The Equipment
Sterilising options
Infant formula
Milk to avoid in baby’s first year
Milk allergy and lactose intolerance issues
Making up the Infant Formula
Feeding Tips
The feeding timetable
Bottle Feeding on the go
Storing or keeping Formula
Bottled water and infant formula

The Equipment

Infant Formula milk

Feeding Bottles

Bottle brush and teat brush

Sterilising equipment

Fast boil kettle

 

Feeding bottles

It is advised you start off with at least 6 bottles because your baby is likely to eat a minimum of about 6 times a day.

Below are the different bottle types you could choose from

  • Glass bottles

This is the pick of moms who are concerned about the chemicals in plastics and the environmental disadvantages of using plastics

Pros

Environmentally friendly if recycled + Doesn’t stain + Lasts long + Can be deep cleaned by boiling

Cons

Breakable + Heavier than plastic bottles

  • Disposable bottles

These are re-usable plastic bottles which use disposable, sterilized liners. So, these liners are fitted into bottles, filled with milk and thrown away when baby is done feeding

Pros

Convenient to use when out

Cons

Bottles are expensive + Constant replacement of disposable inserts is costly + Generates waste

  • Anti colic bottles

It is believed that swallowing air along with milk is a possible cause of colic. So, these bottles have been designed to have air vents, tubes or collapsible vents which help to reduce the amount of air swallowed while feeding.

Pros

May help to reduce colic

Cons

More expensive + More tricky to clean + Cannot guarantee reduction or prevention of colic

  • Standard bottles

All plastic feeding bottles are made of food grade plastics. Hence, what differentiates them are their shapes, sizes and patterns. It is advised you go for any which allows for easy and thorough cleaning.

Pros

Lightweight + Strong + Unbreakable + Least expensive + Widely available + Likely to fit accessories like coolers, sterilisers, etc

Cons

May not last as long as glass bottles

 

Teats

Teats can be categorized based on what material they are made of, their shape and their flow rates.

Teats are made of either latex or silicone. Silicone teats are reputed for being more durable while latex tend to be softer and more flexible, feeling more like a nipple.

Teats can be rounded, flat, wide or natural shaped. Natural shaped teats resemble nipples.

Teats can also be punctured to have slow, medium or fast flows.

When it comes to type of material and shape, there is no evidence as to which teat type is better and there is also no hard or fast rule as to which your baby will prefer. Hence you’re better off with a trial and error method where you try out one teat after another until you get to the one which your baby is obviously compatible with.

However as for flow rate, it is advised you begin with a slow flowing teat for new-borns (who are just learning the art of sucking) in order to prevent situations like choking, spluttering and leaking. As your baby grows and gets more comfortable and skilled at bottle feeding you can make the move to medium flow and then later, fast flow. A sign that your baby is ready for a faster flowing teat is if he gets frustrated as he sucks hard on the slower flowing type.

There are special teats called variflow. They will automatically increase the flow of milk as your baby’s sucking increases or when you rotate the teat and bottle into different positions.

Expect teats to deteriorate with use, more so faster if your baby’s teeth have started shooting out or if you use boiling to sterilise your bottle feeding equipment. Hence it is advised you purchase more teats than bottles.

 

Sterilising options

Compared to adults, babies are much more susceptible to illnesses because their immune systems are not as well developed. Therefore it is paramount that all feeding equipment be sterilised before every use.

However, before sterilising…

  • Wash all equipment in hot, soapy water. Note that it is best to wash all equipment immediately after feeds in order to prevent milk from drying up on them
  • Use a bottle brush for washing bottles
  • To wash the inside of teats thoroughly, turn them inside out
  • Rinse all washed equipment in cold running water

Then, after thorough washing and rinsing, below are different sterilising options to pick from…

Cold water sterilising solution

This involves dissolving the sterilising solution (which sometimes come in tablet form) in cold water and then soaking the equipment in it for at least 30 minutes. Ensure that bottles and teats have no trapped air when put into the solution. Use a floating cover to keep all equipment under the solution for the allotted time. Sterilising solution must be changed every 24 hours and before proceeding with this procedure, manufacturer’s instructions must be read and followed.

Steam sterilising (Electric steriliser or microwave)

This involves using an electric steriliser or microwave. Since every steriliser is different, manufacturer’s instructions must be read and followed for all the nitty gritty on use.

While sterilising, ensure all openings of the bottles and teats are facing downwards

Sterilising by boiling

This involves boiling all equipment over the fire for a minimum of 10 minutes. Ensure all equipment are safe to boil and kept below the water surface while boiling.

Remove the bottles just before use. However if bottles are not to be used immediately, assemble them fully to prevent contamination.

Note that teats get damaged faster with this method. So be sure to regularly check bottles and teats for cracks, tears and other damages

 

Infant formula

Normally children under one are advised not to drink cow’s milk. Hence it may surprise you to know that most infant formula are made of cow’s milk. However this milk has been treated to become suitable for babies. It usually contains a mix or one of two types of protein; whey and casein; and can be categorized as explained below…

First infant formula

  • It is most suitable for new-borns because it is easier to digest than other infant formula
  • It is based on whey of cow’s milk
  • It can be used up to one year of age

Casein based infant formula

  • It takes longer for babies to digest and hence is not recommended for young babies
  • When compared to first infant formula, it has little nutritional difference
  • It is said (but not proven) to be suitable for hungrier babies

Follow on formula

  • It is casein based
  • It must never be used for babies younger than 6 months
  • Some have cereal added to it but there is no real evidence that it helps babies feed longer and better and sleep longer

Soya infant formula

  • It is made from soya beans
  • It should not be served to your baby except the doctor recommends it

Goats’ milk based formula

  • It is made from goat milk
  • It should not be fed to your baby if he is allergic to cow milk

*Labels of first infant and follow on formula are similar. So you have to carefully read all labels in order to avoid mix ups

 

Milk to avoid in baby’s first year

  • Condensed milk
  • Evaporated milk
  • Dried milk
  • Sheep’s milk
  • Goats’ milk
  • Any drink known as milks
  • Cows’ milk as a drink

 

Milk allergy and lactose intolerance issues

Cows’ milk allergy

This is one of the most common food allergies in babies. It is a reaction by the immune system and is usually outgrown by the age of 3. However note that about 20% of adults still have this allergy.

Symptoms

  • Skin rash
  • Diarrhea
  • Vomiting
  • Stomach cramp
  • Difficult breathing
  • Anaphylaxis

Treatment

See a doctor who is likely to recommend an extensively or fully hydrolysed formula where the milk proteins are broken down into smaller parts, making them easier to digest.

Note that formula with partially hydrolysed protein is still not suitable for a child with cows’ milk allergy because not all the allergy triggering properties in the proteins have been broken down.

Cows’ milk protein intolerance

This is a reaction which doesn’t involve the immune system. It is often outgrown by the time the child starts school

Symptoms

  • Diarrhea
  • Vomiting
  • Stomach cramps
  • Eczema sometimes

Lactose Intolerance

This occurs if your baby’s body cannot break down and absorb lactose, which is the natural sugar found in milk. Sources of lactose include milk, dairy products, chocolates, cakes, medications (some medications contain a small amount of lactose), etc.

Symptoms

Lactose intolerance is very rare in babies. However if a baby happens to have it, the following symptoms are likely to show up 30 minutes to 24 hours after taking breast milk, dairy products or any other food containing lactose…

  • Diarrhea
  • Vomiting
  • Bloated stomach
  • Stomach pain
  • Wind

It is important that the above symptoms are discussed with a doctor because there are cases of kids exhibiting temporary symptoms of lactose intolerance when recovering from severe diarrhea or after taking certain medications

Treatment

Lactose intolerance cannot be treated or prevented. However, the situation can be helped by avoiding all food that contains lactose.

However, considering that milk and dairy products are good, essential nutrient sources, there are now lactose free dairy products and formula. Hence, you are advised to try out these options. However if you choose to go the route of eliminating all dairy products from your baby’s diet, ensure you replace them with food containing the lost nutrients and vitamins.

 

Making up the Infant Formula

Sealed tins of powdered infant formula could contain a rare bacteria which can sometimes be life threatening. Whether cooled or kept at room temperature, this bacteria survives. However its rate of multiplication is higher at room temperature. Hence to reduce risk of infection, formula must be made up one feed at a time and freshly boiled water must always be used. In order to ensure the boiled water stays at a temperature which will kill harmful bacteria, ensure it cools for nothing more than 30 minutes before adding the formula to it. You can then allow it cool further before feeding it to your baby.

Below are steps to follow when making up formula:

  • Boil fresh water in a kettle and cool for nothing more than 30 minues. Never use previously boiled water
  • Wash your hands before retrieving the sterilised bottles
  • Retrieve sterilised bottles from the steriliser. If you used cold water sterilising solution, shake off excess solution from the bottle and teat or rinse them with freshly boiled water
  • Stand the bottles on clean, disinfected surfaces but keep the teat and cap on the upturned steriliser lid
  • According to manufacturer’s instructions, make up the formula mix
  • Test the temperature of the milk on the inside of your wrist
  • If the milk feels warm or cool, you can serve your baby. But if it is hot, hold its bottom half under cold, running water until it cools down. Ensure this water does not touch the cap covering the teat

Other points to note

  • To avoid constipation or diarrhea, ensure the ratio of milk to water is as clearly directed on the label
  • Left over milk must always be thrown away
  • Don’t add sugar or cereal to the feed
  • Never warm infant formula in a microwave because it can heat unevenly and may burn your baby’s mouth

 

Feeding Tips

  • Get into a comfortable position before you begin feeding your baby
  • Your baby should be held fairly upright with his head supported in order to allow for easy breathing and swallowing
  • To avoid air intake (which could possibly lead to colic), keep the teat full while feeding.
  • A flattened teat (during feeding) means a vacuum has been created. To remove this vacuum, gently pull the corner of your baby’s mouth
  • Blocked teats should be replaced with another sterile teat
  • Breaks (which may or may not involve burps) may be needed in between feeds
  • To bring up winds at the end of feeds, your baby should be held upright while gently rubbing or patting his back
  • To avoid choking, your baby must never be left alone to feed with a propped up bottle

 

The feeding timetable

Babies are best fed on demand. That is, feed them whenever they show signs of hunger which include sucking on things (usually their fingers) and moving their heads in search of the bottle.

You can expect your new-born to require very little feeding at the beginning. However by the end of his first week and until he turns 6 months, you can expect his daily demand to go up to about 150 – 200ml per kilo of his weight per day. Note that big feeds are not necessarily indications that your baby will want longer breaks in-between feeds.

Weight gain and the number and type of wet and soiled diapers are indications of whether your baby is getting enough of the right kind of formula mix. A few days after birth you should expect about 6 wet diapers a day and pale yellow or yellowish brown stools.

 

Bottle Feeding on the go

If you have to feed your baby outside your home, you are left with one of two choices…

You can make up the formula at home and cool it at the back of the fridge for a minimum of one hour before leaving the house. Then, just before leaving the house, remove it from the fridge and store it in a cool bag with ice packs. This formula must then be used up within 4 hours.

Alternatively, you can carry the sterilised bottle, unprepared formula and hot water along with you, in a bag. When needed, you can then make up the required feed.

Now, rather than carrying the entire tin of formula along, you can simply pour the required quantity into a clean bowl and then tightly seal it up. The hot water can be poured into a vacuum flask and then properly sealed. Doing this will, for several hours, keep the water above 70C which is sufficient temperature to kill any bacteria present in the formula. Note that the flask doesn’t have to be sterilised before use because the hot water will kill any bacteria contained within the flask.

 

Storing or keeping Formula

  • If stored in the fridge use within 24 hours
  • If stored in a cool pack with ice, use within 4 hours
  • If stored at room temperature, use within 2 hours

 

Bottled water and infant formula

Bottled water is usually not sterile and often contains too much salt or sulphate. Hence it is usually not recommended for making infant formula.

However if you are unsure of your drinking water from the tap, buy and boil any bottled water which has less than 200mg a litre of sodium (Na) and no more than 250mg a litre of sulphate (SO).

 

(Source- Nhs, which.co.uk, webmd, Picture courtesy: pinterest, dairyreporter, baby-store.co.uk, breastfeedingmom.com, ehow.com, mothercare.com, bloginabottle.com, istockphoto.com)