A Guide to Bottle-Feeding a Newborn

Bottles

You’ll need bottles, of course. These can be made from glass, plastic, silicone, and/or disposable polypropylene. Some parents find it helpful to try a few different types and brands to see which one makes bottle-feeding easiest for their baby.

If experimenting with several options, “try each bottle one at a time,” suggests Jennifer Shakespeare, a licensed social worker and certified birth and postpartum and infant care doula in Wakefield, Massachusetts. And don’t give up on bottle-feeding if the baby doesn’t take to it at first. “Even if the baby doesn’t like it right away, you can try again in a few days,” she adds. “Remember, just as you’re getting acclimated to the baby, the baby is getting acclimated to the world.”

Once you find a bottle you and baby like, get a few of them so that you aren’t constantly washing them between feedings.

Nipples

When choosing the bottle nipples, check the product’s packaging. “Make sure the nipple used for the bottle is consistent with the baby’s age,” says Jarret Patton, M.D., a board-certified pediatrician and advocate for children’s health issues in eastern Pennsylvania. “Using a nipple that is too advanced for them may supply too much milk or formula at once, which can cause choking.”

For newborns and until infants are 3 to 4 months old, use a slow-flow nipple (size 1 or Newborn). Around 4 months old, you can move to the next size for a slightly faster flow, Patton says.

Formula, If You’re Formula Feeding

You’ll also need something to feed your baby! For newborns, that’s only formula, human milk, or both.

If you’re formula feeding, choose an iron-fortified formula made specifically for infants, as recommended by both the Centers for Disease Control and Prevention and the American Academy of Pediatrics. Formula sold in the United States is regulated by the Food and Drug Administration so that it’s safe and nutritious for babies. Homemade formula isn’t considered safe.

Maybe a Breast Pump, If You’re Using Breast Milk

If you’re planning to express breast milk to bottle-feed your baby, you’ll likely want to purchase a breast pump, too. Some parents also have success with hand expression.

Preparing for Feedings

Boil bottle parts before using them for the first time to be sure they’re sterilized. (If you’d like to sterilize them again in the future, you can use a microwave sterilization bag or sterilizer.)

After that first-time sterilization, you can wash bottle parts between feedings in hot, soapy water (some companies make a special soap with gentle ingredients). Scrub the bottles and parts with a bottle cleaning brush, or put the pieces in the top rack of a dishwasher (a dishwasher basket can hold smaller pieces like nipples, caps, rings, etc.).

Air-dry all items on a dish or bottle rack.

How to Bottle-Feed Your Baby

If you’re formula feeding, first prepare the formula according to the package’s instructions. If you’re using breast milk, you can use freshly expressed milk or milk that’s been covered and refrigerated for up to four days. You can also thaw frozen breast milk by setting its container inside another container of warm water.

Neither formula nor breast milk needs to be warmed, but if you want to do so, never use a microwave, which can warm liquids unevenly, risking burning your baby. Instead, you can hold the bottle under warm running water.

How to Hold a Newborn While Bottle-Feeding

To feed the baby, hold them close and offer them a bottle with a small amount of formula or breast milk. (You can always give them more later if they still seem hungry.)

Position the bottle at an angle so that milk only comes out when they suck. Finding a comfortable angle that works for you and your baby may take a little trial and error, says Edward Kulich, M.D., a board-certified pediatrician who makes house calls in the New York City area.

Let the baby take breaks from drinking when they seem to want to. Stop and burp your baby after each ounce they drink to prevent excess spit-up and stomachaches.

Bottle-Feeding Your Baby After Breastfeeding or Chestfeeding

If you’ve been chest/breastfeeding and would like to introduce the bottle, wait until nursing has been well established before doing so. It may be helpful to have someone else—a partner who isn’t nursing or a caregiver—introduce the bottle so the baby isn’t instinctively seeking out the breast or chest.

Ways to Know Your Baby’s Hungry

Babies can go through phases where they’re very hungry often, and others when they don’t want to feed as frequently—so it’s not always obvious to parents when a baby is in the mood for food.

“Determining when your baby is hungry can be difficult, since they only have a limited number of ways to communicate,” Patton says. Here are some ways to figure out your baby’s hunger status:

Look for Cues

The most obvious sign your newborn is hungry? They just woke up. “Almost all babies wake up when they’re hungry,” says Jada Shapiro, a birth and postpartum doula and certified lactation support counselor in New York City.

When babies are hungry, they tend to open their mouths, stick out their tongues, pucker, move their heads from side to side, and put their fingers, fists, and hands to their mouths.

Sucking on an object is sometimes a hunger cue, but not always. “Parents often mistake their baby sucking on something as an indication that they’re hungry,” Patton says. “In the early months, babies are equipped with a sucking reflex that makes them suck on anything placed near their mouth, whether they’re hungry or not.”

Use the Clock

“Timing is generally more important than physical signs,” says Talitha Phillips, a labor and postpartum doula and CEO of Claris Health, a nonprofit clinic in the Los Angeles area that focuses on sexual health and pregnancy and offers parenting classes. “If it’s been more than two hours since the last feeding and I’m seeing signs, I suspect it’s hunger.”

If it’s been less than two hours and you’re unsure whether the baby’s hungry, try other soothing strategies, like changing the baby’s diaper.

How to Know Your Baby Is Getting Enough to Eat

If you’re wondering whether you’re feeding your baby enough, there are two ways to tell when you’re bottle-feeding: input and output.

Keep Track of the Ounces

With bottle-feeding your child, you can see exactly how much they’re taking in per day. Shapiro shares this advice for how much breast milk or formula babies tend to consume in their first days, weeks, and months:

In the first one to three days of life, babies will eat 1 to 1.5 ounces of formula or breast milk every one to three hours. (It can be as little as 1 to 2 tablespoons if they’re getting colostrum—that thick, nutrition-packed, first breast milk.)

At around Day 3 to 5 through the end of the first month, babies will eat 2 to 3 ounces every two to three hours.

Around 8 weeks of age, babies will eat 4 to 5 ounces at a sitting, at varying points throughout the day.

Shapiro’s rule of thumb: At 1 to 6 months old, babies should eat an average of 25 to 30 ounces a day total. Divide that number by how many times they drink the bottle to see how much they should get at each feeding.

Watch for Spit-Up

A little spit-up is normal, but if your baby is frequently spitting up after feedings, or if the spit-up is excessive—it’s all over their clothes and/or yours after every feeding—it could be a sign of overfeeding. Talk to your doctor if that’s the case and work together on solutions. Limiting how much a baby consumes at each feeding or taking more time between feedings sometimes helps.

Check Your Baby’s Diaper

Taking a peek at diaper change time can help you feel peace of mind that your child is well fed. “What comes out of the baby is how we know they’re getting enough,” Shapiro says.

For the first week, look for one wet diaper per number of days old they are (for example, one wet diaper on Day 1, two wet diapers on Day 2, and so on). “Those are the minimums,” Shapiro says.

She says that on the first day, your baby’s poop will have a sticky tarlike consistency; on Days 2 and 3, it will be greenish in color; on Days 3 and 4, it will be yellow and mustardy, pastier and thicker, and seedlike in texture.

Let the Baby Decide When They’re Done

Let your baby tell you where they’re at: “You don’t want to overfeed the baby,” Shapiro says, adding that it’s common for parents and caregivers to want the baby to finish the bottle. If your baby is trying to pull away, let them do so. They may need a break, need to be burped, or they may actually be finished with the feeding. “Let the baby be the guide,” Shapiro says.

Signs they’re done feeding include turning away from the bottle, thrusting the nipple out of their mouth, sucking at a slower pace, lips fluttering, and seeming sleepy.

Shapiro says that “a clear sign they’re starting to become full is that their hands start to relax” and are no longer clenched in tight fists. They still may suck on the bottle as you pull it away, but this will be less forceful when they’re not interested, she says. Take the bottle away when they’re done drinking from it.

4 Important Bottle-Feeding Safety Tips

It’s best to observe the following safety tips when bottle-feeding your infant.

1. Only Put Formula or Breast Milk in the Bottle

In the past, some parents would mix cereal into bottles to thicken formula for infants with reflux, says Kulich. “But this is less common today with special formulas formulated to be thicker,” he says. It’s now known that baby cereal in a bottle can be a choking hazard. Plus, it adds excessive calories, says Kulich.

2. Use a Clean Bottle for Each New Feeding

“After the baby is fed from a bottle, you don’t want to refeed from the same bottle,” Shapiro says. “The combination of saliva and formula or breast milk can cause bacteria to grow.”

She says that if it’s been more than an hour since you made the bottle, you should throw the remaining contents away. Use prepared formula within two hours of preparation and within one hour from when feeding begins, she says.

3. Hold the Bottle for Your Baby

Avoid propping up the bottle with a blanket or pillow and resting it under the bottle close to the baby’s face. “That can pose a safety concern if they’re unattended and the blanket or pillow covers their face,” Phillips says.

4. Don’t Leave Your Newborn Alone with the Bottle

Babies shouldn’t be left on their own with a bottle until they can hold it without support and remove it themselves, Shakespeare says. (Usually, they aren’t able to do that until around 6 months old.) And never let a baby sleep with their bottle, since it can increase the risk of choking and ear infections.

Extra Help with Bottle-Feeding

If you want to feel more prepared, consider taking a newborn care class before your baby arrives. This will cover bottle-feeding as well as basics like diapering, swaddling, and safety.

Ask your doctor or hospital if there’s a local class they recommend. Often, these are offered at low cost, and some areas have local programs that offer courses like this for free. You can also find newborn care courses online.

You may also consider asking a family member or friend to lend a hand, or hiring a baby nurse or postpartum doula to help with feeding and other baby care issues. Having extra help on hand may give you time to rest.

Always call the doctor if you notice the baby:

• Is lethargic
• Isn’t peeing or pooping as much as expected
• Has a drastic change in stool (such as sudden diarrhea)
• Is running a fever
• Rejects the bottle or doesn’t feed often

Even if something just “doesn’t seem right,” you should call the doctor.

“If they’re acting very different from their normal behavior, that’s a good reason to check in,” Shapiro says. “Always reach out to your pediatrician anytime you feel uncertain that the baby is thriving, or if the baby is having a medical issue.”

The doctor can check for problems and make sure the baby is gaining weight as expected. They may want to watch you bottle-feed your child to help correct any issues, adds Phillips.

Once you get the hang of it, bottle-feeding can be an opportunity for everyone in the family to connect with its newest member. “Enjoy the feedings with your little one,” Phillips says. “Look into your baby’s eyes and use this as a sweet bonding moment.”

You May Also Like:

• The Fourth Trimester: A Postpartum Guide to Life with a New Baby
• 6 Tips for Managing Sleep with a Newborn
• Well-Child Visits: A Guide to Taking Your Baby to the Doctor