Bottles, Bottles, Bottles: A handy guide for bottle-fed babies

Published on: April 07, 2020

Bottles, Bottles, Bottles – A handy guide for bottle-fed babies

In this two-part series, Lactation Counsellor and BAMBI Bumps team member Lia Segall Pasternak explains all things about bottles. In Part 1, Lia discussed introducing a bottle to an exclusively breastfed baby. Here, Lia will give you information for exclusively bottle-fed babies and explain the safe preparation of formula. 

 By Lia Segall Pasternak

If you have chosen to feed your baby by bottle, either with breastmilk, formula or both, you must manage the preparation and feeding of the baby in a way that will ensure your baby is safe and thriving. A bottle is a great tool to feed babies. It is important to know about the proper methods of feeding a baby and teach everyone involved the way that you want things done.

Timing

If you have chosen to bottle feed before your baby is born, then you will need to feed your baby with a bottle from the start. You will need to have bottles with slow flow teats and might want to have faster flow teats to use in the future. Don’t start with those as it might cause your baby to overfeed or have trouble handling the strong flow. If you decided to feed your baby with expressed breastmilk, you will need to hand express the first couple of days while you have colostrum, and after the milk transitions, you can pump. Colostrum is hard to feed by bottle so you can use a syringe or spoon at this stage.

Amounts

To calculate the amount of formula per bottle, you can follow the instructions on the can. For either formula or breastmilk, you can also multiply the weight (in kg) of your baby by 150, to give you the amount of milk per day that he or she should be having, then divide it by the number of times your baby is feeding per day. You can follow your baby’s cues and give smaller amounts than what’s written on the can per feed as long as you increase the number of feeds per day. Just make sure your baby is eating the total amount recommended per 24 hours.

Pumping

If you are going to feed breast milk by a bottle (either by choice or because the situation demands it), then you will need to start expressing milk as close to birth or separation from the baby as possible. If you still have colostrum, it’s preferable to do this by hand expression; if your milk has transitioned you can use a breast pump. You will want to express/pump whenever your baby would be eating, for a newborn that would be every 2-3 hours during the day and every 3-4 hours during the night, no less than 8 times in 24 hours and not letting more than 4 hours go between pumping sessions. You need to make sure to empty your breasts at every pumping session. When a mother is exclusively bottle feeding with expressed milk after a few weeks the supply should be more than enough to feed the baby. When it comes to that stage, the number of times that she pumps per day can be reduced. Please consult with a lactation professional to plan and avoid mastitis or clogged ducts when dropping pumping sessions.

 

Feeding equipment

Make sure to sterilize bottles, teats, and pump parts (except the tubes) before the first use. Some people will sterilize after each use, and that’s okay. If you don’t sterilize, just wash everything thoroughly with hot water and soap after each use and air dry. Try to keep all the baby feeding equipment (until six months of age) away from the sink and use a sponge and/or brush that’s exclusively for this purpose. Always wash your hands before handling a breast pump and preparing a bottle.

Preparation of the bottle

Make sure you use clean water to prepare the formula. In Thailand, it is recommended not to use tap water for this purpose, even if it has been filtered or boiled. Follow the instructions on the container to add the appropriate amount of water. The powder itself isn’t sterile which is why you need to heat the water to 75°C to mix it. Then add the number of scoops according to the instructions. Mix well and let it cool down to a temperature that’s not too hot. You can check by splashing a few drops on your wrist and then you can feed the baby. Never heat water or formula in the microwave; this can cause hot spots that could burn your baby’s mouth. You have one hour to use it; otherwise, you’ll need to discard and prepare a new bottle.

Start with a slow flow bottle, then as the baby grows you can stay with slow flow nipples if he/she is happy; otherwise if the baby gets frustrated you can switch to the next flow level, but try to keep it as slow as possible. The slower a baby eats, the healthier he/she is. Please never mix formula with breastmilk, it should always be mixed with water following the instructions of the manufacturer, and please do not pre-make a batch of formula bottles in the fridge, formula should be made fresh EACH TIME.

*For instructions on preparation of bottles with breastmilk please refer to the first part of this series in the March 2020 issue.

Brands and types of formula

Formula is one of the most controlled foods in the world. All brands offer different kinds, so you can get formula that is aimed at your baby’s stage. It is recommended to start with a cow’s milk-based formula that is simple, and I always suggest that mothers buy a different brand each time, this way the baby doesn’t get used to one flavor and if you travel it’ll be easy to get any formula instead of carrying one brand. It also helps when introducing solids as the baby will be more open to different flavors. If you feel like the formula you used isn’t working you can try a different one. If your baby has vomiting, diarrhea, is in pain, isn’t drinking or gaining weight, please consult with your doctor before you switch to another brand to make sure something serious isn’t causing this discomfort. The most common things that bother babies are colic or reflux but there is always a chance of allergies and intolerances that only a doctor can find. Never switch to a soy-based or goat milk-based formula without consulting with your doctor.

 

How to Give a Bottle ?

When exclusively bottle feeding, we want to imitate what babies experience at the breast because research shows that this way to feed is healthy. Breast-fed babies regulate their own intake at the breast, as they must work to extract milk from the breast. They can pause during their feed and unlatch when they are done. When a bottle is tipped at an angle of less than 180°, it will provide a constant drip/flow and is held in the mouth which disrupts the physiological process. Paced Bottle Feeding is a method of bottle feeding that allows the infant to be more in control of the feeding pace, slowing down the flow of milk into the nipple and the mouth, allowing babies to regulate their intake. Always use a slow flow nipple, which is closest to breastfeeding. A lactation professional can help you to introduce pace feeding and there are also useful videos and instructions online. 

 

Remember

Giving a bottle is a moment for bonding and connection and whoever is giving it should hold the baby and keep eye contact. When a baby is breastfeeding they get about 40 minutes of contact eight times a day. So when a baby is bottle-fed, we should remember to make it bonding time, which is so good for the baby’s development and growth. So try doing skin-to-skin sessions with your baby, even while bottle feeding, this will make it more special and fun for the baby and the person giving it. Enjoy the cuddles!

 

More information and contact

Lia Segall – Lactation Counseling Bangkok:

www.facebook.com/BreastfeedingBangkok

Infant Formula Preparation and Storage:

https://www.cdc.gov/nutrition/infantandtoddlernutrition/formula-feeding/infant-formula-preparation-and-storage.html

Breastmilk calculator:

https://kellymom.com/bf/pumpingmoms/pumping/milkcalc/

Paced Bottle Feeding:

https://www.health.state.mn.us/docs/people/wic/localagency/wedupdate/moyr/2017/topic/1115feeding.pdf

Photos by Lucy Wolski and Ana Tablas on Unsplash.

About the Author

Lia was born and raised in Mexico, she moved to Israel in 2010, got married and had a son in 2014 who made her fall in love with breastfeeding. Lia quit her job and went to study to become a lactation counselor.  After moving to Thailand in February 2017, Lia started volunteering with BAMBI Bumps and Babies and Bangkok Breastfeeding Cafe. She had Maya, her daughter, and continues to give all mothers a human approach and support on their breastfeeding journey. 


The views expressed in the articles in this magazine are not necessarily those of BAMBI committee members and we assume no responsibility for them or their effects.

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