As well as bottles, teats and the formula milk, you’ll need a steriliser and a bottle brush for washing that is never used for general washing up.
1 Always wash the bottles and teats thoroughly as it is not possible to sterilise something that is not clean first.
2 Wash in warm soapy water very thoroughly.
3 Rinse in cold water afterwards to remove soap residue.
Then always follow the manufacturer's instructions to sterilise.
Choosing the right size teat for a bottle
Your baby needs to have a teat which gives them their milk efficiently; if it is too slow it can cause wind and slow down their feeding, or if it is too fast they can cough and splutter a little bit. Each size increases the flow of the milk, so the older your baby gets the faster they’ll be able to down that milk. You’ll get a sense of how long your Little One will take to have their feed.
Trust Yourself
Am I Using the Right Teat?
If your LO is taking longer than 35 minutes to finish a bottle, they need a faster-flowing teat.
How to make up a bottle of formula
There are several formulas on the market and the choice is yours as to which one you use. What goes into formula milk is adapted as time goes on, so if your mum tells you she always fed you on brand X, it won’t be the same formula it was then, so use whatever you want, it’s just a question of choice.
How much formula should I use?
The thing with formula milk is that the instructions on the packet are only a guide. Your baby will have their own requirements, so it’s important to discuss how to make up the bottles and the amount they need with your midwife or health visitor. If your baby is past the newborn stage, whether you are new to formula-feeding or just want to be sure your Little One is getting all they need, don’t hold back – talk to a health professional (it’s what they’re there for!).
Never be tempted to put in an extra scoop of formula powder, as it over-concentrates the salts and nutrients and can lead to hypernatremia* (#litres_trial_promo) very quickly.
Babies can have cold formula as well if needs be. There is also ready-made formula available but this is more expensive than making it up yourself, so just do whatever is right for you at the time.
Making Up a Bottle of Formula
1 Use water that has been freshly drawn, boiled and cooled (although the water does still need to be hot emough to dissolve the powder).
2 Always put the water in first and count the number of scoops you use.
3 Add in the same number of scoops of formula as water, e.g. 3 fl oz (90 ml) of water to 3 level scoops of formula, or 4 fl oz (120 ml) of water to 4 level scoops is just right.
4 Put the top on the bottle and shake. Cool it down rapidly as it will be too hot to give to your baby straight away.
5 Test the temperature on the inner part of your arm to feel how warm it is before you give the bottle to your baby, and be careful it’s not too hot.
Perfecting your bottle-feeding technique
Always ensure that all the formula feed is at the top end the bottle with no gaps for air to get in for the perfect bottle-feeding position. Before you start a feed, check you have everything that you will need at arm’s length. Using feeding time to have a much-needed sit-down gives you more time to bond with your baby; so get comfy with a cushion for back support and a footstool if you want one. Fewer demands on you during feeding time will also give you the opportunity to tune in to how your baby feeds and whether you need to make any little adjustments. After feeding, your baby may need winding (winding techniques are in the A–Z section).
Your baby may take the bottle with no hesitation and suck away merrily, but some babies do not open their mouths easily and can be challenging to feed. If your baby seems to be angry or upset and cries and refuses to take the teat, put the bottle aside. Settle them using the Up-Down Technique (in Chapter 3) and wait till you’re both calm to try again.
Trust Yourself
Taking a Bottle
Gently tickle the corner of your LO’s mouth. This causes the baby to turn towards the teat and take it.
How many feeds does my baby need?
It’ll take a little bit of trial and error, and timings and quantities will change as they grow, but if you work towards getting these things in place you’ll be well ahead of the game. Having a timetable in your head to help you shape your day is helpful, but babies sometimes don’t fit the mould of a strict feeding schedule, though you’ll notice patterns emerging. Here’s what you can do to get off to a flying start with formula-feeding.
Trust Yourself
Has Your LO Had Enough?
Babies feed on demand and have an inner clock that tells them when to feed and how much to have. Listen to your baby – they’ll tell you when they are hungry and when they are full.
Frequency of feeds
Do feed your baby on demand, but be careful not to let your baby go more than four hours in the daytime without a feed. As you can imagine, your baby’s stomach is only as big as their tiny clenched fist, so roughly, depending on the baby’s weight, try 2–3 oz (60–90 ml) every two to three hours at first, and then 3–4 oz (90–120 ml) every three to four hours when you feel they can go a bit longer between feeds.
The quantities and frequency of feeding change all the time, and no doubt you’ll find that your Little One’s needs do vary. If you use a timeframe of no more than four hours between feeds during the daytime in the early weeks, it may help you to avoid having to do frequent feeding at night. Sometimes, especially if a baby is jaundiced, they may be sleepy and will sleep longer than three to four hours. Once they have reached four hours since the start of the last feed, just pop their legs out of their babygro and take off their blanket to let the cool air wake them up naturally. If they are being a real sleepyhead, talk to your Little One and gently move them to wake them up to feed. (Make sure you’ve made up a bottle ready to go – they won’t want to wait once they’ve been woken up!)
I remember when ... I was a student health visitor nearing the end of my training. We could choose another part of the UK to work in for two weeks of alternative practice and I requested South Wales. I stayed with my sister Bridget in the Gower and was fortunate enough to be assigned to a very experienced health visitor in the Mumbles. It was very different to where I had been working, as 95 per cent of mums in the community regularly attended baby clinic after the primary visit, and generally you didn’t visit them at home unless there was a serious problem because home visits provoked a certain amount of curtain-twitching from the neighbours. At one baby clinic a mum arrived with a three-month-old baby. He was a very good size and his mother said to the health visitor, ‘I’ve just started to put a teaspoon of sugar in every feed; that’s not wrong, is it?’ I was shocked and full of youthful verve, and would have told her it was completely wrong, and what did she think she was doing? But my teacher knew better; she gave a wry smile and said, ‘Well, it’s not wrong, but these new formulas have everything a baby could need, so you don’t need to trouble yourself to put the sugar in any more.’ I realised that she had the wisdom to create a win/win solution for mother and baby. Rather than scolding the mother and making her feel embarrassed, she used diplomacy to help the woman save face and ensure the baby wasn’t being given sugar with his formula. All the mothers I have met in recent years have been very careful about making up the formula, and often tell me they have to ignore the advice of their grannies who tell them to ‘put a rusk in every bottle’. I often think back to all the lovely mums I met in Wales, who were really dedicated to their babies.
The timing of feeds affects your baby’s sleep
This shift in when your baby wants to feed may not happen instantly, and sometimes a baby will go down to sleep at, say, 8 pm, and sleep through for a short time, but may then suddenly be awake several times a night. Parents often don’t associate this with the timing of feeds, but the two are often related. Patience and perseverance are what’s needed from you and your partner to get your baby sleeping and feeding well.
Solutions to common bottle-feeding problems
Taking too long to feed or not finishing their bottle
If you find your baby is taking longer and longer to feed from the bottle and is labouring over it more and more, this may be because the teat flow is too slow. It may be time to switch to a number 2 or 3 size teat or variflow-type teat to help your Little One get their milk at the speed that is right for them.
On average it takes a baby 15–20 minutes to drink a bottle of milk and they shouldn’t really be taking longer than 30–35 minutes, because the baby will most likely become tired and frustrated and even give up, which would mean they wouldn’t be getting all the milk they need.
When a baby takes a long time to feed it can also cause wind, which gets them annoyed and makes the whole process a lot harder. So if your baby is taking too long, switch the teat first and, if problems persist, you might want to try changing the brand of formula you are using.
Colic
The movement of the teeth through your baby’s jaw and gums as the early teething pains kick in often happens at the same time as they experience colic. With all this going on, babies need massive amounts of reassurance and comforting. You will be able to see if it is colic that is making your baby cry by signs such as if they draw up their knees, arch their back or try to push themselves off your lap or out of your arms with their feet. Keeping a firm hold will keep them safe and secure. To calm them you may want to try the Up-Down Technique (see Chapter 3 (#litres_trial_promo)) to get them to stop crying – dads are usually great at this.
Try soothing your Little One: babies love sympathy. If you calmly tell them Mummy or Daddy is here and you know how hard it is, it will help focus your mind and give them comfort to get over the colic spasm quickly. It is hard for your baby when they have colic, as they don’t under-stand what this pain is, and they don’t know it will pass soon enough.
Colic is horrid for your baby and for you. Your Little One is experiencing the discomfort of digestion for the first time. Just picture all the rumblings in their tummy and the windy feeling as a brand-new gut has to digest all the nutrients from their milk. Their bodies are learning how to do this, and your baby’s problem is gas, not you. I know it’s horrible when they get beside themselves with colic, but your baby has no idea what is causing this pain and does not know when it will end. It comes as a bit of a shock for them after all those months of a carefree existence in the womb.
You can give them some relief by staying calm and giving them lots of comfort; it may be you want to try some skin-to-skin contact so they can feel your warmth and hear your heartbeat.
There are products on the market to help relieve colic, and your doctor or health visitor can write you a prescription or you can get over-the-counter remedies from the pharmacist.