Top tips for a smooth transition from breast to bottle feeding

If you have chosen not to breast-feed, or if your doctor has indicated that you should bottle-feed your infant or supplement your breast milk he or she may recommend a commercially prepared infant formula.

Infant formulas have been designed to fulfil the nutritional needs of your infant by providing all known essential nutrients in their proper amounts. Most formulas have a protein base derived from cow’s milk, but a few have a soyabean base for infants who may be allergic to or have difficulty digesting the cow’s milk type protein. A majority of infant formulas contain lactose (milk Sugar) as the only carbohydrate, just as breast milk does. Lactose aids digestion and promotes normal bowel function and healthy tissue formation. A mixture of easily digested facts is also contained in the formulas. These help to protect your baby’s skin and aid in the absorption and utilization of certain vitamins.

All know vitamins necessary for the development and growth of your baby are provided by infant formulas, including vitamin A for building body cells and good vision. The B vitamins for maintaining the nervous system, skin and tissues, vitamin C for the healthy gums and teeth, vitamin D for strong bones and teeth and vitamin E for proper functioning of red blood cells. In addition, vital minerals such as calcium and phosphorus for developing bones and teeth, as well as iron for healthy blood and resistance to infection, are among the nutrients supplied in formulas. With iron fortified formulas, no supplementary vitamins or minerals are usually needed.

If your doctor has recommended bottle feeding with an infant formula product, you must follow the sterilization procedures outlined later in this chapter.

Much has been said about the possible relationship between infant feeding habits and the development in later life of health problems such as obesity, high blood pressure, and related diseases. Some feeding, such as whole cow’s milk, low fat milk or skim milk are not appropriate for new-borns, and should be avoided altogether for the first 12 months of life. Cow’s milk is fine for older children and adults, but is deficient in iron and other important nutrients required by your baby during this period, cow’s milk also contains too much protein, salt and other minerals that may place an undue burden on your baby’s body chemistry and could lead to health problems later. For these reasons, when your physician or health advisor recommends an infant formula for your baby, he or she has given much thought to preparing your infant for a healthy future through proper nutrition now.

1) Choice of bottles and teats (Nipples)

 Feeding bottle with a wide neck are easier to fill and clean. They are also better for travelling because the teat can be kept clean and protected by reversing it inside the bottle.

The teats should be properly chosen and the same type used throughout bottle-feeding. The plain-ended teat is the most satisfactory, through certain babies’ prefer the bulb-ended type. A teat with a flange at the base is easier to put on the bottle. The holes in the teat should be of such a size that the milk drips from the upturned bottle at the rate of 12-20 drips a minute. The rate of flow must be adjusted to meet the needs of the individual baby so that he can feed easily without choking.

The most important aspect of bottle-feeding is hygiene. A baby can get an upset tummy or even a severe infection from his bottle if it is not properly sterilized.

The equipment needed for feed preparation is several bottles, teats, measuring jug, spoon to mix the powdered milk, knife for levelling off, cleaning brush, large container for sterilizing, the powdered milk and boiled water.

2) Making the feed

Make a smooth paste with a little of the previously boiled water and powder and then add the correct amount of water, the exact amount of which is clearly set out in the instructions on the milk tin or packet. If you leave any lumps of powdered milk during the mixing which cannot pass through the holes in the teat, your baby will not get his full ration of milk because the lumps, will stick in the teat and block the flow of milk. This will frustrate the baby and also let him suck in air which will give him wind.

Always remember to shake a few drops of the feed on the back of your hand and feel the bottle with the inside of your arm to make sure the milk is not above. Body temperature, before you start feedings your baby.

3) Sterilizing and preparing baby’s bottles

Infants are particularly susceptible to infections caused by bacteria (germs) transmitted while feedings. You can protect your baby from many of these germs by washing your hands with clean water and soap before preparing his bottles. In addition to making sure that you always use the correct amount of feed, you must always use the cleanest, safest drinking water possible. To make sure that germs are destroyed boil the water for at least 10 minutes. It is also essential that all bottles, nipples, screw rings, and caps be sterilized before use.

Here is a list of the feeding utensils you will need.

• Sterilizer or large covered pan
• Feeding bottles and caps
• Nipples and screw rings
• Bottle scrub brush
• Tongs
• Knife

Sterilizing procedure and preparation of feed bottles

a) Wash clean hands with soap and water before preparing baby’s bottle.

b) Fill a large clean pot almost to the top with drinking water and begin heating.

c) While the water is heating wash bottles, nipples, caps, screw rings and knife in hot soapy water, then rinse thoroughly.

d) Submerge bottles nipples, caps, screw rings and knife in heating water, let water boil for at least 10 mins.

e) after boiling, remove contents with clean tongs and drain on a clean surface. Place bottles upside down. Pour water out of pot.

f) Refill clean pot with drinking water, using slightly more water than necessary to prepare formula. Again, let boil for 10 minutes. Let cool.

g) if making 60 ml of formula, that amount of cooled water into bottle.

h) fill measuring scoop provided with formula. Gently press powder into scoop with blade of knife. Do not pack tightly.

i) pass edge of knife blade across top of the scoop so that powder will be level with rim.

j) Empty contents of measuring scoop into bottle.

k) Cap the bottle and shake vigorously until the powder has dissolved.

l) Place nipple on bottle without touching part that enters the baby’s mouth. Sprinkle several drops on the back of your hand. Begin feeding baby when the drops feel neither hot nor cold.

m) when baby finishes feeding, pour out the formula and rinse the bottle thoroughly with cold water. Do not save remaining formula for later use.

n) when preparing a day’s supply of bottle, pour just boiled water into them and cap. Keep in clean, safe place. When ready to feed baby, add powder and shake.

o) or, add the appropriate amount of powder to the previously boiled, cooled water, cap bottle and shake vigorously. Refrigerate prepared formula and use within 24 hours.

4) How to bottle – feed

If you are bottle-feeding your child, you should make a special efforts to snuggle him close during feeding so that he can experience and enjoy the feel, sounds and smells of your body. Before you begin a feeding. Test the temperature of the formula by letting a few drops fall on your or the back of your hand. It should be comfortably warm-not too cold or hot. 

When feeding, tilt the bottle so that the neck is always filled. This keeps the baby from taking in too much air. The milk should not run out in a steam. If the nipple’s

Hole is too small, it may be enlarged with a sterile needle. If the hole is too large, replace the nipple, because fast feeding is a common cause of colic.

During feeding, remove the bottle occasionally, to let the baby rest. He will generally finish his feeding within 10-15 mts. Try not to let him touch the nipple with his fingers and don’t leave him alone with the bottle.

When the baby is through feeding, discard any remaining formula in the bottle and rinse it thoroughly, inside and out, removing all traces of leftover formula. Fill the bottle with water and put it aside until you are ready to sterilize all the baby’s eating utensils. Nipples, caps, and screw rings should be scrubbed with hot, soapy water immediately after use. Make sure they are rinsed completely by forcing water thoroughly the nipple holes, store them in a covered, water-filled jar until they are ready to be sterilized.

5) When to feed

Early in life, most babies seem to want a feeding about every three to four hours, whether they are being bottle-fed or breast-fed. If your baby seems to have difficulty getting on a regular schedule, you can help him along by timing feedings. As weeks go by, most babies wait longer between feedings and the feedings themselves become longer.

Just as with the timings of feedings, babies are also their best judges as to how they should take at a given feedings. Generally, a baby will stop nursing and turn away from the nipple, even fall asleep, when he is satisfied.

6) Burping

Babies tend to take in excessive amounts of air along with the milk or formula when they nurse. For this reason it’s necessary to burp or ‘bubble’ them.

A convenient way to burp your baby is to hold him upright over your shoulder and pat him gently on the back until he brings up the excess air. Protect your shoulder with a towel in case he accidentally spits up part of his meal. An equally effective method of burping your baby is to support him in sitting position on your lap and gently rub his stomach. In either case, if your baby seems to want to burp and cannot, let him lie down for a minute and then try to burp him again.

7) Vomiting

During the early months of life, most babies will spit up from time to time. Especially after feedings. When a baby spits up with enough force to propel the stomach contents several inches away from his mouth, he is vomiting. This is not necessarily a serious condition, but you may want to discuss it with your doctor. A baby who vomits almost each time he is fed, certainly deserves medical attention.

If your baby has vomited most of his feeding, he need not be fed again right away. His stomach maybe temporarily upset and it may be wise to let him wait until his next feedings.

As a healthy baby grows older, the tendency to spit up or vomit decreases. If a baby who has not been vomiting, suddenly begins to do so, it may be a signs of illness. He should be taken to the doctor.

8) Bowel Movements

During the first few days of life, a baby’s bowel movements are black. His stools, called meconium, have been formed in his intestines before birth. By the end of the second day, however, his bowel movements will be influenced by his diet.

A bowel movement produced by reflex may follow every feeding, especially during the early weeks of life. Many breast-fed babies, however, may shift to infrequent movements during their first few months. It is no cause for alarm if a breast-fed baby goes several days without a bowel movement, as long as he is still doing well otherwise.

Breast-fed babies and those fed a formula with a protein similar to that of breast milk, generally produce soft, yellowish-green stools that are unformed and pasty in texture. If the stools are hard or formed, the baby is constipated. If diarrhea occurs. And lasts more than a few hours, it is wise to check with your doctor. A common cause of diarrhea is improperly sterilized formula or feeding utensils.

Remember that every baby’s bowel movements are different and as long as your baby is continuing to eat with good appetite, gain weight and generally do well, there is nothing to worry about.

C) Wearing your baby from Breast to Bottle

1) Reasons for weaning

• In due course of time, various considerations like the ones stated below, may make you consider whether it is time to start to wean baby off breast milk (if you are breast-feeding).
• Due to your sudden sickness, your doctor may advise you to stop feeding your baby through the breast milk.
• If your own diet is not suiting your baby and changing your diet does not help her digestively, you may need to wean hear onto the bottle sooner than you had planned.
• If your baby is not gaining weight and not growing and developing well, she may be in need of better and larger feeds.
• You may feel the need to wean baby off breast milk because you are planning to return to work.

2) How to wean

The process can be started roughly when the baby is four months old. It is not something that will be accomplished overnight. It is a gradual process and could take about 2 months for it to be completed. By the time he is six months old, he will be almost completely off the breast and onto the bottle not only for milk but also other liquids like small quantities of juice. However, if like many mothers you continue breast-feeding him well beyond your months, remember to supplement breast-feed with solid intake.

You will notice that your baby will initially be reluctant at the changes even though he is hungry. This is because he is unaccustomed to the change in taste and the manner of taking the feed. It was so much easier for him to suck at the breast. But as you gently coax and encourage him, he will learn.

3) Tips to wean baby easily from breast to bottle

a) The best feed to start with is the mid-morning one so that he has the whole day to digest the feed. First, offer him the breast. When he is two-thirds full, give him the bottle, preferably with expressed breast milk. He may grimace at the bottle but may try it anyway. If he does not want it, give him the breast again. Always top the bottle feed with going back to the breast or he will feel deprived.

b) Try giving him the bottle for 3-4 days at the same time daily and with the same quantity of expressed milk. This will give him the time to get used to the bottle.

c) Once he has mastered the technique of drinking from the bottle, substitute the expressed breast milk with the milk you are going to be eventually giving him in the first year.

d) If he takes well to this mid-morning feed, your baby is now showing his readiness to take another change of feed, say the evening one.

e) While giving him the bottle, keep him cuddled in your lap and stroke him to encourage with the bottle. Feeding him while he is propped up on pillows may create a feeling of insecurity in him as he does not understand the reason for the change.

D) Introducing solids

Introducing your baby to solid foods and fruit juices should be a gradual, one-food-at-a-time process. Your doctor will instruct you as to the proper time.

It is important to introduce your baby to only one new food each week. In this way, you will be able to test for any allergic reactions that he may have.  A good food to start with is fresh banana, since it is soft and sweet and most infants seem to like the taste. Egg yolk, although high in protein, should be tried with caution at first in protein, should be tried with caution at first because it is especially likely to cause allergic reactions.

If a rash, wheezing or a change in your baby’s bowel habits occurs after he has tried a new food, you should avoid feeding it to him again for one week. If the reaction is repeated, your baby is probably allergic to that food. Avoid feeding it to him for at least six months. At some time in the future, when your baby’s digestive track is more, you may try it again.

It is also important to remember that even though you are beginnings to give your baby solid foods, he is still not likely to be receiving a complete, balanced diet, because he is eating only a limited variety of them. For this reason, you will probably be advised to continue to breast-feed or bottle feed your baby.

The reason for continuing to breast-feed or bottle-feed is simple, to provide the protein, fat, carbohydrate, vitamins and minerals that most babies need to thrive. These are ideal supplements to a limited diet of solid foods that your baby will be eating the first year.

Tips to get baby started on solids

1. It is essential to keep in mind that so far your baby was used to only sucking and swallowing, now he has to get used to the chewing and swallowing action. Do not thus feel discouraged if your baby spits out the food. He may not like the taste or may not by ready yet. Try again few days later.
2. The time of introducing some solid feed is very important. Preferable choose a time nearing lunch time or a little earlier when you are comparatively more free. It might be a good idea to offer him first the tastes of solids between a milk feed when he is feeling happy and contended. Make sure that your baby is not too hungry or sleepy.
3. Make sure that the texture is more liquid than solid. Offer him your breast or the bottle (whichever he is used to) first, then give him some solid from the tip of a shallow and small spoon, just for taste. Again offer him the breast so that he doesn’t feel deprived. Carry on this process for the next 4-5 days till he gets used to the taste, texture and method of eating and is tolerating the change well.
4. Next, increase the solid intake by a half to a teaspoon of cereal served at the same consistency. Gradually, thicken the consistency and then slowly, spoon by spoon, increase the quantity.
5. Once he is very well used to the mid-morning feed, you can start the same process for an evening feed, provided he is tolerating it very well.
6. Let baby associate food with family and fun let her use her fingers to grasp pieces of food for that will be the basis for holding the spoon later and wanting to feed herself along with rest of the family.

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