Q: How the heck do I pick which bottle to go with?
A: "You won't know which your child will like until he tries it," says Hollie Schultz, mother of three and founder of BabyGizmo.com, a product-review site. So poll your mommy friends to get three suggestions. Then "buy one of each and do your own testing when your baby arrives," Schultz suggests. Newborns take in only a couple of ounces at a time, but babies ramp up their eating quickly, so going straight for the bigger bottles could save you money. Can't resist registering for a starter set? "It's best to purchase bottles with features that minimize air bubbles, such as drop-in inserts, vents, or an angled top, because you may have to buy these later anyway if Baby turns out to be gassy," says Jennifer Shu, M.D., a pediatrician in Atlanta and coauthor of Heading Home With Your Newborn. An insider's secret for moms who plan to pump: Buy bottles that are the same brand as your breast pump. "That way, you can express your milk directly into the bottle you'll use later," says Holly Hosler, mom of an 11-month old in Baltimore. One less thing to wash!
If this is your second child, it's best to invest in new bottles for him, says Erika Landau, M.D., a pediatrician in New York City and coauthor of The Essential Guide to Baby's First Year. The older, used ones might not meet current safety or environmental standards. Also, they may release bisphenol A (BPA), a chemical associated with toxic effects on the brain and reproductive organs, because they've probably been warmed countless times and may have scratches. If you do decide to reuse your first child's bottles, be sure they're free of BPA, Dr. Landau says. Most major brands were made with BPA until a few years ago, when bottle manufacturers virtually phased out the chemical. If an older bottle has a recycling code of 7 and isn't labeled BPA-free, or if it has no code at all, chuck it. And always buy new nipples!
When to Introduce the Bottle
Q: I'm planning to nurse and use bottles. When do I introduce the bottle?
A: It's important that Baby gets the hang of breastfeeding before you offer him a bottle, and this process often takes 4 to 6 weeks, says Gina Ciagne, a certified lactation counselor and senior director for professional relations at Lansinoh Laboratories. Infants who are given bottles earlier than this sometimes develop a preference for the bottle, which requires less effort than nursing. Once a baby learns the proper nursing technique, he's less apt to favor the bottle. If your baby is a nursing like a champ at 2 or 3 weeks, it's fine to offer a bottle, Dr. Shu says. But proceed cautiously: If she prefers the bottle, offer it less often for a week or two.
You don't want to wait too long either. "If you go much past 6 weeks, your infant may refuse the bottle," Dr. Shu says. "If you leave Baby with Grandma for an hour, she'll scream and hold out for milk until Mom comes home." That's no fun for anyone!
Q: My baby is fussy during feedings. Does he need a different type of bottle?
A: Maybe -- but there are other things to troubleshoot first. If your sweet pea looks as if he's sucking fiercely (the nipple may even invert) and he's becoming frustrated, you may need to bump up to the next nipple level, which will allow milk to flow faster, Dr. Landau says. If, on the other hand, there's so much milk flowing from the bottle that it's pouring out of his mouth, "he might need a nipple with a smaller hole." (Newborn nipples are known as level 1. The bigger the number, the larger the hole.)
Gas is another reason babies fuss, Dr. Landau says. To reduce it, hold baby so his head is higher than his tummy, and be sure the nipple is always filled with milk. Loud sucking could indicate that he's taking in too much air, but it could just mean he's a loud mouth! In any case, stop after four or five minutes to burp him.
Another possibility? Baby doesn't like the taste of what's in his bottle. Perhaps your pumped milk is strongly flavored by something you've eaten (garlic or onions?), or he isn't digging the formula you've selected. Consider that he's simply not hungry or -- wait a minute! When was the last time you changed his diaper? If you've checked into each of these scenarios and Baby still fusses at most feedings, go ahead and try another kind of bottle.
Is Heating Necessary?
Q: Do I need to heat up my baby's bottle before I feed it to her?
A: It's not necessary, but some little ones prefer their meals heated. No need to buy a warmer: Just fill a large glass measuring cup or a small saucepan with hot water, and submerge the bottle for a minute or two. "Never heat a bottle in a microwave," Dr. Landau advises. "Doing so creates hot spots that can burn Baby's mouth." Zapping breast milk can also destroy proteins and vitamins that are important to your sweetie's health.
Q: Sometimes my baby loses interest in his bottle. Can I save the rest for later?
A: You don't have to throw out the breast milk or formula immediately. Set the bottle aside at room temperature, cap it, and see if Baby is hungry again in a bit. If after an hour, he's still not interested, dump it. "Bacteria can be transferred from Baby's mouth to the bottle," Dr. Shu says. "If the bottle has been sitting out longer than an hour, the bacteria can multiply quickly and may make your child sick." Same goes if you put the bottle in the fridge. Bacteria can breed there, too, Dr. Shu says, so it's best to play it safe and toss the bottle after an hour. To avoid wasting formula or breast milk (liquid gold!), divide a feeding into smaller bottles, Dr. Shu recommends. For instance, if your 1-month-old typically takes 4 ounces at a sitting, make a 2-ounce bottle, and have another 2-ouncer available should he need it, if you don't mind washing an extra.
Q: What's the best way to clean a bottle?
A: "Sterilize new parts and nipples in boiling water for five minutes before the first use," Dr. Landau says. After that, a thorough wash in hot, soapy water is fine. Be sure you get into all the little nooks with a detail brush. Cleaning bottles in the dishwasher works too. (Oxo sells a basket that keeps all the small parts contained.) Then let the bottles and all their components air-dry thoroughly. (A bottle-drying rack is helpful.) If you must store parts before you're sure they're completely dry, wipe with a soft cloth or paper towel first.
Q: Are bottles bad for my little one's teeth?
A: Bottles aren't bad for babies' teeth; it's the frequency of exposure to any beverage containing sugar, in this case breast milk or formula, that's the problem, says Rhea Haugseth, D.M.D., president of the American Academy of Pediatric Dentistry. Sugars pool on the teeth, creating an environment where cavity-causing bacteria produce the acid that can lead to teeth decay. That's why pediatricians recommend that you start to wean your baby from the baba by his first birthday (with the goal of giving up bottles entirely by the time he's 15 months) so as to eventually limit drinks, except for water, to mealtimes. "Any time Baby drinks milk, even from a sippy cup, it starts a 20-minute acid attack in the mouth," Dr. Haugseth says. Gulp!
Boggled by all the options in the feeding supply aisle of the baby store? It helps to know that the bottles tend to differ in four main ways.
They come in different levels. Replace them as Baby is ready for the next size or when they are cracked, discolored, or thinning. You can also choose the material: Silicone is firm; latex is softer and doesn't last as long.
Some are straight, others contoured or wide. A bottle with a broader neck is easier to clean.
No one really knows what causes colic, but bottles with angled tops and special venting features can limit the amount of air that Baby takes in, reducing gas and spit-up.
BPA-free plastic, glass, and stainless steel are all good choices if you're looking for an unbreakable or eco-friendly bottle.
Originally published in the March 2012 issue of American Baby magazine.
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