Bottle Feeding

Some woman are unable to breastfeed their children. They may be unable to produce milk or have a health condition which prevents them from feeding. In either case, advances in infant formula have made it a safe, practical and healthy alternative to breast milk.

Types of Infant Formula

The majority of infant formulas are made of cow's milk. The formula is produced so that it is nearly identical to breast milk in terms of composition. Formula is strictly monitored to ensure that the composition is correct and that it does not contain any chemicals or substances that could cause harm to the child.

Formula is designed to be a high-energy food, just as breast milk is. This serves to meet the high demands of babies growing bodies. Over half of the calories that are contained in formula are from fat, which is a very good energy source. Protein is also added to most formulas either in the form of cow's milk or soy.

Cow's milk based formula is generally regarded as the best quality formula. For infants unable to digest lactose, soybean based formula is the best alternative. There are other specialized formulas, such as those for premature babies - which are much higher in certain vitamins and minerals - and those that are made for babies with certain diseases.

Bottle Feeding Equipment

There are many different brands and styles of bottles and rubber nipples that can be bought. Generally, it makes little difference which ones are bought, so long as overly soft nipples are not purchased. These soft nipples are designed for premature babies, not healthy, full-term infants. Most babies will not care what type of nipple is used on their bottles. Some, however, will be fussy about the type of nipple they are eating from - the way they suck or the shape of their mouth or palate may make feeding with certain nipples difficult or uncomfortable for them. Thus, it is just a matter of finding the right brand and style that works. Once the mother has found a nipple that the baby will eat from, it is important to remain consistent and always use the same nipples.

The flow of the nipple is important. A flow that is too fast or too slow can cause the baby to take in too much air while feeding which can result in stomach discomfort. The mother can test the flow of the nipple by holding a full bottle upside down. If the flow is about one drop per second, it is good.

In terms of bottles, again it makes little or no difference which are used. The only real consideration is the size and shape. Some bottles will be easier for the baby to hold than others.

For bottle feeding, the equipment needed is minimal. A bottle feeding kit should include:

- 2-4 eight ounce bottles

- 10 rubber nipples

- 10 nipple rings

- 10 nipple covers

Bottle Feeding Preparation

Proper preparation and storage of infant formula is essential to ensure appropriate nutrition and to safeguard against bad formula. Infants do not have strong immune systems and have not built up immunity to most bacteria. Thus, proper preparation and sanitization of feeding equipment is vital.

There are some basic steps that can be taken to minimize the danger of contamination in the baby's formula:

- wash hands thoroughly before handling formula and feeding equipment

- wash, rinse, and dry all equipment prior to each feeding

- keep formula containers well sealed

- mix the formula exactly as the manufacturer has recommended. Not doing so can be dangerous to the baby's health

- place prepared formula that is not for immediate use into a fridge

- if made formula goes unused and is refrigerated for more than 24 hours, do not use it

- once formula has been warmed, do not reuse it by refrigerating it and then reheating later

Bottle Feeding Technique

Like breastfeeding, bottle feeding provides the opportunity to bond with the baby and allows him to gain trust in his caregivers. Knowing that his hunger cries are dutifully answered can mean a lot to him.

Like breastfeeding, holding the baby correctly is vital. Ensuring that both the mother and the baby are comfortable while feeding makes the experience much more enjoyable. Using the cradle position outlined in the breastfeeding section with one slight modification is easiest. Rather than having the baby facing towards the person who is feeding him, he should be cradled facing upwards. The other arm of the feeder is then used to hold the bottle. Finding a comfortable chair to sit in is ideal - preferably a chair with low arms and good support. The mother may want to place a pillow on her lap to support her arm while feeding. The mother should pull the baby in snuggly towards her body while feeding. The mother should also make sure that while cradling the baby, he is in an inclined position. This makes swallowing much easier for him.

If the baby does not accept the bottle immediately, the mother can persuade the baby to open his mouth by gently stroking his cheek next to his mouth with a finger or the nipple of the bottle. This should cause the baby to turn his head towards the mother and accept the bottle.

Some parents lay their children down to bed and prop a bottle up to allow them to feed as they fall asleep. This practice is negligent and very dangerous. The baby could choke because he may be unable to push the bottle out of his mouth. This can also promote tooth decay. Prolonged contact between the gums and teeth with the sugary milk can destroy the baby's teeth.

To ensure that the baby is receiving a constant flow of formula while feeding and is not being rewarded with air, the bottle must be held in an upright position when feeding. The bottle should be held on an angle so that the nipple fits directly into the baby's mouth and the nipple stays full of formula at all times. A 45 degree angle is ideal. If the bottle is held at an angle that is too horizontal, the nipple will fill with air. Holding the bottle steady and firm is important as well. If the bottle is held too loosely, the baby will not be able to apply suction.

Bottle Feeding: Schedule and Amount

As with breastfeeding, the baby should dictate the frequency and times of feeding, as well as the amount consumed. The mother must pay careful attention to the baby for signs of hunger. Eventually the mother will be able to distinguish his cries of hunger from others problems. Again, all infants are different. They will adhere to different feeding schedules and will eat different amounts when feeding. If the baby urinates six to eight times a day and has at least two bowel movements, it is probably safe to say that he is satisfied with the amount he has eaten. For an average baby, a feeding schedule may look like the following:

The baby's Age	Avg. Feeding Size in Ounces	Number of Times Fed Each Day	Total Avg. Ounces Per Day
First 2 Weeks	2-3	6-8	22
2-8 Weeks	3-5	5-6	28
2 Months	4-6	4-5	30

By the age of two months most babies will have established a regular eating schedule. Bottle fed babies will tend to eat every three to four hours, where as breast fed infants will eat more frequently. At this age, the baby will also be eating less during the night.

By the age of three to four months the baby is gaining a strong interest in the world around him. This interest will mean that meal times are interrupted by the baby's desire to look at his environment, make noises, smile, stare at his parents, and socialize. Feeding may become a challenge.

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