Help needed with FF

[Mozismyhero]

Hi all,

I am new to FF. Planned to BF but have not been able to produce the volume of milk my DS (3 weeks old) needs so have had to move to mix feeding. This comes at the end of hospitalisation due to DS's weight loss and is not a decision with have taken lightly.

But... as I didn't plan to FF I never really found out much about it so could anyone answer a couple of questions for me?

• When I boil the water do I need to wait for the water to cool down (for 30 mins) or can I make up a bottle with the boiling water and then cool it down by putting the bottle into cold water?
  

• When I sterilise the bottles in our microwave steriliser, how long do they keep once I have opened the lid?
  

Think that's it. Is there anything else I need to know?

Thank you!

[mumblecrumble]

Hi there,
Many conratulations on your (I;m sure he is!) gorgeous DS. Sorry you've had a ifficult start. This info is quite good....

www.mumsnet.com/babies/bottlefeeding

We mix fed and found it can work really well if you take a 'best of both worlds' approach. I also found DD became 'better at feeding' as she got older and stronger.

Advice has changes since we bottle fed but I know lots of people who say, if you can afford it, to use the cartons of ready made milk during the night as you don;t have to wait around.

Bet FF advice I got (and same with breast feeding I suppose) was to learn your DS's feeding cues - hands in mouth, snuffles etc.. so you have time to make bottle before the screaming starts.


Is this yor first baby? DO you think you'll continue mixing or moving to FF?

[Mozismyhero]

Thanks. Yeah, he is my first. I hope to continue to mix feed if I can. How long did you manage to do this for with your DD?

[TheSugarPlumFairy]

Hi Mozismyhero

Taking your questions in order

• i used to think you had to let the water cool to about 70 degrees (which takes about 30 minutes if you leave the water in a conventional kettle to cool) but have recently read a paper produced by the WHO which another poster recently provided a link for which confirmed that you don't actually have to wait. You can use hot water straight from the kettle.
  
  Once the bottle is made up, cool it in a jug of cold water. Alternatively make it up with 1/2 hot water, add powder and dissolve it then add 1/2 cold water. It should be ready to drink straight away.
  
  
• re sterilising. Technically the bottles wont be sterile once you open the lid. That is not really that important if you are making bottles up as you go. What is most important is that the bottles are washed in hot soapy water and are free from any milk residue. The sterilising is just an added layer of protection.
  
  Sterilise the bottles and put them on a rack to dry then use them as needed. Alternatively put them through the dishwasher which will wash and sterilise them at the same time.
  
  Re night feeds, you are fine to make bottles up before you go to bed. Make them up as you would normally, cool them in a jug of cold water and then stick them in the back of the fridge to be gotten out as needed. You can warm them in a microwave (be sure to give them a good shake when you take them out to remove any hotspots) or a jug of warm water.
  
  Hope that helps. There is a FF support thread which I will bump for you.
  
  

[mumblecrumble]

Mix feeding - gave cows milk in place of formular, on cereal and little drinks etc from about a year. Found formular expensive so reduced amount.

DD had breast milk till around 18 months and to be honest often found it easier to breast feed than to make up bottle. Or I gave both - made up bottle, breast fed till, frankly, I was falling asleep, then gave small bottle.

To be honest we just went as seemed right at he time.

• Is there anything else I need to know
  

Yes. Never, never never allow anybody to make you feel any guilt at not breastfeeding or mix feeding or what ever. You do exactly as your situation and your love for your child dictates. Parenting is about comprimising and doing what is best for your own family.

Congratulations again and enjoy :)

[mumblecrumble]

Do you mind me asking what has caused the problems?

[tabouleh]

TheSugarPlumFairy - was that the link cardomonginger provided?

The WHO guidelines clearly state to use water at 70 degrees as do the UK guidelines.

If it is the link I am thinking of it is just an appendix to the guidelines where they discuss possible issues with hotter water and mention one study which showed that degredation of vitamin C did not cause it to go below recommended levels. It pointed out that there was just 1 study and there have not been lots of studies done re nutrient degredation.

I know it's easier to not wait 30 mins but I'm concerned to see this info being bandied around to people asking for advice.

What was your understanding of the link?

[tabouleh]

sorry - think I am a bit muddled re the vitamins - one study shows vitamins ok - but it's just one study and other nutrients weren't studied AFAIK

Appendix 3 - I very much read that Appendix as a justification for it being ok to use 70 degrees - despite some queries - certainly not a recommendation or "ok" to use boiling water .

[splatt]

There's been several posts on this subject of late. one started by me!

I wanted to breast feed, and was gutted when at 6 weeks my DD had only gained 5oz from birth and only 2 per week for the previous 4 weeks. We introduced formula top ups and she gained 21 oz over the following 6 days! SO the right decision. So I would echo what mumblecrumble says about not feeling guilty. I battled the the decision to use formula for a few weeks before we introduced it and until we had that weigh in but we are all happier and less stressed now. I even got a lie in this morning as DH got up with her and feed her.

I've bought a tommee tippee flask for out and about and nights. Otherwise whilst in the house, when DD startes demanding I put the kettle on, breast feed for 15 mins each side then make up a bottle (currently 4 oz she's 7.5 weeks) and cool it before giving it to her. She wolfs it down.

[cardamomginger]

Tabouleh - have you found the links to those studies that do show that nutrients degrade if you use water hotter than 70 degrees? Would be interested to see them. BTW the link is to the entire WHO publication - I merely pointed out that the information on use of water hotter than 70 degrees was in Appendix 3. The appendix also notes that "... the UK has recently updated advice on preparation of PIF, recommending reconstitution with water that is greater than 70 °C to reduce the risk associated with
using PIF (FSA, 2006)."
The study the appendix refers to found that Vitamin C was the ONLY vitamin that showed degradation at temperatures higher than 70 degrees but that the levels of vit C present in formula meant that this was not seen to be of significant concern. Concerns with using water hotter than 70 degrees were firstly clumping of the powder (which I mentioned in my post on the other thread) and secondly the risk of scalding to the person preparing the formula. I accept that the appendix refers to only one study - I have never pretended otherwise. I am not bandying information about, so please do not imply that I am acting irresponsibly when people are asking for advice. I believe in facts and evidence-based practice - so if you can point me in the direction of research that shows nutrients degrade, I will read it with interest and am more than happy to be corrected and to amend my practice accordingly.

[TheSugarPlumFairy]

tabouleh, yes it was cardamomginger's link but i cant seem to find it now to double check exactly what was written.

I see Cardamomginger has responded herself so will leave it there.

[Grumpla]

The mini cartons are a total rip off IMHO.

When DS was tiny I used to make up a sterile container of boiled water, then cool that and put in the fridge. Use that and freshly boiled kettle water for instant night feed - faster than running bottle under cold tap, and no freezing cold hands!

DS is now 18mo so I add freshly boiled water to powder and top up with cold water straight out the tap.

I just figured that the instructions changed because formula manufacturers didn't want to be sued if some knackered parent gave their baby a too-hot bottle and injured it.

If you are worried about nutrients degrading then you could mix the cooled boiled water and the hot boiled water before adding to the formula.

[tabouleh]

Look the guidelines say using water at or just over 70 degrees. If you want to do something different then do it. But please don't use that who document as a justification as it is not.

Surely people asking for advice should be told the guidelines,why they are there and reasons people don't follow them.

On the other thread I linked to an Irish document which mentions concerns with boiling water. Really the onus shouldn't be on me to show evidence of problems! You should link to studies showing that it is fine!

[Mozismyhero]

Thanks. Still finding this difficult tbh. How do people manage who just ff and have babies that feed on demand? You can't always know a baby wants food 30 mins before, can you?

Also, what if I am going out? I have been taking empty bottles (sterilised) and cartons. Is this OK?

Have read the WHO documents about FF but just wanted some RL advice from mums who are actually doing it.

Mumble - my milk has just never been there in the volume needed. My DS got to 17 days and had still not put on weight - in fact he was back at 10% off his birth weight because my milk was not there - hence the hospitalisation and need for FF. I still offer breast each feed but realistically, this is not enough for him.

[cardamomginger]

At the risk of being flamed, but in the spirit of giving an account of what I do in RL (please note people - an account, not advice!!) I don't feed on demand. We were in a routine from day 1 with feeds every 3 hours. I accept that we were lucky in that DD fitted into a 3-hour schedule naturally and continues to do so. If DD was peckish inbetween, then it's pretty quick to make up an extra 30 or 60 mls (if you are cooling to 70 degrees before adding powder then you can pour the boiling water into the bottle and then let that cool either on its own or by cooling in a bowl of water before adding the powder - no idea how long this would take so you would need to experiment beforehand, but it will be a darn sight quicker than 30 minutes). Before we went on to specialist dairy-free formula (long story on another thread) we used cartons of ready made formula for such peckish moments as these, and also for feeding at night. Yes, they are expensive, but as someone said on another thread less hassle at night is worth the extra 50p. When you are going out empty sterlised bottles and cartons (don't forget the scissors!) is fine. That's what we did before we had to change. And take an extra bottle to pour the remainder into . At the end of the day FF is a faff. But then having a baby is a bit of a faff (well worth it!), so I guess it's all part of the fun!

[Grumpla]

I fed on demand whilst feeding expressed breast milk and also formula. TBH it was easier to do so with formula than with milk. I used to take two bottles of boiling hot water in one of those insulated bags, and pre-measured formula in a little divided plastic tupperware doohickey.

Water stayed warm for about six hours, if he needed a feed before it was cool enough to make up it was always easier to cool it (either by undoing the lid of the bottle and blowing on it or by running under a cold tap) than it was to warm milk up (especially as lots of cafes will refuse to do it, very irritating)

Sterilised bottles and cartons is fine if you are happy paying for it (all those 50ps add up though!)

As your baby gets older he will get better at signalling approaching hunger (rather than going straight into "AAARRGHH I'M STARVING!!!" mode) and that will make things easier as well. I found that DS got fairly predictable fairly quickly (for example, if he produced an enormous poo then it was a safe bet he would be wanting a bottle fairly soon afterwards.

Whatever you decide, buying plenty of bottles means you won't have to wash up more than once or twice a day / get stuck without a clean one when you have a screaming baby to deal with. Buying / borrowing an electronic steriliser also much easier than faffing about with Milton. I wouldn't recommend cutting corners with washing and sterilising bottles thoroughly- they always seem an absolutely ideal environment for bacteria to me! I still sterilise all of DS's bottles (nothing else though) and he doesn't seem to get as many upset tums as some other babies.

It does seem really complicated when you first start doing it but in a few weeks you will be able to assemble a perfect bottle of milk one handed and with one eye shut. It won't ever be as convenient as breastfeeding (especially when you are at a festival) but it is do-able.