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Basic equipment needed for bottle feeding

We advocate breastfeeding and suggest that if you are having problems or doubts about breastfeeding it would be best to talk to your parenting coach about your concerns.  If on the other hand you choose to bottle feed possibly because of a bad experience or there is some other reason you can’t, or you have just chosen not to breastfeed this chapter will help you with the next best thing.  Bottle feeding.   If you are expressing and giving breast milk in a bottle this chapter can help you understand such things as sterilising, choosing the right bottle and teats.

Formula

There are many different formulas on the market no brand is better than another but some babies may react to certain formulas.  Their reaction may be seen as a rash, diarrhoea, constipation, unsettled irritable baby.   Some babies may have lactose intolerance or a cow’s milk intolerance.  Some of the ‘Gold’ formulas are renowned for causing constipation.  If your baby begins to shows any of these signs it may be wise to change formula within the brand or to a different brand all together. 

Teats and Bottles

Again there are a variety of types of teats and bottles available.  The most popular brand are not always the best.  The long thin bottles or the wide bottles are suitable but make sure they have clear measurements.  If you are going to exclusively bottle feed I suggest you invest in six large bottle.  Look for teats that are long and straight or slightly cone shaped.  Avoid short or irregular shaped teat and those that bulge at the neck.  These may cause baby to slurp and are not assisting in the development of the correct muscles for speech.  For this reason I don’t recommend buying orthodontic or anti colic bottles or teats.  When feeding, if baby is heard to be slurping the teat is not fitting snugly in her mouth.  Baby’s lips should flange out while drinking and not role in.  Some teats are interchangeable with other brands of bottles so I suggest you try a few before purchasing the type that suits your baby best.  The most recommended brand (at the publication of this book) is Pigeon Peristaltic slow flow for newborns and ‘Y’ teat for three months and older. 

Preparation of formula

Before starting make sure you have all the necessary equipment – formula, sterilised bottles and teats.  There are several ways to store your bottles ready for use two of which are as follows:

1. Make up bottles of formula and keep them ready-to-go in the fridge.  With this method you will need to warm the milk either in a bottle warmer or boil a kettle and pour the water into a cup or container into which the bottle of milk is immersed.   Takes 5-8 minutes.  Never microwave milk as some of the nutrition is destroyed.
2. Keep bottles of measured cooled boiled water in the fridge and add the formula when needed.  Take off the teat and cap before warming the bottled of water in the microwave for 20 -30 seconds then add the formula and shake thoroughly.  This disperses the hot-spots while dissolving the formula.

Always test the temperature of the milk on the inside of your writs before offering it to baby – it should be luke warm.
 
Once you have decided on the method you will be using both will require the following instructions:

• Always wash your hands before handling food and in particular baby’s food and formula.
• All equipment should be thoroughly washed with hot soapy water and sterilised.
• Prepare your boiled water (5 mins of rapid boiling) and allow it to cool slightly before measuring it into the bottles.  Never use bottled water as many have high sodium and mineral contents which may be harmful to baby.  Bottle water is not sterilised.
• Read the instructions on the formula label and make up to the exact proportions of water to powder.   Always measure the water first then add the powder.   * Never add more water to a formula as this will dilute the calories and nutrition, too much powder can cause constipation or dehydration.  
• If you would like to give your baby additional cooled boiled water it is advisable to offer it a short time after she has finished her formula feed or twenty minutes before bed.  This insures she has had her quota of nutrition and gives some time for the milk to go down.
• Always use the ladle provided.  This ladle should not be packed down or knocked against the side of the tin to compact the powder.  Scoop the ladle into the powder to fill it and level it flat with the back edge of a sterile knife.  Tap the bottom of the ladle with the knife to empty the powder into the bottle.  If the water is too hot the steam will cause the powder to stick to the ladle.   Seal and shake thoroughly.
• When making up the bottle the powder will always increase the quantity in the bottle.  Only give the amount necessary for baby’s weight don’t force her to take the whole bottle just because there is some left.  It is better to decant the excess before offering it to her and keeping it in the fridge to be added to then next feed if need be.
• Store pre-prepared bottles in the fridge with their caps over the teats.
• Formula or sterile water stored in the fridge will last 24 hours.  Discard any remaining bottles, wash and sterilise before reusing.
• Never reheat milk.  Always discard used milk after one hour of warming.  Bacteria breeds quickly in warm milk.

Tips on bottle feeding

Baby should take fifteen to twenty minutes to take a bottle feed.  If your baby drinks her bottle quicker than this then the teat is to fast and may cause discomfort and possibly vomiting.  Try a slower teat.  If baby is taking longer than this there may be several reasons.  Is she sleeping on the bottle?  Is she feeding more than four hourly from the beginning of one feed to the beginning of the next?  Is she getting the correct quota for her weight?  Is the teat too slow?  Is the teat on to tightly and baby is finding it difficult to suck out.  Some bottle fed babies don’t know when to stop and can be over fed.  Avoid overfeeding by only feeding three and a half (for premature or small babies) and four hourly for term babies.  All healthy babies should be on four hourly feeds by three weeks. 
Something to be aware of is not to over tighten the collar of the teat.  When attaching the teat to the bottle tighten just till you feel it catching.  Loose enough to allow bubbles to be seen rising in the milk. But not to loose as the milk will leak out.  You can then adjust the flow of the milk by tightening or loosing the collar making sure you can see the bubbles rising.  This allows the air to flow freely into the bottle through the collar releasing the vacuum which allows a steady flow of milk.  If there are no bubbles rising the vacuum will prevent the milk from flowing and eventually baby will need to break her seal to allow the air to enter the bottle through the hole of the teat.  If it is a cross cut or ‘Y’ teat the teat may invert into the bottle.
  
Watch when you are feeding as the bottle should always be inline with her nose and parallel to her lips not angled to high or to low.   You may like to support your arm while feeding baby.   Rest her in the crook of your arm tilted back at an angle that will allow the milk to always be in the teat which means she is being satisfied.  To dispel a myth - sucking on air does not cause wind.   Allow her to drink as much as she wants, she will generally show you when she needs a break.  Sit her upright holding her under her chin with two fingers under her arm and the palm of your hand against her chest.  The other hand, firmly support her back with your fingers supporting her head.   This straight upright or slightly backward leaning position will allow the wind to rise without obstruction.  It is not necessary to pat her back.  Sitting upright will also help her to stay awake and eventually take an interest in her surroundings whereas resting over your shoulder will very often put baby off to sleep.
 
Never prop baby up with a bottle or leave them alone with a bottle, this is very dangerous as baby may choke.   This includes putting a baby to bed with a bottle when they are older. 
If need be change the nappy towards the end of the feed to wake her up.  When she becomes more alert leave the nappy change till just before bed so that you know she is clean for bed.  Because bottle feeding is quicker than breastfeed you will have a longer play time so encourage lots of tummy time.  

If you would like more information on this and other similar topics our E-books are packed full of practical parenting tips.  Down load an E-Book specifically related to your child's age group through Publications at Our Shop.

Over the years of helping parents with their children I have often been called out to homes where babies have refused to take the bottle when Mum decides for some reason or another that it’s time to wean.  Many mothers wean when returning to work. Others just want to be able to offer a bottle when they are going out and leaving their child with a guardian or babysitter. 

When visiting a mother who is breastfeeding a newborn, I suggest they introduce a bottle early so that the child will be able to adapt to both the breast and the bottle. Suckling from the breast and sucking from a bottle are totally different actions and can sometimes cause ‘nipple confusion’.  Supplementary feeding can cause problems with milk supply.  Therefore I would recommend to give only 20 mls of EBM (expressed breast milk) twice a week from birth.  This will not interfere with milk supply and is not sufficient to confuse the baby - it is just enough for the baby to remember how to suck on a bottle.  I would not suggest that you replace a breastfeed with a bottle feed until the baby is at least six week old, the reason being that this can cause your supply to decrease. 

Once the baby is over six weeks old you may like to introduce one full bottle feed once or twice a week.

What bottles do we recommend?

If you have a low supply I suggest using the Haberman Feeder which has a variable flow teat.  If you are justs introducing a bottle for convenience then be aware that some of the more expensive brands are not always the best for newborns, as their teats can be too fast.  Try finding a teat that regulates the flow, such as a Y or X cut teat.  This will help the baby to work for his feed, and not just have it drip into his mouth, making him lazy and possibly causing breast refusal. 

Tips:  Choose a long, straight shank teat, as it is better for the development of the mouth muscles.  Try the Pigon Peristaltic teats.

Remember: EBM can be kept for 48 hours in the fridge, and up to 3 months if frozen correctly.  Once offered, milk must be discarded after one hour. Wash equipment and bottles in hot soapy water and sterilize the pump, bottles and teats after every use.  

If you would like more information on this and other similar topics our E-books are packed full of practical parenting tips.  Down load an E-Book specifically related to your child's age group through Publications at Our Shop.

How Cradle 2 Kindy Can Help

Cradle 2 Kindy parenting coaches can provide more information on breastfeeding related concerns, bottles, teats and formulas or help you develop a plan for weaning which best suits your needs.

Call Cradle 2 Kindy now and make a booking on 1300 786 101

Also see: What happens at a Coaching session?

More Articles on Breastfeeding

Non-infective mastitis can result from a blocked milk duct.  The mother notices that an area of the breast becomes tender, reddish and hardened.  Sometimes there appears to be a red cord leading from the areola (brown area) up the breast.  The inflammation (at this stage it is not infected) is caused by the blocked duct not allowing milk to flow.  The milk banks up causing localized distension.

If the blockage is not cleared rapidly, milk is forced into the surrounding breast tissue, and, it is thought, into the blood stream.  Quite suddenly (eg. in a matter of hours) the mother experiences systemic symptoms such as high fever, aches and pains, and feels like she has the flu. 

What causes mastitis?

Usually poor drainage of the breast, which may result from poor positioning and baby not attaching well or not properly draining the breast due to short feeds or swapping breasts before one side is properlydrained.  Quite a few other factors may be implicated.  Baby may prefer to only suck in one position at the breast.  Even a couple of missed feeds from one breast can predispose towards mastitis.  Other reasons could be an ill-fitting bra or lying persistently on one side when sleeping. 

How can the mother clear the blocked ducts?

The primary aim must be to clear the blocked ducts.  This is certainly not the time to wean, as doing so may well result in a breast abscess developing. 

Feed frequently from the breast and try, if possible, to have baby place his lower jaw over the red and tender area.  Sometimes it helps to feed from the infected breast first for a couple of feeds in a row.  Gently massaging the area of mastitis towards the areola as the baby is sucking, or later under the shower, helps to get the milk flowing. Cold cabbage leaves applied after a feed can help inflammation.  Usually, when treated promptly, the blockage clears in 12 to 24 hours.

Warm cloths can be applied to the breast before a feed to assist with the let-down reflex.  If the mother is confident, she may try expressing her milk - either by hand or with a pump.

If, after trying these measures for a full 12 hours, symptoms persist, then the local doctor will prescribe antibiotics.  On completion of the course (no less than 10 days) the mother must be careful to ensure her milk continues to flow well, with baby sucking vigorously over the previously tender area. 

Some form of pain relief and anti-inflammation medication can be taken as soon as symptoms become apparent.  They do not harm the breast-feeding baby.

Blockage of ducts can recur and mothers become adept at recognizing this and can encourage adequate drainage.

Article by Wendy Back.  Lactation Consultant.  

If you would like more information on this and other similar topics our E-books are packed full of practical parenting tips.  Down load an E-Book specifically related to your child's age group through Publications at Our Shop.

How Cradle 2 Kindy Can Help

Cradle 2 Kindy can provide you with support and advice on breastfeeding that will guide you through the first critical weeks at home.  Your own personal parenting coach will help you avoid problems such as mastitis and poor attachment.
Call now and book your personal Cradle 2 Kindy coach on1300 786 101

Also see: What happens at a Coaching session?

More Articles on Breastfeeding

Breast refusal can be a distressing occurrence for both mother and baby.  Often the baby has previously fed happily, then for some unknown reason, begins to refuse to feed.  Causes may be apparent, but often there does not seem to be a cause.  Known factors are: an alert baby being easily distracted, over-feeding or force-feeding, gastric reflux, illness in the infant or mother, oral or nipple thrush, mastitis, medications and hormonal changes (e.g. ovulation, menstruation), There may also be issues relating to mother’s milk supply,  such as: low supply, or slow let-down reflex (thus baby becomes frustrated), or the milk flowing too quickly and baby needs a breather.

The mother needs much support and encouragement during these occasions, and usually, after a few days the baby begins feeding again as though there had never been a problem.

If the cause can be located it can be treated, e.g. thrush, gastric reflux.

I find putting a baby to the breast as soon as she begins to stir from sleep enables her to attach well and begin feeding.  If you persist in trying to make a baby breast feed when she adamantly refuses to do so, the infant just becomes more upset.  Try distracting them for five to ten minutes with a bit of tummy time and try again.  If she continues to refuse, it is most likely she has had sufficient. 

It is also important not to feed baby too soon after the last feed as she will not feed well and you will only be setting up a bad habit of snack feeding and cat napping.  Another possible solution is for mother and baby to get into a warm bath together and after baby has relaxed, she is slowly brought up to the breast.  Usually such a baby enjoys the skin-to-skin contact and will begin to suck well.

If mother’s milk supply is suspected to be low in comparison to the demands of her growing baby, measures to increase production can be put into action and after a couple of weeks the infant is often contentedly sucking away as before. If you feel baby is not getting enough and are giving her a supplementary or top up feed from a bottle, this may eventually cause your milk supply to dwindle unless you are expressing to stimulate your breast after every day-time feed.  If you are expressing, do not over-express.  Five to seven minutes is sufficient but should be done regularly to have any effect.  Remember you are not expressing to store milk.  If your supply is low you may not express any milk.  Expressing is to stimulate the breast to make more. 

Also be aware that if you introduce a bottle on a regular basis your baby may refuse the breast totally as drinking from a bottle requires less on a regular basis your baby may refuse the breast totally as drinking from a bottle requires less effort than the breast.

Article by Wendy Back.  Lactation Consultant.  

If you would like more information on this and other similar topics our E-books are packed full of practical parenting tips.  Down load an E-Book specifically related to your child's age group through Publications at Our Shop.

How Cradle 2 Kindy Can Help

A Cradle 2 Kindy parenting coach can offer assistance to help you dismiss many of your concerns relating to breastfeeding.  We provide the encouragement and support that will help you through these sometimes difficult times. 

Call and make a booking for your personal Cradle 2 Kindy coach on 1300 786 101

Also see: What happens at a Coaching session?

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If you have chosen to demand-feed are you feeding to your baby’s hunger or to their crying?  Many mothers fall into a trap when demand-feeding and are actually snack feeding their baby and teaching them to cat-nap.  A well-fed baby will, of his own accord, begin to ‘demand-feed’ every four hours if encouraged to do so from the beginning.

Feeding baby to sleep, except for the two night feeds, is not a good idea, as he begins to associate feeding as a technique to get himself to sleep.  If he falls asleep during a feed, wake him up and make sure he feeds well so he is not hungry later on.  If baby wakes after a one hour sleep and you know he has fed well at the last feed it is not hunger that has woken him, resettle him. 

Tips:  Babies that feed well are generally settled and sleep well. The exception to this is when they have never learnt to resettle themselves after the first sleep cycle, or there may be a problem with reflux or an infection. 

Remember:  Baby should be getting enough if –

• he/she is content directly after a feed,
• putting on weight and
• has plenty of wet nappies.  If the nappies are light and urine is dark and smelly, your baby may not be getting enough to drink. 

If you would like more information on this and other similar topics our E-books are packed full of practical parenting tips.  Down load an E-Book specifically related to your child's age group through Publications at Our Shop.

How Cradle 2 Kindy Can Help

Cradle 2 Kindy parenting coaches are trained to assist with breastfeeding concerns to help you establish good breastfeeding habits and overcome your anxiety and any difficulties you may encounter. 

Call and ask how your personal Cradle 2 Kindy coach can help you.  1300 786 101

Also see: What happens at a Coaching session?

More Articles on Breastfeeding