Although it is strongly recommended that women breastfeed their babies, for a variety of reasons some mothers may choose not to, or may be unable to breastfeed. When breastfeeding is not an option, the only acceptable alternative to breastmilk is commercial iron-fortified infant formula. Babies should be fed either breastmilk or formula, or a combination of both, for at least 12 months according to American health guidelines, or for at least 9 to 12 months according to Canadian guidelines. Despite popular belief, cow’s milk is not suitable for children younger than 9 to 12 months. Neither are “homemade” formulas, which are nutritionally inadequate, and may even be harmful.
Are infant formulas safe?
Today, commercial infant formulas are designed to imitate the content and performance of human milk as much as scientifically possible. However, there are no formulas which are perfectly identical to breastmilk, nor as perfectly designed for your baby. But commercial formulas are a safe and nutritious alternative to breastmilk when breastfeeding is not an option.
If you’re considering using formula to feed your baby, consult your doctor about the type of formula that is best suited for your baby’s particular needs. The formula you use should be iron-fortified and contain the recommended levels of other vitamins and minerals. Contrary to popular belief, research has shown that iron in formula does not cause constipation. Iron-fortification is important as it helps protect your baby from developing iron deficiency anemia, a serious condition which can lead to long-term delays in mental and physical development (for additional information, please see Preventing Iron-Deficiency Anemia During Infancy). Additional vitamin supplements are generally not needed for formula-fed babies.
How much formula does my baby need?
During the first few weeks, formula-fed babies need to drink between two and a half to three ounces of formula per pound daily. For example, a 10 pound baby will need to drink about 25 to 30 ounces of formula per day. In addition, during this time, your baby will need to drink quite frequently; during the first week, your baby may have 6 to 10 feeds per 24 hour period, 6 to 8 per day by one month, 5 to 6 per day by 3 months, 4 to 5 per day between 3 to 7 months, and 3 per day after 8 months of age.
Commercial formulas come in a variety of forms. Ready-made types come in disposable, sterile bottles, or in cans for pouring into bottles at home. Concentrated and powdered formulas are also popular, and tend to be less expensive. These need to be diluted and poured into bottles before serving. Be sure to read instructions for these types of formula carefully. It’s very important that directions for mixing be followed exactly. Incorrectly mixed formula can result in malnutrition if it is too diluted. Formula which is made too concentrated can also be dangerous as it is too difficult for a baby’s system to metabolize.
For your baby’s first three months, water used in formula should be sterilized by boiling it. Many people aren’t aware that bottled water is not sterile. If you use bottled water to mix your baby’s formula, boil it first as you would with tap water.
No matter which type of formula you use, always check packaging for the expiration date. Discard any formula which is past due. Storage instructions should be read and followed carefully. Do not reuse formula which is leftover in the bottle after a feeding – it can easily become contaminated with bacteria.
Bottles and containers used to prepare formula should be sterilized or washed in very hot soapy water to avoid contaminating the milk with germs. Never warm formula on the stove, or in the microwave. Excessive heat can destroy important nutrients in the milk, and can burn your baby’s mouth. Microwaves are particularly dangerous as they heat unevenly, often giving a false impression of the actual temperature of the milk. Formula can be served at room temperature, or warmed slightly by immersing the bottle in lukewarm water, then shaking it to distribute the heat evenly.
A word of caution
Never leave your baby with a propped bottle – this could cause your baby to choke. Until your baby has developed the coordination to hold the bottle herself, hold both her and the bottle during a feeding. Besides, holding and cuddling your baby while feeding her will strengthen the bond between you – so enjoy this time together!
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Pediatrician DR.PAUL Roumeliotis is certified by the American Board of Pediatrics and Royal College of Physicians and Surgeons of Canada. The information provided above is designed to be an educational aid only. It is not intended to replace the advice and care of your child’s physician, nor is it intended to be used for medical diagnosis or treatment. If you suspect that your child has a medical condition always consult a physician.