Bottle feeding baby

Bottle feeding with formula milk enables the baby to grow and develop normally.
Mothers should not feel guilty about choosing to formula feed their baby and should be reassured that formula milk meets all the baby's nutritional requirements. Formula milk is similar to breast milk and it is normally enriched with essential vitamins, iron and calcium

Advice about bottle feeding

The advice given to mothers that bottle feed their baby's is the same for mothers that breast feed: be relaxed, comfortably positioned, speak gently or sing a lullaby while feeding the baby, and ensure the environment is quiet and calm .....

Which formula milk should you choose for the baby?

  • First stage milk, also known as infant formula milk, it is intended for babies during their first 6 months of life.
    • Its composition is very close to that of breast milk.
    • The teat on a feeding bottle should meet the suction capacity of the baby
    • This type of milk can be given safely to a baby up to 6 months or more.
    • There are specific types of formula milk for babies with allergies or digestion problems and your GP or Health Visitor can advise on these.
  • Second stage milk also known as follow on milk and is given from 6 months onwards.
    • This type of milk is normally enriched in linoleic acid, iron, calcium and various vitamins important for the healthy growth of your baby.
    • Follow on milk is normally given as part of a weaning diet around 6 months, but no earlier than 4 months.
    • From 6 months of age give at least 500 ml of milk per day until the age of 1 year.
    • Growing Up milk is given in the next stage from one year to approximately three years of age: these types of milk are fortified in iron and essential fatty acids.

Vitamin K : if the baby is fed with formula milk from birth, two doses of Vitamin K should be given during the first days of life. However, formula milks are sufficiently fortified in Vitamin K.

If necessary and following your doctors advice, Vitamin D can also be given.

How to prepare a bottle feed

  • Thoroughly wash your hands before preparing the feeding bottle
  • All the equipment used for feeding your baby needs to be sterilised.
  • Use fresh tap water to fill the kettle. Boil the kettle and let the water cool for no more than 30 minutes. It is important the water is still hot otherwise bacteria in the milk power may not be destroyed.
  • Always follow the manufacturer's instructions for making up formula milk.
  • Fill the feeding bottle with the recommended quantity of water.
  • Using only the dosing scoop provided with the milk powder, loosely fill the scoop and level it off with a clean knife or leveler provided.
  • The dosage for 30 ml of water is one leveled off dose of milk powder, but check with the manufacturer's instructions first.
  • Shake the mixture well to ensure the powder is thoroughly mixed
  • Always cool down the milk; ensure the cap covering the teat hold the bottle under cold running water.
  • Check that the temperature is not too hot by shaking some drops onto the back of your hand or wrist.
  • Do not add sugar.
  • Ideally a formula feed should not be prepared in advance , but just before feeding.
  • Throw away any milk left over within two hours.

If you use mineral water to make up a formula feed it must be labeled "Suitable for the preparation of baby formula."

Sterilising Equipment

It is advised that all feeding bottles and equipment be sterilised for the first year of life.
  • Steam sterilising (electric or microwave): Follow the manufacturers instructions. Place the thoroughly washed and clean feeding bottles in the steriliser. It usually takes 8 to 12 minutes excluding cooling time. Make sure bottles and teats are facing down in the steriliser and do not place any metal parts in the microwave. Allow time for the bottles to cool and take care when removing the lid as the lid can become very hot.
    • Boiling is the traditional method: plunge the feeding bottles into boiling water in a saucepan or a pressure cooker that has not been used for cooking for approximately 15 minutes
  • Cold water sterilising :
    • Place the cleaned feeding bottles, the teats and covers in a container with a sealed fitted lid. Fill with cold water and add a specific sterilising tablet. Follow the manufacturers instructions for the correct amount of water and allow at least 30 minutes before using. The solution can be used for up to 24 hours, but no longer allowing you to leave the bottles in the solution until just before use.

Do not forget
  • to assemble the bottles correctly and to shake it vigorously until the milk powder has completely dissolved

Choosing a teat:
  • Teats recommended for a newborn up to 4 - 6 weeks of age: are designed to have a low flow rate which helps the baby drink small amounts of milk at a time.
  • Teats with a single or medium flow are recommended for babies from 3 to 6 months: they can be sold separately or together with the feeding-bottles.
  • Higher flow rate teats are recommended for babies from approximately 6 months old during the introduction to solid food.

The feeding-bottles must not be sterilised if they have not first been well washed and prepared.

Be aware of the risk of burns if using a steam sterilising system.

Do not over-tighten the screwed cap on the teat as this may allow air to re-enter so forcing the baby to suck too strongly.

Hand hygiene is important and that you wash your hands before handling the bottles and avoid toughing the teats with your fingers.

Never prepare feeding-bottles in advance.

If using a ready made carton of formula milk, is can be kept up to a maximum of 24 hours after opening in the refrigerator. Milk must not be re-heated once made up and any formula left in the bottle, which has not been used, MUST thrown away after 2 hours.

Do not force your baby to drink more milk than it needs, some babies will drink and need more milk than others.

Clean the feeding bottles, teats and screw caps thoroughly after feeding and scrupulously remove any milk residue which remains. Unclean bottles can become a real breading ground for microbes, therefore use hot soapy water and rinse well.

Do not give your baby a feed which has already been started.

The number of bottle feeds and the quantities to give

Quantities vary according to the size, the weight and the appetite of the baby.
A baby is fed when it is hungry , whether it be day or night.

The hungry baby will cry and scream, getting louder and for longer.
  • The baby's feeding regime may not always be at regular times

  • Be flexible: adapt the feeding time to suit the baby and not the opposite
  • If your baby turns its head away repeatedly during a feed, it can mean that the baby has had enough, therefore do not worry if he/she does not finish it.
  • During the first few weeks of life , a baby feeds approximately every 3 or 4 hours therefore 5 to 7 times during a 24 hours period.
  • Your health visitor will advise you on the quantity of feed and a regime for feeding your baby.

Example of a formula feeding regimes
  • 6 to 7 feeds a day of 90 ml each during the first 4 weeks
  • 6 feeds a day from the age of 1 to 2 months
  • 5 feeds a day from the ages 2 to 4 months
  • 3 bottle-feeds a day from the ages 5 to 6 months
  • 2 bottle-feeds a day from the ages 7 to 12 months

Babies that cry a lot after a feed may not have taken enough milk. Check that the teat is not blocked.

Good position for bottle feeding

Bottle feeding is an important and special time for making eye contact and bonding with your baby

It is helpful to be at ease, relaxed and comfortable so that feeding your baby remains a special time.
Choose a calm place and try to be comfortably seated in an armchair with a cushion supporting your back.

The bottle needs to be tilted when the baby is feeding so that the baby correctly sucks on the teat and does not simply chew on it: the appearance of small bubbles in the feeding-bottle indicates that the bottle is being held at a good angle.

The teat must always be full to prevent the baby swallowing air, which can cause colic and frequent regurgitations.

Cleaning the feeding bottle and the teat

  • Use clean hot water, soap and a brush
  • Scrub the feeding bottle vigorously, both inside and outside
  • Pay special attention to where the teat is joined to the bottle and screwed and thoroughly scrub clean
  • Clean the cover

Your local health visitor or GP can advise you on the choice of milk products.

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