Your Step-by-Step Guide to Bottlefeeding

If you've recently decided to bottlefeed your newborn, you're probably full of questions about formula preparation, sanitizing utensils, feeding positions, and burping techniques. Here are seven steps for successfully bottlefeeding your baby.

1. Make sure all bottles, nipples, and other utensils are clean. If the water in your home is chlorinated, clean the utensils in your dishwasher or wash them in hot tap water with dishwashing detergent and then rinse them in hot tap water. If you have well water or nonchlorinated water, either place the utensils in boiling water for five to 10 minutes or use a process called terminal heating.

In terminal heating you clean, but do not sterilize, the bottles in advance. You then fill them with the prepared formula and cap them loosely. Next, the filled bottles are placed in a pan with water reaching about halfway up the bottles, and the water is brought to a gentle boil for about 25 minutes.

2. Read the directions. Be sure to follow the manufacturer's directions exactly for the formula type you choose. Too much water and your baby won't get the calories and nutrients she needs; too little water and the high concentration of formula could cause diarrhea or dehydration.

3. Prepare the formula. Bring the water you plan to use in the formula to a boil for approximately one minute. Then add it to the formula powder. If you're preparing this in advance, be sure to store it in the refrigerator. If the formula is left out of the refrigerator for longer than one hour or if you don't use refrigerated formula within 24 hours, throw it out.

4. Warm the refrigerated formula. Refrigerated formula doesn't necessarily have to be warmed up for your baby, but most infants prefer it at least at room temperature. The easiest way to warm refrigerated or frozen milk is to place the container in a pan of water on the stove at low heat and rotate it frequently. Microwave ovens should not be used for heating bottles; this can overheat the milk in the center of the container. Even if the bottle feels comfortably warm to your touch, the superheated milk in the center can scald your baby's mouth. Also, the bottle itself can explode if left in the microwave too long.

If you warm a bottle or use it immediately after terminal heating, test it in advance to make sure it's not too hot for your baby. The easiest way to test the temperature is to shake a few drops on the inside of your wrist.

5. Place your baby in a feeding position. Cradle her in a semi-upright position and support her head. Don't feed her lying down -- formula can flow into the middle ear, causing an infection. To prevent your baby from swallowing air as she sucks, tilt the bottle so that the formula fills the neck of the bottle and covers the nipple.

6. Take note of your baby's intake. The pediatrician will probably ask you how much your baby has eaten, so be prepared to answer the question. Your newborn will probably take between two and four ounces per feeding during his first few weeks (during the first few days, he may take less than an ounce at feedings), and will probably be hungry every two to four hours. It's best to feed your baby on demand. Don't encourage your baby to finish the bottle if he's not interested. And if he's still sucking enthusiastically when the bottle is empty, offer him more.

7. Burp your baby. Babies get fussy and cranky when they swallow air during feedings. This happens more often with bottlefed infants, though breastfed infants can also swallow air. To prevent a tummy full of air, burp your baby frequently -- after every two or three ounces of formula. If your baby doesn't burp after a couple of minutes of trying, resume feeding. Here are the three best positions:

• Over the shoulder: Drape your baby over your shoulder and firmly pat or rub her back.
• On the lap: Sit your baby upright, lean her weight forward against the heel of your hand, and firmly pat or rub her back.
• Lying down: Place baby stomach-down on your lap and firmly rub or pat her back.

Source: Caring for Your Baby and Young Child: Birth to Age 5 (Bantam)

All content here, including advice from doctors and other health professionals, should be considered as opinion only. Always seek the direct advice of your own doctor in connection with any questions or issues you may have regarding your own health or the health of others.