Bottle Feeding your Baby
The following information is designed to support you should you choose to bottle feed your baby, whether with formula or Expressed Breast Milk.
When should you worry?
Newborn
NEWBORN
Contact your health visitor or GP if your baby is newborn and they…
- Feel very stiff, for example:
- Hold their arms and legs in the same position, such as always pulling their arm into their chest, or always crossing their legs
- Find it difficult to change their position on their own
- You may also find it difficult to move your baby’s arms or legs, making it tricky to change their nappy or clothes
- Feel very floppy, or have floppy arms or legs when awake
- Move their arms and legs in repetitive jerky movements, or writhing movements
- Don’t have a Grasp Reflex (doesn’t grab your finger or small object when you put it in their hand)
- Are often startling and you cannot understand why
- Move one side of their body more than the other, for example:
- Rarely moves one of their arms compared to the other arm
- Rarely moves one leg compared to the other leg
- When your baby startles, one side moves or looks different from the other
6-8 weeks
6-8 WEEKS
Contact your health visitor or GP if your baby is 6-8 weeks and they…
- Feel very stiff, for example:
- Hold their arms and legs in the same position, such as always pulling their arm into their chest, or always crossing their legs
- Find it difficult to change their position on their own
- You may also find it difficult to move your baby’s arms or legs, making it tricky to change their nappy or clothes
- Feel very floppy, or have floppy arms or legs when awake
- Move their arms and legs in repetitive jerky movements, or writhing movements
- Have not started to bring both their hands to their face, or do not move their arms much
- Keep their hands fisted, and you find it difficult to open their hands
- Can’t lift their head when lying on their tummy
- Move one side of their body more than the other, for example:
- Mostly moves one arm or mostly brings one hand to their face
- Rarely kicks or moves one leg compared to the other leg
2-3 months
2-3 MONTHS
Contact your health visitor or GP if your baby is 2-3 months and they…
- Feel very stiff, for example:
- Hold their arms and legs in the same position, such as always pulling their arm into their chest, or always crossing their legs
- Find it difficult to change their position on their own
- You may also find it difficult to move your baby’s arms or legs, making it tricky to change their nappy or clothes
- Feel very floppy, or have floppy arms or legs when awake
- Move their arms and legs in repetitive jerky movements, or writhing movements
- Have not started to bring both their hands to their face, or do not move their arms much
- Keep their hands fisted, and you find it difficult to open their hands
- Can’t lift their head when lying on their tummy
- Move one side of their body more than the other, for example:
- Mostly moves one arm or mostly brings one hand to their face
- Rarely kicks or moves one leg compared to the other leg
3-4 months
3-4 MONTHS
Contact your health visitor or GP if your baby is 3-4 months and they…
- Have lost skills which they could do before
- Feel very stiff, for example:
- Hold their arms and legs in the same position, such as always pulling their arm to their chest, or always crossing their legs
- Find it difficult to change their position on their own
- You find it difficult to move your baby’s arms or legs, making it tricky to change their nappy or clothes
- Feel very floppy when awake
- Prefer to keep their arms by their sides. For example, they do not reach for things, or do not bring their hands together over their face or tummy
- Move their arms or legs in repetitive, jerky, or strange ways
- Still need you to support their head, or can’t lift their head when lying on their tummy
- Have very tight fists and it’s hard to open their hand
- Move one side of their body more than the other, for example:
- Rarely use one of their arms to pick up toys
- Rarely kick one leg compared to the other
4-6 months
4-6 MONTHS
Contact your health visitor or GP if your baby is 4-6 months and they…
- Have lost skills which they could do before
- Feel very stiff, for example:
- Hold their arms and legs in the same position, such as always pulling their arm to their chest, or always crossing their legs
- Find it difficult to change their position on their own
- You find it difficult to move your baby’s arms or legs, making it tricky to change their nappy or clothes
- Feel very floppy when they are awake
- Move their arms or legs in repetitive, jerky, or strange ways
- Move one side of their body more than the other, for example:
- Rarely use one of their arms to pick up toys
- Rarely kick one leg compared to the other
- Are unable to roll, or can roll in one direction but not the other
- Find it difficult to reach their arms out. For example, they do not reach for toys
- Still have their early reflexes, like the startle reflex and grasp reflex
- Keep their legs flat when lying on their back. For example, they do not bring their feet to their chest
- Still need you to support their head
6-9 months
6-9 MONTHS
Contact your health visitor or GP if your baby is 6-9 months and they…
- Have lost skills which they could do before
- Feel very stiff, for example:
- Hold their arms and legs in the same position, such as always pulling their arm to their chest, or always crossing their legs
- Find it difficult to change their position on their own
- You find it difficult to move your baby’s arms or legs, making it tricky to change their nappy or clothes
- Feel very floppy when they are awake
- Move their arms or legs in repetitive, jerky or strange ways
- Move one side of their body more than the other, for example:
- Rarely use one of their arms to pick up toys, or eat and drink
- Rarely kick one leg compared to the other
- Can’t sit without support. For example, they lean on their hand, or, when they sit, their back is very curved
- Still have their early reflexes, like the startle reflex and grasp reflex
- Keep their legs flat when lying on their back, for example, do not bring their feet to their chest
- Still need you to support their head
- Still need you to help turn their head when lying on their back
- Can’t crawl, or find it hard, for example, drags one of their legs behind them
- Find it difficult to stand, for example:
- Can’t stand with support
- Doesn’t try to pull themselves up to stand
- Can’t move a toy from one hand to the other
- Doesn’t use both hands to hold larger things
9-12 months
9-12 MONTHS
Contact your health visitor or GP if your baby is 9-12 months and they…
- Have lost skills which they could do before
- Feel very stiff, for example:
- Hold their arms and legs in the same position, such as always pulling their arm to their chest, or always crossing their legs
- Find it difficult to change their position on their own
- You find it difficult to move your baby’s arms or legs, making it tricky to change their nappy or clothes
- Feel very floppy when they are awake
- Move their arms and legs in repetitive, jerky, or strange ways
- Use one side of their body more than the other, for example:
- Lean to the side when they sit
- Use one arm to pull to stand more than the other
- Rarely use one of their arms to pick up toys, or eat and drink.
- Rarely kick one leg compared to the other
- Find it difficult to sit, for example:
- Only sit with support
- Lean on their hand when sitting
- When they sit their back is very curved
- Can’t move a toy from one hand to the other
- Don’t use both hands to hold larger things
- Don’t point to objects
- Can’t crawl, or find it hard, for example, drags one leg behind them
- Find it difficult to stand, for example:
- Can’t pull themselves up to stand
- Find it hard to pull themselves up. For example, they only use their arms and don’t push with their legs
- Can’t stand with support
2 months
Your Baby By Two Months
Social/Emotional Milestones
- Calms down when spoken to or picked up
- Looks at your face
- Seems happy to see you when you walk up to her
- Smiles when you talk to or smile at her
Language/Communication Milestones
- Makes sounds other than crying
- Reacts to loud sounds
Cognitive Milestones (learning, thinking, problem-solving)
- Watches you as you move
- Looks at a toy for several seconds
Movement/Physical Development Milestones
- Holds head up when on tummy
- Moves both arms and both legs
- Opens hands briefly
4 months
Your Baby By Four Months
Social/Emotional Milestones
- Smiles on his own to get your attention
- Chuckles (not yet a full laugh) when you try to make him laugh
- Looks at you, moves, or makes sounds to get or keep your attention
Language/Communication Milestones
- Makes sounds like “oooo”, “aahh” (cooing)
- Makes sounds back when you talk to him
- Turns head towards the sound of your voice
Cognitive Milestones (learning, thinking, problem-solving
- If hungry, opens mouth when he sees breast or bottle
- Looks at her hands with interest
Movement/Physical Development Milestones
- Holds head steady without support when you are holding him
- Holds a toy when you put it in his hand
- Uses his arm to swing at toys
- Brings hands to mouth
- Pushes up onto elbows/forearms when on tummy
6 months
Your Baby By Six Months
Social/Emotional Milestones
- Knows familiar people
- Likes to look at self in a mirror
- Laughs
Language/Communication Milestones
- Takes turns making sounds with you
- Blows “raspberries” (sticks tongue out and blows)
- Makes squealing noises
Cognitive Milestones (learning, thinking, problem-solving)
- Puts things in her mouth to explore them
- Reaches to grab a toy she wants
- Closes lips to show she doesn’t want more food
Movement/Physical Development Milestones
- Rolls from tummy to back
- Pushes up with straight arms when on tummy
- Leans on hands to support herself when sitting
9 months
Your Baby By Nine Months
Social/Emotional Milestones
- Is shy, clingy, or fearful around strangers
- Shows several facial expressions, like happy, sad, angry, and surprised
- Looks when you call her name
- Reacts when you leave (looks, reaches for you, or cries)
- Smiles or laughs when you play peek-a-boo
Language/Communication Milestones
- Makes a lot of different sounds like “mamamama” and “bababababa”
- Lifts arms up to be picked up
Cognitive Milestones (learning, thinking, problem-solving)
- Looks for objects when dropped out of sight (like his spoon or toy)
- Bangs two things together
Movement/Physical Development Milestones
- Gets to a sitting position by herself
- Moves things from one hand to her other hand
- Uses fingers to “rake” food towards himself
- Sits without support
1 year
Your Baby By One Year
Social/Emotional Milestones
- Plays games with you, like pat-a-cake
Language/Communication Milestones
- Waves “bye-bye”
- Calls a parent “mama” or “dada” or another special name
- Understands “no” (pauses briefly or stops when you say it)
Cognitive Milestones (learning, thinking, problem-solving)
- Puts something in a container, like a block in a cup
- Looks for things he sees you hide, like a toy under a blanket
Movement/Physical Development Milestones
- Pulls up to stand
- Walks, holding on to furniture
- Drinks from a cup without a lid, as you hold it
- Picks things up between thumb and pointer finger, like small bits of food
Advice and Guidance
Feeding is a special time for you to create a strong and secure bond with your baby. If you and your partner give your baby most of their feeds yourselves, this will promote a close and loving relationship with your baby and help them feel safe and secure. Being held and fed by different people with different techniques can be stressful for your baby.
Responsive bottle feeding supports that special bond between you and your baby as you:
- offer your baby a bottle in response to their feeding cues
- gently invite your baby to take the teat into their mouth
- feed your baby using a paced bottle-feeding technique
By using a paced bottle-feeding technique, you will allow your baby to control both the flow of milk and the amount of milk they drink. Your baby may take regular breaks and will let you know when they have finished. By slowing down the flow of milk into your baby’s mouth you will also reduce the amount of air they take in.
Feeding your baby using a paced bottle-feeding technique also prevents you from overfeeding your baby and helps reduce their risk of becoming overweight.
1.
Feed your baby when they show signs of being hungry. Look for feeding cues (such as head turning, mouth opening or sucking on fingers). Crying is the last sign of hunger, so try to feed your baby before they cry.
2.
Hold your baby close in a semi-upright position, so you can see their face. Reassure them by looking into their eyes and talking to them. Begin the feed by gently rubbing the teat of the bottle against their top lip, inviting them to open their mouth.
3.
Gently insert the teat into your baby’s mouth, keeping the bottle in a horizontal position so that just enough milk covers the hole in the teat. This will stop the milk from flowing too fast.
4.
Your baby may need some short breaks during the feed and may need to occasionally burp. Watch your baby and follow their cues for when they need a break. Cues will vary from one baby to the next. They may splay their fingers and toes, spill milk out of their mouth, stop sucking, turn their head away or push the bottle away. When you see these cues, gently remove the teat from your baby’s mouth or tilt the bottle downwards to cut off the flow of milk. When your baby does not want any more milk, hold them upright and gently rub or pat their back to bring up any wind.
5. If the teat becomes flattened while you are feeding, gently put your finger into the corner of your baby’s mouth to release the vacuum.
Never use a prop for a bottle or leave your baby alone with a bottle, as there is a risk they might choke. You baby will know how milk they need. Forcing your baby to finish a feed will.
For more information about bottle feeding your baby, please visit:
www.unicef.org.uk/babyfriendly/baby-friendly-resources/bottle-feeding-resources
When you first start bottle feeding your baby, you may wonder how much milk your baby needs. This is normal and it can take a while to feel confident that your baby is getting what they need.
A baby’s stomach is very small when they are born (approximately the size of a cherry), so they will need small, frequent feeds during the first few days and may not finish their bottle.
The amount of milk and frequency of the feeds will depend on your baby’s individual needs. Forcing your baby to drink large amounts of milk and finish a feed will not cause them to sleep for longer between feeds. Instead, it can make them more uncomfortable and less able to settle.
The number of wet and dirty nappies your baby produces, and your baby’s weight gain will let you know if your baby is getting enough milk.
You can use the guide below to see if bottle feeding is going well or if you would benefit from some support from your midwifery or health visiting service.
Signs that bottle feeding is going well
Your baby is:
- alert, has good muscle tone and is a normal skin colour
- being fed responsively
- invited to take the teat into their mouth and the bottle is held horizontally allowing just enough milk to cover the teat
- calm and relaxed during a feed and content after most feeds
- producing the expected number of wet and dirty nappies according to their age
- is receiving expressed breastmilk and/or first stage formula milk (unless a specialist milk has been prescribed or advised by a health professional)
You or your baby’s main care giver are:
- recognising and responding to your baby’s early feeding cues
- giving most of the feeds
- holding your baby in close, in a semi upright position and maintaining eye contact
- aware of when your baby needs a break and when your baby has had enough milk (turning away, splaying hands, or spitting out milk)
- are confident with washing and sterilising your baby’s feeding equipment
- expressing breastmilk effectively and/or making and storing formula milk safely as per the manufacturer’s guidelines
There are no concerns about your baby’s weight gain and/or growth
Your baby’s weight gain and the number of wet and dirty nappies they produce will tell you if your baby is getting enough milk. Formula-fed babies may have firmer and less frequent poos when compared to a breastfed baby of the same age. If you are concerned your baby is not drinking enough milk, contact your midwifery or health visiting service.
Your baby’s nappies are a good guide to the amount of milk they are drinking.
Day 1
A minimum of 1 wet nappy in 24 hours.
Your baby’s nappy may contain rust (orange-brown) coloured spots of concentrated urine. These are known as urates. At this age, they are not a problem, but if they continue beyond the first couple of days, you should tell your midwife as they can be a sign that your baby is not getting enough milk.
A minimum of 1 dirty nappy in 24 hours.
Your baby’s poo will be a dark green or black colour and tar-like. This is known as ‘meconium.’
Day 2
A minimum of 2 wet nappies in 24 hours.
Your baby’s nappy may contain rust (orange-brown) coloured spots of concentrated urine. These are known as urates. At this age, they are not a problem, but if they continue beyond the first couple of days, you should tell your midwife as they can be a sign that your baby is not getting enough milk.
A minimum of 1 dirty nappy in 24 hours.
Your baby’s poo will be a dark green or black colour and tar-like. This is known as ‘meconium.’
Day 3
A minimum of 3 wet nappies in 24 hours.
Your baby’s nappies should feel heavier.
A minimum of 2 dirty nappies in 24 hours.
Your baby’s poo will change to a brown, green, or yellow colour and be looser in consistency. This is known as a ‘changing stool’.
Day 4
A minimum of 4 wet nappies in 24 hours.
Your baby’s nappies should feel heavier.
A minimum of 2 dirty nappies in 24 hours.
Your baby’s poo will change to a brown, green, or yellow colour and be looser in consistency. This is known as a ‘changing stool’.
Day 5
A minimum of 5 wet, heavy nappies in 24 hours.
A minimum of 2 dirty nappies in 24 hours.
Your baby’s poo will change to a yellow colour and should be at least the size of a £2 coin and runny.
By day 6
A minimum of 6 wet, heavy nappies in 24 hours.
A minimum of 2 dirty nappies in 24 hours.
Your baby’s poo will be a yellow colour and should be at least the size of a £2 coin and runny.
4 to 6 weeks
A minimum of 6 wet, heavy nappies in 24 hours.
After 4 to 6 weeks, when breastfeeding is more established, some babies may go a few days or more without opening their bowels. This is normal.
A breastfed baby is unlikely to become constipated, and when they do poo, it will still be soft, yellow, and plentiful. If you are concerned your baby is constipated, please discuss this with your midwife, health visitor or GP.
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