Baby_with_bottleThere are many reasons a mother chooses not to breastfeed and that bottle feeding is the preferred or safest method. Certain medications or medical conditions can necessitate a mother to bottle feed. Other times it can be a situation with the infant and formula feeding is the preferred, such as a newborn metabolic disorder. Or there can be a situation when the mother does both, breast and bottle feed.

There are specific things that should be followed if a newborn is bottle feed. These include:

    • Do not give a newborn cow’s or goat’s milk during the first year of life
    • Do not give a newborn 1% or 2% or evaporated milk
    • Always sterilize the equipment before feedings
    • Always wash your hands before preparing formula

Manufactured formula can not 100% replicate breastmilk. Recommended formula is those that are iron-fortified. There are both animal/milk based formulas and those that are soy based formulas. Formulas can come ready-to-feed, liquid concentration or as a powder.

Ready-to-feed formula is the most expensive and usually very little risk of contamination. It is important to add water to ready-to-feed formulas because this can result in the baby not receiving enough nutrients and too much water. Receiving too much water can lead to your baby becoming very sick, causing water toxicity and possibly seizures.

Liquid concentrated formula is a liquid that requires you to mix with water in a 1:1 ratio. This means that for every 2 ounces of concentrated formula you need to mix it with 2 ounces of water. When you are mixing the formula with the water you need to make sure that the water is from a clean source because the water that is dirty or contaminated can make the baby very sick.

This consumer report video shares important tips on infant formula:

Powdered formulas require that you mix it with water. It is important that you follow the directions on how much water to mix.

Water considerations:

Tap water from municipal systems is safe in most parts of the United States. However, if your home as lead, copper or other contaminants in the pipes, then this can get into the water. There are more contaminants in the hot tap water and you should always run the tap water on cold for a few minutes before you use the water.  Some places put fluoride into the water and too much fluoride given to your baby can result in what is called enamel fluorosis, which can cause white lines on your baby’s teeth.

Bottle water that has met the Food and Drug Association standards have the impurities removed, but not necessarily sterilized. This means that the baby can still get sick.The American Association of Pediatrics recommends that all water is boiled for 1-2 minutes in a covered pan, then cooled. Once cooled it can be mixed with the formula.


There are many different types of bottle and nipples each with good and bad points. Each baby will be different and finding the right type of bottle and nipple may take a few tries until you find the one that works the best. Consumer Reports has a Baby Bottle Guide that provides all kinds of information about the various baby bottle products and what was good and bad about each. For access Click Here


Nipple holes should allow a few drops of formula to come out of them when they are tipped upside down. If the holes are too big then the formula will come out too fast and your baby may not be able to swallow the formula at the same rate. If the holes are too small then the formula will not come out as easy and your baby will have to work harder to get the formula to come out. In general, smaller babies do better with slow flow nipples and bigger babies do better will do better with a faster flow nipple. Try to avoid latex nipples because after time babies can develop an allergic reaction.


Bottles can come in a variety of shapes, the classical shape bottle, the angle-neck bottle, natural flow bottle and ones with disposable liners. Many bottles are designed to prevent the baby from swallowing air, which is the angle-neck bottle and natural flow bottles.

Bisphenol A

BPA Bisphenol A

BPA is a chemical that is used to harden plastics and to keep bacteria from contaminating foods. Over time traces of this chemical can enter into ours and the baby’s system. It is important to avoid this chemical and look for bottles or bag liners that are BPA free or the recycle code of “7” or”PC”


Watch these videos by Nurse Practitioner Barb on how to prepare and store formula:


The importance of Breast Feeding