Guidance for pregnant women and information on what is happening in their regional unit during the coronavirus (COVID-19) outbreak can be found on NI Maternity
Choosing a formula
There are a number of different brands of infant formula available. All should meet the legal standards for formula milk and it’s up to you to decide which to use.
In the past it was thought better to stick to one brand, but there is no evidence that changing brands does any harm or good.
Infant formula usually comes in powder form and is based on processed, skimmed cow’s milk. It is treated so babies can digest it. Vegetable oils, vitamins, minerals and fatty acids are added to make sure the formula contains everything your baby needs.
Formula is either whey-dominant or casein-dominant depending on the balance of proteins it contains. It may also be known as stage one or stage two milk. Whey-dominant milk is thought to be easier to digest than casein-dominant milk so should be the first formula you give to your baby.
If your baby is formula fed, you should give them vitamin drops from the age of six months, or if they are drinking less than 500ml of formula a day. You can buy suitable drops at any pharmacy.
If you have any worries about the infant formula you are giving to your baby or if you need any advice about vitamin drops, your midwife, health visitor or GP will be able to help you.
Using formula milk safely
Powdered infant formula must be prepared as carefully as possible. It is not sterile, even though packets and tins of powder are sealed. Formula can contain bacteria such as Cronobacter sakazakii and, more rarely, salmonella.
If the feed is not prepared safely, these bacteria can cause infections. This is rare, but can be life threatening. Very young babies are most at risk and it is better to use liquid ready-to-feed products for premature or low birth weight babies.
It is essential to make up a fresh bottle for each feed and to throw away any unused formula within two hours.
Whether you use formula or expressed breastmilk, all the equipment used in feeding your baby must be sterilised. This will reduce the risk of your baby getting sickness and diarrhoea.
To sterilise feeding equipment, you should;
- rinse all equipment in cold, running water, then clean the bottle and teat in hot, soapy water
- cold water sterilising – follow the manufacturer’s instructions, change the sterilising solution every 24 hours and leave feeding equipment in the solution for at least 30 minutes
- steam sterilising (electric or microwave) – follow the manufacturer’s instructions, make sure the openings of bottles and teats are face down in the steriliser and re-sterilise any equipment which is not used immediately
Preparing a feed
There are a number of steps you should follow when preparing a feed;
- step one – clean and disinfect the surface you are going to use, keep the teat and cap on the upturned lid of the steriliser, not on the work surface
- step two – boil fresh tap water in a kettle and then let it cool for no more than 30 minutes,
- step three – loosely fill the scoop with milk powder and level it off using the flat edge of a clean, dry knife or the leveller provided
- step four – add the milk powder to the water, using the scoop that is enclosed, until you have added the number of scoops stated in the instructions
- step five – holding the edge of the teat, put it on the bottle and screw the retaining ring onto the bottle, cover the teat with the cap and shake the bottle until the powder dissolves
Make sure you always make a fresh bottle every time you feed your baby and throw away unused feed after two hours.
Feeding your baby
Always cool your baby’s milk down before feeding. At 70°C it is still hot enough to scald. To cool it, hold the bottle, with the cap covering the teat, under cold running water. Test the temperature of the feed by dropping a little onto the side of your wrist. It should feel warm, but not hot.
If the milk is too cool, you can warm it up by putting the bottle upright in some hot water, keeping the teat out of the water. Never warm milk in a microwave, it will continue to warm up after you take it out and could scald your baby’s mouth.
When feeding, make sure you keep the teat full of milk or your baby will take in air and get wind. If the teat becomes flattened while you are feeding, pull gently on the corner of your baby’s mouth to release the vacuum. If the teat gets blocked, replace it with another sterile teat.
Bottles and teats
You might find it useful to have about six bottles and teats, so you can always have at least one or two bottles clean, sterilised and ready to use.
You should always buy new teats for your new baby. They come in different shapes, with different hole sizes and you may have to try several before you find one that suits your baby. If the hole is too small, your baby won’t get enough milk, if it is too big, the milk will come too fast.
Feeding away from home
The safest way of feeding your baby away from home is to carry a measured amount of milk powder in a small, clean, dry container, a flask of boiled hot water and an empty sterilised feeding bottle.
The water must still be hot when you use it or any bacteria in the milk powder might not be destroyed. Remember to cool the bottle under cold running water.
Alternatively, you could use ready-to-drink infant formula.