How much formula does your baby need? A lot depends on your baby’s weight, age, and once solids are being taken, how much he or she is eating. As a general rule, infants under six
months (those not supplementing with solids) should be taking 2 to 2ẵ ounces of formula per pound of body weight over a twenty-four-hour period. So, if your baby weighs 10 pounds, that would translate to 20 to 25 ounces of formula a day; in a twenty-four-hour period, you’ll be feeding your baby around 3 to 4 ounces every four hours.
But because these are just rough guidelines, and because every baby is different (and even the same baby’s needs are different on two different days), you shouldn’t expect your infant to follow this formula (so to speak) with mathematical precision. How much your baby needs to take may vary somewhat—from day to day and feeding to feeding—and may stray
significantly from what baby’s peers need.
Keep in mind, too, that your baby’s consumption will depend not just on weight but also on age. A large newborn, for example, probably won’t be able to drink as much as a small three-month-old—even if their weights are the same. So start your newborn out slow, with an ounce or two at each feeding for the first week every three to four hours (or on demand).
Gradually up the ounces, adding more as the demand becomes greater, but never push baby to take more than he or she wants. After all, your baby’s tummy is the size of his or her fist (not yours). Put too much in the tummy, and it’s bound to overflow—in the form of excessive spit- up.
Most of all, remember that bottle-fed babies, just like breastfed babies, know when they’ve had enough—and enough, for a newborn, is like a feast. Take your cues from baby’s hunger, and you’re sure to find the perfect formula for feeding your baby. As long as your baby is gaining enough weight, is wetting and dirtying enough diapers, and is happy and healthy (see page 164), you can be sure you’re on target. For more reassurance, check with your baby’s pediatrician on formula intake.
Follow-ups are not always best. Follow-up formulas are designed for babies older than four months who are also eating solid foods. Check with your baby’s doctor before using follow-up formula; some doctors don’t recommend them.
Iron-fortified is best. While formulas come in low-iron formulations, they aren’t considered a healthy option. The AAP and most pediatricians recommend that babies be given iron-fortified formula from birth until one year.
For best results, look to your baby. Different formulas work well for different babies at different times. Coupled with the advice of the pediatrician, your baby’s reaction to the formula you’re feeding will help you assess what’s best.
Once you’ve narrowed your selection down to a general type, you’ll need to choose, too, between the different forms those formulations come in:
Ready-to-use. Premixed ready-to-go formula comes in 4- and 8-ounce single-serving bottles and is ready for baby with the simple addition of a bottle nipple. It doesn’t get easier than this, but it does get less expensive (see options below) and less environmentally unfriendly (with this choice you’ll be tossing or recycling a lot of bottles during the next year).
Ready-to-pour. Available in cans or plastic containers of various sizes, this liquid formula need only be poured into the bottle of your choice to be ready for use. It’s less expensive than single- serving feedings, but the formula left in the container needs to be stored properly. You’ll also pay more for the convenience of ready-to-pours than formulas that need to be mixed.
Concentrated liquid. Less expensive than ready-to-pour but a little more time-consuming to prepare, this concentrated liquid is diluted with equal parts of water to make the finished formula.
Powder. The least expensive option, yet the most time-consuming and potentially messy, powered formula is reconstituted with a specified amount of water. It’s available in cans or single-serving packets. Besides the low cost, another compelling reason to opt for powder (at least when you’re out and about with baby) is that it doesn’t need to be refrigerated until it’s mixed.
SAFE BOTTLE FEEDING
Formula feeding has never been safer—as long as you take just a few precautions:
Always check the expiration date on formula; do not purchase or use any formula that has expired.
Don’t buy or use dented, leaky, or otherwise damaged cans or other containers.
Wash your hands thoroughly before preparing formula.
Before opening, wash the tops of formula cans with detergent and hot water; rinse well and dry.
Shake, if the label specifies.
Use a clean punch-type opener to open cans of liquid formula, making two openings—one large, one small—on opposite sides of the can to make pouring easier. Wash the opener after each use.
Most powdered formula cans come with special pull-open tops, making the use of a can opener unnecessary. If you’re using a single-serving bottle, make sure you hear the top “pop” when you open it.
It isn’t necessary to sterilize the water used to mix formula by boiling it. If you’re unsure about the safety of your tap water, or if you use well water that hasn’t been purified, have your supply tested
and, if necessary, purified. Or just use bottled water (not distilled).
Here’s another step you can save: Bottles and nipples don’t need to be sterilized with special equipment. Dishwashers (or sink washing with detergent and hot water) get them clean enough.
Some doctors recommend submerging bottles and nipples in a pot of boiling water for a few minutes before the first use.
But here’s a step you should never skip: Follow the manufacturer’s directions precisely when mixing formula. Always check cans to see if formula needs to be diluted: Diluting a formula that shouldn’t be diluted, or not diluting one that should be, could be dangerous. Formula that is too weak can stunt growth. Formula that is too strong can lead to dehydration.
Bottle warming is a matter of taste, namely baby’s. There is no health reason to warm formula before feedings, though some babies prefer it this way, especially if that’s what they’ve become accustomed to. In fact, you might consider starting your baby out on formula that’s been mixed with room temperature water or even a bottle right out of the fridge; if he or she gets used to it that way, you can save yourself the time and the hassle of warming bottles (something you’ll especially appreciate in the middle of the night or when your baby’s frantic for a feed). If you do plan to serve the bottle warm, place it in a pot or bowl of hot water or run hot water over it. Check the temperature of the formula frequently by shaking a few drops on your inner wrist; it’s ready for baby when it no longer feels cold to the touch—it doesn’t need to be very warm, just body temperature. Once it’s warmed, use formula immediately, since bacteria multiply rapidly at
lukewarm temperatures. Never heat formula in a microwave oven—the liquid may warm unevenly, or the container may remain cool when the formula has gotten hot enough to burn baby’s mouth or throat.
Throw out formula remaining in the bottle after a feeding. It’s a potential breeding ground for bacteria, even if you refrigerate it, and should never be reused, tempting as that might be.
Rinse bottles and nipples right after use, for easier cleaning.
Cover opened cans or bottles of liquid formula tightly and store them in the refrigerator for no longer than the times specified on the labels, usually forty-eight hours. Opened cans of dry formula should be covered and stored in a cool, dry place for use within the month.
Store unopened cans or bottles of liquid formula at between 55°F and 75°F. Don’t use unopened liquid for long periods at temperatures at or below 32°F or in direct heat above 95°F. Also, don’t use formula that has been frozen (soy products freeze more quickly) or that shows white specks or streaks even after shaking.
Keep prepared bottles of formula refrigerated until ready to use. If you are traveling away from home, store previously prepared bottles in an insulated container or in a plastic bag with a small ice pack or a dozen ice cubes (the formula will stay fresh as long as most of the ice is frozen); or pack the bottles with a small box or can of juice that you’ve prefrozen (not only will the formula stay fresh, but you’ll have a cold drink handy, too). Do not use formula that is no longer cold to the touch (unless, of course, it’s ready-to-serve and hasn’t been opened or is powdered formula that has just been mixed with warm or room temperature water). You can also take along ready-to-use bottled formula, or bottles of water and single-serving formula packets to mix with them.
BOTTLE FEEDING WITH LOVE
Whether you’ve chosen to feed your baby exclusively with formula or to mix it up with breast, the most important ingredient in any feeding session is love. Though you’ll always feel that love, it’s also essential that you communicate it to your baby. The kind of skin-to-skin, eye-to-eye contact that’s linked to optimum brain development and attachment in a newborn is a built-in feature of
breastfeeding. With bottle feeding, that contact takes a conscious effort, and many well-meaning but harried bottle-feeding parents at least occasionally give in to feeding shortcuts that compromise closeness for convenience. To make sure you keep in touch with your baby while you’re bottle feeding:
Don’t prop the bottle. For a young baby, who is as hungry for emotional gratification in the form of cuddling as for oral gratification in the form of food, propping is very unsatisfying. And besides the emotional drawbacks, there are physical ones as well. For one thing, the risk of choking is always present when you prop, even if your baby is in a reclining high chair or infant seat. Prop with baby lying down, and he or she may also be more susceptible to ear infections. Once teeth come in, letting a baby fall asleep with a bottle in his or her mouth (which wouldn’t happen if you were administering the feeding) can lead to tooth decay, since the formula is left to pool in the mouth. So avoid the
temptation to prop the bottle and leave your baby during a feeding, even if it means the million and one things you have to do won’t get done.
Go skin to skin, when possible. There are piles of research to show the developmental benefits of regular close contact with a newborn. But no research is as convincing as the satisfaction both you and your baby will get by sharing the warmth and intimacy of skin-to-skin contact. So whenever
possible (it won’t work in public, but it will in private), open your shirt and nestle your baby close to you when you bottle feed. Breasts aren’t necessary to achieve the desired effect, either; dads can cuddle their babies cheek-to-chest just as effectively during an open-shirt feeding.
Switch arms. Breastfeeding also builds in this feature (alternating breasts means alternating arms);
with bottle feeding, you’ll have to remember to switch. A switch midfeeding serves two purposes:
First, it gives your baby a chance to see the world from different perspectives. Second, it gives you a chance to relieve the aches that can develop from staying in one position for so long.
Let baby call it quits. When it comes to feedings, your baby’s the boss. If you see only 3 ounces have been emptied when the usual meal is 4, don’t be tempted to push the rest. A healthy baby knows when to stop. And it’s this kind of pushing that often leads bottle-fed babies to become too plump—much more often than breastfed babies, who eat to appetite.
Take your time. A nursing baby can keep suckling on a breast long after it’s been drained, just for comfort and sucking satisfaction. Your bottle-fed baby can’t do the same with an empty bottle, but there are ways you can supply some of the same satisfactions. Extend the pleasure of the feeding session by socializing once the bottle is drained—assuming he or she hasn’t dropped off into a milk- induced sleep. If your baby doesn’t seem satisfied with the amount of sucking each feeding’s
providing, try using nipples with smaller holes, which will ensure that your baby will get to suck longer for the same meal. Or finish off feedings by offering a pacifier briefly. If your baby seems to be fussing for more at meal’s end, consider whether you’re offering enough formula. Increase it an ounce or two to see if it’s really hunger that’s making your baby fretful.
Feel good about bottle feeding. If you were eager to breastfeed and for some reason couldn’t—or couldn’t keep it up—don’t feel guilty or frustrated. Such negative feelings can be unwittingly
transmitted to your baby during feedings, and keep you both from enjoying what should be a treasured ritual. Remember: Filled with the right formula and given the right way, a bottle can be used to pass along good nutrition and lots of love.