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Formula Feeding FAQs: Starting Solids and Milk

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Whether you've decided to formula feed your baby from the start, are supplementing your breast milk with formula, or are switching from breast milk to formula, you're bound to have questions. Here are answers to some common queries about formula feeding.

When should I introduce solid foods and juice?

The best time to introduce solid foods is when your baby has developed the skills needed to eat. This usually happens between the ages of 4 and 6 months. How do you know when your baby is ready?

Babies who are ready to eat solids foods:

are interested in foods (for example, they may watch others eat, reach for food, and open their mouths when food approaches)
hold up their heads well, and sit up with little or no help
have the oral motor skills needed to eat (meaning that they don't push food of the mouth but move it to the throat and swallow it)
usually weigh twice their birth weight, or close to it

Wait until your baby is at least 4 months old and shows these signs of readiness before introducing solids. Babies who start solid foods before 4 months are at a higher risk for obesity and other problems later on. They also aren't coordinated enough to safely swallow solid foods and may choke on the food or inhale it into their lungs.

When the time is right, start with a single-grain, iron-fortified baby cereal (rice cereal has traditionally been the first food for babies, but you can start with any you prefer). Start with 1 or 2 tablespoons of cereal mixed with breast milk, formula, or water. Another good first option is an iron-rich puréed meat. Feed your baby with a small baby spoon, and never add cereal to a baby's bottle unless your doctor recommends it.

At this stage, solids should be fed after a nursing session, not before. That way, your baby fills up on breast milk, which should be your baby's main source of nutrition until age 1.

When your baby gets the hang of eating the first food, introduce a variety of other foods, such as puréed fruits, vegetables, beans, lentils, or yogurt. Wait a few days between introducing new foods to make sure your baby doesn't have an allergic reaction.

Experts recommend introducing common food allergens to babies when they're 4–6 months old. This includes babies with a family history of food allergies. In the past, they thought that babies should not get such foods (like eggs, peanuts, and fish) until after the first birthday. But recent studies suggest that waiting that long could make a baby more likely to develop food allergies.

Offer these foods to your baby as soon as your little one starts eating solids. Make sure they're served in forms that your baby can easily swallow. You can try a small amount of peanut butter mixed into fruit purée or yogurt, for example, or soft scrambled eggs.

Note: There is no benefit to offering fruit juice, even to older babies. Juice can fill them up and leave little room for more nutritious foods, promote obesity, cause diarrhea, and even put a baby at an increased risk for cavities when teeth start coming in.

When can I start giving my baby cow's milk?

Before their first birthday, babies still need the nutrients in breast milk or formula. But at 1 year old, your baby can try whole cow's milk. Why not skim or 2%? Because babies need the fat in whole milk for normal growth and brain development during the busy early toddler period.

You can transition your baby from formula to whole milk by beginning to replace bottles of formula with bottles — or sippy cups — of milk. By 1 year old, your baby should be eating a variety of other foods and only 2-3 cups (480-720 milliliters) of milk per day.

If your baby was put on a soy or hypoallergenic formula because of a milk allergy, talk to your doctor before introducing milk.

When can I start giving my baby water?

In their first few months, babies usually don't need extra water. On very hot days, most babies do well with additional feedings. But you may want to offer your infant water, especially if your baby's pee is dark or your baby pees less often than usual.

Once your baby is eating solid foods, you can offer a few ounces of water between feedings, but don't force it. Water that is fortified with fluoride will help your baby develop healthy teeth and gums. If you live in an area with nonfluoridated water, your doctor or dentist may prescribe fluoride drops.

Note: All information is for educational purposes only. For specific medical advice, diagnoses, and treatment, consult your doctor.
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Formula Feeding FAQs: Starting Solids and Milk (for Parents)

Whether you plan to formula feed your baby from the start, want to supplement your breast milk with formula, or are switching from breast milk to formula, you probably have questions.

Here are answers to some common questions about formula feeding.

When Can My Baby Try Solid Foods?

Doctors recommend waiting until your baby is about 6 months old to start solid foods. Some babies may be ready for solids sooner than 6 months, but wait until your baby is at least 4 months old.

Babies who are ready to eat solids foods:

are interested in foods (for example, they may watch others eat, reach for food, and open their mouths when food is near)
hold up their heads well, and sit up with little or no help
don't push food of their mouth (which is a natural tongue reflex that disappears when babies are 4–6 months old)
usually weigh twice their birth weight, or close to it

Talk to your doctor about the right time to start solid foods.

How Do I Introduce Solid Foods?

When the time is right, start with a single-grain, iron-fortified baby cereal. Start with 1 or 2 tablespoons of cereal mixed with breast milk, formula, or water. Feed your baby with a small baby spoon. Don’t add cereal to a baby's bottle unless your doctor recommends it.

When your baby gets the hang of eating the first food, introduce other foods from all food groups, such as puréed meats, fruits, vegetables, grains, beans, and yogurt. Wait a few days between introducing new foods to make sure your baby doesn't have an allergic reaction.

You can include foods that are more likely to cause allergies — such as peanuts, eggs, cow’s milk, seafood, nuts, wheat, and soy — among the foods you introduce to your infant. Waiting to start these foods does not prevent food allergies.

Talk to your doctor before giving foods that contain peanuts if your baby has severe eczema or an egg allergy, as these conditions make an allergy to peanuts more likely. Eating peanut-containing foods early on may lower a child’s chances of developing a peanut allergy. But your doctor will need to decide if you can give peanuts to your baby, and the safest way to do it. Usually, this requires allergy tests.

Should We Avoid Some Foods?

Yes, don’t give your baby:

foods with added sugars or no-calorie sweeteners
high-sodium foods
honey until after the first birthday. It can cause botulism in babies.
unpasteurized juice, milk, yogurt, or cheese
regular cow's milk or soy beverages instead of breast milk or formula before 12 months. It’s OK to offer pasteurized yogurt and cheese.
foods that may cause choking, such as hot dogs, raw carrots, grapes, popcorn, and nuts

Always supervise your child when eating. Make sure your child is sitting up in high chair or other safe place.

When Can My Baby Have Cow's Milk?

Before their first birthday, babies still need the nutrients in breast milk or formula. But after that, they’re ready to switch to cow's milk.

Most kids under age 2 should drink whole milk. If a toddler is overweight or there is a family history of obesity, high cholesterol, or heart problems, your doctor might recommend switching to reduced fat (2%) milk.

If your child can’t drink cow’s milk, choose an unsweetened soy beverage fortified with calcium and vitamin D. Other milk alternatives, like almond, oat, rice, or coconut milk, have less protein and may not be fortified.

How Do We Switch to Cow’s Milk?

You can switch your baby from formula to whole milk by replace bottles of formula with bottles — or sippy cups — of milk. By 1 year old, your baby should be eating a variety of solid foods and drinking about 16 to 24 ounces (480–720 milliliters) of milk per day.

When Can I Start Giving My Baby Water and Other Drinks?

In their first 6 months, healthy babies drinking enough formula usually don't need extra water. Once your baby is eating solid foods, you can offer a small amount of water between feedings, up to 4–8 ounces a day.

Water that has fluoride helps prevent tooth decay. If your water does not have fluoride, talk to your doctor or dentist about fluoride drops.

Do not give juice to babies younger than 12 months. After your child’s first birthday, limit 100% fruit juice to no more than 4 ounces a day. Always serve juice in a cup, not in a bottle. Don’t give your child sugar-sweetened beverages, including soda, juice drinks, sports drinks, and flavored milks.

Reviewed by: Mary L. Gavin, MD

Date reviewed: November 2021

11 Questions and Answers - ROCROS

Once you have chosen your infant formula, read the formula instructions carefully. All manufacturers pay great attention to the issue of proper food preparation. The bottle and nipple are also selected according to the age of the child. At the same time, there are still questions that parents often have when feeding a baby from a bottle.

1. How to properly prepare a formula bottle

We sterilize bottles and teats. Better not just one, suddenly the nipple will fall or the bottle will tip over. You should always have a spare bottle and nipple.
We wash our hands. This is the basic rule and you should always remember about it.
Fill the bottle with water. If you are using tap water, boil and cool it to the temperature indicated on the package. Purchased baby water can not be boiled, but it can be stored and used for 1-2 days after opening. It is specially designed for preparing baby food and does not require boiling.
Pour mixture into the bottle in the amount indicated on the baby food package according to the child's age.
Close bottle with a lid with a teat and put on the cap. After that, the mixture is intensively stirred.

An electric baby bottle warmer can be used to heat formula to the correct temperature.

Check the food temperature on your wrist before feeding your baby.

2. How many bottles per day for formula-fed newborns

Depends on the age of the child, the feeding schedule and the specific formula feeding chart. Buy six bottles of different sizes - 125 ml, 150 ml, 240 ml. Start small, the big ones will come in handy. And yet, the more often you are ready to sterilize the bottles, the smaller the number you will need to purchase.

3. Why do I need a measuring spoon

A measuring spoon has a certain volume in grams. Therefore, each manufacturer puts his spoon in the package. You need to add the mixture with full measuring spoons, but without a slide.

4. How far to tilt the feeding bottle

The main thing here is to hold the bottle at such an angle that there is no empty space in the nipple without formula. Otherwise, the child will swallow air along with the incoming mixture, which can cause regurgitation. Do not rush the child, he will tell you when he is full.

5. What is the temperature of the water for infant formula

If you use boiled water, it must be cooled to the temperature indicated on the package. Usually it is around 40°C. Only after that, the mixture is poured into the water. Before feeding, even if the bottle itself is not hot to the touch, put a drop of the mixture on your wrist and make sure it is at a comfortable temperature.

6. Is it possible to heat infant formula in the microwave

It is better not to do this. In the microwave oven, the mixture warms up unevenly and you risk burning the baby.

7. Can I give my baby a bottle left over from a previous feeding?

No. Pour out the mixture that the child did not finish. Bacteria may begin to multiply after use in the mixture. Therefore, before each feeding, prepare a fresh bottle of formula.

8. Which order to follow with mixed feeding

On mixed feeding, it is correct to breastfeed the baby first and only then supplement with formula. This feeding schedule is important to follow. Breast sucking is harder and the baby makes every effort to eat. If you start bottle feeding, he simply will not want to take the breast later.

9. Is it possible to cook baby food with tap water

It depends on the area where you live. Tap water can be ideal for a baby bottle if you are sure of its quality and safety. In this case, it will still need to be boiled before use.

10. How to sterilize baby bottles and teats

The baby bottle sterilizer is one of the most useful tools. They are different:

electric;
ultrasonic;
microwave steam;
reusable bags for microwave sterilization.

Bottles, teats and pacifiers can be sterilized. If there is no sterilizer, then you can boil in a saucepan for about ten minutes. It is important not to forget about the pot and keep an eye on it: if the water boils away during boiling, then the bottles and nipples will be spoiled. They can not be used, you can harm the child.

11. Which nipple to choose for a baby bottle

Round or anatomic shape - the choice is up to the child. It is better to try to give an anatomically shaped nipple, and if the child does not like it, then a round nipple. The size of the hole and the age of the child are indicated on the packaging of the pacifier or bottle. Also on the packaging indicate what kind of food the nipple can be used for - water, milk or cereal. Now almost all nipples are silicone, latex ones are rare. The nipples have a universal size and fit two types of bottles - with a wide or narrow neck.

alternative ways. Articles to help mom

N The need to supplement non-bottle feeding occurs in mothers who want to continue breastfeeding but for various reasons have to supplement with formula or expressed milk, for example:

Mom needs to go away, and another adult will feed the baby.
Mom is ill and is taking medications that are incompatible with GW (breastfeeding).
It is necessary to give a medicine diluted in milk.
Mom has a severe cracked nipple and breastfeeding is very painful.
The baby is not gaining weight, and the pediatrician prescribed supplementary feeding with formula.
Any other reason why a baby would need to be supplemented from a non-breastfeed.

The article will be useful to mothers who want to return or maintain breastfeeding after the introduction of supplementary feeding.

Why not a bottle

There is no unequivocal recommendation to give non-bottle supplements. But there is a threat that after the bottle the baby will refuse the breast or stop latching on properly.

For some children, it is enough to kiss the nipple once to start acting up at the breast. After all, milk from the breast does not flow as quickly and not as evenly as from a bottle. It does not mean at all that this will happen to you, but there is such a possibility.

Methods of supplementary feeding according to degree of proximity to breastfeeding

Consider the pros and cons of the methods known to us, which are recommended by the World Health Organization (WHO) and breastfeeding consultants.

Breast feeding systems

You give your baby a breast and bring a soft catheter to the nipple, through which pumped milk or formula is supplied. At the opposite end of the catheter is a container of milk. It can be a syringe or a bottle, or a glass - which is more convenient for mom. Medela has a ready-to-use breastfeeding system. This option is only suitable for babies who can breastfeed. On the Internet you will find videos on how to build such a system yourself or use a ready-made one. Google it.

Pros

The undoubted advantage of the breastfeeding system is that the baby suckles at the breast. He not only receives milk "from the breast", but also stimulates the mammary glands.

Cons

You have to get used to using it. The container and catheter will have to be washed or changed frequently, interrupt feeding, or prepare milk in advance for supplementary feeding. You will spend some time learning how to secure the catheter to your chest.

Finger feeding

Very similar to the previous version, only instead of the breast, the child sucks your finger, to which the catheter is attached. Instead of a catheter, you can give milk to the corner of your mouth from a syringe without a needle. Drop by drop. It is better to choose a larger finger, usually the middle or index finger, so that the baby opens his mouth wide.

pros

The baby has skin contact while suckling and feels the warmth of your finger. In the case of using a catheter, you can hold the baby in your arms, as with breastfeeding.

Minuses

If you are syringe feeding, some of the milk will spill out at first. Stock up on stock. If a stranger is feeding the child, then it is advisable to use a glove or abandon this method so as not to create an additional burden on the intestines with an unfamiliar microflora.

Cup feeding

WHO recommends this method. You pour milk into a small cup. Even a plastic bottle cap will do. Tilt it so that the milk does not spill out, but stands at the edge. And put this edge on the baby's lower lip. He will begin to stick out his tongue and slowly lap up milk. You gradually tilt the cup so that the milk is always available to him. It is important not to pour milk into the child's mouth, otherwise it will choke.

With this method of feeding, you need to keep the baby as upright as possible.

Pros

The child eats milk at his own pace. He may take a break from lapping, as well as from breast sucking. At this point, it is important to continue to hold the cup on his lip. The kid will continue when he is ready.

Cons

Milk is likely to spill, prepare with a margin.

Spoon feeding

The principle is the same. Instead of a cup, you use a spoon, which you serve with a thin or wide edge - as you like - on the child's lower lip. The difference is that the spoon will have to be refilled more often. Medela has a special feeding spoon. The principle of its application is the same, but it is filled from the attached container with a light touch. Choose what is more convenient.

Syringe feeding

Give milk from a syringe without a needle to the baby's cheek. It is important to give it by the cheek and drop by drop so that the child does not choke. Take a syringe of at least 10 ml. Try different manufacturers. The piston should move as easily and without jerks as possible. To make it possible for you to smoothly supply milk, grab the syringe with your little finger and ring finger, and press the plunger with your thumb.

Pros

Milk almost does not spill with this method if you are not in a hurry.

Cons

The syringe will need to be refilled frequently if the amount of supplementation is significant.

Finally

In the minuses of all methods, one important point is deliberately not indicated - such supplementary feeding takes significantly more time than supplementary feeding from a bottle.