Bottle feeding

The Swedish National Food Agency recommends full-time breastfeeding of all babies up to 4-6 months, and most breastfeeding problems can be solved. However, if for any reason you choose bottle feeding, here are some useful tips.

Infant formula – powdered or ready-mixed
Infant formula, also known as baby formula or formula milk, is available either as a powder or ready-mixed and vacuum packed. Read the instructions on how to prepare it.

Here are a few tips:
• Always wash your hands before preparing the formula.
• Wash and boil all the equipment between feeds.
• Newborn babies should preferably be given freshly prepared formula.
• Never add anything to the formula, since other drinks can make infants sick.
• Check the temperature of the formula by pouring some on the inside of your wrist. It should be lukewarm when you feed it to the baby.
• Never reheat formula. If there is any left over, pour it away.

How much formula should you give to the baby?
Age, weight, time of day, activity level, warm weather, illness and growth rate – all these factors affect your infant's food requirements. You will find general indications on the formula package. Infants usually eat the amount they require, so learn to recognise your baby's hunger signals.

Here are signs that your baby is eating enough formula:
• if the baby remains satisfied and contented for a couple of hours after a meal
• if the baby is gaining weight at a steady rate
• if you are changing baby's nappy at least six times a day

Continue feeding your infant breast milk or formula as its main food until it is about 12 months old. Of course, it's fine to give bottle fed babies tastes of solid foods just like breastfed babies. There is no need to change formulas at six months, which is usually the age when breastfed babies are ready to try solid foods.

How to bottle feed
Bottle feeding is quicker than breastfeeding, which can take about half an hour. When bottle feeding, spend a little extra time with the baby in your arms to make the feeding session a cosy and intimate time.

• Hold the baby as close as possible, ideally with skin-to-skin contact, and have eye contact during the feed.

• As with breastfeeding, you should sit comfortably in a calm environment while feeding. You might want to switch off your mobile phone.

• Wait for the child to open its mouth before giving it the bottle. You can stimulate the baby's searching reflex by touching its cheek with the teat. If the baby turns to look for something, don't follow after it with the bottle. Instead, let the baby come back for its food.

• If the hole in the teat is too big, the baby will swallow too much air and may get stomach pain. If you angle the bottle so that the teat is filled with formula, the baby will swallow less air. You can make the hole bigger as the baby grows.

• If the baby seems to be sucking hard without getting any formula, the hole may be too small, the teat may be too hard or a vacuum may have formed inside the bottle because you screwed the top on too tight. Hardly any formula should drip out of the bottle when you turn it upside down.

• Trust the baby's sense of fullness. Your baby's appetite may vary so the bottle might not be emptied every time. The baby might also pause to burp and then start feeding again.

• Don't let the baby drink out of the bottle unassisted. It is important both for the bonding process and the baby's safety that you sit with the baby.

• If your infant falls asleep while feeding, let it sleep. But don't leave it lying down with the bottle to suck.

If you suspect your baby has a food intolerance
Ask a paediatric nurse what type of formula is best for your baby.
If you suspect your baby has an intolerance or allergy, contact a paediatric centre for a consultation. Read more about food allergy symptoms

The most common type of infant formula is made of cow's milk with a modified composition. If the baby is found to be allergic to cow's milk protein, a paediatrician can give you a prescription for formula without cow's milk protein. Do not use soya-based infant formula without first consulting a doctor or nurse.

Breastfeeding combined with formula
If you give the baby formula to supplement your breast milk, it is recommended to give the baby the breast milk before the formula. This will make the baby suck more strongly and stimulate your milk production. Some babies may prefer feeding from a bottle because the milk might flow out faster.

Breastfeeding and bottle feeding require slightly different sucking techniques, so if you are only using the formula temporarily, you might consider giving it from a cup or a spoon bottle. However, bear in mind that your body will produce less milk if the baby is not feeding at the breast and you do not pump the milk out yourself. If you want to increase your breast milk production again later on, allow the baby to feed as often as it wants, which is usually about once every two hours.

More tips and advice
Places to contact for advice about infant formula:
• Paediatric clinic
• Breastfeeding centre
• Maternity clinic
• Medical helpline
• Association of Lactation Consultants (Amningshjälpen)
• You can read more about infant formula on the National Board of Health and Welfare's website.