Bottle Feeding Your Newborn

Breastfeeding is best!

This admonition features prominently on cans of infant formula and on advertising for breast milk substitutes in many third-world countries, and there is little doubt that it is true. Because of poverty, poor hygiene and poorly prepared formula, bottle-feeding should be actively discouraged in such areas.

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Although cow's milk is part of the normal diet of most Western nations, it is not suitable for young babies. The naturally intended food for babies is breast milk, and a baby who is not being breastfed must be fed with special formulas developed to approximate breast milk, which has more sugar and less protein than cow's milk. Most formulas are based on cow's milk but have been extensively modified by removing or adding appropriate food groups, vitamins and minerals. They are usually marketed in a dried or concentrated form, and have to be reconstituted with boiled water for use.

Provided the manufacturer's instructions are followed exactly, most babies will thrive on formula. It is quite wrong to think that a slightly stronger formula might give the baby more nourishment. If you make the mixture stronger than the manufacturer recommends, the baby will get too much fat, protein, minerals and salt, and not enough water.

A baby needs time to develop its resistance to infection. Bacteria exist in all environments, and our homes are no exception. Most of us have developed immunity to common germs, and even young babies are able to fight off germs that are inhaled or sucked off hands. Feeding is different. Milk, especially when at room temperature, is an ideal breeding ground for bacteria, and it is therefore essential that formula is prepared in a sterile environment. Bottles, utensils, measuring implements, teats and anything used in the preparation of a baby's food must be boiled and stored in one of the commercially available sterilizing solutions. You should also wash your hands before embarking on preparation. Made-up formula must be stored in the refrigerator. If these precautions are not followed, the baby may develop gastroenteritis and require hospitalization.

You should allow your baby some say in how much food s/he needs. You will generally be advised by the hospital or baby health clinic how much to offer the baby (calculated according to weight), but just as breastfed babies have different needs that can vary from feed to feed, so too do bottle-fed babies. Mothers often feel that the baby should finish the last drop in the bottle. But breastfeeding mothers have no means of measuring out the quantity the baby will receive (other than weighing the baby before and after a feed) and how much is left over, and mothers giving a bottle should adopt the same approach. Within reason, babies can generally be relied upon to assess their own needs quite satisfactorily.

Just as with breastfed babies, it is generally considered best to feed a baby as and when they are hungry. In the first few weeks this may be at irregular and frequent intervals. After all, in the womb, the baby's food was constantly replenished. It takes about three or four hours for a feed to be digested, and as the baby's digestive system matures, signs of hunger will normally settle down into a regular pattern.

A baby who is fed according to a rigid four-hourly schedule will go through the same process - except it is likely to make life miserable for everyone. After a few weeks the baby will happily accept the routine because it fits in with their natural requirements, but in the meantime you will have a fretful crying baby and have to expend a great deal of effort in trying to find other means of comfort.

The rate at which babies feed also varies. Some like to gulp down their formula, while others like to take things easy. The rate of feed can upset a baby if it is too fast or slow for its liking. Teats with different hole sizes can be purchased, and a small hole can be enlarged with a hot needle. Frequent breaks from the bottle during a feed in order to let a burp come up and the milk go down can also smooth the progress of the feed and avoid stomach discomfort afterwards.

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