Bottle-feeding: Everything you need to know now

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Moms know that breast is best for babies. But for a number of reasons, some new moms don’t breastfeed, or stop breastfeeding within six months after giving birth. That’s where formula comes in as a bridge between breast milk and cow’s milk. Whether you bottle-feed from day one or months later, follow this advice from moms and experts and feel good about formula.

Bond with the bottle

Even though formula feeding puts a bottle between you and your baby, you can still use feeding time to build an intimate relationship with your child. After all, dads and other relatives will bond with the baby just fine that way.

Know that you can still bond: “Maybe I don’t know what I missed since I didn’t breastfeed successfully, but the bonding thing is a non-issue to me,” says a New York City– based mom of twins, “With the bottle you are still cuddling and having eye contact. All the activities I did with them were a chance to bond.”

Hold her close: “Just because bottle-feeding is easier, don’t ignore your baby,” says Jennifer Shu, M.D., co-author of Heading Home with Your Newborn: From Birth to Reality. Our New York mom concurs. “The way I held her was very similar to the way I held her when I breastfed her. She was in my arms, close to my face, looking into my eyes. She and I were still the same distance apart, spending time together.”

Relax:  Sit in a comfortable place and try to put any distractions out of your mind—including any guilt over not breastfeeding. “Babies will respond to how mom is doing emotionally. Moms who are more relaxed are going to have babies who are more relaxed,” says Jennifer Walker, R.N., co-author of The Moms on Call Guide to Basic Baby Care: The First Six Months.

Go skin to skin: Even though you’re not breastfeeding, you can use this nursing technique to facilitate bonding. To ensure skin contact, remove or loosen your clothes and the baby’s.

Don’t multitask: It might be tempting to try to cross many items off your to-do list or simply zone out while your baby eats. But don’t miss this opportunity to cuddle and get close to your little one. “You want to be attending to the baby while you’re feeding him— not on the phone or watching TV,” Shu says. Take the time to connect with baby to make her feel safe and secure.

Formula Options

Walk through the baby aisle in your grocery store and you’ll see a wide range of formula forms and brands. Confused? It’s important for parents to know that the different brands have roughly the same ingredients, so you don’t necessarily have to buy the most expensive or the brand you were given in the hospital. “Formula companies are regulated,” Walker explains. “They are required to have a certain combination of nutrients.” With that in mind, consider the pros and cons of these choices.

Forms: Infant formula comes in three formulations—powder, concentrate, and ready-to-eat. Powder is the least expensive. Ready-to-feed may be ideal for travel, because it requires no measuring or stirring—but it’s the priciest option.

Types: The most widely used formula is made from cow’s milk. But there are several other kinds, including lactose-free, soybased, hypo allergenic, ones with rice added, and toddler formula for older babies. “Talk to your pediatrician first about what’s best for your baby,” Shu suggests. “Most babies do fine with standard, milk-based formula.”

Extras: Formula manufacturers aim to make formula as much like breast milk as possible. “As research becomes available, formula companies find ways to add things that they know are in breast milk but not in formula,” Shu says. To that end, most have added some healthy fats, such as DHA and ARA, to their products. “They are special fats that babies need for the development of their brains, nerves, and eyes,” she explains.

A more recent addition is probiotics, or “good” bacteria, like that found in yogurt. “It can help with digestion and cut back on gastrointestinal diseases like stomach viruses,” Shu says. Additionally, probiotics may help reduce colic and lower the risk of food allergies.

From Breast to Bottle

The majority of newborns—75 percent according to the Centers for Disease Control and Prevention–start out breastfeeding. But by the six month, that percentage drops to 44 percent, and at 12 months, 24 percent. That means most moms switch to formula and/or solids at some point during the first six months. In fact, one quarter of breastfed infants receive some formula during the first two days of life. Cow’s milk is not recommended until at least the ninth month. The transition might be easy or difficult, depending on the timing and your baby’s temperament. To move from breast to bottle smoothly:

Start early: Introduce the bottle at one month, give or take a week, Shu says. “By that time, breastfeeding is well-established,” she contends. If you do it much earlier, your baby might reject the breast; wait too long, and she might reject the bottle.

Plan the transition: “Calculate the number of weeks you have, figure out how many bottles a day, and plan a schedule to transition your child,” Shu advises. You might, for example, substitute one daily breastfeeding session with bottle-feeding the first week, adding another session each week, until your baby is taking all formula meals from a bottle.

Use breast milk initially: Instead of giving formula right away, fill the bottle with pumped breast milk. “Start with breast milk first, because babies are used to the taste and texture,” Shu notes. You can also try using the bottle at the beginning of a feeding and finishing off with the breast, giving more and more from the bottle each time.

Try this strategy: Give the baby a mix of formula and milk in the bottle, with an increasing amount of formula each time. The first mixed bottle can contain 3 ounces of breast milk, 1 ounce of formula. Gradually increase the formula portion until it’s all formula.

Switch slowly: Give baby a formula-filled bottle during one meal per day or every other day. Some babies will have no problem accepting formula. But others, like finicky infants or preemies, will need more time.

Enlist a helper: Sometimes a baby might resist the bottle because she smells mom’s breast milk. “If babies are having trouble at first, let grandma or dad do the bottle-feeding when mom is not even in the room,” suggests Walker. “When they can’t even smell you, they’ll focus and take it better.”

Experiment with bottles: There are a few different types of bottle systems. For example, Walker has witnessed success with bottles that come with flesh-colored nipples.

User’s guide

It might seem obvious—just open the container, add water, and stir. But some new parents make mistakes during formula preparation that could impact their baby’s health. Here’s how to get it right:

Follow the directions: Powder and concentrated formula labels specify exactly how much water to add. “If formula has either too much or too little water, it can cause an electrolyte imbalance in babies,” Shu notes. Too little water can cause overfeeding or constipation.

Skip the blender: “Some parents put it in a blender,” Walker says, but “that makes a lot of little air bubbles.” It’s best to just shake it up instead.

Toss after a day: Most formulas stay fresh for 24 hours after mixing. To avoid wasting formula only prepare what you need for one day.

Finish it or throw it away: Don’t put an unfinished bottle back in the refrigerator for later use. Once the baby has drunk from it, bacteria from the baby’s mouth gets in the formula, contaminating the rest. Only mix what you need and toss any leftovers.

Research your water: In most cases, you will not need to boil water to sterilize it. But ask your pediatrician. While you’re at it, find out whether your tap water contains fluoride. “The latest recommendation is to use water that doesn’t have fluoride at least some of the time,” Shu says. Too much fluoride too early in life can cause hardening, or white or gray spotting of teeth. If your local water is fluoridated—for 74 percent of Americans the answer is yes—your pediatrician might suggest using bottled water or water with fluoride removed with a reverse osmosis filter.

Keep equipment clean: Wash baby bottles and nipples in hot, sudsy water or in the dish washer. Alternatively, you can use a steam sterilizer or boil the equipment, then let it air dry.

— Ziba Kashef

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