May 18

Bottle Feeding

The Basics

The most obvious difference between bottle-feeding and breastfeeding is that the bottle lets you see how much your baby is drinking.

Depending on what kind of parent you are, this may make you feel better because you know what your baby is getting, or it may give you something new to obsess about.

Whenever you read guidelines for bottle-feeding, remember that each baby is different. Bigger babies need more food.

Your baby may go through a growth spurt and seem hungry all the time, and then they may have a period when they eat less for a while.

In general babies know how much food they need to grow.

If you attend to your baby’s hunger cues, they will tell you how much food they want and when they are full.

How Many Ounces?

Just like breastfed babies, bottle-fed newborns may start off slowly for 2 to 3 days, often taking only 1 to 2 ounces (30–60 mL) at a time.

After the first 2 to 3 days of life your infant will probably be taking 2 to 3 ounces (60–90 mL) every 3 to 4 hours.

Sometimes your baby may sleep 4 to 5 hours between bottles, but they need a lot of food over the first month or so of life, so if they haven’t awakened to eat after 5 hours it’s a good idea to go ahead and wake them up.

You might even consider waking them up after 3 or 4 hours during the daytime, hoping they will sleep a little longer at night.

After the first month of life your infant is likely to take around 4 ounces from the bottle every 4 hours or so, at least on average.

That intake rises gradually so that by age 6 months, they should take 6 to 8 ounces (180–240 mL) 4 or 5 times a day.

Another way to think about normal intake is by weight; for every pound of body weight, your infant will consume around 2½ ounces (75 mL) per day.

That said, every baby is different, and their doctor will weigh and measure them at each wellness examination to assess whether their growth is appropriate for their age.

Hunger Cues

Whether you’re breastfeeding or bottle-feeding, your baby will give the same cues to let you know when they are hungry and when they are full.

Your infant will start rooting, scooting, sucking on their hand, and smacking their lips when they need food.

Babies will release the nipple, turn away, and often fall asleep when they are full.

As they grow, infants may fall asleep less often and instead look up and grin at you.

You can be pretty confident at this point that the feeding is over, especially if they are letting milk drip on your pants.

Do’s And Don’ts Of Bottle Feeding

Bottle feeding can be a warm, loving experience—cuddle your baby closely, gaze into their eyes, and coo and talk to them.

Never prop the bottle and let your baby feed alone; not only will you miss the opportunity to bond with them while they feed, but there’s also a danger that they will choke or the bottle will slip out of position.

Propping the bottle also increases the risk of ear infections.

We do not recommend devices to hold a bottle in a baby’s mouth—they could be dangerous.

Although some babies will drink a bottle straight from the refrigerator, most prefer milk warmed to room temperature.

You can warm a bottle by placing it in a bowl of hot water for a few minutes.

Sprinkle a few drops on your wrist; it should feel lukewarm. If it’s too warm, wait for it to cool a bit and test again.

Never warm a bottle of formula or human milk in the microwave. The bottle itself may feel cool while the liquid inside can be too hot.

Microwaving also heats unevenly. Even though a few drops sprinkled on your wrist may feel OK, some of the formula or human milk may be scalding.

The composition of human milk may change if it is warmed too much, as well.

Make sure the nipple hole is the right size. If your baby seems to be gagging or gulping too fast, the nipple hole may be too large. If your baby is sucking hard and seems frustrated, the hole may be too small.

Try different nipple shapes to see which your baby prefers. There is no correct shape.

Angle the bottle so your baby isn’t sucking in air. Burp your baby a couple of times during the course of a feeding.

 

Encourage your partner to give your baby a bottle now and then, perhaps one of the late-night feedings. This not only allows you some extra rest, but it also fosters bonding with your baby.

Don’t let your baby fall asleep sucking on a bottle of milk, especially if they are beginning to cut teeth. Milk pooled in your baby’s mouth can cause serious tooth decay, known as nursing-bottle caries.

After feeding and before putting your baby to sleep, gently wipe any milk residue from their gums.

If your baby needs to suck to get them to sleep, give them a pacifier instead of a bottle.

Repeated sterilization may distort nipple openings. Test to make sure milk flow through the nipple is adequate.


Healthychildren.org website  (Copyright © 2018 American Academy of Pediatrics)
Rachel Y. Moon, MD, FAAP (Copyright © 2016 American Academy of Pediatrics)
Tia Hubbard MD FAAP UCSD Associate Professor of Clinical Pediatrics at UC San Diego Health
Dad to Dad: Parenting Like a Pro (Copyright © American Academy of Pediatrics 2012)