Formula feeding

A first stage formula milk of any brand will meet all your baby’s nutritional needs and is easier for them to digest. 

It’s advisable they stay on the first stage milk until they’re one year old when they can have cows milk. There is no need to buy any follow on  or growing up milks  

If you think your baby may be allergic to their formula milk it’s important to speak to your GP or health visitor.

It’s important not to give goat’s milk to babies with cow’s milk allergies. 

Should my baby move onto different formula milk as they grow up?

There’s no scientific evidence to suggest that offering your baby hungrier baby milks, second milks, toddler or growing up milks offer your baby any additional nutritional benefits.

Anti-reflux, comfort, lactose free, hypoallergenic and soya formula milks should only be used under medical advice from your GP and health visitor.

How to prepare formula milk safely

Good hygiene is crucial when you’re making your baby’s formula milk, it’s recommended to make it when your baby needs it, not before.

Your baby’s immune system is less developed than an adult’s, so there’s a chance they can get ill if you don’t follow the instructions and powdered infant formula is not a sterile product once opened so careful preparation ensures that any bacteria present is killed by using water above 70 degrees.

Here is a step-by-step guide on how to safely make your baby’s formula milk, plus other important information about making a formula feed safely.

Step 1. Empty your kettle and refill with at least one litre of fresh tap water. Do not use bottled water.

Bottled water isn’t sterile and contains too much sodium which can be harmful to your baby. However, if you don’t have access to tap water, you’ll have to use bottled water. To do this safely you must read the label to make sure:

• The sodium level (written as Na) is less than 200 milligrams (mg) per litre
• The sulphate level (written as SO or SO4) is less than 250mg per litre
• Remember that bottled water is not sterile so would still need to be boiled before using it

Step 2. Boil the kettle and leave to cool for no longer than 30 minutes to ensure that the water remains above 70 degrees celcius.

Step 3. Clean the preparation area and wash your hands thoroughly.

Step 4. Place your baby’s sterilised bottle/teat on the clean preparation area. If you’ve used cold water sterilisation, shake off the excess sterilisation solution and rinse with cool boiled water from the kettle.

Step 5. Pour boiled water into your baby’s bottle making sure the water level is correct for the feed you’re going to make.

Step 6. Loosely fill the scoop that came with your tin of formula milk and level off with the edge of a clean knife. Always ensure you follow the manufacturer’s instructions.

Step 7. Carefully handle the edge of the teat and put it on the bottle with retaining ring and bottle cap, then gently swirl the bottle until the powder has dissolved. Vigorous shaking increases air bubbles

Step 8. Cool the bottle for your baby by holding the bottle under cold running water.

Step 9. Test the temperature of the feed on the inside of your wrist to ensure it’s at the right temperature, it should feel warm.

Step 10. Pour away any formula milk left in the bottle that hasn’t been used as soon as the feed is finished.

Can I use a formula preparation machine?

Preparation machines are not recommended because of a lack of evidence surrounding their safety. For further information on different formula preparation products and why they are not advised for safely preparing formula, First Steps Nutrition Trust have evidence based information: Infant Milk Safety

Important safety notes about making up formula feeds

• Always follow the formula milk manufacturers’ guidance as they can be different for different brands
• Never add extra formula milk powder to your baby’s feed. Too much can cause your baby to become dehydrated or constipated
• Not enough powder will mean your baby is not getting enough nourishment
• Never add extra sugar, rusks, cereals or anything else to your baby’s feed 
• Never use a microwave to warm your baby’s feed as this can cause burns to your baby because the feed isn’t warmed evenly
• Never cut your baby’s feeding teat or try to make it bigger as this can cause choking
• Never leave your baby to feed unsupervised or 'prop' their bottle with something when feeding.

Responding to early feeding cues contributes to a more pleasurable feeding experience for you and your baby, it can sometimes be difficult to feed a crying baby. When you start to see your baby displaying the below behaviours you can offer them a feed.

• Becoming restless and shuffling around in their moses basket or crib
• They start sucking their fist or fingers
• You may hear them smacking their lips or making murmuring sounds
• They try to root by turning their heads and opening their mouths

Your health visitor will support you to recognise these cues before your baby starts to cry. Visit baby cues for more information.

Firstly, make sure you’re comfortable and allow plenty of time to feed your baby.

• Hold your baby close to you in a semi-upright position
• Look and talk to your baby during feeding
• Invite your baby to take the teat in their mouth by brushing it against their lips
• Holding your baby’s bottle horizontally will allow your baby to pace their feed and pause between swallowing.
• Once your baby is drinking from the bottle the lips should look wide on the teat and your baby should be calmly swallowing milk.
• If your baby starts to spill milk from the sides of their mouth during the feed or slows down with their swallowing this is likely to mean that they would like a break or may have had enough.
• You may also start to notice changes in their facial features or arm positions that are signalling the need for a break or that they are full.  Give a break in the feed by either removing the teat from your baby’s mouth or lowering the bottle so that the flow of milk is paused. Giving breaks in this way allows your baby’s tummy and brain signals to ‘catch up’ with each other and for the baby to feel fullness, reducing the risk of overfeeding.
• Avoid forcing your baby to finish their feed, they may only want part of their feed sometimes which is normal.
• When your baby has finished their feed, hold them upright and gently rub or pat their back to help them bring up any wind.
• Some parents find it to helpful to use a sling or baby carrier to support their baby when feeding. You should always make sure your baby’s airway is clear and they’re well supported. Never lie a baby down in a sling or carrier to feed them as this could cause breathing problems. Carrying Matters have some great information to get you started.

Why is the time I spend feeding my baby so important to us both?

The time spent feeding your baby is very special. It’s during this time that you’ll start to build a close bond and get to know each other.

Keeping your baby close to you will help your baby feel safe and secure as they adjust to life outside your womb and it helps you recognise your baby’s feeding cues.

Your baby should be in the same rooms as you for the first 6 months of their life. This will help you with responsive feeding and has also been proven to reduce the risk Sudden Infant Death. It’s impossible to spoil your baby with love and affection. 

We encourage you to limit the number of people who feed your baby. It’s important for you to get to know your baby’s feeding cues, so you can respond to their feeding needs. 

The amount of formula milk your baby will need will vary as every baby is different.

Newborn babies will only take very small amounts of formula milk because their stomachs are very small and unable to tolerate a large amount of milk.

As a general guide, after your baby’s first week, they’ll be taking 150-200ml per kg of their weight per day until they’re around the age of 6 months. 

When you start to wean your baby, they’ll take less formula milk as they start to eat more solid foods, this is normal. 

How can I tell my baby is getting enough milk?

As long as your baby is producing 6-8 wet nappies and at least 2 dirty nappies per day and they’re putting on weight consistently you can be assured your baby is getting enough formula milk. 

If you’re worried about any aspect of your baby’s feeding, please talk to your health visitor. 

• Fill a vacuum flask with boiling water and then measure out the desired amount of formula milk powder in a small dry container. Take a sterile feeding bottle with you and make the feed as needed by your baby.
• Use ready-made formula which is sterile, therefore all you need to take with you is a sterilised feeding bottle.
• Some parents find to helpful to use a sling or baby carrier to support their baby when feeding out and about. You should always make sure your baby’s airway is clear and they are well supported. Never lie a baby down in a sling or carrier to feed them as this could cause breathing problems. Safe Feeding in a Sling.

You may qualify for Healthy Start scheme which will also entitle you to free vitamin drops for your baby. Healthy Start is a national means tested scheme to help families give their children the very best start in life. 

If you’re pregnant or have a child under the age of 4 years you could be entitled to a Healthy Start card which will help you buy some basic family foods. You’ll receive weekly ‘top-up’ on your Healthy Start card to the value of around £8.50 (in your babies 1^st year of life) to spend on milk, fresh or frozen fruit and vegetables and infant formula milk. Your vitamin voucher will be attached to your Healthy Start card.

The application process is available online or via email or phone and is straightforward. How to apply.

• NHS bottle feeding advice
• NHS types of infant formula
• NCT what is the best kind formula?
• Healthy start