Bottle feeding

If you are bottle feeding these tips will help keep your baby safe and healthy.

If you decide to use infant formula, first infant formula (first milk) should always be the formula you give your baby. You can use it throughout the first year. When your baby is one year old, they can start of drink whole cows' milk.

When bottle feeding remember to hold your baby in an upright position and keep the bottle more horizontal rather than facing downwards. Stop the feed regularly to give your baby a rest.

You will 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. But some feeding bottles have shapes or patterns that make them difficult to clean thoroughly. As hygiene is so important, simple bottles that are easy to wash and sterilise are probably best.

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 then wash them in hot soapy water. Do not use salt to clean teats, as 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 will clean it but it does not 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 the items you want to sterilise in this way are 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 do not 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.

Find out more about expressing breast milk and how to make up formula feeds.

When a bottle is put into your baby's mouth, milk comes out of the teat with little or no effort from the baby. As the milk touches the back of the tongue, it triggers the swallow reflex and your baby has to swallow the milk to avoid choking. It is easy to interpret this as a signal that your baby is definitely hungry. For this reason it is very easy to over-feed a baby from a bottle whether it contains formula or expressed breastmilk. this puts your baby at risk of gaining too much weight.

It is important to recognise when your baby is getting full. This is easier to do by "pacing". This means letting your baby pause every few sucks to see if they want to stop feeding, taking the bottle out of your baby's mouth and then only starting again if they draw the teat into their mouth themselves. 

Never force the teat into your baby's mouth or keep trying to feed if your baby turns their head away or pushes the teat out with their tongue. If the bottle is still half full so be it.

To help attachment keep the number of people who feed your baby to a minimum - ideally just you and your partner or one other close family member.

Responsive feeding

  • Hold your baby close to you, look into their eyes to help them feel safe and loved.
  • Hold your baby fairly upright, with their head supported in a comfortable, neutral position.
  • Rub the teat gently against your baby's lips to encourage them to open their mouth wide and draw the teat into their mouth. Do not force the teat into your baby's mouth.
  • Hold the bottle level, in line with the ground (horizontal), and then tilt the bottle upwards enough to ensure your baby is taking in milk and not air through the teat.
  • Babies feed in bursts of sucking, swallowing and short rests. As your baby is in a fairly upright position, when they pause for a rest the milk will stop flowing allowing them to decide when they are ready to start sucking again.
  • During the feed you will see bubbles in the bottle. If you can't see any bubbles, break the suction between your baby's tongue and the teat by moving the teat slightly to the side of their mouth. You should then see bubbles rushing back up into the remaining milk.
  • Interrupting the feed from time to time gives your baby a chance to register how full they are and allows them to control what they want. It also gives them the chance to bring up any wind.
  • Try to keep the number of people who feed your baby to as few as possible. If another close family member gives an occasional feed, make sure they use the same technique as you so that your baby does not feel frightened or confused.
  • Your baby should always be held and never left unattended while feeding from a bottle.
  • Do not try to make your baby finish the bottle if it is clear they have had enough.
  • Do not use a fast flow teat as babies can find it difficult to control their breathing if they are forced to swallow large volumes of milk quickly.

Have a look at the Unicef baby friendly information for responsive bottle feeding

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

Your baby's immune system is not 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

  1. Fill the kettle with at least 1 litre of fresh tap water (do not use water that has been boiled before).
  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.
  3. Clean and disinfect the surface you are going to use.
  4. It's important that you wash your hands.
  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).
  6. Stand the bottle on the cleaned, disinfected surface.
  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.
  8. baby-formula.jpgLoosely fill the scoop with formula powder, according to the manufacturer's instructions, then level it 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.
  9. Holding the edge of the teat, put it into the retaining ring, check it is secure, then screw the ring onto the bottle.
  10. Cover the teat with the cap and shake the bottle until the powder is dissolved.
  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.
  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.
  13. If there is any made-up formula left in the bottle after a feed, throw it away.

Dos and dont’s of making up formula feeds

  • Do follow the manufacturers' instructions very carefully, as they vary as to how much water and powder to use.
  • Do not 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.
  • Do not 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 1 at a time, as your baby needs them.
Use freshly boiled drinking water from the tap to make up a feed. Do not 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 hold the bottle (with the lid on) under cold water from the tap.

Do not 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.

More information

Find out more about bottle feeding and answers to common questions about formula feeds.

Why is my baby does not 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.

Your baby may sometimes only burp up a small amount of air.

Why is my baby sometimes sick 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.

Do not force them to take more milk than they want during a feed. This may be distressing for your baby and can lead to overfeeding.

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.

Do not 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 has not done a poo for 2 to 3 days, talk to your midwife, health visitor or GP, particularly if your baby is 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 is not 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.

Read more about cows' milk allergy and lactose intolerance.

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