Should I use formula?
Breast milk is best for babies, but breast-feeding isn't always
possible. You will need to use a baby formula if:
- You decide not to breast-feed.
- You need to stop breast-feeding and your baby is less than 1
year old.
- You need to occasionally supplement breast-feeding with formula
(after breast-feeding is well established).
If you want to breast-feed but you think you are not making enough
milk, don't stop breast-feeding. Talk to your healthcare provider
or lactation nurse before you stop. Any bottle feeding, before
breast-feeding has been well established, could reduce your supply
of breast milk and make it difficult to continue breast-feeding.
What type of formula should I use?
If your child is less than 1 year old, discuss which formula to use
with your healthcare provider.
Baby formulas are designed to give your baby all known essential
nutrients in their proper amounts. Most formulas are made from
cow's milk. A few are made from soybeans. Soy formula is used for
babies who may be allergic to or have difficulty digesting the type
of protein in cow's milk. The American Academy for Pediatrics
recommends you use iron-fortified (not low-iron) formula to prevent
anemia.
Most formulas are available in three forms: powder, ready-to-serve
liquid, and concentrated liquid. Powder and ready-to-serve liquid
are best if you are using it to supplement breast milk. You must
mix concentrated liquid before using. It forces you to prepare 26
ounces at a time. Powder and concentrated liquid formulas are less
expensive per feeding than ready-to-serve formulas.
When can I give my baby regular milk?
Regular, whole cow's milk should not be given to babies before 12
months of age. This is due to increased risks such as iron
deficiency anemia and allergies. Skim or low-fat milk should not be
given to babies before they are 2 years old because the fat in
whole milk is needed for rapid brain growth.
How do I prepare formula?
Mix concentrated liquid formula with water in a ratio of one to
one. Mix each level scoop of powdered formula with 2 ounces of
water. Never make the formula for your baby more concentrated by
adding extra concentrated liquid or extra powder. Never dilute the
formula by adding extra water. Careful measuring and mixing ensure
that your baby receives the proper mix of formula.
Do I need to boil the water first?
Most city water supplies are quite safe. If you make one bottle at
a time, you don't need to use boiled water. When using tap water
for preparing formula, use only water from the cold water tap. Let
the water run for 2 minutes before you use it. (Old water pipes may
contain lead-based solder and lead dissolves more in warm water or
standing water.) Fresh, cold water is safe. After you prepare the
formula with the cold water, you can heat the bottle to the right
temperature. Ask your healthcare provider if you are not sure
whether your water supply is safe for your baby.
If you have well water, you need to boil your water for 10 minutes
(plus 1 minute for each 1000 feet of elevation above sea level) or
use distilled water until your child is 6 months old.
If you prefer to prepare a batch of formula, you must use boiled or
distilled water and closely follow the directions printed on the
side of the formula can. This prepared formula should be stored in
the refrigerator and must be used within 48 hours.
Can I make my own formula?
If necessary, you can make your own formula temporarily from
evaporated milk. (Evaporated milk formulas have some of the same
risks as whole cow's milk, namely, iron deficiency anemia and
allergies.) Mix 13 ounces of evaporated milk with 19 ounces of
boiled water and 2 tablespoons of corn syrup. Place this mixture in
sterilized bottles and keep the bottles refrigerated until use (up
to 48 hours).
What temperature does the formula need to be?
In the summertime, many children prefer cold formula. In the
wintertime, most prefer warm formula. By trying formula at various
temperatures you can probably find out what your child prefers. If
you do warm the formula, check the temperature of the formula
before you give it to your baby. If it is too hot it will burn your
baby's mouth. Be especially careful if you heat the formula in a
microwave because the formula can get too hot very quickly.
How often should I feed my baby?
Your healthcare provider will tell you when and how often to feed
your baby. In general, your baby will probably need:
- 6 to 8 formula feedings per day for the first month
- 5 to 6 formula feedings per day from 1 to 3 months
- 4 to 5 formula feedings per day from 3 to 7 months
- 3 to 4 formula feedings per day from 7 to 12 months
If your baby is not hungry at some feedings, increase the time
between feedings.
How much formula should I give my baby?
Newborns usually start with 1 ounce per feeding, but by 7 days they
can take 3 ounces. The amount of formula that most babies take per
feeding (in ounces) can be calculated by dividing your baby's
weight (in pounds) in half. For example, if your baby weighs 8
pounds, your baby will probably drink 4 ounces of formula per
feeding. No baby should drink more than 32 ounces of formula a day.
If your baby needs more than 32 ounces and is not overweight,
consider starting solid foods. Overfeeding can cause vomiting,
diarrhea, or excessive weight gain.
How should I hold the baby during feedings?
Feeding should be a relaxing time -- a time for you to provide both
food and comfort for your baby. Make sure that both you and the
baby are comfortable:
- Your arm supported by a pillow.
- Baby in a semi-upright feeding position supported in the crook
of your arm. This position reduces choking and the flow of milk
into the middle ear.
- The bottle tilted so that the nipple and the neck of the bottle
are always filled with formula. (This prevents your baby from
taking in too much air.)
How long should I feed my baby?
Gently remove the bottle from time to time to let your baby rest. A
feeding shouldn't take more than 20 minutes. If it does, you are
overfeeding your baby or the nipple is clogged. A clean nipple
should drip about 1 drop per second when the bottle of formula is
turned upside-down.
Do I need to burp my baby?
Burping is optional. It doesn't decrease crying. Burping helps your
baby spit up less. Air in the stomach does not cause pain. If you
burp your baby, be sure to wait until your baby reaches a natural
pause in the feeding process. Burping two times during feeding and
for about a minute is plenty. More burping may be needed if your
baby spits up a lot.
How long can I store formula?
Prepared formula should be stored in the refrigerator. It must be
used within 48 hours. Prepared formula left at room temperature for
more than 1 hour should be thrown away. At the end of each feeding,
throw away any formula left in the bottle.
Does my baby need to drink water?
Babies do not routinely need extra water. However, when they have a
fever or the weather is hot they should be offered a bottle of
water twice a day. Run the water from the tap for 2 minutes before
you use it for drinking. Keep some of this water in your
refrigerator.
Do I need to give my baby vitamins?
No. Baby formulas contain all the vitamins and minerals your baby
will need.
Do I need to give my baby fluoride?
From 6 months to 16 years of age, children need fluoride to prevent
cavities. If the water supply where you live contains fluoride and
your child drinks at least 1 pint of formula made with water each
day, this should be enough. Otherwise, fluoride drops or tablets
should be given. Formula-fed infants should receive fluoride
supplements without vitamins. You can get a prescription for
fluoride drops from your child's healthcare provider.
Another way you can help your baby's teeth is by making sure your
baby does not sleep with a bottle. Milk, juice, or any sweetened
liquid in the mouth can cause severe decay of your baby's first
teeth. Liquids tend to pool in the mouth during sleep. The sugar in
these drinks is changed to acid by bacteria in the mouth. The acid
then etches the tooth enamel and causes decay.
Prevent tooth decay by not using the bottle as a daytime or
nighttime pacifier. If you cannot stop the nighttime bottle or
replace it with a pacifier, fill the bottle with water.
Written by B.D. Schmitt, MD, author of "Your Child's Health," Bantam Books.
This content is reviewed periodically and is subject to
change as new health information becomes available. The
information is intended to inform and educate and is not a
replacement for medical evaluation, advice, diagnosis or
treatment by a healthcare professional.
© 2009 RelayHealth and/or its affiliates. All Rights Reserved.