Newborn Feeding: Bottle Feeding and Baby Formula

If bottle feeding is opted for, the first feed is usually given within four hours of birth. Subsequent feedings are offered as and when the baby demands it. In the first week, each feed may be one or two ounces only, but in the next week it may gradually increase to 6 to 8 feeds of three to four ounces each. The baby should be allowed to decide how much feed it should have at a time; parents are not to insist that the baby finishes the bottle every time. As the baby grows, the quantity of each feed may increase up to 8 ounces, while the frequency slightly decreases.

Babies should be held in a semi-reclining or upright position during bottle feeding. They should not be lying flat while feeding from the bottle as there is a high risk of the milk entering into the nose. It may flow into the eustachian tube and lead to ear infections too. Babies may eventually learn to hold the bottle and feed themselves, but it is not safe to leave them unattended while feeding. Allowing the babies to drink themselves to sleep is a bad practice which can lead to dental decay due to prolonged contact with milk or fruit juices.

The baby formulas available commercially contain all the different nutrients necessary for the healthy growth and development of the baby. They are available in different forms such as powders, concentrated liquids which can be diluted with water, and as ready-mixed servings in feeding bottles. Though formulas containing additional iron are recommended by many doctors, some are available without the addition of iron too. Whichever formula is being used, it is essential to follow the exact directions for mixing and usage as printed on the container. Even though cow’s milk in the plain form is not recommended for babies under one year of age, most formulas are manufactured from cow’s milk. But for babies who have low tolerance to cow’s milk, there are many options. A pediatrician can prescribe a hydrolyzed formula or a special amino acid formula suitable to the baby. Using a specially made baby formula, instead of the standard formula, does not adversely affect the growth and development of the baby in any way.

Good hygiene practices should be followed while preparing and feeding formula milk to the baby to avoid possible infections. Sterile containers and bottles should be used to mix the formula and to feed the baby. Boiling for at least 5 minutes in plain water can sterilize the feeding bottles and nipples. Plastic liners for the bottles can be used to eliminate the need of sterilizing the bottles. These disposable liners and single-use nipples are very convenient when travelling.

The formula should be just as warm as the body temperature. Before starting bottle feeding,  the temperature of the bottle should be checked by putting a few drops of the milk on the inner part of the wrist. Hot milk can cause serious burns in an infant. Refrigerated or ready-mixed bottles of formula should be warmed by placing it in a tub of hot water. The bottle should be shaken to distribute the heat evenly, and the wrist test should be performed before feeding the baby. Microwaving is not recommended for heating up formula milk as they heat the liquid quickly and unevenly, without heating the bottle, increasing the chance of causing accidental burns. The hole in the nipple determines the rate of flow of milk. The flow can be tested by holding the bottle upside down. The liquid should be dripping slowly. The nipple opening can be wider in the case of older babies who can drink faster.

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Yasser Elnahas

MD, PHD, Professor Of CardioVascular Surgery
Dr. Yasser Elnahas, Is an associate Professor of Cardiovascular Surgery. Dr. Elnahas was trained as a fellow At Texas Heart Institute And Mayo Clinic Foundation.Dr. Elnahas is dedicated to educating the general public about different disease conditions and simplifying the medical knowledge in an easy to understand terminology.

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