Baby can thrive on bottle-feeding

These days many babies not only survive on infant formula, they thrive. Most full-term infants who are not breastfeeding should get a conventional cow's milk formula. You can buy it in three forms:

Ready-to-use is the most expensive. You don't have to mix it, so it's the easiest formula to use.

Concentrated liquid is less expensive. Generally you mix the formula liquid with water.

Powder is the least expensive. To mix follow manufacturer directions.

Measure carefully

Be sure to use the correct proportion of water. Under-diluted (too strong) formula can cause problems for the baby's organs and digestive system. Over-diluted (too weak) formula will not provide enough nutrition.

Babies who have an allergy to cow's milk formula may be candidates for soy formula, but soy is not as good a protein source. Be sure to check with your doctor before switching your baby to a soy formula.

The American Academy of Pediatrics recommends boiling water for one to two minutes, letting it cool and then mixing with formula. This will eliminate bacteria or any parasites that could be in the water. Your doctor may feel the water supply in your area is safe enough to use tap water, but check first.

Stick with iron-fortified formula

You can either buy "iron-fortified" formula with about 12mg of iron per liter or "low iron" with about 2mg of iron. The chairman of the American Academy of Pediatrics Committee on Nutrition has said there should not be a low-iron formula on the market for the average child, because a low-iron formula is nutritionally deficient.

The reason the low-iron formula is still available is because it was once thought iron caused constipation, colic and abdominal discomfort. Studies have shown that iron does not cause these problems.

Sterilize first, then wash well

To sterilize bottles and nipples before you use them for the first time, boil them in water for five minutes. After that it's only necessary to wash them in hot soapy water or run them through the dishwasher.

Getting the temperature right

As long as it's not too hot, it does not matter what temperature the formula is. Some people find they can run warm water over a refrigerated bottle and that's enough to take the chill off.

Do not use the microwave to heat the bottle. The microwave heats unevenly so there may hot spots in the milk that can burn your baby's mouth.

More bottle-feeding tips

Be sure to hold your baby and hold the bottle. You may be busy, but your baby needs cuddling and closeness as part of feeding. Don't leave her to eat on her own.

Don't watch the clock. If your baby seems hungry an hour before she usually eats, go ahead and feed her. For the first year of life, feed on demand.

Check nipple hole size to be sure the milk isn't coming out too fast or too slow. If it's too hard to get the milk out of the bottle the baby may get frustrated trying to get enough to eat. If it comes out too fast the baby can choke.

Replace nipples every six months. When a nipple gets so old that it sticks to itself or collapses, the baby will have a hard time feeding.

Don't leave the bottle in the crib to soothe your baby. As tempting as this may seem, this can cause extreme early dental decay.

Trading up to a cup

Serve a cold cup of milk with that first birthday cake, and make sure it's whole milk. Low-fat and skim milk don't have enough fat to meet the nutritional needs of a one-year-old. Stay with the whole milk until your child is at least age two.

Date last reviewed: October 2002.

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