Bottle Feeding

Bottle feeding breast milk

Breastmilk is the only food your baby needs for the first six month. At about six months, it is recommended to introduce babies to solid foods while continuing to breastfeed up to two years and beyond.

You can express your breast milk using your hand or a breast pump.

A breast pump may be needed to remove breast milk from mother's breasts. Choosing a pump that's appropriate for your situation can be confusing. If you have questions, speak with a public health nurse at Niagara Region Public Health.

After the baby is finished feeding, throw out any leftover breastmilk. Don't refreeze breast milk once it's thawed. For more information, check out proper storage and preparation of breast milk by Centers for Disease Control and Prevention.

When storing breast milk:

• Use clean glass or hard plastic containers that are BPA free, or bags made for freezing milk
• Bottle liners can break easily, but may be used if they're stored in another container in your freezer
• Mark the date you expressed the milk on the bags or bottles. Use older milk first and throw out any milk that's older than the storage times given.

Bottle feeding formula

Parents may consider formula feeding their baby for various personal or medical reasons. For parents who cannot breastfeed or have made an informed decision not to, properly prepared commercial infant formula is a safe alternative. If you have made an informed decision to give your baby infant formula, review the information below to ensure safe and healthy feedings.

Infant formula can be the only source of nutrition for babies aged zero to six months and usually given to babies up until nine to 12 months of age

Formula made outside of Canada is not recommended as it may not meet Canadian manufacturing guidelines.

Powdered formula is not sterile and could cause some babies to get sick. Babies at greatest risk of infections from powdered infant formula are those who are premature, low birth weight and are under two months of age, and have a weakened immune system. Babies who have the greatest chance of infections should have sterile liquid formula such as ready-to-feed or liquid concentrate formulas.

Understanding infant formulas

There are three forms of infant formulas as well as different types.

• Ready to feed - no water needed
• Liquid concentrate - mix with water
• Powder - mix with water

If you're unsure about what type of formula to use, ask your doctor or health care provider. Learn more about infant formula (available in multiple languages) by Best Start, Ontario's Maternal Newborn and Early Child Development Resource Centre.

Vitamin D supplementation

Babies who are bottle fed with formula should be supplemented with vitamin D if they are drinking less than 1000 millilitres (or 35 ounces) of formula per day.

This is recommended because infants would need to drink 1000 millilitres (35 ounces) of formula each day to receive the recommended 400IU of vitamin D from formula alone.

This will help reduce vitamin D deficiency, which could cause other health problems. Infant vitamin D supplements can be bought over the counter at a pharmacy. Talk to your doctor or pharmacist about which option is best for you and your baby.

How to use bottles

• Paced bottle feeding

  This method allows your baby to drink at a comfortable pace and helps prevent choking and overfeeding.

  • Hold your baby in an upright position, supporting the head and neck with your hand
  • Use a wide-based, slow-flow bottle nipple
  • Touch your baby's upper lip with the bottle nipple to encourage your baby to open their mouth wide
  • Gently allow your baby to pull the nipple into their mouth. Don't force the nipple into baby's mouth.
  • Keep the bottle horizontal so that the nipple is partially full. This will slow the flow of milk.

  Remove the bottle if your baby is:

  • Coughing or choking
  • Swallowing quickly without taking a breath after each swallow
  • Spilling milk from their mouth
  • Opening eyes widely
  • Stiffening arms and legs
  • Flaring nostrils
  • Having their lips turn blue

  Watch How to Bottle Feed your Baby: Paced Bottle Feeding video by Region of Peel. Review our factsheet on propped bottle feeding to make sure your baby has a safe feeding experience

• Choosing bottle nipples
  • Bottle nipples can be different shapes and sizes
  • The flow rate of a nipple is how fast the milk or formula comes out. The flow rate plus the size of the nipple hole may be different from one nipple to another, even for nipples in the same package.
  • Always follow the age recommendations on the nipple package
  • Different nipples work better at different times. Buy one package and watch that your baby is relaxed while feeding. If your baby is having problems, try a different type.
  • Bottle nipples can be made of various materials
  • Check bottle nipples often. Replace them when they are cracked, sticky, torn, discoloured or if the hole gets larger and the formula drips out quickly.
• Cleaning and sanitation
  • Always follow the manufacturer's instructions
  • Bottles should be cleaned after every feeding. Germs can grow quickly if breast milk or formula is added to a partially used bottle, or if a used bottle is only rinsed, rather than cleaned.
  • Bottles, spoons and nipples should be sterilized in boiling water for two minutes and then air-dried before use or storage. Bottles and equipment should be left covered until ready-for-use.
  • How to clean, sanitize, and store infant feeding items by the Centers for Disease Control and Prevention

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