Feeding your baby infant formula by bottle: Information for parents who choose to feed infant formula by bottle

What infant formula should I choose?

Use a first infant formula throughout the first year. It doesn’t matter which brand you choose as they are all very similar.

Talk to your midwife or health visitor if you have any concerns.

How long do I need to use first infant formula for?

Stick to a first infant formula throughout the first year. Only breastmilk or formula milk should be given as a drink to babies under 12 months of age.

When your baby is six months old, it’s okay when cooking and preparing foods to use small amounts of pasteurised whole cows’ milk.

When your baby is one year old, they will be getting more of their energy, from food,

vitamins and minerals, and then full fat cows’ milk can be their main milk drink; there is no need for follow-on formula.

What you need for formula feeding

You need to make sure you clean and sterilise all equipment to prevent your baby from getting infections and stomach upsets.

You will need:

• Bottles with teats and bottle covers
• Bottle brush and teat brush
• Sterilising equipment (such as cold-water steriliser, microwave or steam steriliser)
• Formula milk powder or ready-to-feed liquid formula

How to make up a feed

Preparation and hygiene

Even when tins and packets of powdered infant formula are sealed, they can sometimes contain harmful bacteria that could make your baby ill. Although these bacteria are rare, the infections they cause can be life-threatening.

A baby's immune system is not as strong nor as well developed as an adult's. This means that babies are much more susceptible to illness and infection. Therefore, good hygiene is very important when making up a feed.

All equipment used to feed your baby must be sterilised. Bottles, teats and any other feeding equipment need to be cleaned and sterilised before each feed to reduce the chances of your baby getting sickness and diarrhoea.

It is best to use drinking water from the tap that has been freshly boiled (and cooled slightly to 70°C or above) to make up a feed. Do not use water that has been previously boiled or artificially softened water.

This is because the balance of minerals in previously boiled water and artificially softened water may not be suitable for making up formula feeds.

How to sterilise feeding equipment

The following instructions apply to all feeding equipment you use for your baby,

whether you are using expressed breastmilk or first infant formula.

1. First, wash your hands well with soap and water.
2. Clean the work surfaces with hot, soapy water.
3. Check that the bottle and teat are not damaged, then clean the bottle and teat in hot, soapy water using a clean bottle brush – a dishwasher will clean the bottle feeding equipment but won’t sterilise
4. Rinse all your equipment in clean, cold running water before sterilising.

How to make up a feed

Use fresh water from the cold tap to fill your kettle every time you make up formula. Do not use water that has been previously boiled or artificially softened water. Bottled water is not recommended to make up a feed as it is not sterile and may contain too much salt (sodium) or sulphate.

1. Fill the kettle with at least 1 litre of fresh tap water from the cold tap (don’t use water that has been boiled before).

2. Boil the water. Then leave the water to cool in the kettle for no more than 30 minutes so that it remains at a temperature of at least 70 Celsius.

3. Clean and disinfect the surface you are going to use. It’s really important that you wash your hands to stop bacteria spreading.

4. If you are using a cold-water steriliser, shake off any excess solution from the bottle and the teat, or rinse the bottle with cooled boiled water from the kettle (not the tap).

5. Keep the teat and cap on the upturned lid of the steriliser. Avoid putting them on the work surface.

6. Follow the manufacturer’s instructions and pour the correct amount of water into the bottle first. Double check that the water level is correct.

7. Loosely fill the supplied scoop with the formula and level it off using either the flat edge of a clean, dry knife or the leveller provided. Follow the manufacturer’s instructions and only put the suggested number of scoops in the bottle.

8. Holding the edge of the retaining ring, put it on the bottle and screw it in. Cover the teat with the cap and shake the bottle until the powder is dissolved.

9. It is really important to cool the formula so it is not too hot to drink. Cool the formula by holding the bottom half of the bottle under cold running water. Move the bottle about under the tap to ensure even cooling.

10. Test the temperature of the infant formula 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.

11. If there is any made-up infant formula left in the bottle after a feed, throw it away.

12. To reduce the risk of infection, make up feeds as your baby needs them. One at a time.

Ready-to-feed liquid infant formula

Ready-to-feed liquid infant formula is sterile until opened. All feeding equipment will still need to be sterilised. Once opened, any unused liquid infant formula that remains in the carton needs to be stored at the back of the fridge on the top shelf with the cut corner turned down, for no longer than 24 hours.

Storing a feed

A feed should be freshly made up when it is needed to reduce the risk of making your baby ill. If you have no choice and need to store a feed, please speak to your health visitor about the best way to do this. Leftover formula should be discarded at the end of a feed.

Unused bottles of formula should be discarded if they have been kept at room temperature for over 2 hours.

A baby’s immune system is not as strong nor as well developed as an adult's. This means that babies are much more susceptible to illness and infection. Therefore, good hygiene is very important when making up a feed. All equipment used to feed your baby must be sterilised. Bottles, teats and any other feeding equipment needs to be cleaned and sterilised before each feed to reduce the chances of your baby getting sickness and diarrhoea. It is best to use drinking water from the tap that has been freshly boiled (and cooled slightly to 70"C or above) to make up a feed. Do not use water that has been previously boiled or artificially softened water.

This is because the balance of minerals in previously boiled water and artificially softened water may not be suitable for making up formula feeds.

Steam sterilising – electric steriliser or microwave

1. Follow the manufacturer’s instructions.
2. Make sure the openings of the bottles and teats are facing down in the steriliser.

Cold-water sterilising

1. Follow the manufacturer’s instructions.
2. Change the sterilising solution every 24 hours.
3. Leave feeding equipment in the sterilising solution for at least 30 minutes.
4. Make sure that there is no air trapped in the bottles or teats when putting them in the sterilising solution.
5. Keep all the equipment under the solution with a floating cover.

Sterilising by boiling

1. Never leave hot pans and liquids unattended.
2. Make sure that whatever you sterilise in this way is safe to boil.
3. Boil the feeding equipment in water for at least 10 minutes, making sure that all items stay under the surface of the water. You may need to use a small plate to keep the bottles under the water.
4. Remember that teats tend to get damaged faster with this method.

Feeding your baby

The early days with your baby are a great time to get to know and love each other. This can be done by keeping your baby close to you, enjoying skin contact and feeding according to these tips. Babies will feel more secure if most feeds are given by parents or main caregivers, especially in the early weeks, as this will really help you bond with each other.

1. Feed your baby when they show signs of being hungry - look out for cues (moving head and mouth around, sucking on fingers). Crying is the last sign of wanting to feed, so try and feed your baby before they cry.
2. Hold baby close in a semi-upright position so you can see their face and reassure them by looking into their eyes and talking to them during the feed. Begin by inviting baby to open their mouth - gently rub the teat against their top lip.
3. Gently insert the teat into baby’s mouth keeping the bottle in a horizontal position (just slightly tipped) to prevent milk from flowing too fast.
4. Watch your baby and follow the cues for when they need a break; these signs will be different from one baby to the next. They may splay their fingers and toes, spill milk out of their mouth, stop sucking, turn their head away or push the bottle away. Gently remove the teat or bring the bottle downwards to cut off the flow of milk.
5. If the teat becomes flattened while you are feeding, pull gently on the corner of your baby’s mouth to release the vacuum.
6. Your baby may need short breaks during the feed and may need to burp sometimes. When your baby does not want any more feed, hold them upright and gently rub or pat their back to bring up any wind.
7. Never use a prop for the bottle or leave your baby alone with a bottle as there is a risk they might choke.
8. Your baby will know how much milk they need. Forcing your baby to finish a feed will be distressing and can mean your baby is overfed.

Why is closeness and comfort important for your baby’s development?

• It helps your baby to feel secure
• It is good for your baby’s brain development

Cuddle and comfort your baby as much as you like. You can’t “spoil” a baby with love.

How do I know if my baby is getting enough infant formula?

Your baby’s weight gain and the number of wet and dirty nappies will help to tell you if your baby is getting enough formula.

For the first few days after the birth, your baby should be producing around six wet nappies a day. These nappies should be heavy with clear or pale yellow urine.

For the first few days after birth, your baby will pass dark, sticky stools (known as meconium). However, after the first week, your baby should pass pale yellow or yellowish-brown stools.

Your baby should have at least six wet nappies a day, and at least one soft stool a day. If you are concerned your baby is not getting enough milk, speak to your midwife or health visitor.

Top Tips for parents in the early weeks

• Try holding your baby skin to skin.
• Consider limiting the number of people who feed your baby.
• Look out for feeding cues in your baby.
• Hold and talk to your baby, avoid leaving them to cry.
• Keep your baby in the same room as you at night for the first 6 months.
• Hold your baby close and look into their eyes when they feed.

Breastfeeding and giving infant formula

If you are combining both breastfeeding and formula feeding and would like to discuss any changes, such as increasing your milk supply, remember to talk to your midwife or health visitor. You can also call the National Breastfeeding Helpline on 0300 100 0212 to speak to someone, often local, about breastfeeding your baby.

Choosing to restart breastfeeding

If you decide not to breastfeed or have stopped breastfeeding, it is possible to restart. This can be difficult because your milk supply will naturally reduce once you are not breastfeeding, but it can increase again to meet your baby’s needs. Giving infant formula to a breastfed baby will reduce your breastmilk supply.

Contacts / further information

If you need more information about bottle feeding or breastfeeding your baby, speak to your midwife, health visitor or GP.

References / sources of evidence

More information is also available on NHS - Better health start for life (opens in a new tab)