Bottle Feeding Newborns: How Long Is Optimal?

Bottle feeding a newborn is a relatively straightforward process, but it's important to be aware of the basics to ensure your baby is getting the nutrition they need. The amount of formula a newborn needs varies depending on their age and weight, but in general, newborns drink about 1.5–3 ounces (45–90 milliliters) every 2–3 hours. This amount increases as the baby grows and their tummy can hold more milk. It's important to feed your baby whenever they seem hungry, which is known as on-demand feeding. This usually happens every 2–3 hours for newborns and young babies. Additionally, proper cleaning, sterilisation, and preparation of bottle-feeding equipment are crucial to keep your baby safe from infections and ensure they receive proper nutrition.

How to know if your baby is hungry

Babies have their own ways of communicating their needs. A hungry baby will give you clear signs that they’re ready for their next feed by using sounds and movements, also known as baby feeding cues.

Signs Your Baby is Hungry

• Rooting – turning their head side to side looking for the breast or bottle teat
• Opening and closing their mouth
• Increase in movement, becoming more active and restless
• Sticking out their tongue
• Making sucking sounds
• Sucking on their hand or fingers
• Putting their hands/fingers/fists in or around their mouth
• Crying (this is more likely to be a late sign of hunger, and that your baby crying doesn't always mean they are hungry)

What to Do if Your Baby is Upset

If your baby is upset, try soothing them before feeding – a cuddle and some skin-to-skin contact may help.

What to Do if Your Baby Refuses to Feed

If your baby refuses to feed, this could be due to a number of reasons, including:

• Tiredness
• Boredom
• Discomfort
• Needing a diaper change
• Being too cold or too hot
• Being overstimulated
• Needing a cuddle
• Experiencing reflux or an allergy

How to hold the bottle

Holding a newborn baby can be a daunting task, especially when it comes to feeding them. Here is a detailed guide on how to hold the bottle while feeding your newborn:

Cradle the baby in your arms:

Rest the baby's head in the crook of your elbow, with their body tilted up at a comfortable angle, usually against your chest. This classic feeding position allows for skin-to-skin contact and ensures the baby's head and neck are supported.

Use a feeding pillow:

Nursing or feeding pillows provide excellent support and comfort for the baby during bottle feeds. Place the pillow on your lap, and rest the baby on it, ensuring their head and neck are adequately supported. Feeding pillows help keep the baby at a slight incline, which is the recommended position for feeding.

Hold the baby upright:

This position is ideal for infants with reflux. Sit down and place the baby upright in your lap, with their back against your stomach and chest. Ensure the bottle is tilted so that milk fills the nipple completely, preventing the baby from gulping air, which can cause gas and reflux.

Rest the baby on your legs:

Sit or lie down and prop the baby on your legs, with their back against your thighs and their head near your bent knees. This position allows for eye contact and interaction during feeding. Remember to keep the baby at a slight incline to aid digestion and prevent milk from flowing into the ear cavity, which can cause ear infections.

Switch sides:

Switching sides during feeding has multiple benefits. It gives your arms a break, prevents the baby from developing a side preference, and allows them to decide if they are full before finishing the bottle.

Be mindful of your own comfort:

Feeding sessions can last 20 to 30 minutes, so it is essential to find a comfortable position for yourself as well. Choose a position that does not tire your arms and ensures you can support the baby fully throughout the feed.

See your baby's face and hands:

During feeding, ensure you can see the baby's eyes, mouth, arms, and hands. These body parts are crucial for communicating discomfort or problems. For example, feeding splaying (fingers spread wide apart), clenched fists, or grimacing may indicate that the baby is overwhelmed and needs a break.

Support your baby fully:

Newborns have little control over their bodies, so it is vital to ensure they feel relaxed and comfortable during feeding. Their bodies should be fully supported to allow them to focus on coordinating the complex movements of sucking, swallowing, and breathing.

Remember to always hold the bottle at a horizontal angle, and take breaks every few minutes to burp the baby and prevent them from taking in too much air, which can cause gas and fussiness.

How to know if your baby is full

Bottle feeding a newborn can take anywhere from 15 to 30 minutes. However, it is important to remember that every baby is different, and there is no one-size-fits-all approach to feeding. As a parent, it is essential to pay attention to your baby's hunger and fullness cues to ensure they are getting the nourishment they need. Here are some signs that your baby is full:

Slowing down or losing interest in feeding

One of the most obvious signs that your baby is full is when they start to slow down or lose interest in feeding. A baby who is full may suck with less enthusiasm or intensity than when they first started feeding. They may also start to pause more frequently or take longer breaks between sucks. This is their way of telling you that they are getting full and need a break.

Turning away from the bottle

Another clear sign that your baby is full is when they actively turn their head away from the bottle. This is a deliberate action that indicates they no longer want to feed. Respect your baby's decision and avoid forcing them to finish the bottle. It is important to follow their lead and let them decide when they have had enough.

Falling asleep during feeding

If your baby falls asleep during a feeding, it could be a sign that they are full and satisfied. However, it is important to distinguish between active sucking and drowsy feeding. If your baby is actively sucking and then slowly drifts off to sleep, they are likely full. On the other hand, if they seem disinterested in feeding and quickly fall asleep, they may not be getting enough nourishment. In this case, try burping them or changing their diaper to wake them up and offer the bottle again.

Pushing the bottle or nipple away

As your baby gets older and more aware of their surroundings, they may start to push the bottle or nipple away when they are full. This is their way of communicating that they have had enough and want to stop feeding. Respect their decision and avoid forcing them to finish the bottle.

Spitting out or dribbling milk

If your baby starts to spit out or dribble milk during feeding, it could be a sign that they are full and can't swallow any more. The flow of milk may be too fast or too much for them to handle, causing them to reject the bottle. Try burping them and offering the bottle again at a slower pace or with a slower-flow teat.

Responding to your baby's cues

It is important to always respond to your baby's hunger and fullness cues. Feed your baby whenever they seem hungry and allow them to stop when they seem full. By following their lead, you can ensure they are getting the right amount of nourishment and developing a healthy relationship with food. Remember, every baby is unique, and their feeding patterns may vary from day to day. Trust your instincts and don't be afraid to reach out to your healthcare provider if you have any concerns about your baby's feeding habits.

How to clean and sterilise bottle-feeding equipment

Bottle-feeding a newborn can take around 20 minutes or so. During this time, it's important to hold the baby at a slight incline, keeping their head supported with the crook of your arm.

Now, here's how to clean and sterilise bottle-feeding equipment:

Cleaning Bottle-Feeding Equipment

It's important to clean bottle-feeding equipment after every feed. If you can't clean the bottle and teat immediately, rinse them with clean water to make them easier to clean later. Here's a step-by-step guide:

• Wash your hands with soapy water and dry them with a clean cloth or paper towel.
• Check teats for any cracks. Throw away any damaged teats as bacteria can grow in the cracks.
• Wash all bottle-feeding equipment in hot, soapy water using a bottle brush. Pay special attention to the caps, discs, rings, and screw-top areas as bacteria are most likely to grow in these places.
• Squirt water through the teat to clear the hole.
• Rinse everything thoroughly.

Sterilising Bottle-Feeding Equipment

It's important to sterilise bottle-feeding equipment until your baby is 12 months old. Here are three common methods:

Sterilising by Boiling

Boiling is a simple and reliable way to sterilise bottle-feeding equipment:

• Put the washed bottles, teats, rings, caps, and discs in a large pot.
• Fill the pot with water, ensuring all items are covered, and remove any air bubbles.
• Bring the water to a boil and boil for 5 minutes.
• Allow everything to cool in the pot until you can handle it without scalding yourself.
• Shake off excess water and store the equipment in a clean container in the fridge.
• Sterilising Using Chemicals

You can use an antibacterial solution (liquid or tablet form) to sterilise your bottles. This is a type of diluted bleach that's safe for your baby but strong enough to kill bacteria:

• Follow the manufacturer's instructions carefully when preparing the solution.
• Submerge washed bottles, teats, rings, caps, and discs in the solution, ensuring they are completely covered.
• Leave the equipment in the solution for at least the recommended time, up to a maximum of 24 hours.
• Remove the equipment from the solution using tongs, shake off excess liquid, and store it in a clean container in the fridge.
• Steam Sterilisation

Steam sterilisers are automatic units that heat your equipment to a temperature high enough to kill bacteria:

• Place your clean equipment into the unit.
• Add water according to the manufacturer's instructions.
• The unit will switch off automatically when the cycle is complete.
• Store the equipment in a clean container in the fridge. Check the manufacturer's instructions for how long you can store steam-sterilised equipment.

How to store breast milk or formula

Storing Breast Milk

Breast milk is highly perishable, so it's important to store it correctly to avoid contamination or spoilage. Here are some guidelines for storing breast milk:

• Wash your hands with soap and water before expressing or handling breast milk. If soap and water are not available, use an alcohol-based hand sanitiser with at least 60% alcohol content.
• Use breast milk storage bags or clean, food-grade containers made of glass or plastic with tight-fitting lids.
• Do not store breast milk in disposable bottle liners or plastic bags that are not intended for breast milk storage.
• Store breast milk in small batches of 2 to 4 ounces (60 to 120 millilitres) to avoid wasting milk. Label each container with the date and amount of milk.
• Store freshly pumped milk in the back of the fridge, as it is the coldest area. Do not store it in the fridge door, as the temperature fluctuates.
• If you won't be using the milk within 4 days, freeze it. Use freezer-safe containers such as glass jars with screw caps or hard plastic containers with snap-on lids.
• Leave about one inch of space at the top of the container, as breast milk expands when frozen.
• Find the coldest spot in your freezer. Place the milk in the back centre, as this area has the most constant temperature.
• Breast milk can be stored in a freezer for up to 12 months, but it's best to use it within 6 months. For premature or hospitalised infants, use frozen milk within 2 to 3 months.
• To thaw frozen breast milk, place the container in the refrigerator overnight or put it in a bowl of warm water. Do not use a microwave, as it can create hot spots that may burn your baby's mouth.
• Once thawed, breast milk should be used within 24 hours and cannot be refrozen.

Storing Formula

• If using infant formula, always follow the preparation instructions on the canister. Different formulas may require different ratios of powder or liquid concentrate to water.
• Store prepared formula in the refrigerator and use it within 24 hours.
• Do not add baby cereal to bottles of formula or pumped breast milk, as it can cause choking and is unnecessary for sleep.

General Tips for Storing and Feeding

• Whether you are bottle-feeding breast milk or formula, always test the temperature before feeding it to your baby. A few drops on the inside of your wrist will tell you if it's too hot.
• Wash and sterilise all feeding and pumping equipment after use to prevent contamination.
• Feed your baby whenever they show signs of hunger, such as nuzzling, sucking on their hands, or the rooting reflex.
• Burp your baby during and after feeding to bring up gas bubbles and prevent discomfort.
• If your baby falls asleep during a feed, try burping them, changing their nappy, or rubbing their back to wake them up.
• Throw away any leftover formula or breast milk within one hour of feeding. Bacteria from your baby's mouth can get into the milk and make them sick if you offer it again later.

Frequently asked questions