Resorting to, is perhaps one of the biggest disappointments that can afflict a new mother if she finds that she is unable to . She may have been looking forward to this all through pregnancy and, if, for one reason or another, it proves impossible, the let-down can cause unhappiness and feelings of guilt and frustration.
If this happens to you, console yourself with the thought that tests have shown that bottle-fed babies develop as quickly as breastfed babies. If in addition you hold your baby lovingly close as you give him his bottle this will be a good substitute for.
Much work has been done, particularly over the last few years, to ensure that artificial milks are as like human milk as possible. The protein content has been reduced, and the carbohydrate, vitamin and mineral content made as similar as possible.
- DRIED FORMULA MILK
- TYPE OF BOTTLE
- TYPES OF TEAT
- CLEANING AND STERILIZATION OF BOTTLES AND TEATS
- Boiling Method of Cleaning Baby Bottles
- The Chemical Method
- PREPARING FEEDS
- TEMPERATURE OF FEED
- AMOUNT OF MILK NEEDED
- THE TECHNIQUE OF BOTTLE-FEEDING A BABY
- TIMING OF FEEDS
- VITAMIN SUPPLEMENTS
- THE SLOW FEEDER
- WAYWARD FEEDERS!
- WHAT TO AVOID WHEN BOTTLE-FEEDING
There are several well known brands of dried milk, and your midwife, doctor or health visitor will be able to help you to decide which one to choose. Basically, all dried milks are cow’s milk which has been passed through various processes to alter its constituents and to add the correct quantities of vitamins and minerals. The process of drying the milk has the additional benefits of ensuring that milk can be bought in quantity, and that it will store for several months.
Tinned evaporated milk was given to babies in the past, but this is now considered unwise as it is not possible to adjust the proportions of the constituent parts. Ordinary cow’s milk straight from the bottle can be used to feed babies of over 6 months of age.
Whatever type of milk you decide on, do keep to it. Chopping and changing the brand of milk is never necessary. If your baby does not seem to be thriving or settling well after his feeds, you will need expert help to find the cause.
TYPE OF BOTTLE
After deciding which milk your baby should have, you will then need to buy bottles, teats and sterilizing equipment. Nowadays all baby bottles are upright ones, made of both plastic and glass. They come in two sizes, the 2oo ml (8 fl oz) size and the 120 ml (4 fl oz) size. The latter size is useful for small babies, or for giving extra drinks of water or unsweetened fruit juice. Most bottles have a wide neck for easy cleaning, and a teat that can be inverted inside the bottle and covered with a cap for storage and travelling.
TYPES OF TEAT
When choosing a bottle, be sure that you buy a teat that will fit it! The most important thing to check is the size of the hole, as this will determine the rate at which the milk flows out. The milk should fall out in a succession of rapid drops approximately one drop per second. If you feel that the hole in the teat you have bought is too small, you can easily enlarge this with a red-hot needle. Before each feed, when you check the temperature of the milk on the back of your hand, check that the rate of flow is still satisfactory. Teat holes do enlarge with use.
CLEANING AND STERILIZATION OF BOTTLES AND TEATS
Cleaning and sterilizing is a vital part of the bottle-feeding routine. Without very great attention to this aspect of care, a baby risks contracting gastroenteritis, a dangerous, and sometimes fatal, condition in young babies.
There are two main ways of sterilizing a baby’s feeding utensils, the boiling method and the chemical method. Before you embark on either, there are three important tasks to be done. Preliminary steps
- Wash your hands thoroughly. Hands can carry the germs which cause disease.
- Clean the bottle, first with cold water to remove as much milk as possible. Then wash with hot soapy water, using a special bottle-brush to get into all the awkward places. Finally rinse thoroughly with cold water.
- The teat needs special care to remove all the deposit of milk. Rubbing with salt, both inside and out, ensures maximum cleanliness. Rinse out afterwards with cold water.
Boiling Method of Cleaning Baby Bottles
Remember that it is not enough to boil bottles and teats once a day. They must be boiled after every feed. After cleaning thoroughly, put both bottle and teat in a clean pan, cover completely with cold water and bring to the boil. Boil rapidly for at least 10 minutes. There are some disadvantages to the boiling method. Teats spoil rapidly and, therefore, need to be replaced frequently. Also, glass bottles do occasionally break. For these reasons many mothers prefer the chemical method.
The Chemical Method
After thorough cleaning, place the bottles and teats in a container of chemical solution. The solution should be made up according to the manufacturer’s instructions. The feeding utensils must be left fully submerged in this solution for at least three hours, so it will be necessary for you to have other bottles and teats available for use. Before the next feed remove the bottle, allow it to drain for a short while and then put the feed straight into the bottle.
The vast majority of mothers who decide to bottle-feed their babies choose one of the proprietary dried milks. The instructions on how to make up these feeds are given on the packet, and should be followed to the letter. There are, however, a few guide-lines to remember when making up a feed.
- Cleanliness. Hands must be thoroughly washed before being brought into contact with bottle, teat, scoop or milk powder.
- Mixing the Feed. The water you add to the dried milk powder must be boiled and then cooled to just above blood-heat. Too hot water will cause the fat content of the milk to separate. If it is too cold, the powder will be difficult to dissolve. Manufacturers recommend adding the powder to the water.
- Amount of Powder in the Scoop. The correct amount is vitally important, so do not be tempted to heap the powder on the scoop, to press it down hard. Similarly, never add extra scoopfuls of powder.
- Correct Amount of water. Be sure you measure the correct amount of water before adding the powder. When you have done this, hold the bottle upside down to make sure that the teat is not blocked. The milk should drip out at a rate of approximately one drop per second.
TEMPERATURE OF FEED
Most feeds are given to babies at about blood heat, but they will come to no harm if their milk is given cold. Always judge the temperature of a warm feed on the back of your hand before giving it to him. Never keep milk warm for a long period of time – warm milk is an ideal breeding ground for germs. For this reason, bottle-warmers are not recommended. Many mothers prefer to make up a day’s feeds in bulk, and this is perfectly all right if you have a large enough refrigerator for storage.
AMOUNT OF MILK NEEDED
Remember that over a twenty-four hour period the average baby needs 70 ml (2.5 fl oz) of milk for every pound he weighs. This is given in divided amounts approximately every four hours. For example, a 4.5 kg (ten-pound) baby, being fed five times a day, will need 7I0 ml (25 fl oz) in twenty-four hours. Each feed will, therefore, consist of 142 ml (5 fl oz).
A baby may, however, vary in his needs from day to day. Always make up a little more milk mixture than you think he will need, and always throw away any that is left over from each feed. The actual feed should last for no longer than haIf-an-hour. if your baby has not taken the full amount by this time, put him down to sleep, but be prepared to feed him a little earlier next time. (If you are worried about this aspect of caring for your baby, ask your health visitor for advice.) Your best guide to the adequacy of your baby’s intake is a steady weight gain over the weeks.
All babies return a little of their milk after a feed. If you are worried about the amount he is possetting, ask your health visitors advice.
Remember that babies get thirsty, particularly in hot weather, and may need a drink of cooled boiled water between feeds. Alternatively, you can give him his vitamin C in the form of unsweetened orange juice or rose hip syrup.
THE TECHNIQUE OF BOTTLE-FEEDING A BABY
Bottle-feeding your baby can be made as satisfying as. Allow feed-times to be relaxed and peaceful and use them as an opportunity to get to know each other. Make yourself comfortable in the same way that you would if you were . Likewise, cuddle your baby close, as you would if breastfeeding.
As with breastfeeding, the baby must get a firm grip on the teat, although the actual mechanism of obtaining the milk is slightly different. More sucking is needed with a bottle, and less gripping with the jaws to force the milk out.
First test the temperature of the milk, then tip the bottle so that your baby will not be sucking air, and gently touch the side of his mouth with the teat. You will find that he will ‘root’ for the teat as he would for the nipple. During a bottle-feed it is necessary, at intervals, to gently move the teat away from the side of his mouth to break the vacuum. You will be able to see when this needs to be done by the flattening of the teat, the level of the milk remaining static and, of course, a frustrated baby!
TIMING OF FEEDS
Newborn babies are given their first bottle-feed any time between four and eight hours after birth. Only a little milk will be taken at first. This is a direct parallel with breastfed babies who are only able to take the small amount of colostrum that is secreted during the first two days after birth.
As the baby becomes hungry, you and he, together, will evolve a routine that suits you both. Most babies settle quite happily into a routine of approximately four-hourly feeds, initially, perhaps, and especially if your baby is small at birth, he may need to be fed every three hours. Within reason, be guided by his appetite.
Bottle-fed babies need supplements of vitamins A, D and C, as insufficient amounts of these vitamins are present in unmodified cow’s milk. But as the specially modified dried milks have these vitamins added, there is no need to give extra vitamins in the form of drops.
Extra vitamin C, in the form of orange, blackcurrant or rose hip juice, diluted with cooled, boiled water, can be given as a drink between feeds if your baby is awake. As vitamin C is not stored in the body, there is no danger of giving excess of this vitamin.
THE SLOW FEEDER
Some babies do seem more difficult than others to wake and get started on their feed. This is particularly true of small and premature babies who, for obvious reasons, need their food regularly and in full measure.
If your baby is very slow, try to limit the time you spend feeding him to around half to three-quarters of an hour. If your baby sucks for longer than this he will tire anyway. Put him down to sleep, but be prepared to feed him earlier the next time round. With bottle-fed babies you can at least be sure of how much he has taken at each feed. By adding up the amounts, you can also arrive at the total for twenty-four hours.
Some babies gulp the first few mouthfuls down, then lose interest and start playing with the teat or nipple. These babies need firm but gentle handling to get them to concentrate on their feeds. A little time can be allowed for play but, after a few minutes, remind them of the business in hand. Giving the feed a little earlier, before a lively baby is awake and, can often settle him into a more satisfactory routine.
In the modern world, we have become obsessed with the necessity of bringing up a baby’s wind, and no baby is allowed to sleep until he has made the requisite noise! All babies, whether bottle or breastfed-swallow air as they feed. If your baby is sucking happily at the bottle, there is absolutely no need to distract him by breaking off to ‘wind’ him. This will only irritate him, make him cry, and swallow yet more air.
If he is willing to suck his feed all in one go, by all means let him. At the end of the feed, cuddle him close for a while on your shoulder or propped in the crook of your arm. He may then reward you with a sleepy burp. If this does not happen don’t worry, there is probably no air that needs to come up. Prolonged winding will only make him miserable and irritable.
WHAT TO AVOID WHEN BOTTLE-FEEDING
Never leave your baby alone with his bottle. This is a cruel deprivation which can also prove to be physically dangerous. A baby cannot manage to hold the bottle in a way that allows him to suck, and he will, therefore, get very frustrated. More importantly, he can choke on the milk.
Alternatively, if he regurgitates some of the milk, this can pass into his lungs and suffocate him. Milk can also readily pass into his middle ear, via the small tubes from the back of his throat, and set up an inflammation.
Bottle feeding baby is not just the physical fact of sucking milk, but a time for love, comfort and security. One further hazard that must be avoided when bottle-feeding is the giving of more milk from a bottle that has been left standing for any length of time. Germs breed rapidly in warm milk. If a baby does not finish all his feed, it should be thrown away.