Getting your baby to drink formula milk out of a bottle may not be as 'technically' demanding as getting her to drink breastmilk from your breast can be, but that's not to say you can just shove a teat in roughly the right direction and be done with it. Bottle feeding comes with its own set of challenges including preparation and hygiene.
First off, you have to make sure you're putting the formula into the bottle in exactly the right way first. This is important stuff: even though tins or packets of formula milk powder are sealed, they are not sterile and may contain bacteria, such as Enterobacter sakazakii or Salmonella, that can potentially cause life-threatening infections in babies. So making up formula carelessly or incorrectly could make your baby ill.
NHS guidelines for making up bottles of formula have changed, so whatever your mum/sister/best friend did may no longer be considered safe, however much they insist it never did their babies any harm.
How to make up bottles of formula milk safely
- Boil a kettle of freshly run water. Don't use softened or repeatedly boiled water. If you have to use bottled water, first make sure that the sodium (or Na) is less that 200mg per litre and the sulphate is less than 250mg per litre. You should also boil it first.
- Let it cool but do not allow it to cool for more than 30 minutes before putting it in the bottle. The water must still be hot (at least 70C) when the formula milk is added to otherwise any bacteria in the powder may not be destroyed.
- Always add the formula powder to the water, and not the water to the powder.
- Be careful when pouring water from the kettle because even at 70C it's still hot enough to scald.
- Fill the bottle to the correct level (as specified on the formula packet or container).
- Using the scoop provided, loosely fill it with milk powder and level it off using a clean, dry knife.
- Add the number of scoops specified on the formula container to the water in the bottle.
- Hold the edge of the teat, put it on to the bottle, screw the retaining ring into place and cover the teat with the cap.
- Shake the bottle until all the powder has dissolved.
- Always test the temperature of the feed by dropping a little of the milk onto the inside of your wrist before you feed it to your baby - it should be body temperature, so shouldn't feel too cold or hot.
- If it's too hot, cool the feed by holding the bottle - with the cap still covering the teat - under cold running water.
- Throw away any milk that hasn't been used within two hours.
For premature or low-birth weight babies, the NHS recommends using ready-made cartons of formula milk.
So the upshot is meticulous hygiene, using water at the correct temperature and making up each feed as you need it, rather than making up a day's (or a night's) batch and keeping in the fridge till your baby hollers for it.
When it comes to actually putting teat to mouth, your midwife/health visitor should be able to help and advise you. You may have to ask quite loudly, though: the drive to encourage more women to breastfeed does mean that information about formula feeding is not routinely given out. Rightly or wrongly, this can mean that some formula-feeding mothers can miss out on stuff that would come in really useful, such as when to change bottles and teats for new ones.
Even more surprisingly, many mothers who choose to use/change to formula aren't made aware they should never:
- Leave a baby with a bottle propped up in her mouth - she could choke (and anyway, all babies could do with a cuddle as they feed). Hold her upright so that she can breathe and swallow easily.
- Put anything else in the bottle with her milk, such as a rusk.
- Encourage a baby to finish each bottle. 'Feeding up' a small baby, especially a low-birthweight one, is associated with a higher risk of childhood obesity.
- Give a baby 'follow-on' milk before she's six months old (if at all), no matter how big she is. Her digestive system just won't be able to cope with it yet.
What Mumsnetters say about bottle feeding
- If formula is not made up correctly and is infected with a bug (like many batches have been found to be), a baby could die. And babies have died in recent years in Europe due to formula not being prepared properly. BabiesEverywhere
- Despite all the various health claims on the tins, the difference between brands of formula is probably very small. tiktok
Some babies switch from breast to bottle without a murmur. Others turn the occasion into a regular screamfest. Even if they've taken a bottle before. And even if it's full of breastmilk.
If you've got a bottle-battler on your hands, these Mumsnet tactics should do the trick...
- Try a different teat/bottle. Wider-necked bottles with short, stubby teats look more like a real breast but only the long, silicone teats will deliver milk far back in the mouth, in the same way breastfeeding does. There's no knowing which your baby will prefer. To further complicate matters, you'll find teats come with a choice of slow-flow, medium-flow or fast-flow holes at the tip: breastfed babies tend to prefer slow-flow (because they have to suck harder to get the milk, just like they do at the breast) but an older baby may turn out to prefer a faster flow. It's worth experimenting a bit to see what works best...
- Get your timing right. It's obviously best to bring the bottle out when your baby is calm and slightly peckish, rather than frenzied and starving. Some people would even suggest stretching the meaning of 'calm' to its logical limit and waiting till your baby's sound asleep.
- Pimp your scene. Sometimes, just a few lighting/prop changes can make all the difference.
- Be patient and persistent. Because getting in a flap (however flap-worthy you feel this situation is) won't make your baby relax and give the bottle a try.
- If all else fails, try a cup. Or a beaker with a soft spout.
Mumsnetters' tips for switching from breast to bottle
- We kept perservering with bottles, and trying all sizes of teats. In the end, we found a slow-flow teat which made her 'work' for the milk suited her the best. missgriss
- I would just choose something and then persevere for a couple of weeks with it. Constantly changing from one to another method is bound to be a bit disorienting. doggiesayswoof
- My son wouldn't take a bottle at all and then we noticed he was sucking madly in his sleep. So, we sneakily took out his dummy and replaced it with a bottle - he drank the lot! We repeated this a few times, then he suddenly decided he would take the bottle whilst awake after all. moominsmummy
- After a few abortive attempts, we figured it was the sight of the bottle that was freaking our son out so much. So we turned the lights off and fed him in the dark. It worked - but I did fall over the coffee table trying to find the light switch afterwards! Porpoise
- I suggest you don't cradle your baby in the same way you normally would if you were breastfeeding. Try having him sitting up on your lap facing outwards. Or even in his bouncy chair. Keep him away from the breast area as much as you can. Or maybe get someone else can do it – someone without breasts! popeye123
- You could try milk that you expressed immediately before. I remember tasting expressed breastmilk that had been in the fridge and then warmed, and it really wasn't the same! fruitful
- I think a lot of babies don't take to it straightaway. It's often just a question of being persistent. Don't get upset and push it. Just try again a day or so later. FirstAtForty
- I just let her chew on it for 10 minutes every day and eventually she started sucking merrily away. It took about two weeks of gentle persuasion. jorange5
- My son would not take a bottle but would take full feed from a beaker from around three and a half months. And, actually, that was really good as we never had to take the bottle away when he was aged one or whatever. naughtymummy
Perhaps you always intended to formula-feed but feel looked down on for your choice? Perhaps you wanted – or tried – to breastfeed but found you couldn't and now feel a failure? Whatever your reasons for ending up with a teat, a bottle and a tin of formula, there's no need to waste a moment feeling bad about it.
You've taken your decision (or had it taken for you by circumstances you could never have predicted) and, whatever anybody else might say, you're providing your baby with a perfectly acceptable source of nourishment in a way that gives her the love and contact she needs.
As this Mumsnetter puts it: "If you can't breastfeed, then you can't. No guilt needed. If you choose to bottlefeed, then you do. No guilt needed either."
Unfortunately, succinct thinking isn't what you're best at when you've just had a baby. Especially if you've spent the last few days struggling to get your breasts working as Nature intended – and as everyone seemed hell-bent on assuring you they would, if only you tried hard enough.
You need to give full vent to your regret/disappointment/grief/pissed-off-ness before you can even begin to stop feeling guilty.
What Mumsnetters say about dealing with feelings of failure
- Forgiving yourself is the hardest bit. What doesn't help is the assumption that, given the facts, we will somehow all breastfeed. The Department of Health can recommend breastfeeding for six months all it likes, but they're not there when your child is throwing up your blood at 2am. Or when the breastfeeding counsellor won't come out to you. Or when the midwives all tell you you're doing fine (we weren't). BlueyDragon
- I think there is a lot of unexpressed grief among women who wanted to breastfeed and didn't. It's a grief that can't even be expressed in its fullness, as it is so 'normal' (culturally) to bottlefeed. Many people think someone grieving over not breastfeeding is crackers: 'Where's the problem? Baby's alive and kicking!' tiktok
- I don't know how I would have made it through the week after stopping breastfeeding without the support of my husband and, especially, Mumsnet. I felt guilty, a failure, useless, was ready to give up my son for adoption... but it passed. I realised there is so much more to having a baby than breastfeeding. bunnyrabbit
- In a short while, you'll forget about this and start to feel guilty about something else, then something else, then something else. and so on and so on. Motherhood equals guilt. People who bottlefeed don't have the monopoly on guilt. hercules
At some point after your child's first birthday, there will come a time when the people in your life who see it as their duty to pronounce helpfully upon such things (your mum/your mother-in-law/your health visitor) will inform you that it's time to 'give up the bottle'.
After the inevitable misunderstanding about your nightly penchant for a glass of wine (or three), you'll come to realise they're talking about stopping your baby from having a bottle.
And they've kind of got a point. Continuing to drink cow's milk or formula milk (or fruit juice) from a bottle can damage your child's teeth – especially if she takes the bottle to bed with her at night.
Plus, if your baby's necking pints of the stuff during the day, that could be restricting her appetite for 'proper' food, which, by now, is where she should be getting most of her calories from. (For more on this, see our section on weaning.)
The solution to the daytime-bottle-glugathon thing is a soft-spouted beaker. It'll allow your child stlll to drink the milk she wants without being lulled by the comfort of sucking on a teat into drinking more than she really needs. Of course, all this is obviously easier said that done but, as with all thing parenting, persistence and patience usually pay off in the end.
What about that bedtime bottle? Well, if it's your passport to a (reasonably) good night's sleep, then there's really no massive rush to give it up - as long as you make sure it's drunk before your child actually gets into bed and is always followed by a good old session with a toothbrush.
But when you feel the time has come (or when you can't stand the 'helpful pronouncements' anymore), here are some clever ways to make it one of life's smoother rites of passage:
- I'm sure lots of people do this differently but I just offered a beaker of water with her story instead and then put her to bed. That was it, really. StickyNote
- We let our son continue with his bedtime bottle until he was around 22 months. Then we went cold turkey and told him bottles were only for babies (he had a new baby sister by then) and that big boys used a beaker. We also bought him a second beaker just for his milk. I found that, no matter how clean his other beaker was, it always smelled slightly of juice. gloworm
- I remember when we did this with our children, we were sort of 'forced' into it. First time round, we lost the only teat we had left, so our son had to have a cup – I made my husband deal with that! And then, with our daughter, we were on holiday at my parents and my dad threw the only teat out by mistake one afternoon. Again, I made my husband do it – I'm a coward! poppiesinaline