Facts about formula milk

You may choose to formula milk feed or offer breast and formula milk to feed your baby.

Types of formula milk

Firstly, most infant formula milk is produced from processed cow’s milk so that it’s suitable for babies. There are also formula milks available that are produced from goat’s milk or soya protein (not recommended in babies under six months).

Formula milk comes in two forms; either as a ready-made liquid or as a powder. The ready-made liquid is sterile until the container is opened, the powder formula is not sterile.

There are many different brands of formula milk available, which can make choosing one for your baby confusing.

All first infant formula milk is strictly regulated, which means that it has to include certain ingredients, so anything added in addition to the minimum standard is not proven to be beneficial. First Steps Nutrition and NHS Start for Life provide additional useful information.

There is no need to change from first formula milk until your baby is one year old, at which time they can go onto full fat cow’s milk.

Preparing formula milk safely

Powdered infant formula milk isn’t sterile once the tin has been opened, which means that harmful bacteria can be introduced to it, causing babies to be unwell.

Therefore it’s important that you prepare the formula correctly, follow good hygiene and wash and sterilise all the equipment you use.

• Step 1: Fill the kettle with at least one litre of fresh tap water (do not use water that has been boiled before or bottled mineral water)
• Step 2: Boil the water. Then leave the water to cool for no more than 30 minutes, so that it remains at a temperature of at least 70C
• Step 3: Clean and disinfect the surface you are going to use
• Step 4: It’s important that you wash your hands
• Step 5: If you are using a cold-water steriliser, shake off any excess solution from the bottle and the teat
• Step 6: Stand the bottle on the cleaned, disinfected surface
• Step 7: Follow the manufacturer’s instructions and pour the amount of water you need into the bottle. Double check that the water level is correct. Always put the water in the bottle first, while it is still hot, before adding the powdered formula
• Step 8: Loosely fill the scoop with formula milk powder, according to the manufacturer’s instructions, then level it using either the flat edge of a clean, dry knife or the leveller provided. Different tins of formula milk come with different scoops. Make sure you only use the scoop that comes with the formula
• Step 9: Holding the edge of the teat, put it into the retaining ring, check it is secure then screw the ring onto the bottle
• Step 10: Cover the teat with the cap and shake the bottle until the powder is dissolved
• Step 11: Allow the formula milk to cool so it’s not too hot to drink. Do this by holding the bottle (with the lid on) under cold running water
• Step 12: Test the temperature of the formula milk on the inside of your wrist before giving it to your baby. It should be body temperature, which means it should feel warm or cool, but not hot
• Step 13: If there is any made-up formula left in the bottle after a feed, throw it away

Health professionals don’t recommend the use of formula preparation machines. If you plan to use a formula preparation machine, make sure you follow the manufacturer’s instructions precisely and don’t be tempted to make cheaper substitutions, such as using alternative filters as there are concerns around their safety. Research has shown that most prep machines did not get above 70 degrees when making the bottle.

Click here for further guidance if you are making up bottles using hot taps and baby kettles.

It is strongly advised that you make up each feed fresh as and when you need it.

Most babies will accept milk at room temperature, but if you do need to warm up a feed, stand the bottle of formula in a container of warm water for no more than 15 minutes. Never use a microwave to warm the milk as it can cause hot spots and always test the temperature of the milk before offering it to your baby.

Using a baby formula preparation machine

If you use a baby formula preparation machine, follow the manufacturer’s instructions.

Make sure the water that comes out of the machine is at least 70C when it’s mixed with the formula powder. You can use a digital food thermometer to check this. Water at 70C or more will kill any harmful bacteria.

If the water is less than 70C, stop using the machine and follow the step-by-step guide to preparing formula feed instead.

You may also want to contact the manufacturer, your local Trading Standards office or Citizens Advice to report a fault with your machine.

Paced feeding with a bottle

Just like breast fed babies, bottle fed babies benefit from skin-to-skin contact. It is also a good idea to limit the number of people that feed your baby as this enables them to build those important close relationships.

Follow your babies lead. They will let you know when they are hungry; they will give you clues such as moving their head and mouth around or sucking on their fingers. As soon as you spot these signs, you can offer a feed.

Hold your baby close and in a semi upright position so that you can see their face. Gently rub the bottle teat against their top lip to encourage them to open their mouth. Make eye contact and talk to them whilst they feed as this will reassure them.

Your baby will let you know when they need a break; when they do, gently remove the teat from their mouth or bring the bottle downwards to cut off the flow of milk.

It’s also a good idea to switch sides each time you feed so that it’s not just one side of your baby’s head that is put under pressure.

Your baby will know when they have had enough as they will turn their head away, fall asleep, push the bottle out with their tongue or not open their mouth. Don’t force your baby to finish a feed.

Remember that the amount suggested on the tin is only a guide on the amount to use and timing. Your baby is likely to feed little and often, and this is normal.

Giving your baby a lot of milk in one feed doesn’t mean they’ll last longer between feeds; it’s just as likely to make your baby sick and uncomfortable.

You will know your baby is getting enough milk if they are growing and having lots of wet and dirty nappies.

Formula feeding when you are out and about

When you are away from home, there are three options when it comes to preparing your baby’s formula milk.

You could:

1. Take a sterilised bottle and a carton of readymade liquid formula with you
2. Take a vacuum flask with boiled water and a container with the measured amount of powder required. Don’t forget your sterilised bottle to make the formula milk up in
3. Make up the feed as usual, cool it quickly and store it in the back of the fridge for at least an hour before you go out. You can then transfer it into a cool box or bag using frozen ice blocks to keep it cold. You will need to use the feed within four hours

Useful links

• First Steps Nutrition – a website that provides more detailed information about UK formula milks.
• NHS Start for Life- Bottle feeding