Even with tremendous effort and plenty of support, breastfeeding does not always go well for every mother-infant pair. In other cases, parents who recognize the benefits of breadfeeding may still prefer bottle-feeding. Some believe bottle-feeding provides more freedom and time for activities. Dad, granparents, sitters, and even older siblings can feed an infant breast milk or formula in a bottle. This may give some mothers more flexibility. There are other reasons some feel more comfortable with bottle-feeding, such as knowing exactly how much food the baby is getting. Others prefer formula-feeding for reasons such as not needing to worry about the mother's diet or medications that might affect the milk.
Even so, it is impossible for fomula manufaturers to reproduce the components that make break milk from mothers so unique. Althhough formula does provide the basic nutrients for an infant, it lacks the antibodies, some of the specific components and sugars that feed good bacteria in a baby's gut, and many of the other components found in breast milk. Formula-feeding is also costly and may be inconvenient for some families. The formula must be bought and prepared or otherwise managed, and you'll need a reliable source of clean water for mixing the formula. This means trips to the kitchen in the middle of the night, as well as extra bottles, nipples, and other equipment.
If you have decided to bettle-feed your baby, you'll start by selecting a fomula. Your pediatrician will help you pick one based on your baby's needs. Today there are several varieties and brands of commerical formulas from which to choose, all of which are equally safe and nutritious. The American Academy of Pediatrician does not recommend homemade baby formulas, since they can be deficient in vitamins and other important nutrients and may be contaminated with potentially harmful bacteria.
Preparing, Sterilizing, and Storing Formula
Most infant formulas are available in ready-to-feed liquid forms, concentrates, and powders. Although ready-to-feed formulas are very convenient, they are also the most expensive. Formula from concentrate is prepared by adding water as the manufacturer directs. Unused concentrate may be covered and refrigerated for no more than forty-eight hours. Powder, the least expensive, comes either in premeasured packets or in a larger can. Most powdered formula requires one level scoop of powder for every 2 ounces (60 ml) of water. Mix thoroughly to ensure that tere are no clumps of undissovled powder. Always read the label instructions for mixing the formula properly.
Aside from the price, powder is also light and portable. The powder will not sopil, even if it stays in the bottle several days before adding water. If you choose a formula requiring preparation, be sure to follow the manufacturer's directions exactly. Too much water and your baby won't ge tthe calories and nutrients needed for proper growth; too little and the extra-concentrated formula could cause diarrhea or dehydration and will give your infant more calories than needed.
If you use well water or are concerned abour the safty of your tap water, boil it for approximately one minitute before adding it to the formula, making sure to let it return to room temperature before feeding. (If there is any concern, it may be a goos idea to have your well water tested for bacteria or other contaminants.) You also can use bottled water.
Powdered infant formula is not commercially sterile and has been associated with a severe illness attributed to Cronobacter bacteria. However, the illness is very rare and the Wold Health Organization (WTO) has issued guidelines to improve the safety of powdered infant formula. The CDC and other US organizations recommend heating the water at least 158 degrees Fahreheit (70 degrees Celsius) before mixing with powder to reduce the possibility of infection with this bacteria. These instructions may be found at: cdc.gov/features/cronobacter.
Make sure all bottles, nipples, and other utensils used in preparation and feeding are clean. If your home has chlorinated water, a dishwasher or hot tap water with dishwashing detergent can be used. Rinse in hot tap water. For nonchlorinated water, boil the ustensils for five to ten minutes.
Store formula prepared in advance in the refirgerator to discourage bacterial growth. Unused refirgerated formula should be discarded after twenty-four hours. Refrigerated formula doesn't necessarily have to be warmed, but most infants prefer it at least at room temperature. To warm it, you can either leave the bottle out for an hour or warm it in a pan of hot water (again, do not use a microwave). If you warm it, tets it in advance to makr sure it's not too hot by shaking a few drops onto the inside of your wrist.
Bottles may be glass or plastic and may have a soft plastic liner. These inner liners are convenient and may limit the amount of air your baby swallows when feeding, but they are also more expensive. As your baby begins holding the bottle herself, avoid using breakable glass bottles. Also, bottles designed to promote self-feeding are not recommended, as they may contribute to early childhood caries (ECC, formerly known as baby bottle tooth decay) by promoting constant feeding and overexposing the teeth to sugars. When milk or any other sugar-containing liquid sits in contact with tooth enamel over a prolonged period of time, bacterial overgrowth and acid production occurs. ECC is most commonly seen in children six months and older who bottle or breastfeed to fall asleep or demand at-will feedings throughout the night. Also, self-feeding while lying on the back has been shown to contribute occasionally to ear infections. A bottle should not be given to suck on overnight. If you give your infant a bedtime feeding, take away the bottle and brush his teeth before he falls asleep to prevent ECC.
You may need to try several nipples before finding the one your baby prefers. There are standard silicone or rubber nipples, orthodontic ones, and special designs for premature infants and babies with cleft palates. Whichever type used, always check the size of the hole. If the hole is too small, your baby may suck so hard that he’ll swallow too much air; if it’s too big, the formula may flow so fast he might choke. Ideally, formula should flow from an upended bottle at a rate of one drop per second and stop dripping after a few seconds.
The Feeding Process
Feeding times should be relaxing, comforting, and enjoyable. They provide opportunities to show your love and to get to know each other. If you are calm and content, your infant will respond in kind. If you are nervous or uninterested, he may sense these negative feelings and a feeding problem can result. You will probably be most comfortable in a chair with arms or with pillows that let you prop up your arms as you feed your infant. Cradle your baby in a semi-upright position and support his head. Don’t feed him when he’s lying down flat as this will increase the risk of choking and may also cause formula to flow into the middle ear, leading to possible infection. Hold the bottle so that formula fills the neck of the bottle and fills the nipple. This will prevent your baby from swallowing air as he sucks. To get him to open his mouth and grasp the nipple, stimulate his rooting reflex by stroking the nipple against the lower lip or cheek. Once the nipple is in his mouth, he will begin to suck and swallow naturally.
Too Much Feeding
Some signs that your baby may be overfeeding:
■ If bottle-fed, the baby is consuming more than 4 to 6 ounces (120 to 180 ml) per feeding.
■ She vomits most or all of the food after a complete feeding.
■ Her stools are loose and very watery, and occur eight or more times a day. (Keep in mind that breastfed babies normally tend to have much more frequent and looser stools.)
Too Little Feeding
Some signs that your baby may be underfeeding:
■ If breastfed, the baby falls asleep while feeding after a short time, and does not seem satisfied after the feeding.
■ She wets fewer than four diapers per day; particularly if she has begun sleeping through the night, she may be feeding inadequately (since most babies feed at least once during the night), and may urinate less often and become mildly dehydrated.
■ She has infrequent or very hard stools in the first month.
■ She appears hungry, searching for something to suck shortly after feedings.
■ She becomes more yellow, instead of less, during the first week.
■ She seems excessively sleepy or lethargic
Feeding Allergy Or Digestive Disturbance
Signs of a feeding allergy or problem with digestion:
■ Your baby vomits most or all food after a complete feeding.
■ She produces loose and very watery stools eight or more times a day or
has blood in the stools.
■ She has a severe skin rash
*Source:Caring for your baby and young child birth to age 5, Sixth Edition Paperback" by American Academy of Pediatrics (Author)