Bottle Feeding Your Baby
- Why do you count and measure everything in the hospital?
- How much formula should my baby be drinking?
- How will I know if my baby is hungry or not?
- Which brand of formula should I give my baby?
- What if his poop gets hard?
- A couple more bottle feeding tips
You have decided to bottle feed your baby. And, indeed, we are fortunate that there are safe, nutritious formulas available. Your baby will thrive. Like any new skill, feeding a baby takes some practice. But just like changing diapers you will be an expert within a week. This section of BABYFAQ contains some of the answers to common questions about bottle feeding new babies.
If you can give your baby mom's colostrum (breast secretions produced just after birth) or mom's milk, even if it is only for a few days or weeks, please do so. ANY breast milk is beneficial to your baby.
Why do you count and measure everything in the hospital?
In the hospital, we are obsessive about counting and measuring everything. So you are asked over and over again: How much did he take? How long did he suck? How long since his last feeding? Did he pee? Did he poop? We don't really mean to drive you crazy. This sort of "data" is what we use in the hospital to determine if a patient is progressing or worsening. Once your baby is a week or two old, and you know he is gaining weight, please don't worry about the details of how much, how long and how often.
In the hospital, we measure liquids in metric units. So we will say, "Your baby took 15ml or 30ml of formula." There are 30ml in one English liquid ounce, so we can also say, "Your baby took a half of an ounce (15ml) or one ounce (30ml) of formula."
How much formula should my baby be drinking?
The most common question parents ask about bottle feeding their baby is how much to feed him. The answer depends on the baby. Once your baby gets through his sleepy period in the first 24 hours, he should be the one to determine how much he takes. Your job is to watch that he is getting the amount he needs to grow and gain weight.
In the first two or three days, an average newborn baby will take 1/2 to 1 ounce of formula in about 20 minutes. Some babies don't take that much, but want to be fed more often. Some babies take more, but don't want to be fed so often. Gradually, the amount your baby takes will increase. By a week of age, he will drink one to two ounces in 20 minutes. Each day the amount will increase a little.
How do you know your baby is getting enough formula? If he empties the bottle every feeding, you have no way of knowing. But if there is a little formula left in the bottle at the end of the feeding then you know he got enough. Gradually increase the amount of formula that you put in the bottle so there is always just a little bit left when your baby is done sucking.
How will I know if my baby is hungry or not?
At first, your baby's feedings will be unpredictable. Newborn babies are not born with any sort of schedule. Your baby may want a feeding every hour for three hours; then sleep for four hours; then take two feedings an hour apart. What you want your baby to do is to take at least eight strong feedings in a 24 hour period. A strong feeding is at least 20 minutes of effective sucking. The 20 minutes don't need to be all in a row. There can be some burping and diaper-changing in between the sucking periods.
Sucking is an activity that is comforting to a newborn. So it is important to know that just because he wants to suck, doesn't mean he is hungry. Newborn babies actually can't tell what "hungry" feels like, or what "I just ate too much" feels like, or "I need to poop" feels like. For newborns it is more like, "something doesn't feel right. . .WHAAAAH!"
Don't try to stop every episode of crying with a bottle, especially if you you just fed him. It is up to us adults to use our brains to figure out what the baby needs. If he just took a big feeding, it is not more milk that he needs to comfort him. He may need to burp, or even burp up some of the extra milk that is making his stomach too full. Maybe he just wants to be held more. Or he needs to pass some gas. Sometimes you do everything you know to do, and he won't stop crying.
Over the weeks, your baby will settle into more and more of a schedule of sleeping, feeding, peeing and pooping. When he is about two months old you will find yourself saying, "I think I have this baby figured out!"
Which brand of formula should I give my baby?
Honestly, I don't care. All modern formulas are safe and nutritious. They are constantly tested and regulated by federal laws. Pick a formula and stick with it. It takes most babies digestive systems six to eight weeks to get used to digesting formula. So, please don't switch formulas unless your doctor recommends it.
If you qualified for WIC (Special Supplemental Nutrition Program for Women, Infants and Children) during your pregnancy, your baby will probably qualify for WIC formula. This is good, because baby formula is expensive. In New Mexico (where I practice), each county has a separate WIC program. Each program has a separate contract with a formula company. The contract will determine which brand of formula your baby will get. Don't worry. You will still have a lot of choices.
If your first two children ended up on soy formula, and did well on it, go ahead and start your new baby on soy formula. Soy formula is just as nutritious as cow's milk formula.
What if his poop gets hard?
Just about every baby who is fed formula will go through a period of hard, painful poop, right about four weeks of age. We want babies' poop to be "mash potato" soft or softer. Changing formula is not the answer to this problem.
To get your baby through the few weeks of hard poop, offer extra water, pear juice, or prune juice. The first serving of juice or water is not going to soften his stools. But if you give water or juice two or three times a day, within three days his poop should be soft and not hurt any more. Keep up the water or juice for a few weeks, then you can taper it off.
By two months of age, most babies have grown out of the hard poop stage without changing formulas.
A couple more bottle feeding tips:
Always hold your baby when you feed him. While it may be really tempting to leave him in his crib with the bottle propped up, it is not good to do this. First, it teaches him that he needs to eat to fall asleep, which is a contributing factor to obesity. More importantly, it bypasses all the social teaching that goes on while we feed him — smiling, talking, singing, holding, and looking at each other. Feeding him teaches him a whole lot about human interaction — not just how to get calories.
Don't ever let him hold his own bottle. Make sure the adult is always holding the bottle. Don't even let him "think" he can hold the bottle himself. Why? Because, when he gets to be 8 or 10 months old, he will be both old enough to learn how to drink out of a cup and have started crawling. He will be SO EXCITED about moving around on his own that he won't want to sit in your lap to be fed. He will want to MOVE more than he will want his bottle. This behavior makes it easier to wean him off his bottle.
Thanks to Janelle Aby MD, Stanford School Of Medicine, Newborn Nursery, and Lucille Packard Children's Hospital for the use of occasional photographs.