What to Expect the First Year (30 page)

Once you've narrowed your selection down to a general type, you'll need to choose between:

Ready-to-use.
Premixed ready-to-go formula comes in 2-, 4-, 6-, and 8-ounce single-serving bottles and is ready for baby with the simple addition of a bottle nipple. It doesn't get easier and more convenient than this—especially because the unopened bottles don't need to be refrigerated—but this is definitely the priciest option.

Ready-to-pour.
Available in cans or plastic containers of various sizes, this liquid formula need only be poured into the bottle to be ready for use. It's less expensive than single-serving feedings, but the formula left in the container needs to be stored properly, and used within 48 hours. You'll also pay more for the convenience of ready-to-pours than you would for formulas that need to be mixed.

Concentrated liquid.
Less expensive than ready-to-pour but a little more time-consuming to prepare, this concentrated liquid is diluted with equal parts water to make the finished formula.

Powder.
The least expensive option, if a bit more time-consuming, powdered formula is reconstituted with a specified amount of water. It's available in cans, plastic containers, or single-serving packets. Besides the low cost, another compelling reason to opt for powder (at least when you're out and about with baby) is that it doesn't need to be refrigerated until it's mixed. Look for bottles that allow you to keep fresh water and formula powder separate until you mix them together.

For the safest formula prepping and feeding:

• Always check the use-by date on formula, not only when you buy it, but when you prepare it. Don't purchase or use expired formula. And steer clear of dented, leaky, or otherwise damaged cans or other containers.

• Wash your hands thoroughly before preparing formula.

• If necessary, use a clean punch-type opener to open cans of liquid formula, making two openings on opposite sides of the can to make pouring easier. Wash the opener after each use.
Most powdered formula cans come with special pull-open tops, making the use of a can opener unnecessary. If you're using a single-serving bottle, make sure you hear the top “pop” when you open it.

• It isn't necessary to sterilize the water used to mix formula by boiling it. If you're unsure about the safety of your tap water, or if you use well water that hasn't been purified, have your supply tested and, if necessary, purified. Or just use filtered water. Also ask your baby's doctor if fluoride levels in your area's tap water are appropriate for baby.

• Here's another step you can save: Bottles and nipples don't need to be sterilized with special equipment. Dishwashers (or sink washing with detergent and hot water) get them clean enough. If your baby's doctor does recommend sterilizing for any reason, it's easy to do. Just submerge the bottles and nipples in a pot of boiling water for 5 minutes, then let them air dry.

• But here's a step you should never skip: Follow the manufacturer's directions precisely when mixing formula. Always check cans to see if formula needs to be diluted: Diluting a formula that shouldn't be diluted, or not diluting one that should be, could be dangerous. Formula that is too weak can stunt growth. Formula that is too strong can lead to an electrolyte imbalance (aka salt poisoning).

• Bottle warming is a matter of taste, namely baby's. There is absolutely no health reason to warm formula before feeding—but babies who get accustomed to having their formula served up warm often come to expect it that way. That's why you might consider starting your baby out on formula that's been mixed with room temperature water or even a bottle right out of the fridge, so he or she gets used to it that way. Then you can save yourself the time and the hassle of warming bottles—something you'll especially appreciate in the middle of the night or when your baby's frantic for a feed. If you do plan to serve a bottle warm, use a bottle warmer or place the bottle in a pot or bowl of hot water or run hot water over it. Check the temperature of the formula frequently by shaking a few drops on your inner wrist—it'll be ready for baby when it no longer feels cool to the touch (it shouldn't be very warm, just body temperature). Once it's warmed, use the formula immediately, since bacteria multiply rapidly at lukewarm temperatures. Never heat formula in a microwave oven—the liquid may warm unevenly, or the container may remain cool when the formula has gotten hot enough to burn baby's mouth or throat.

• Throw out any formula that's left in the bottle for longer than 1 hour after a feeding has started. Once baby has fed from a bottle of formula, bacteria can grow in it, even if it's refrigerated. So as tempting as it might be, don't reuse leftover formula.

• Cover opened cans or bottles of liquid formula tightly and store in the refrigerator for no longer than the times specified on the labels, usually 48 hours (mark with the day and time you opened it so you don't lose track). Opened cans of powdered formula should be covered and stored in a cool, dry place for use within a month.

• Store unopened cans or bottles of liquid formula at temperatures between 55°F and 75°F. Don't use unopened liquid that has been kept for long periods at or below 32°F or in direct heat above 95°F. Also, don't freeze formula or use formula that has been frozen or that shows white specks or streaks even after shaking.

• Keep prepared bottles of formula refrigerated until ready to use. If you are traveling away from home, store previously prepared bottles in an insulated container or in a tightly sealed plastic bag with a small ice pack or a dozen ice cubes (the formula will stay fresh as long as most of the ice is frozen). Don't use Premixed formula that's no longer cold to the touch (it'll have to be tossed). Easier options on the go: Take along ready-to-use single serving bottles of formula, bottles of water and single-serving formula packets to mix with them, or bottles that have separate compartments to keep the powder and water apart until you're ready to combine them and feed your baby.

Need to bone up on bottle-feeding? Whether you'll be feeding formula exclusively, combining it with breast, or using bottles to serve up expressed breast milk, these step-by-step tips should help:

Give notice.
Let baby know that “milk's on” by stroking his or her cheek with your finger or the tip of the nipple. That will encourage your baby to “root”—turn in the direction of the stroke. Then place the nipple gently between baby's lips and, hopefully, sucking will begin. If baby still doesn't get the picture, a drop of formula on those sweet lips should clue him or her in.

Make air the enemy.
Tilt the bottle so that formula always fills the nipple completely. If you don't, and air fills part of it, baby will be chasing formula down with air—a recipe for gassiness, which will make both of you miserable. Anti-air precautions aren't necessary, however, if you're using disposable bottle liners, which automatically deflate (eliminating air pockets) or if you're using specially designed bottles that keep the formula pooled near the nipple. Keeping baby propped up in your arms instead of lying horizontal can also help.

Start slow.
Brand new babies have minimal nutritional needs in their first few days of life—which is good, because they also have minimal appetite (they're usually more eager to sleep than feed). That's why nature's food delivery system makes so much sense (just a teaspoon or so of colostrum is served up at each feed until mama's milk arrives)—and why, if you're delivering those first feeds via bottle, you can expect your newborn to
take only tiny amounts of formula. The nursery will probably provide you with 2-ounce bottles, but it's unlikely your little one will drain them at first.

Break for bubbles.
A baby who falls asleep after taking just half an ounce or so is probably saying, “I've had enough.” On the other hand, if baby doesn't fall asleep but turns away from the bottle fussily after just a few minutes of nipping, it's more likely a matter of gas than overfilling. In that case, don't give up without a bubble. If after a good burping (
click here
), baby still won't budge on the bottle, take that as your signal that the meal is over. (
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for more details on how much formula to feed.)

Check your speed.
Be certain that formula isn't coming through the nipple too quickly or too slowly. Nipples are available in different sizes for babies of different sizes and ages. A newborn nipple dispenses milk more slowly, which is usually perfect for a baby who's just getting the hang of sucking (and whose appetite is still tender). Ditto for nipples designed to mimic breastfeeding—they're also slower flow. You can check the speed of the nipples you're using by turning the bottle upside down and giving it a few quick shakes. If milk pours or spurts out, it's flowing too quickly—if just a drop or two escapes, too slowly. If you get a little spray and then some drops, the flow is just about right. But the very best way to test the flow is by observing the little mouth it's flowing into. If there's a lot of gulping and sputtering going on, and milk is always dripping out of the corners of baby's mouth, the flow is too fast. If baby seems to work very hard at sucking for a few moments, then seems frustrated (possibly letting go of the nipple to complain), the flow is too slow. Sometimes, a flow problem has less to do with the size of the nipple than with the way the cap is fastened. A very tight cap inhibits flow by creating a partial vacuum, so loosening it up a bit may make the formula flow more freely.

Let baby call it quits.
When it comes to feedings, your baby's the boss. If you see only 1 ounce has been emptied when the usual meal is 2, don't be tempted to push the rest. A healthy baby knows when to keep feeding and when to stop. And it's this kind of pushing that often leads bottle-fed babies to become too plump—much more often than breastfed babies, who naturally eat to appetite.

Minimize midnight hassles.
If you can afford the premium price, consider using ready-to-serve single-serving bottles at night (just keep them bedside along with clean nipples) so you can skip the midnight bottle prep. Or use a bottle that stores water and formula powder separately. Or invest in a bedside bottle holder, which keeps baby's bottle safely chilled until ready to use and then warms it to room temperature in minutes.

Whether you've chosen to feed your baby exclusively with formula or to mix it up with breast, the most important ingredient in any feeding session is love. The kind of skin-to-skin, eye-to-eye contact that's linked to optimum brain development and attachment in a newborn is a built-in feature of breastfeeding. But, it can easily be added to bottle-feeding. To make sure you keep in touch with your baby while you're bottle-feeding:

Don't prop the bottle.
It may be the easy thing to do—propping the bottle so you can tackle the bills or catch up on Facebook—but it's definitely not a good thing. Not only does propping your baby's bottle mean that you'll both be missing out on quality cuddle time, it increases the risks of choking (even if your baby is in a reclining high chair or infant seat), ear infections, and, once those pearly whites come in, tooth decay.

Go skin-to-skin, when you can.
There are piles of research showing the piles of benefits provided by sharing skin-to-skin contact with a newborn—including the fact that so-called “kangaroo care” lifts levels of oxytocin (aka the love hormone), which plays a major role in parent-baby bonding. But you won't need scientists to prove what you'll discover the first time you go skin-to-skin with your baby: that it feels warm, cozy, and generally awesome for you both. So whenever you can, go ahead—open your shirt and nestle your baby close to you when you bottle-feed. To cocoon your cutie even more snugly, tuck his or her body under your shirt or sweatshirt (there are even kangaroo care tops made specifically for skin-to-skin wear). That goes for daddies, too—your baby will love to cuddle cheek-to-chest (and yes, even cheek-to-chest-hair).

Switch arms.
Breastfeeding also builds in this feature (alternating breasts means alternating arms), but with bottle-feeding, you'll have to remember to switch. A switch midfeeding serves two purposes: First, it gives your baby a chance to see the world from different perspectives. Second, it gives you a chance to relieve the aches that can develop from staying in one position for so long.