteins, fats and carbohydrates in a proportion that is close to human milk. Then they add vitamins, minerals and other ingredients to bring the final product as close to human milk as possible. As ongoing research reveals factors in mothers’ milk that were previously not known, the drug companies that manufacture infant formula add them, and advertise the product as being “new” or “improved.” Some recent additions are ARA and DHA. The living cells in breastmilk, so important to a baby’s immune system cannot be duplicated. Read labels carefully to know what is in the brand you purchase. When you choose a formula for your baby, it is usually best to start with one that is milk-based, since these are tolerated by most babies and are lower in cost than the specialized formulas. If your baby does not tolerate his formula, consult your pediatrician about which one to try next. While soy based formulas contain all of the nutrients needed to sustain growth, they also contain phytoestrogens that may affect a baby’s growth and development, and they hinder the absorption of zinc and calcium. According to an FDA paper, the AAP states “Healthy full-term infants should be given soy formula only when medically necessary." ( Specialized formulas for allergic babies are more expensive, and should be used on the recommendation of a pediatrician.


If your formula feed your baby, you will need bottles, nipples (teats), and a bottle brush for effective cleaning. There are many types and styles of bottles available, and what you choose depends upon your preference.
Bottles with disposable liners are fairly easy to use and easy to clean, but they are more expensive than other types because the liners have to be purchased throughout the months that your baby uses a bottle. Plastic bottles are lightweight, and most are easy to clean with hot soapy water and a brush. In recent months, news articles have warned about possible dangers from the leaching of a chemical called bisphenol A or BPA into milk from the plastic when bottles are heated, and also from the linings of the can the formula comes in. Although the FDA states that plastic bottles do not present a hazard to babies, you might want to research the different brands to see which are considered safer before purchasing bottles for your baby. A google search turned up lists of brands which are BPA free.

Different babies do better with different types of nipples. You should choose those with a slow flow at first, especially for a very young baby. If the milk flows too fast the baby may choke, or take in too much air. Be sure to replace nipples that become worn so that they do not break during a feeding. At times a baby who is teething may chew on the nipple and cause tiny pieces to come off, so inspect them on a regular basis.

Formula Preparation:

Infant formula comes in three forms: ready to feed, concentrate, and powder. Ready to feed formula is the easiest to use. It can be stored at room temperature until the can is opened, and is fed to the baby directly as it comes from the can. It is, however, expensive compared to the other types. Both other forms of formula must be mixed with water before feeding. It is very important to read the directions on the can to be sure that you add exactly the right amount of water so that the milk the baby receives is neither too dilute (which could lead to malnutrition) nor too concentrated (which could be hard on the baby’s kidneys). Some pediatricians (and the World Health Organization) recommend boiling all water prior to using it for a baby. Other doctors feel that it is OK to use water directly from the tap as long as it has been proven safe for drinking. If you are not sure, ask your pediatrician. Powdered formula is not sterile, and in recent months, reports have warned about the potential contamination of some such formulas with Enterobacter sakazakii, a bacteria that can cause infections in all ages, but newborns (under 1 month of age) and premature babies are at greatest risk. The World Health Organization recommends that formula given to these infants be ready to feed, or concentrate. If powdered formula must be used for a newborn, it should be prepared with boiling water or heated almost to boiling, then cooled before feeding to kill the bacteria if it is present. Once it is prepared, the formula should be refrigerated or kept cold with ice packs until the baby is fed. Discard any unused milk left in the bottle after feeding, since bacteria multiply quickly in warmed milk. Heating baby bottles in the microwave is not recommended because “hot spots” that can scald a baby may occur. If you do use a microwave, be sure to shake the bottle thoroughly to mix the formula completely. (Never microwave expressed breastmilk because that would kill some of the living cells that protect the baby from illness.)

Feeding the Baby:

Feeding time is very important in terms of your baby’s emotional and social well-being. You should always hold your baby in your arms when giving him a bottle, and cuddle him close. This is a good time to talk to your baby, look into his eyes, and watch him smile and interact with you. His head should be slightly elevated because most bottle nipples flow fast enough to choke a baby who is lying flat when he swallows. When feeding a newborn, stop and try to burp the baby every ounce or so. As baby grows, he can take in larger amounts without burping. Ask your pediatrician how much formula to feed your baby. Don’t force him to finish a bottle if he stops drinking and acts full. Most babies know how much they need, and overfeeding can predispose him to obesity later on. Never prop a bottle because of the danger of choking, and don’t put your baby to bed with a bottle. Milk that remains on his teeth during the night will promote tooth decay.

However your baby is fed, feeding time should be very comfortable and enjoyable for both of you.

About the Author:

Anne Stiller, RNC, IBCLC
is a certified Maternal-Newborn nurse, Certified Lactation Consultant and a
writer on topics related to baby care
and parenting at, a
social networking website for Mothers.

Anne Stiller, RNC, IBCLC is a certified Maternal-Newborn nurse, Certified Lactation Consultant and a writer on topics related to baby care and parenting at, a social networking website for Mothers.

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