If you choose to bottle feed or are supplementing your breast feeding with bottle feeds you may be confused about what bottle and/or nipple is best for your child. There are so many brands of bottles and nipples on the market today that it can be mind boggling. But, there are also some other things to think about when bottle feeding your baby.

• All plastic bottles sold in the United States are now BPA (bisphenol A) free, so choosing plastic over glass means bottles will be shatterproof and lighter than glass bottles. The downside is that they may not last as long as a glass bottle. Brand new bottles should be sterilized in a pot of boiling water for about 5 minutes.
• You should wash bottles each and every time you use them. There is no longer a need to boil bottles, but they should be washed either in the dishwasher or by hand with dish detergent. Check bottles periodically for damage, leaks, wear and tear especially if washing in the dishwasher because ultra hot water can damage some plastics over time.
• Use only pumped breast milk or formula in your baby’s bottle. Always follow directions on the formula package for correct mixing. Mixing incorrectly can make formula too thick causing problems with sucking and flow for your baby and mixing too thin can cause her to gag or choke as well as miss vital nutrients.
• You may need to try several nipples until you find one that works best for your baby. Nipples are available in may shapes and sizes and come in silicone and latex. They also have a flow rate based on the size of the hole in the nipple. If your baby seems like he is getting too much too fast and/or gags, chokes or loses liquid during feedings you may need a nipple with a slower flow/smaller hole. Always check nipples for damage such as discoloration or cracks, breaks.
• There are many types of formula. Many parent’s begin by selecting a cow’s milk formula, but if their baby is sensitive the pediatrician may recommend a soy formula or another type of special formula suited to your baby’s dietary needs. Many babies only take a few ounces of formula every few hours at first, but by the time they reach about 6 months of age most babies are drinking 6-8 ounce bottles at each feeding.

• Babies should always be held during feedings and not have bottles propped. Propping bottles can lead to choking , tooth decay and contribute to ear infections. You should hold your baby so that his head is a bit more elevated than the rest of his body. Make eye contact and talk softly to your baby while feeding her. This is a great time for bonding. Bring your baby’s hands forward so that he can pat the bottle or hold your fingers during feedings to eventually prepare him for holding his own bottle.
• Use a bib and always keep a burp cloth nearby for feedings. Burping your baby about halfway through a feeding can eliminate or minimize spitting up or excess gas.
• Your baby may prefer room temperature, cool or warm formula. Never heat bottles in the microwave. Run bottles under warm water or use a bottle warmer. Contrary to what grandma says, formula temperature should be tested on the back of your hand rather than your wrist which is less sensitive.
• How long can you keep formula? WebMD states “Formula left over in the bottle should be thrown out. Immediately refrigerate opened packages of unused liquid formula and extra mixed formula and use within 48 hours. If left out more than one hour, trash it. Don’t mix big batches of formula. Make it as needed. Refrigerate breast milk for use within 5 days. Or freeze it. It can last up to four months in a standard freezer, or up to six to 12 months in a deep freeze of 0 degrees or colder. Make sure it is stored in the back of the freezer and not in the door.”

Concerns: If your baby is not taking enough formula, gags or chokes during feeding, constantly loses liquid during feeding, vomits often or projectile vomits, develops a rash or constipation or diarrhea consult your pediatrician for advice. Some babies may need to change formulas, need a different bottle/nipple or some may benefit from having a feeding evaluation through Early Intervention. Early Intervention can address feeding concerns early on and help your baby move smoothly through the developmental process of feeding.

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