Advice about breast and bottlefeeding

Whether you plan to express, combine breast and bottle, or just want general advice, here’s what you need to know

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We all know that breast is best for babies, but it can still be useful to familiarise yourself with the basics of bottlefeeding. It may be that you decide to combine breast and bottle, or that for some reason your breastfeeding doesn’t go as well as you’d hoped. And even if you’re breastfeeding exclusively, it can often be useful to express milk that you can then feed to your baby in a bottle later. Many mums also like to use a bottle sometimes if they feel self-conscious feeding in public, or to enable their partners to share feeding duties.

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Important info if you’re combining

If you’re planning to combine breastfeeding with bottlefeeding, get your baby used to the breast first. “It’s important that your baby-feeding technique at the breast is good, and that your milk supply is given time to fully establish,” advises Vicki Scott, Avent feeding expert. “You can then start to gradually introduce bottlefeeds, so there are no sudden upsets if you’re planning to go back to work or want to go out and can’t be there to feed.”

What equipment will I need?

  • At least six bottles. You can choose from anti-colic, BPA-free microwave-sterilised or disposable bottles to suit your needs.
  • At least six teats. These come in different flow sizes, which are designed to accommodate a baby’s changing feeding speeds as they grow.
  • If you’re planning to express, you’ll need a breast pump. Choose from either a hand or electric pump. Electric systems are more expensive but will save you time and effort if you’re planning to express a lot
  • If you’re not expressing, you’ll need a supply of formula milk, suitable for the age of your infant. At six months you can move on to a follow-on formula. Cows’ milk shouldn’t be used as a main drink for babies under a year as it doesn’t contain all the nutrients that infants need.
  • A sterilising system. You can choose between kits that work in a microwave, electric systems that steam-clean bottles, or cold water kits that use a chemical solution to kill germs.

How to make up a bottle with formula milk

  • Boil fresh tap water and let it cool for a few minutes (but not longer than half an hour to ensure it’s still hot enough).
  • Make sure the area where you’re preparing the feed is clean, and wash your hands thoroughly.
  • Sterilise all feeding equipment.
  • Make up the feed according to the instructions on the formula container.
  • Pour the boiled water in first, then add the recommended amount of powder – don’t be tempted to use more.
  • Screw the cap on tightly and shake well until all of the powder is dissolved.
  • Cool the feed down, and test its temperature by dripping a of it little on to the inside of your wrist before you give it to your baby.
  • Throw away any unused feed and clean the bottle thoroughly.

The UK Department of Health and the Food Standards Agency revised their advice in November 2005, following UNICEF guidelines, advising you to make up a fresh bottle for each feed, using hot (but not boiling) water of over 70ºC. These instructions were introduced because powdered infant formula milk is not sterile and there’s a small risk of contamination from micro-organisms if made-up formula is kept. It’s now advised that feeds are made fresh when required.

In practice, however, this may not always be practical, especially if your baby isn’t in a routine. If your baby suddenly decides he’s going to scream if he doesn’t get his bottle immediately (not once the water is boiled and cooled), it’s suggested you keep freshly boiled water in a sealed flask for up to a couple of hours. When he demands his feed, pour this water into a sterilised bottle, then add the formula.

Five key steps for stress-free mixed feeding

If you’re combining breastfeeding and bottlefeeding, Gail Johnson from the Royal College of Midwives advises the following to help maintain your milk flow:

  • The more you put your baby to your breast, the more milk you produce.
  • Eat well, drink plenty and rest to ensure constant milk supply.
  • Give breast milk first and if he’s still hungry, then offer formula.
  • If he’s undernourished – he’ll be listless and sleepy – feed him more often and seek medical help.
  • If you’re worried about public breastfeeding, express milk. This will maintain your milk supply.

The correct feeding position

Vicki Scott, Avent feeding expert, offers her advice:

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  • Get yourself comfortable and have some close contact with your baby during and after feeding.
  • Encourage your baby to open his mouth wide by touching the teat of his feeding bottle to his lip.
  • As your baby opens his mouth, gently introduce the teat. As you do this, make sure that your baby’s tongue is facing down.
  • Your baby’s lips should be around the wide part of the teat at the bottom. Look for a natural jaw movement and a wave-like pattern of tongue movement, which encourages natural suckling behavior.
  • Tilt the bottle so that the teat is always full of milk – this will make sure that your baby avoids swallowing air as he feeds.
  • He will naturally release the bottle when he needs a break – or he may fall asleep.

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