A winning formula

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By: Suzanne Dixon

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Article Summary

Although there is no real substitute for breast milk, most babies get some formula milk some of the time. For some women, breastfeeding just isn't a possibility. If you're an adoptive mother, for instance, or if you can't or won't be breastfeeding for a medical reason or any other reason, you'll need to know about formula feeding.

For some mums, an initial period of breastfeeding is followed by formula feeding. If you are breastfeeding, wait until the baby is 3 to 4 weeks old before supplementing with formula in order to maintain your milk supply.

The moments when you're giving your baby a bottle are wonderful times to feel close and to get to know each other. And your baby's father, as well as other family members, can do some of the feeding right from the start, or whenever you decide to switch. Make sure that each feed has the same amount of closeness, cuddles and coos as it would have if you were breastfeeding. Hold your baby's head at a slightly elevated angle and keep the bottle held up so he doesn't suck in a lot of air.

Choosing the Right Formula

How Much Is Enough?

Good Things to Know

Watch Out

Choosing the Right Formula

You can be assured that infant formulas are made to meet your baby's nutritional needs, very much like breast milk, on which they're modelled. The major formula brands are similar. Unless your GP tells you otherwise, pick one that is fortified with iron. Formulas come in three basic varieties:

 Ready-to-feed (the most expensive)

 Liquid concentrate (less expensive)

 Powder (the most economical)

Not surprisingly, the ones that save time and effort are the most expensive. But if mixed properly, they are the same. Read the directions carefully each time you mix formula. Mix it exactly according to directions. Avoid making up bottles in the middle of the night when you're sleepy, or at times when you're distracted.

Water and Formula

You don't need to use bottled water in your baby's formula unless there's a problem with your water supply. Check with your doctor and with your local water company about the state of your water if you have any questions. Many water companies will issue a notice if water is unfit for babies or pregnant women.

How Much Is Enough?

Newborns start out with a stomach that can hold only 1 or 2 teaspoons (5 to 10 ml), then can hold more and more after the first week. Thirty to 60 ml (one to two ounces) per feed is usually enough at first. By the time he's 2 months old, for example, he'll need 720 to 960 ml (24 to 32 ounces) a day and about six to seven feeds in a 24-hour period.

Here's a rough idea of how much formula your baby needs, and how often he needs to be fed:

Age	Amount per feed	Feeding frequency
Newborn	60 to 90 ml (2 to 3 ounces)	Every 3 to 4 hours
One month	120 ml (4 ounces)	Every 4 hours
Two months	120 ml (4 ounces)	6 to 7 feeds every 24 hours
Four months	120 to 180 ml (4 to 6 ounces)	6 feeds every 24 hours
Six months	180 to 240 ml (6 to 8 ounces)	5 feeds every 24 hours
One year	480 to 720 ml (16 to 24 ounces)	3 to 4 feeds every 24 hours

 Allow 150 ml of formula for each kilogram of body weight (2 1/2 ounces for each pound of body weight) as a daily amount.

 After the first month, babies add about 30 ml (1 ounce) to each feed for every month of life, starting at a base of 90 to 120 ml (3 to 4 ounces) per feed. This increase stops when they reach 240 ml (8 ounces) per feed.

Thus the amount of formula your baby needs depends on his age and current weight. Needs and appetites also vary with each baby, and most babies change from day to day and month to month. Your baby will feed as often as he needs to, as long as you learn to detect his cues and respond to them appropriately. Make sure you don't automatically give a bottle every time your baby cries, but learn to read his actions and figure out whether he's hungry or wants attention. When your baby is 3 months old or younger, you will need small, 120 ml (4-ounce) bottles to feed him. Sometime later, you will find the taller, 240 ml (8-ounce) bottles will be needed.

Formula moves more slowly through the digestive tract than breast milk, so expect the time between feeds to be a bit longer (three to four hours) and the stools to be a bit larger and drier than those of breastfed babies.

Remember, each baby is unique and each baby will vary his intake from feed to feed, day to day. Never force-feed him extra and don't leave him still smacking his lips for more. A baby who often regurgitates milk may do better with smaller, more frequent feeds. Follow his lead.

Good Things to Know

Don't worry if your baby loses weight in the first few days after birth, provided he is still accepting feeding. He was packed with water and extra fat to get him through the "marathon" of birth. He'll probably be back up to his birth weight after the first week. Of course, check with your infant's health visitor or GP if you have concerns.

All feeding equipment, e.g.bottles, teats and other measuring or mixing tools, should be washed and sterilised before they are used. Use warm soapy water to wash them and rinse thoroughly. Sterilisation of bottles/teats can be done in a sterilising unit which uses cold water and sterilising tablets (remember to follow the manufacturer's instructions) or in boiling water for at least three minutes.

Always wash your hands carefully before you prepare formula. Make sure all containers and utensils are very clean. Wipe the formula can before opening.

Prepared formula can be kept in the refrigerator for 48 hours if the teat hasn't been touched by the baby. If it has, throw out whatever remains after a feed.

You don't necessarily have to heat up the formula. Although very few babies appreciate really cold formula, some babies are more particular than others. Never heat formula in the microwave. Microwaves heat the formula unevenly, making it deceptively cool in spots and more likely to burn your baby when he comes across a hot spot. Hold the bottle under hot water for a few minutes to bring it up to room temperature.

Formulas are all pretty similar, but stay with one if it's working well for your baby. In a few cases, switching formulas can help settle little digestive problems, although not usually. Talk to your health visitor or GP before switching your baby's formula.

All formulas are modified cow's milk, except those made from soya products. If your family has a lot of allergies and you choose to formula feed, discuss the use of a soya formula with your doctor.

Watch Out

 Throw out any unused formula. It goes off quickly and that could upset your baby's sensitive stomach. Mix up just a little more than your baby usually takes at a feed, in case he's extra hungry.

 Your baby needs to be held as much as he needs to be fed, so don't just prop him up with his bottle. He could choke feeding this way, too.

 If your baby wets fewer than six nappies each day, call your health visitor or GP straight away. He may be dehydrated or undernourished.

 Carefully clean off the formula can before you open it to avoid contaminating it.

 Make sure the teat hole is the right size. If it is too large, your baby will gag and look alarmed at the fast milk flow. If it seems as if he is sucking too hard, the hole may be too small or the teat too hard for him.

 Teats come in a lot of shapes and sizes. There is no best one for all infants. Try out a couple to see what works best for your baby.

Other Cautions

 Don't substitute goat's milk for breast milk or formula. The nutrient balance is wrong for babies although great for (real) kids.

 Evaporated milk may have been your first food, but it's not the best we can offer now. It has the wrong protein, mineral and fat balance for humans. It's unmodified cow's milk and puts stress on a baby's gut and kidneys.

 Cow's milk in any form is not recommended for children younger than 1 year. Stay with breast milk or commercial formula until after the first birthday party.

 Don't add honey to anything. It can contain spores that can produce serious disease in infants under 1 year.

 Don't dilute formula or make it weaker than directed.

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