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Dads feeding baby

How often should I bottle-feed my baby?

When it comes to bottle-feeding or breastfeeding, all health professionals recommend ‘responsive’ feeding. This means learning to recognise the early signs that your baby is hungry (often called feeding cues) and never forcing them to finish a feed if they’ve had enough.

This is particularly important for babies who are formula fed because they can be over-fed and either become sick or put on too much weight (UNICEF UK, 2016).

Responsive feeding may therefore help reduce the risk of obesity (DiSantis et al, 2011).

Watch our video for tips on how to bottle-feed your baby.

How do I know when my baby is hungry?

Your baby’s early feeding cues can include movements like:

  • sticking their tongue out
  • putting their hands to their mouth
  • starting to get restless
  • opening their mouth and turning their head to the side
  • sucking on their fists or fingers.

(NHS, 2015; UNICEF UK, 2016)

Crying is usually a late sign of hunger. If you wait until your baby starts crying for milk, you might find it more difficult to settle them for a feed (UNICEF UK, 2016). If your baby is upset, try to soothe them before you offer a feed. Skin-to-skin contact is great for calming babies.

How do I bottle-feed my baby?

You can read more about expressing breastmilk for a feed. If you’re using formula milk, you’ll need to safely prepare your baby’s feed first

Find somewhere comfy to sit and hold your baby close to you. They should be fairly upright, with their head supported, so they can breathe and swallow comfortably (NHS, 2015; UNICEF UK, 2016).

Feeding your baby responsively is a lovely way to bond with them (UNICEF UK, 2016; First Steps Nutrition Trust, 2017). Try talking to them gently and look into their eyes to reassure them during feeds. This helps them to feel safe and loved (NHS, 2015; UNICEF UK, 2016; NHS, 2018).

Focusing on your baby while you’re feeding them also helps to pick up their feeding cues. Research has shown that mums who were distracted by things like using a mobile device or talking to another adult were less sensitive to their baby’s cues. Distraction made mums more likely to overfeed their baby, possibly increasing their risk of obesity (Golen and Ventura, 2015).

Hold them upright and rub or pat their back to bring up any wind (NHS, 2015; UNICEF UK, 2016). Read our tips for bottle-feeding your baby for more information.

Babies should never be left alone to feed with a propped-up bottle, as they could choke on the milk (NHS, 2015; First Steps Nutrition Trust, 2017).

A quick guide to responsive/paced bottle feeding:

  • Feed on demand – rather than to a schedule. 

  • Watch out for your baby’s hunger cues. 

  • Hold your baby in an upright position, with their head supported, close to the parent’s body.  

  • Touch the teat against your baby’s top lip, encourage them to open their mouth and pull the teat into the mouth. 

  • Keep the bottle in a horizontal position (not tipped above your baby where the weight of the milk could force them to drink too quickly). A horizontal positions means when your baby pauses in sucking, the milk stops flowing, so they aren't forced to drink. 

  • Allow pauses in drinking. When your baby pauses, withdraw the bottle slightly or completely to give them a break. They may need to burp in the pauses.   

  • Short breaks allow babies to register fullness, so they can regulate the amount of milk they drink. 

  • If your baby is showing hunger cues, offer the bottle again. 

  • Be careful not to force your baby to take the bottle or to finish the bottle. 

  • Follow your baby’s lead on how much they want to drink, rather than going by how much is in the bottle. 

(UNICEF 2017, UNICEF 2016, NHS 2015) 

Who should bottle feed my baby?

Babies build up trust and confidence during feeding, gradually learning what to expect. This is partly how they develop healthy emotional and social attachment (UNICEF UK, 2016). In the early weeks and months, it might help to keep most of your baby’s bottle-feeds for you and your partner, or one other trusted person (NHS, 2015; UNICEF UK, 2016).

If someone else is bottle-feeding your baby, talk to them about how you feed your baby so there’s some consistency (UNICEF UK, 2016).

How much milk should I give them?

You can usually trust your baby to feed according to their appetite, so be guided by them. In the early weeks, your baby might be unpredictable, and their needs may change day by day. Newborn babies generally take quite small amounts of formula to start with in frequent intervals (NHS, 2015; First Steps Nutrition 2021).

As a general rule, by the end of the first week most babies will require approximately 150ml to 200ml per kilogram of body weight per day, until they’re six months old. For example, a baby weighing 6kg at the end of four months, would approximately need 900ml to 1200ml of infant formula per day (First Steps Nutrition Trust, 2021).

A formula fed baby will need to be fed according to the guidelines for their weight and age (First Steps Nutrition, 2021).

Babies are likely to need night feeds for first year of life, as 70% of 6-18 month olds wake up at least once per night (Hysing, 2014)

Babies start eating solid food from about six months – this leads to a gradual reduction in the amount of milk they need. But as milk is still their main food for the first year of life, most babies are still drinking around a pint of milk a day at 12 months (NHS, 2015; First Steps Nutrition 2021).

What if my baby refuses the bottle or is fussy with bottle-feeding?

If your baby is hard to feed after the first 20ml to 30ml then they may need a break at this point (see the information about responsive feeding above). You could try changing their position, putting them over your shoulder to see if they need burping and then offer them the bottle again. If they're not interested, they may just need to feed little and often – this is normal for some babies (NHS, 2015).

If this doesn't help or your baby is often fussy or fights the bottle, ask your health visitor to watch you feed them, as they might have some suggestions (NHS, 2015).

If you’ve breastfed your baby so far, they may be reluctant to take a bottle at first. The different sucking actions needed may confuse them and they may not take a bottle feed from you (Zimmerman and Thompson, 2015).  There are plenty of different things you can try to help your baby.

  • You could ask someone else to offer them a bottle.
  • Hold your baby in a different position from your normal breastfeeding one.
  • Offer the bottle when your baby isn't particularly hungry. When a breastfed baby is hungry, they are thinking about the breast, so might get agitated if offered a bottle until they learn that this is also food.
  • You can try a variety of teats.
  • Some breastfed babies never drink from a bottle, but move straight onto a sippy cup (NHS, 2017).

How do I know if my baby is getting enough milk?

There are certain signs that will tell you if your baby is getting enough milk. For example, their weight gain and number of wet and soiled nappies. Generally, your baby should be producing around six wet nappies a few days after birth (NHS, 2017).

Read our article Is my baby feeding well and getting enough milk? to find out more.

What sort of bottles and teats should I use?

You can use whichever bottles and teats you and your baby prefer. Yet the use of larger bottles (more than 6oz) has been associated with increased formula intake among two month old babies, leading to a risk of overfeeding (Wood et al, 2015).

Some teats are more suited to paced bottle feeding.  Choose teats that fill with milk when the bottle is held in a horizontal position, as some need the bottle to be inverted to fill the teat. These are less suited to responsive feeding.

You can buy teats with different sized holes that vary the flow depending on your baby’s age and ability to suck and swallow (UNICEF UK, 2016; Which?, 2018).

It’s important to replace bottles and teats when they look worn. This is because it’s not possible to keep them clean otherwise and worn teats can also disintegrate or split (NHS, 2017).

You might like to take a look at our page on how to make up formula safely.

This page was last reviewed in March 2021.

Further information

We support all parents, however they feed their baby. If you have questions, concerns or need support, you can speak to a breastfeeding counsellor by calling our support line on 0300 330 0700, whether you are exclusively breastfeeding or using formula milk. Breastfeeding counsellors have had extensive training, will listen without judging or criticising and will offer relevant information and suggestions. You can also find more useful articles here.

You might find attending one of our Early Days groups helpful as they give you the opportunity to explore different approaches to important parenting issues with a qualified group leader and other new parents in your area.

Make friends with other parents-to-be and new parents in your local area for support and friendship by seeing what NCT activities are happening nearby.

Read more about bottle-feeding in the UNICEF UK 2016 guide to infant formula for parents.

DiSantis KI, Hodges EA, Johnson SL, Fisher JO. (2011) The role of responsive feeding in overweight during infancy and toddlerhood: a systematic review. International Journal of Obesity. 35(4):480-492. Available at: https://www.nature.com/articles/ijo20113 [Accessed 29 March 2021].

First Steps Nutrition Trust (2021) A simple guide to infant formula, follow-on formula and other infant milks. Available at: https://www.firststepsnutrition.org/parents-carers/ [Accessed 29 March 2021].

Golen R, Ventura A. (2015) Mindless feeding: Is maternal distraction during bottle-feeding associated with overfeeding? Appetite. 91:385-392. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4464819/ [Accessed 29 March 2021].

Hysing M, Harvey AG, Torgersen L, Ystrom E, Reichborn-Kjennerud T, Sivertsen B. (2014)Trajectories and predictors of nocturnal awakenings and sleep duration in infants. J Dev Behav Pediatr.  Jun;35(5):309-16. Available at https://pubmed.ncbi.nlm.nih.gov/24906032/ [Accessed 29th March 2021] 

NHS. (2015) Guide to bottle feeding. Available at: https://www.unicef.org.uk/babyfriendly/wp-content/uploads/sites/2/2008/02/start4life_guide_to_bottle_-feeding.pdf  [Accessed 29 March 2021].

NHS. (2017) Formula milk: common questions. Available at: https://www.nhs.uk/Conditions/pregnancy-and-baby/Pages/infant-formula-questions.aspx [Accessed 29 March 2021].

UNICEF UK. (2016) A guide to infant formula for parents who are bottle feeding. Available at: https://www.unicef.org.uk/babyfriendly/wp-content/uploads/sites/2/2016/12/Parents-guide-to-infant-formula.pdf [Accessed 29 March 2021].

Which? (2018) Baby bottles and teats. Available at: https://www.which.co.uk/reviews/baby-feeding-products/article/buying-baby-feeding-products/baby-bottles-and-teats [Accessed 29 March 2021].

Wood CT, Skinner AC, Yin HS, Rothman RL, Sanders LM, Delamater A, Ravanbakht SN, Perrin EM. (2015) Association between bottle size and formula intake in 2-month-old infants. Academic Pediatrics. 16(3):254-259. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4808476/ [Accessed 29 March 2021].

Zimmerman E, Thompson K (2015) Clarifying nipple confusion. Journal of Perinatology. 35(11):895-899. Available at: https://www.ncbi.nlm.nih.gov/pubmed/26181720 [Accessed 29 March 2021].

 

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