Health considerations when bottle-feeding

If you decide not to breastfeed, or you are unable to breastfeed, commercial iron-fortified formulas can give your baby the nutrition they need. Infant formulas have the right amounts of protein, calories, fat, vitamins, and minerals for growth. However, formula doesn't contain the immune factors that are in breastmilk. The immune factors in breastmilk help prevent infections and other health conditions throughout a baby's life.

Infants who take enough iron-fortified infant formula usually don’t need vitamin and mineral supplements. However, the American Academy of Pediatrics recommends vitamin D supplementation for all babies drinking formula until they are drinking at least 32 ounces a day. Fluoride supplements are recommended for babies whose primary water supply is not fluoridated. Check with your baby's healthcare provider about vitamin D and fluoride supplements.

Helpful hints for feeding your baby

• Breastmilk only is the ideal feeding for at least 6 months. This means no water, sugar water, or formula.

• Wait until breastfeeding is well established before giving your baby breastmilk in a bottle.

• Working mothers can use a breast pump on break time and refrigerate or freeze the milk for later use as a bottle-feeding. Refrigerated breastmilk should be used within 24 hours after pumping. Frozen breastmilk is good for several months in the freezer. Fathers and other family members can be involved in feeding time if breastmilk is offered from a bottle occasionally.

• Offer cow's milk–based formula with iron as the first choice of formula if not breastfeeding.

• Keep your baby on breastmilk or baby formula until they are 1 year old. After this time, you may switch to whole milk. Children under 2 years old should not drink skim or low-fat milk.

• It’s important to follow the formula preparation directions exactly as directed on the packaging. Using too much water can result in poor weight gain. It's also important to discuss your water supply with your child's healthcare provider. In some areas, water must be boiled first, or bottled water should be used.

• Bottles should never be propped up.

• Babies should never be put to sleep with a bottle. This can cause cavities to develop.

• All babies, whether breastfed or bottle-fed, should be offered a feeding whenever they show signs of hunger.