Infant Feeding Choices 

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Parents consider giving their babies formula for many reasons. In some cases it is medically necessary.  Before giving formula, contact a La Leche League Leader or Lactation Care Provider for breastfeeding support.  The use of formula can shorten the breastfeeding relationship, and comes with increased health risks for baby and mother (even in the US and other developed countries).  Parents need to be aware of these risks so they can make an informed decision around using formula. Parents should look at their individual circumstances and decide whether the benefits of formula use outweigh the risks. Remember that breastfeeding does not have to be “all or nothing” - any amount of breastfeeding is beneficial to both mom and baby.  

The Hierarchy of Infant Feeding Choices

  • Baby being nursed at the breast is best.  There is a communication between baby and mother’s body.  The mother’s body will respond to any germs the baby has been exposed to by passing antibodies through the breastmilk.  It’s also better for baby’s jaw and mouth development.  There are many more benefits for mom and baby
  • If a mother cannot nurse her baby at the breast, then her expressed breastmilk is the second best choice.  Click here to learn how to pump more milk, and how to hand express breastmilk.  Whenever possible, cup-feeding or another alternative feeding method should be used rather than a bottle, especially when working on latching issues.  If using a bottle, paced bottle feeding is best.  Be sure to handed and store breastmilk safely.
  • If mother cannot nurse or provide expressed breastmilk, then donor breastmilk from a human milk bank is the third choice.  The donors are screened and milk is pasteurized and tested. Again, consider using an alternative feeding method as suggested above if you’re working on getting baby to latch.  
  • If human milk is unavailable, then formula should be used.  Cow’s milk-based infant formula is preferred over soy-based infant formula.  Choose an infant formula sold in liquid form, especially when your baby is a newborn or very young, premature, or medically fragile.  Liquid infant formulas are made to be sterile.  Powdered formula is usually the lowest cost, but manufacturers of powdered infant formula report that it is not possible to get rid of all germs from powdered infant formula in the factory.  If choosing powdered infant formula, it’s important to prepare it using the CDC guide line below.  It’s also suggested families bottle feeding with formula used paced bottle feeding.  

How To Safely Prepare Powdered Infant Formula

Clean up before preparation:

  • Wash hands with soap and water
  • Clean bottles in a dishwasher with hot water and a heated drying cycle, or scrub bottles in hot, soapy water and then sterilize them
  • Clean work surfaces, such as countertops and sinks

Prepare safely:

  • Keep powdered formula lids and scoops clean (be careful about what they touch)
  • Close containers of infant formula or bottled water as soon as possible
  • Use hot water (158 degrees F/70 degrees C and above) to make formula
  • Measure carefully.  Adding formula to the bottle then water until it reaches the correct number of ounces on the bottle can result in a higher concentrate of formula.  If using the bottle to measure water, add water first, then formula.  
  • Carefully shake, rather than stir, formula in the bottle
  • Cool formula to ensure it is not too hot before feeding your baby by running the prepared, capped bottle under cool water or placing it into an ice bath, taking care to keep the cooling water from getting into the bottle or on the nipple
  • Before feeding the baby, test the temperature by shaking a few drops on your wrist

Use up quickly or store safely:

  • Use formula within 2 hours of preparation. If the baby does not finish the entire bottle of formula, throw away the unused formula.
  • If you do not plan to use the prepared formula right away, refrigerate it immediately and use it within 24 hours. Refrigeration slows the growth of germs and increases safety.
  • When in doubt, throw it out. If you can't remember how long you have kept formula in the refrigerator, it is safer to throw it out than to feed it to your baby.

Practice proper hygiene:

  • Wash your hands carefully with soap and water, especially after using the toilet or changing diapers. Always wash your hands:
    • before preparing and feeding bottles or foods to your infant
    • before touching your infant's mouth, and
    • before touching pacifiers or other things that go into your infant's mouth.
  • If soap and water aren't available, use an alcohol-based hand sanitizer. These alcohol-based products can quickly reduce the number of germs on hands in some situations, but they are not a substitute for washing with soap and water.
  • It is also important to keep all objects that enter infants’ mouths (such as pacifiers and teethers) clean.

For more information, visit the CDC’s website or the World Health Organization’s site.

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Flourish Baby is committed to diversity and inclusion. Amanda Dean supports all birthing, breastfeeding, chestfeeding, and human milk feeding families, inclusive of their race, ethnicity, immigration status, national origin, creed, age, sexual orientation, gender identity, family structure, primary language, ability, or socio-economic status.

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