Safe Bottle feeding your baby

This page aims to provide parents who are bottle feeding  with an overview on how to bottle feed responsibly, and how to choose an infant formula. 

Responsive Bottle Feeding

Bottle feeding responsively can help support the development of close and loving parent-infant relationship. Hold your baby close during feeds and look into their eyes. Learn to notice their cues that they want to be fed and when they have had enough. It is recommended that you and other carer give most of the feeds yourselves, this will help build up a close and loving bond with your baby and help baby feel secure. Continuing skin-to-skin contact can calm and comfort you both at any time.

Infant milks

The different types of infant formula, and other infant milks, marketed for babies and young children can seem confusing when you see lots of different brands on the supermarket shelf, but the information you need as a parent or carer is simple. Most infants who are formula fed or mixed fed should be given a first infant milk (sometimes called first stage or stage 1 milk) throughout the first year. All infant formula on the UK market must meet compositional regulations, so all products are perfectly ok to feed a baby. More expensive brands still must meet the same compositional standards as cheaper brands.

How to bottle feed your baby

Bottle feeding is a chance to feel close to your baby and get to know and bond with them. Babies will feel more secure if most feeds are given by you, your partner, or their main caregiver. Make sure you’re sitting comfortably with your baby close to you. Enjoy holding your baby, look into their eyes and talk to them as you feed them. Hold your baby in a semi-upright position for bottle feeds, supporting their head so they can breathe and swallow comfortably. Brush the teat against your baby’s lips and when they open their mouth wide let them draw in the teat. Keep the bottle horizontal (just slightly tipped). This will allow the milk to flow steadily and help prevent your baby from taking in air. Support their head so they can breathe and swallow comfortably. Always give your baby plenty of time to feed.

If the teat goes flat while you’re feeding, pull gently on the corner of your baby’s mouth to release the suction. If the teat gets blocked, replace it with another sterile teat.

Do not leave your baby alone whilst feeding -never feed with a propped-up bottle and never leave them alone in bed with a bottle. They may choke on the milk.

How to prepare infant formula and sterilise feeding equipment to minimise the risks to your baby

It is important that infant milks are made up safely and one feed at a time as needed (throw away any unused formula or breastmilk after you’ve finished bottle feeding your baby). Powdered infant formula is not sterile and needs to be made up a temperature which will kill any potential bacteria present. The current NHS guidance for making up powdered infant formula safely recommends using water that has been boiled in a kettle (1 litre), and is no less than 70 degrees Celsius, to kill any potential bacteria present.

How to recognise that bottle feeding is going well

Your baby will have;

• Around six heavy, wet nappies a day by day five.
• At least one soft stool a day.
• Be generally calm and relaxed during a feed and be content after most feeds.
• Has a normal skin colour and is alert and waking for feeds.

How to ensure bottle feeding goes well;

• Feed preparation: wash and sterilise equipment appropriately and make formula feeds as per manufacturer’s guidelines.
• Responsive bottle-feeding: parents to give most of the feeds and limit number of caregivers, follow baby’s feeding cues, holding baby close and semi-upright. Maintain eye contact.
• Pacing the feed: allow baby to take breaks when showing signs (remove or lower the teat to cut off flow).
• Recognise signs when baby has had enough milk (turning head away, splaying hands, spitting out milk) and not force baby to finish the feed if showing cues they have had enough.
• Discard leftover milk at the end of the feed.

Remember, most infants who are formula fed or mixed fed should be given a first infant milk (sometimes called first stage or stage 1 milk) throughout the first year. All infant formula on the UK market must meet compositional regulations, so all products are perfectly ok to feed a baby.

Bottled water

It is recommended to boil cold water from the tap when preparing infant formula feeds. However, in certain circumstances, you may need to use bottled water.

If you are using bottled water, you should:

• use still water only, never use fizzy or sparkling water
• always boil the bottled water before using it to make formula milk (bottled water is not sterile)
• Choose a lower sodium bottled water (less than 200mg per litre, this will be clearly labelled on the bottle as ‘Sodium’ or ‘Na’)

It is better not to use bottled water that is labelled as ‘natural mineral water’, as it can have higher levels of sodium and other minerals. However, it can be used temporarily to keep your baby hydrated if no other water is available.

For further advice:

Bottle feeding advice – NHS (www.nhs.uk)

Formula Preparation Machines: for more information about the bacterial contamination of infant formula Making infant milk safely — First Steps Nutrition Trust

Domestic Hot Taps: for more information about making up bottles of infant formula from hot taps and baby kettles, please visit Making infant milk safely — First Steps Nutrition Trust

Baby kettles: evidence examining the safety of baby kettles is limited. For more information, please visit Making infant milk safely — First Steps Nutrition Trust