Bottle Feeding

Underfeeding

Underfeeding is rare in bottle-fed babies but it can happen. A baby who cries a great deal, seems generally discontented with life and is gaining weight slowly, is probably not getting enough to eat. Check the following points:

You may be working out your baby's needs too rigidly.

Although it is true that his body will require about 3oz (85ml) of formula for each pound of his "expected" weight, this does not mean that you should prepare exactly that number of ounces, divide it equally between the number of bottles he takes, and then wait for him to drain each one.

If you do this you are not allowing for the fact that, like anyone else, he will be hungrier at some times than at others. Suppose that his "requirement" is 3oz (85ml) of milk per day and you divide this into five bottles of 6oz (170ml) each. If he drains the first two, leaves 2oz (57ml) in each of the next two and then drains the fifth, he will have had 4oz (115m) less than he is likely to need during the 24 hours. Regularly emptied bottles are a reproach, not a cause for congratulation. If the bottle is emptied, how can you be sure that the baby would not have liked a little more?

Use your calculations of his requirements as a rough guide only. Put at least 2oz (57ml) more than you think he will drink into each bottle. Only in this way can you be sure of giving him the chance to drink all he wants and to compensate for a small breakfast by having a huge lunch. 

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You may be scheduling feedings too strictly.

The baby's digestion will take around three hours to deal with a full feeding, so most of the time he will not demand food much more often than this. But his appetite will vary; he will not always take a full feeding. If you do not allow him to make up for a small breakfast by having a mid-morning snack, but make him wait until the next "proper" mealtime, he may not then be able to hold enough extra milk to make up. Suppose that he only drinks 3oz (85ml) of milk at breakfast time instead of the usual 6oz (170ml). A couple of hours later he will be hungry. If you make him wait until lunch time he will not be able to drink the usual 6oz (170ml) plus the 3oz (85ml) he missed earlier. His stomach simply will not hold 9oz (255ml) of milk. Repeated day after day this kind of situation can lead to a great deal of fretfulness as well as to low weight gain.   

You may be using a nipple with too small a hole.

A baby who is really hungry will work hard and patiently to get milk however slowly it flows. But once he has had 2 to 3oz (57 to 85ml) the acute hunger pains stop. Then the effort becomes too much; the feeding is taking a long time; the baby gives up and goes to sleep.

He will wake again in a couple of hours and demand more food, but if the same thing happens repeatedly you may find that you have a baby who demands frequent feedings, never takes much of any of them and does not gain much weight.

So make sure that the milk drips rapidly out of the nipple when you turn it upside down. The baby should be able to get at least half the feeding during the first five minutes of sucking. 

You may be dealing with an exceptionally sleepy baby.

This will right itself in a few weeks as he grows up enough to be more alert. In the meantime don't rely on him telling you he needs food. Watch the clock, wake him for feedings at reasonable intervals and use the things that will interest him most - your face and voice - to keep him awake while he sucks. If he drops off despite your efforts, don't try to pour milk into his sleeping mouth; you cannot force him to feed. He will not starve if you feed him little and often while you wait for him to grow up a bit.

Overfeeding

Many bottle-fed babies gain weight rapidly from birth and are fat by the time they are six weeks old. The risk of obesity is one of the reasons for preferring breast to bottle-feeding.

Unfortunately it is not a risk that many people take seriously because a fat baby looks cuddly and sweet. But it is not good for him to be fat now and some experts believe that if you let him get fat during the early months he will be more liable to obesity later in life. A fat child may be laughed at; a fat teenager may suffer agonies of self-consciousness, while a fat adult is extra liable to many illnesses and may go through misery trying to keep his weight down. So don't let yourself envy the parents of roly-poly babies: you want fitness not fatness.

Bottle-fed babies do not get too fat from being allowed to drink as much properly-made formula as they want, whenever they want it. They get fat either because the formula is not made up accurately or because they are given extra foods or sweet drinks as well. Remember that unless your doctor specifically recommends it (which he might if your baby is exceptionally large) he should not have "solids" until he is at least four months old. Remember, too, that when he does have solids they should never be concealed in his bottle, but should be given separately, from a spoon, so that he can take all his milk, if he wants it, without having a lot of extra hidden calories forced down.  

Make those bottles up accurately.

Extra milk powder or concentrate means a bottle containing the usual number of ounces but more than the usual number of calories.

Remember that a baby can be thirsty without being hungry.

A drink of water will break the vicious circle of formula-thirst-crying-more formula-more thirst-more crying.

Remember that vitamin C fruit drinks contain a lot of fructose

even if they "contain no added sugar." That natural fruit sugar means calories. Modern babymilks usually contain adequate vitamin C so that your baby does not need these drinks at all, especially since he can take extra vitamin C in multi-vitamin drops. If you want him to have fruit drinks for pleasure, stick to once a day and make sure they are well-diluted.