Bottlefeeding: Finding the Formula for Success

 Bottlefeeding: Finding the Formula for Success:

Arriving home from the hospital with your new baby, you mix the formula your doctor recommended. Then you happily settle down to feed the newest member of the family, anticipating a peaceful, fulfilling experience.

But for some reason it doesn't work out the way you planned. Your baby fusses, or squirms, or spits up, or refuses the bottle. You're disappointed, frustrated and worried that your baby won't thrive.

What went wrong? There are a number of possible reasons--your baby could be allergic to milk products, for example. But chances are you just haven't smoothed out the process yet. To help you do that, here are some tips from our professional advisers to make bottlefeeding easier, more trouble-free and more rewarding for both parent and tot.


Make the mood mellow. Feeding your baby is an important comforting and bonding time. Hold your infant securely, but not tightly. And try to focus your attention on the child. "It's important to give your baby uninterrupted time," says DeVito-Agins. Turn off the TV and turn on your telephone answering machine (or turn off the telephone ringer).

Pay attention to temperature. Babies have individual tastes: Some like their bottles the same temperature every day, and some don't care if you feed them warmed formula one day and chilled formula the next. If yours fusses when the temperature varies, keep it constant.

But what temperature should it be? As long as it isn't so hot it will burn your baby, it doesn't matter (test a few drops on your wrist). "For my daughter I ran warm water over the refrigerated bottle to take the chill off," says Alvin N. Eden, M.D., associate clinical professor of pediatrics at the New York Hospital Cornell Medical Center in Manhattan, chairman of the Department of Pediatrics at Wyckoff Heights Medical Center in Brooklyn, New York, and author of Positive Parenting and Dr. Eden's Healthy Kids. Another alternative is warming the bottle in a saucepan of water--and it won't harm your baby if you feed formula straight out of the fridge.

Beware the microwave. It's a good idea to avoid microwaving formula, however. "Microwaving infant formula improperly may cause injury by either scalding or burning the tongue, lips, esophagus or cheeks," says Madeleine Sigman-Grant, Ph.D., R.D., assistant professor of food science in the Department of Food Science at the Pennsylvania State University in University Park. "The plastic bag liners of the bottle may explode, or a hot spot in the formula may cause a mild burn."

If you do microwave formula, you should only use clean, clear plastic bottles--glass ones can crack--and never heat less than four ounces of formula at a time to avoid overheating. You also must shake formula after heating so that hot spots mix with cooler spots, and test it by shaking a few drops on your wrist before serving. Don't simply check it by holding the middle of the bottle--you'll miss the hot spots.

Keep formula consistent. Mix your formula precisely the same way every time, says DeVito-Agins. Never dilute the formula any more than recommended on the label, because your child will end up being shortchanged of necessary nutrients.

Go for pure water. Because chemicals such as chlorine are added to tap water, you're better off mixing bottled water in your infant's formula, according to DeVito-Agins. Distilled water and bottled spring water are both fine for formulas. Filtered tap water may also be used: "But be sure you change the filter properly and frequently," says DeVito-Agins.

Boil new nipples. Brand-new nipples can have a plastic taste that your baby may not like, says Becky Luttkus, lead teacher at the National Academy of Nannies in Denver, Colorado. To get rid of that new taste, boil the nipple in water before using it.

Consider the hole thing. It's important that the size of the hole in the nipple is neither too big nor too small, says Dr. Eden. If it's too large, formula will pour through too quickly and your baby may choke, and if it's too small, your baby may become frustrated and tired trying to get enough formula.

One way to check hole size is by turning the bottle upside down and watching the formula drip out, says Luttkus. If the formula comes out in a stream, buy nipples with smaller size openings. If formula won't come out until you squeeze the bottle, either buy nipples with larger holes or make the hole bigger, she says. To do this, boil the nipples for a couple of minutes in water and, while the nipples are still hot, use a needle to enlarge the hole.

You also need to keep aware of nipple hole size as your baby grows, says Luttkus. Nipples intended for newborns have smaller holes and are shorter than nipples for older infants, so if you're still using newborn nipples with your eight-month-old, it's time to make a change.

Replace aging nipples. Saliva and heat cause rubber to deteriorate. Change bottle nipples as soon as they begin to get rough or sticky, says Luttkus. Once a nipple starts sticking to itself or collapsing, your baby will have a much harder time feeding. "Most nipples have about a six-month life span," says Luttkus.

Hold on to the bottle. A parent with a million things to do may want to prop up the bottle so the baby can eat on her own. But babies need the cuddling and closeness that's a part of feeding, says Luttkus. "Look at your baby, talk to him," she advises. "It's important to have one-on-one time."

Also, a baby left alone with a bottle can choke if milk runs down her throat, cautions Dr. Eden. And when a baby lies flat on her back to drink, milk may back up into her throat and eustachian tube, possibly causing an earache or ear infection.

Get the right tilt. Start out holding your baby's bottle at a 45-degree angle, and raise the end as the baby feeds, recommends Luttkus. "Watch the neck of the bottle and keep it tilted so you don't get an air bubble," she says.

Alter positions. If your baby tends to spit up more than once during feedings, a change of position may help. Pediatricians haven't found one "correct" way to hold your baby while you feed him. So you need to try out various angles until you find one that agrees with your baby. "The best position depends on each baby's esophagus and gastrointestinal tract," explains DeVito-Agins.

Go with the flow. Don't expect your child to drink a full bottle at noon today just because she took a full bottle at noon yesterday, says Dr. Eden. "Appetite varies from day to day," he explains.

You also shouldn't live by the clock. If it's a half hour before your baby's usual eating time, and he's fussing and seems hungry, feed him. Or if he naps past his usual feeding time, let him sleep and feed him when he awakens.

Clue in to the signals. Your baby should be the one to decide how much he eats, says Dr. Eden. "When a baby stops sucking vigorously or starts squirming or looking around the room, that should signal the end of the feeding," he says. Never urge the rest of a bottle on a child who doesn't want it. "Don't force every last drop down your baby," says Dr. Eden. It's better to throw formula out than to have your baby overeat.

And don't hesitate to give more than the amount you measured out if your baby wants it, adds Dr. Eden: "If the baby drains the bottle in a few minutes, there wasn't enough in it in the first place."

Learn your baby's cries. "Babies cry for a lot of different reasons: because they're hungry or cranky or gassy or lonely," says Dr. Eden. "Most parents can learn to differentiate the different types of messages from crying." Another clue is timing. If it has been less than two hours since the last full feeding, it isn't likely that the baby is hungry. There may be another problem that needs attention.

Give some attention without the formula. If you doubt that your child is hungry and can't find any other reason for her fussing, try cuddling her, smiling at her or taking her into another room for a change of scene, suggests DeVito-Agins. Your baby may just want attention. "Ask yourself if feeding time is the only contact the baby has with you," says DeVito-Agins. "If so, she may demand to eat more often, just because she needs more of your time."

Know when to switch to milk. At a year, children are usually ready to switch from formula to whole pasteurized milk, says Dr. Eden.

When to see the doctor

For some bottlefeeding problems you'll need to consult with a pediatrician.

Your baby could have a stomach problem or might need a different type of formula if she isn't gaining weight adequately or doesn't suck vigorously, points out Dr. Eden. Other signs of possible feeding problems are loud crying after feeding, accompanied by vomiting and/or diarrhea with blood.

Since some babies are allergic to milk products, just switching to another kind of nonmilk-based formula could solve the problem. But you need a doctor's advice before doing so.

Nix the Bottle at Naptime

A bottle may seem like the perfect way to soothe a toddler to sleep--but pediatric dentists are strongly against it.

When a child falls asleep with a bottle in her mouth, the formula, milk or juice stays there and ferments, explains Heidi L. Hills, D.M.D., chief of the Section of Pediatric Dentistry, Preventive Dentistry and Behavioral Sciences at Columbia University School of Dental and Oral Surgery in New York City. If your baby's teeth have started to emerge, that naptime or nighttime bottle can cause the top front teeth to decay rapidly.

While your child sleeps, he doesn't manufacture much saliva or swallow very often, notes Dr. Hills. The sugars in juice or milk form an enamel-dissolving acid when they combine with bacteria present in the mouth, resulting in early tooth decay.

If you must put your baby to bed with a bottle, put only clear water in it, advises Dr. Hill. Or try a pacifier instead.