Bottle feeding

Whether bottle-feedings are supplementing your baby's breastfeeding or your baby's complete source of nutrients, there are numerous factors to consider.

What do I feed my baby?

It's always best to discuss this question with your baby's physician or lactation consultant, but typical options include:

• The American Academy of Pediatrics (AAP) recommends breast milk as the preferred feeding for infants.
  • There is a demonstrated lower rate of infectious illness in breast milk fed babies.
  • Breast milk can be pumped and stored for later use as bottle feeding, providing an opportunity for the father and other family members to be involved in feeding time.
  • Refrigerated breast milk should be used within 48 hours after pumping or be frozen.
  • Frozen breast milk should be used within three months. Once breast milk is thawed, it should be used within 24 hours and cannot be re-frozen.
  • Infants exclusively or primarily on breast milk require supplementation with a multivitamin containing at least 200 IU of Vitamin D.
  • Flouride is sometimes needed after six months if the water supply does not have enough flouride.
  • Always discuss any supplementation with your pediatrician prior to initiating.
• Infant formulas are modeled after breast milk to contain the needed amounts of protein, calories, fat and minerals for growth. However, formula does not contain the immune factors that are in breast milk. Infants taking adequate amounts of iron-fortified formula typically do not need vitamin and mineral supplementation.
  • Cow's milk-based formulas such as, Enfamil Lipil with Iron, Similac Advance with Iron, Good Start Supreme with Iron. These formulas are modeled after breast milk with cow's milk as the protein source and lactose as the carbohydrate source. The terms "Lipil," "Advance," and "Supreme" were added to indicate the addition of DHA (Docosahexaenoic Acid) and ARA (Arachadonic Acid), polyunsaturated fatty acids thought to aid in brain and eye development.
  • Soy milk-based formulas, such as Prosobee Lipil and Isomil Advance, contain soy protein and are lactose free.
  • Protein hydrolysate formulas, such as Alimentum Advance, Nutramigen Lipil and Prestimil contain cow's milk protein in a more broken down form that may help your child tolerate the formula. These formulas are also lactose free.
  • Elemental formulas, such as Neocate and Elecare are cow and soy protein free formulas with completely broken down protein (free amino acids). These formulas are commonly used for babies with severe allergies and are lactose free.
  • Premature infant formulas, such as Premature Enfamil Lipil and Similac Special Care Advance are products used during hospitalization. They are modified to contain more protein, vitamins and minerals to met the special nutritional needs and digestive capabilities of your premature infant. The protein source is cow's milk and there is a modified amount of carbohydrates as lactose.

When and how should I introduce bottle feeding to my baby?

If possible, it's best for your baby to breastfeed exclusively for the first three to four weeks before a bottle is introduced. This allows your body to fully establish milk production prior to separation from your baby and helps avoid nipple confusion between the breast and artificial nipple.

Breast milk can be expressed for bottle feedings or formula may be substituted. Your baby may be initially unwilling to take a bottle from you, if he or she is accustomed to breastfeeding. Bottle-feeding by the father or another caregiver may be necessary for successful introduction of bottle-feeding. Lactation consultants can provide assistance with this transition.

When you introduce a bottle in preparation for returning to work may also depend on the length of your maternity leave. If you return to work within four to eight weeks of giving birth, start by adding a bottle of your expressed milk about one or two weeks beforehand. Choose a feeding when you may normally be away from your baby and only provide a bottle to him or her during that time. This may help your baby adapt more easily to the change.

For a longer maternity leave, you may want to introduce a bottle with your milk by eight to 10 weeks, but there is no need to offer it on a daily basis or at a time when you will be away at work. That can wait until one or two weeks before your return to work.

If you do not have to return to work until the second part of your baby's first year, you can probably avoid introducing a bottle altogether.