Stephanie Martin

Bottle Feeding Guide

If you are planning to bottle feed your baby infant formula or expressed breast milk it is important you know which feeding equipment you will need and how to sterilise bottles to minimise the risks to your baby.

Buying bottle feeding equipment

You'll need a number of bottles and teats, as well as sterilising equipment. 

There's no evidence that one type of teat or bottle is better than any other.

Simple bottles that are easy to wash and sterilise are probably best.

Sterilising baby bottles

Sterilising baby bottles

It's important to sterilise all your baby's feeding equipment, including bottles and teats, until they are at least 12 months old.

This will protect your baby against infections, in particular diarrhoea and vomiting.

Before sterilising, you need to:

  • Clean bottles, teats and other feeding equipment in hot, soapy water as soon as possible after feeds.
  • Use a clean bottle brush to clean bottles (only use this brush for cleaning bottles), and a small teat brush to clean the inside of teats. You can also turn teats inside out and wash in hot soapy water. Don't be tempted to use salt to clean teats, this can be dangerous for your baby.
  • You can put your baby's feeding equipment in the dishwasher to clean it if you prefer. (Putting feeding equipment through the dishwasher cleans it but doesn't sterilise it.) Make sure bottles, lids and teats are facing downwards. You may prefer to wash teats separately by hand to make sure they are completely clean.
  • Rinse all your equipment in clean, cold running water before sterilising.

The advice above applies to all your baby's feeding equipment, and whether you are using expressed breast milk or formula milk.

How to sterilise baby feeding equipment

There are several ways you can sterilise your baby’s feeding equipment. These include:

  • cold water sterilising solution
  • steam sterilising
  • boiling

Cold water sterilising solution

  • Follow the manufacturer's instructions.
  • Leave feeding equipment in the sterilising solution for at least 30 minutes.
  • Change the sterilising solution every 24 hours.
  • Make sure there are no air bubbles trapped in the bottles or teats when putting them in the sterilising solution.
  • Your steriliser should have a floating cover or a plunger to keep all the equipment under the solution.

Steam sterilising (electric steriliser or microwave)

  • It's important to follow the manufacturer's instructions, as there are several different types of sterilisers.
  • Make sure the openings of the bottles and teats are facing downwards in the steriliser.
  • Manufacturers will give guidelines on how long you can leave equipment in the steriliser before it needs to be sterilised again.

Sterilising by boiling

  • Make sure that whatever you want to sterilise in this way is safe to boil.
  • Boil the feeding equipment in a large pan of water for at least 10 minutes, making sure it all stays under the surface.
  • Set a timer so you don't forget to turn the heat off. 
  • Remember that teats tend to get damaged faster with this method. Regularly check that teats and bottles are not torn, cracked or damaged.

After you've finished sterilising

  • It's best to leave bottles and teats in the steriliser or pan until you need them.
  • If you do take them out, put the teats and lids on the bottles straightaway.
  • Wash and dry your hands before handling sterilised equipment. Better still, use some sterile tongs.
  • Assemble the bottles on a clean, disinfected surface or the upturned lid of the steriliser.

Making up bottles

Make sure your bottles and teats are sterilised and wash your hands thoroughly.

If you're using infant formula, follow the instructions on the packaging carefully when you make up the feed.

Good hygiene is very important when making up a formula feed.

Your baby's immune system isn't as strong as an adult's. That's why bottles, teats and any other feeding equipment need to be washed and sterilised before each feed.

This will reduce the chance of your baby getting an infection, in particular diarrhoea and vomiting.

Step-by-step guide to preparing a formula feed

  • Step 1: Fill the kettle with at least 1 litre of fresh tap water (don't use water that has been boiled before).
  • Step 2: Boil the water. Then leave the water to cool for no more than 30 minutes, so that it remains at a temperature of at least 70C.
  • Step 3: Clean and disinfect the surface you are going to use.
  • Step 4: It's important that you wash your hands.
  • Step 5: If you are using a cold-water steriliser, shake off any excess solution from the bottle and the teat, or rinse them with cooled boiled water from the kettle (not tap water).
  • Step 6: Stand the bottle on the cleaned, disinfected surface.
  • Step 7: Follow the manufacturer's instructions and pour the amount of water you need into the bottle. Double check that the water level is correct. Always put the water in the bottle first, while it is still hot, before adding the powdered formula.
  • Step 8:
Infant formula

Loosely fill the scoop with formula powder, according to the manufacturer's instructions, and level it off using either the flat edge of a clean, dry knife or the leveller provided. Different tins of formula come with different scoops. Make sure you only use the scoop that comes with the formula.

  • Step 9: Holding the edge of the teat, put it on the bottle. Then screw the retaining ring onto the bottle.
  • Step 10: Cover the teat with the cap and shake the bottle until the powder is dissolved.
  • Step 11: It's important to cool the formula so it's not too hot to drink. Do this by holding the bottle (with the lid on) under cold running water.
  • Step 12: Test the temperature of the formula on the inside of your wrist before giving it to your baby. It should be body temperature, which means it should feel warm or cool, but not hot.
  • Step 13: If there is any made-up formula left after a feed, throw it away.

Dos and don'ts of making up formula feeds

  • Manufacturers' instructions vary as to how much water and powder to use, so it's important to follow them very carefully.
  • Don't add extra formula powder when making up a feed. This can make your baby constipated or dehydrated. Too little powder may not give your baby enough nourishment.
  • Don't add sugar or cereals to your baby's formula.
  • Never warm up formula in a microwave, as it may heat the feed unevenly and burn your baby's mouth.

Reducing the risk of infection

Even when tins and packets of powdered infant formula are sealed, they can sometimes contain bacteria.

Bacteria multiply very fast at room temperature. Even when a feed is kept in a fridge, bacteria can still survive and multiply, although more slowly.

To reduce the risk of infection, it's best to make up feeds one at a time, as your baby needs them.

Use freshly boiled drinking water from the tap to make up a feed. Don't use artificially softened water or water that has been boiled before.

Leave the water to cool in the kettle for no more than 30 minutes. Then it will stay at a temperature of at least 70C. Water at this temperature will kill any harmful bacteria.

Remember to let the feed cool before you give it to your baby. Or you can run the bottle (with the lid on) under a cold tap.

Don't use bottled water to make up formula feeds

Bottled water is not recommended for making up feeds, as it's not sterile and may contain too much salt (sodium) or sulphate.

How to bottle feed your baby

Bottle feeding is a chance to feel close to your baby and get to know them.

Make sure you're sitting comfortably. Enjoy holding your baby and looking into their eyes as you feed them. 

Hold your baby fairly upright for bottle feeds. Support their head so they can breathe and swallow comfortably. 

Brush the teat against your baby's lips and, when your they open their mouth wide, let them draw in the teat.  

Always give your baby plenty of time to feed.

Keep the teat full

When bottle feeding, keep the teat full of milk, otherwise your baby will take in air.

If the teat goes flat while you're feeding, gently poke your little finger into the corner of your baby's mouth to release the suction.

If the teat gets blocked, replace it with another sterile teat.

Winding your baby

Your baby may take short breaks during a feed and may need to burp sometimes.

When your baby has had enough milk, hold them upright and gently rub or pat their back to bring up any wind.

Throw away unused milk

Throw away any unused formula or breast milk after you have finished bottle feeding your baby.

Be guided by your baby

All babies are different. Some want to feed more often that others, and some want more milk.

Just follow your baby's lead.

Feed them when they seem hungry and don't worry if they don't finish the bottle.

Don't leave your baby alone

Never leave your baby alone to feed with a propped-up bottle as they may choke on the milk.

Help with bottle feeding

Talk to your midwife, health visitor or other mothers who have bottle fed if you need help.

You'll find the phone number for your health visitor in your baby's red book.

Your questions about bottle feeding

Why doesn't my baby settle after feeds?

If your baby swallows air while bottle feeding, they may feel uncomfortable and cry.

After a feed, hold your baby upright against your shoulder or propped forward on your lap. Gently rub their back so any trapped air can find its way out.

There's no need to overdo it – wind isn't as big a problem as many people think.

Why does my baby sometimes vomit after feeds?

It's normal for babies to bring up a little milk during or just after a feed. This is called possetting, regurgitation or reflux. 

Keep a muslin square handy just in case.

Check that the hole in your baby's teat is not too big. Drinking milk too quickly can make your baby sick.

Don't force them to take more milk than they want during a feed.

Sitting your baby upright on your lap after a feed may help.

If it happens a lot, or your baby is violently sick, seems to be in pain or you're worried for any other reason, talk to your health visitor or GP.

Can formula make my baby constipated?

When using formula, always use the amount of powder recommended on the packaging.

Don't add extra formula powder. Using too much can make your baby constipated and may cause dehydration.

If your baby is under 8 weeks old and hasn't done a poo for 2 to 3 days, talk to your midwife, health visitor or GP, particularly if they are gaining weight slowly.

Your baby should be gaining weight and have plenty of wet and dirty nappies.

Infant formula and allergies

If you think your baby might be allergic to or intolerant of formula, talk to your GP. If necessary, they can prescribe a special formula feed.

Some formula is labelled as hypoallergenic, but this isn't suitable for babies with a diagnosed cows' milk allergy.

Soya formula should only be given to babies under medical supervision.

Always talk to your GP before using hypoallergenic or soya-based formula.

References nhs.uk

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