Formula Feeding

Preparing infant formula safely is critical for your baby’s health. Not preparing formula safely can lead to serious illness in an infant. Follow the guidelines below to ensure you are sterilizing all equipment every time you prepare formula. To make it easier for your baby to feed from a bottle, use a paced bottle feeding method to slow the flow.

Formula comes in three types: powder, liquid concentrate, and ready-to-feed. Instructions to prepare are different for each kind of formula. This section will give you step-by-step instructions to prepare each type.

Prepare formula safely

Follow these step-by-step instructions to prepare formula safely. This information is also available in different languages on printable fact sheets. 

Paced bottle feeding

Paced bottle feeding is a technique which allows your baby to drink at a comfortable rate.

In traditional bottle feeding it may look like your baby is very hungry as she gulps but she may actually be trying to swallow quickly to avoid choking. This can be unsafe for baby.

This video shows you how to use paced bottle feeding (Video, 3:50 minutes).

Try to feed your baby when you see early feeding cues. Your baby will be more content and feed easier if she is not crying. When your baby is hungry she will:

  • Start to wake up
  • Make rapid eye movement under the eyelids
  • Lick/suck/move her mouth
  • Turn her head while opening her mouth (rooting)
  • Make smacking and grunting sounds
  • Bring hands to mouth and fists become tight
  • Cry (the last sign of hunger)

How to pace feeds:

  • Hold your baby in an upright position, supporting her head and neck.
  • Feed your baby skin-to-skin if possible.
  • Use a medium or wide-based, slow-flow nipple.
  • Touch the baby’s upper lip with the bottle nipple to encourage her to open her mouth wide.
  • Gently allow baby to pull the nipple into her mouth. Do not force the nipple into baby’s mouth.
  • Keep the bottle horizontal so that the nipple is partially full. This will slow the flow of milk. It is not necessary to keep the nipple full of milk as all babies swallow air while feeding.
  • Count your baby’s sucks and swallows. If your baby does not take a breath by the third to fifth suck, tip the bottle down, keeping it in baby’s mouth and give her a 3-5 second pause to let her breathe.
  • Often baby will swallow, then breathe, then start to suck again when she is ready to begin feeding again.

How much your baby may drink

When bottle feeding, use the chart below as a guide to prevent overfeeding your baby.

Newborns have very small stomachs and need to eat at least 8 times in 24 hours:

Days old Amount the stomach can hold
 
1 5-7 ml per feeding (size of a cherry)
2 12-14 ml per feeding
3 30 ml (1 oz.) per feeding
7 (one week) 60 ml (2 oz.) per feeding (size of an egg)

After the first week, gradually increase the amount in the bottle, watching for signs that your baby is finished. Throw out any milk your baby does not drink. The amount that your baby drinks may vary from feed to feed depending on how hungry she is at that time.

Signs that your baby is finished:

  • Falls asleep
  • Turns head to side
  • No longer sucks
  • Lets go of the nipple
  • Closes her lips

Remove the bottle if your baby shows any of these dangerous signs:

  • Milk spilling from mouth
  • Opening eyes widely
  • Stiffening of arms and legs
  • Flaring nostrils
  • Grimacing
  • Lips turning blue

If you see any of the above signs:

  • Give your baby a break from feeding and then re-offer the bottle, watching her to see if she is interested in continuing the feeding.
  • Try a different nipple on the bottle if these signs happen often.
  • If problems continue, see your healthcare provider and have them watch your baby feed.

Ways to encourage bonding while bottle feeding