Do you have any tips on how to formula feed?
Breastfeeding is the optimal source of food for infants less than 6 months of age and, whenever possible, should be an infant’s sole source of nutrition. If you cannot or choose not to breastfeed for some reason, you need to find a safe alternative to breast milk. Infant formulas are ideal choices because they are manufactured using strict hygiene standards and formulated according to recognized, international, nutritional standards. Although no formula will ever be the equivalent of breast milk, commercialized infant formulas offer mothers the best and safest alternative.
When done correctly, formula feeding, like breastfeeding, can offer mother and child an opportunity to enjoy warm bonding moments. Yet, infant formula is a safe alternative only if the mother or caregiver knows to use clean utensils, clean, safe water, and the exact proportions of water to formula. Proper preparation and storage of formula can make the difference between a healthy baby and a sick one, and may even save a baby's life. In addition, the way an infant formula is fed can make a big difference. Since the tips below are simple generalizations, be sure to check with your health care provider if you have any questions about feeding your baby.
Do you have tips on how to ensure safe preparation and storage of formula?
Preparation and Storage
- Choose a clean area in which to prepare the formula. Counters frequently used for cooking should be carefully cleaned before the formula is mixed.
- Always wash your hands thoroughly with clean water and soap before handling the items required for formula preparation as well as before you actually mix the formula.
- When preparing formula, always use safe, clean drinking water. Many families choose to boil the water used for formula preparation, although infant water can be purchased in stores. To ensure the safety of boiled water, bring the water to a boil and keep it boiling for at least one minute.
- Always use clean bottles and utensils. If your tap water is safe and clean, you can simply use your dishwasher or wash utensils in hot tap water with dishwashing detergent and then rinse them in hot water. In homes with unsafe tap water, bottles and other utensils should be sterilized before using. To do this, place the bottles and utensils in boiling water for five to ten minutes.
- If you boil the water to be used for mixing, make sure to let it cool to body temperature before starting. Be sure to follow the manufacturer’s directions exactly when mixing. If you put in too much water, your baby won’t get enough nutrients; too little water may cause a risk of dehydration.
- If possible, prepare one bottle at a time and feed immediately. If you prepare more than one bottle at a time, store the bottles immediately in the refrigerator and use them within 24 hours. If the bottles aren’t used within that timeframe, throw them out. If you need to, mark the date and time you mixed the formula with a piece of tape on each bottle.
- Always start each feeding with a freshly prepared bottle of formula. Automatically discard any left over formula from a feeding.
In summary, you need to be consistently and meticulously careful or your baby may become ill from dirty water, bottles, nipples or unsanitary conditions in the preparation area.
How to Formula Feed your Baby
- Find a comfortable, quiet place to breastfeed, especially if your household is a very busy and hectic one. Choose a comfortable position—many mothers find that a rocking chair works best.
- Position your baby on your lap, either in an upright or semi-upright position. You should have a full view of your baby’s face and he or she should have a full view of yours.
- Stimulate your baby to arouse interest. Try tickling baby's lips with your finger or the nipple of the bottle. This will stimulate your baby to open his or her mouth widely.
- In the first few weeks, feed your baby whenever he or she seems hungry. Common signs of hunger include increased alertness or activity, mouthing, or rooting. Crying is usually a late sign of hunger. Wake your baby up to eat if he or she has not eaten for 3 to 4 hours. However, by the time your baby is one month old, he or she should be able to occasionally go longer stretches (4-5 hours) in between feedings.
- If your baby is sleepy or is distracted easily during feeding, stroke him under the chin, or tickle her on the feet, before offering the bottle.
- Allow your baby to pace himself or herself during the feeding by occasionally removing the bottle for a rest when your baby seems to slow down.
- Never prop the bottle up. Make the most of formula feeding; take the time to focus and fully bond with your baby.
What Not to Use as an Alternative to Breast Milk
- Do not give ordinary cow or goat's milk as an exclusive source of food to your infant for the entire first year. While cow’s milk and goat’s milk can be used as ingredients in complementary foods for infants older than 6 months of age, they should not be given as an exclusive food. These milks do not meet your baby's vitamin and mineral needs and have a high level of protein that is hard for your baby to digest, and which may place a strain on a baby's immature kidneys.
- Avoid cereals or gruels made from cassava, rice, maize or other grains. These foods are unsuitable for infants less than 4 months old. If they are used in place of formula, your baby may not be receiving adequate nutrition, as these cereals usually don't contain enough of the nutrients required by young infants. In addition, they can pose a choking hazard, especially if they contain any solids such as dried fruits or nuts.
While new parents may not always choose or prefer formula feeding, they should remember that the goal is to provide their child with the best nutrition possible regardless of the source. For mothers, formula feeding can provide bonding and nurturing time with baby. It has one extra advantage—fathers and other caregivers have an opportunity to bond with the baby as well.
Why is infant formula safe for my baby?
Breast milk has long been considered the gold standard of infant feeding. Before the 20th century, infants who were not breastfed had a poor prognosis and many died. The development of commercial infant formula in the early 1920’s provided the first safe and nutritious alternative to human milk for mothers who could not or chose not to breastfeed. When developing an infant formula, many of the companies who make these products adhere to the following principles:
- To consider adding a new ingredient only if it has been proven to or is highly likely to benefit infants,
- To introduce a new product or modify an existing product only after the product has been shown to be safe.
The World Health Organization (WHO) acknowledges that when mothers do not breastfeed, or do so only partially, infant formula fills a legitimate need. Properly prepared infant formula that conforms to Codex Alimentarius standards is the only safe alternative to breast milk. It is manufactured using strict rules of hygiene and formulated according to recognized, international standards based on expert medical and nutritional opinion.
Most commercial infant formulas are available in two forms: ready-to-feed and powder. When properly prepared and stored, these formulas provide the safest and most nutritious alternative to breast milk for infants up to the age of 12 months. Infants who are breastfed but who are weaned before 12 months should still receive milk-based, iron-fortified commercial infant formula, not cow’s milk. In some cases, when infants show signs of intolerance to milk-based formulas, parents can switch to a soy-based one.
If breastfeeding is the best choice for infants, why would someone choose to use formula?
Many women cannot or choose not to breastfeed even though breast milk is universally recognized as the best source of nutrition for infants and is recommended to be the exclusive food for the first 6 months of life. A baby’s health may depend on safe and nutritious alternatives to breastfeeding in a variety of circumstances:
- The mother does not breastfeed or stops breastfeeding, for whatever reason, before her baby has reached the age of six months. This may occur when mothers do not receive adequate maternity leave or are not allowed time off during work hours for breastfeeding or to pump.
- The mother dies in childbirth or is separated from her baby for any reason.
- The baby fails to thrive because the mother's milk alone does not satisfy the baby's nutritional needs. This may occur in situations where the mother has an inadequate diet or in cases of multiple births.
- The baby is at risk because it was born prematurely or with metabolic or other nutritional disorders.
- The mother’s healthcare provider advises her not to breastfeed because she suffers from an infectious disease such as active tuberculosis or HIV/AIDS, which could be transmitted to the baby.
- The mother is receiving cancer treatments such as chemotherapy or other medications that may be excreted in the breast milk; or she has been exposed to hazardous environmental agents, such as lead.
- The mother frequently uses addictive drugs or alcohol.
Updated May 2003
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