Starting Bottle Feeding

Your baby's bottle, nipples and the equipment used to prepare the milk need scrupulous attention to prevent a build-up of bacteria. The amount of equipment you buy depends on which type of formula you use and on how you organize your sterilizing. The bottles and accessories below give some idea of the available choice.

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Easy Sterilizing

You can sterilize everything by keeping it totally submerged in fully boiling water for at least ten minutes. Make sure bottles are full of water, nipples etc. trapped under a cup: equipment which floats may not be fully safe.

Once a day . . .

Wash everything with hot water, detergent and bottle brush.

Turn nipples inside out; rub with salt if slimy but rinse very well. Force water through holes to be sure no milk is left there.

Put all your washed bottles, nipples, spoons, jars etc. into a container. Make sure everything is covered with water. Boil, covered, for ten minutes. Remove equipment with sterile tongs.

After a feeding, rinse bottle and nipple and leave by the sink ready for your daily wash-up and sterilize session. If using disposable bottles, treat nipples, caps, rings etc. in the same way.

Glass bottles can be sterilized in a dishwasher with a sterilizing cycle.

Preparing Bottle Feedings

Formula must be made up accurately if the bottle is to contain the right number of calories. Use only the scoop provided for milk powder and level off with a knife to avoid overfull measures. Sterilize water by boiling before measuring as some will evaporate. If you want to make up feedings for 24 hours, you can store them in a sterile jar in the refrigerator, or fill sterile bottles and refrigerate those.

Making Up Powdered Formula

Boil water and let it cool to hand-heat. Wash your hands.

Pour water into sterile jar. Check correct quantity by holding at eye level.

Add required number of scoops of milk powder, levelling each with knife.

Stir the mixture thoroughly with the sterile spoon.

Either cover jar and refrigerate . . .

. . . or fill sterile bottles from the jar, putting more in each than the baby will drink.

Taking care not to touch the tops, screw nipples upside down on the bottles. Cover with their sterile caps.

Put in refrigerator.

If you have no refrigerator . . .

Each bottle must be made as needed; it is not safe to leave prepared bottles standing at room temperature. Choose a powdered formula that will mix when shaken in the bottle. Put warm boiled water in bottle; check quantity at eye level. Add correct number of carefully levelled scoops of powder. Screw on nipple and nipple cover. Shake well.

Making Up a Liquid Formula

Wash top of can. Sterilize by pouring boiling water over it. Punch two holes with sterilized opener.

Pour ready-to-feed formula into sterile bottles. Pour correct quantity of concentrate, checking by holding at eye level.

For the concentrate, add the correct amount of cooled boiled water.

Cap bottles. Refrigerate and use within 24 hours. Cover and refrigerate remaining concentrate.

Giving the Bottle

Being physically close to you during feedings is just as important to the bottle-fed baby as to the breast-fed one. Always give him the bottle while he is cradled in your arms: resist any temptation to prop it for him so that he can feed himself. Choose a chair that supports your back while your feet are flat on the floor. Have a table nearby to hold the bottle in its warmer. Support the baby's head well above the level of his stomach, and support your cradling arm too or it will ache.

Testing temperature and flow

Cold milk is not harmful but most babies prefer it warm. Stand it in a jar of hot water for a few minutes. Then shake the bottle and uncap it; put the nipple upright and test the milk's temperature on the inside of your wrist. It should feel just warm. Milk should come out at several drops per second. Enlarge a too-small hole with a red-hot needle.

Sucking reflexes

Make sure that you are settled and ready before you alert the baby to the bottle.

Using one finger of the hand that is holding the bottle, gently stroke the cheek nearest you.

He will turn his head toward your touch, pursing his mouth as he does so.

At the touch of the nipple on his pursed lips he will take it deeply into his mouth and settle to sucking.

Tilting the bottle

Make sure the baby gets the bulbous tip of the nipple well back in his mouth. Always keep the nipple full of milk.

This bottle is being held too flat, the nipple is only half full of milk and the baby will suck in air with his feeding.

As the baby sucks, he removes both milk and the air from the unfilled space in the bottle. If no air can get back in, a vacuum will form. The nipple will go flat and the baby will not be able to get any more milk. To prevent or cure this, pull gently against his suction so that the vacuum is momentarily released and you see air bubbling back in. Hold the bottle firmly all the time so that the baby can pull against it with his suction. If you hold it too loosely, his efforts will move the bottle around instead of pulling milk out.

Carrying Bottles with You

Never carry warm formula. It is a dangerously ideal breeding ground for bacteria. Carry the baby's milk icy cold from the refrigerator. Keep it that way by putting the sterile sealed bottles in an insulated picnic box (safe for up to 8 hours) or by burying them in ice cubes in a plastic bag (safe for around 4 hours). Warm the bottles as you need them by standing them in hot water from a thermos for a few minutes.

Wide-necked flasks will take a bottle direct; narrow-necked ones mean carrying a jar as well. If you are going to need more bottles than you can safely keep cold, measure milk powder (not liquid) into empty sterile bottles and seal. Mix with boiled water from a thermos as you need each one. Always carry at least one more feeding than you think you will need during the trip. This will help in case of breakdowns or delays.