Early Infant Diet: Bottle Feeding

Breast milk is considered to be the best source of nutrition for infants. The World Health Organization (WHO) recommends that infants be exclusively breast-fed for the first six months. Under certain circumstances, orphaned infants living in institutions may have access to breast milk from a repository or wet nurse. However, because access is to breast milk is limited for the majority of infants living without parental care, this section will focus on viable alternatives to breast milk commonly used in institutions. One such option for infants who are unable to be breast-fed is iron-fortified infant formula. Because it is often the primary source of nutrition for orphaned infants, it is important that formula be prepared and fed correctly to ensure proper growth and development.

There are several key factors to consider when feeding formula with a bottle, including:

Types of Infant Formula

Infant formula can come in several forms:

  • Powdered Infant Formula (PIF)
    Formula that comes in powder form and should be mixed with clean water before feeding to an infant. This is generally the most widely available and economical option.
  • Liquid Concentrate
    Formula that comes in liquid form and should be mixed with clean water before feeding to an infant.
  • Ready-to-Use
    Formula that is pre-mixed and can be fed directly to an infant.

Many infant formulas produce stages of formula that are designed specifically for different aged infants. The different stages of formula address unique calorie, macronutrient and micronutrient needs at different stages of early childhood development. For example,

  • Stage 1 Formula: newborns or infants 0-6 months
  • Stage 2 Formula: infants 6-12 months
  • Stage 3 Formula: children 12-36 months (1-3 years)

Additionally, different types of formula are available for differing dietary needs.

Iron-fortified Infant Formula

Iron-fortified infant formula is a cow milk-based formula that is the most recommended substitute for breast milk. It provides adequate iron during an infant’s first year, decreasing the risk for iron-deficiency (anemia).

Soy-based Infant Formula

Soy-based formulas were developed for infants who cannot tolerate cow’s milk-based formulas. Soy-based formulas are typically fortified with similar amounts of iron as milk-based formulas.

Hypoallergenic Infant Formula

Hypoallergenic formulas were developed for infants who present allergies to both milk and soy. Learn more about common allergens.

Lactose-free Infant Formula

This type of formula lacks lactose, a carbohydrate found in cow’s milk-based formulas. Infants with lactose intolerance may experience excess diarrhea, gas, discomfort and fussiness if they consume milk-based formulas.

Soy-based formulas are also lactose-free and may be used with infants with lactose intolerance.

Exempt Infant Formula

Exempt (specialized) infant formulas are recommended for infants with metabolism problems, low birth weight, or unusual medical or dietary problems.

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Bottle Feeding

Infants feed best in a relaxing environment. When bottle-feeding infants, caregivers should strive to:

  • Find a comfortable place to sit
  • Hold the infant in their arms or lap
  • Interact with the infant
  • Feed only one infant at a time

In general, infants should be fed in a position that minimizes their risk of choking and allows physical and eye contact with caregivers. The following bottle-feeding tips are to help caregivers create an optimal feeding situation:

  • Wash hands with soap and water before feeding
  • Hold the infant in a semi-upright position with the infant’s head
    • Tilted forward
    • Slightly above the rest of the body
    • Supported by the caregiver
  • Hold the bottle at an angle so the nipple is completely filled with formula
  • Ensure formula flows from the bottle by checking the nipple hole is the right size
  • Periodically burp the infant at natural breaks in feeding

Infants with special needs may require specialized techniques or equipment for optimal bottle feeding. Learn more about meeting special needs.

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Learn about preparing and handling infant formula.