If the mother is unable to breastfeed for health reasons or the baby refuses to breastfeed, it must be bottle-fed. Many parents also choose a combined breast and bottle feeding so that the father can feed the baby too.
The baby can be fed either breast milk or baby food from the bottle. In this article we explain how you can express breast milk for the bottle, which baby food is suitable for the baby and what else you need to know about bottle feeding.
Breastfeeding and giving bottles
We already explained that breast milk is the ideal nutrition for the baby in our article on breastfeeding . However, sometimes it is not possible for milk directly from the breast.
Exhaustion of the baby or a disease of the mother can cause problems with breastfeeding, as can anatomical features in the baby’s mouth. Whatever the reason for breastfeeding problems, in many cases breast milk can also be given from the bottle.
Expressed breast milk can be used to feed the baby wherever breastfeeding is not an option for the mother. In addition, a bottle with breast milk gives family members the opportunity to relieve the mother when feeding.
Because the baby can only take in little food in the first few weeks of life due to its small stomach, it has to be fed very often. With the help of the bottle, the father is happy to take on this task.
Because breastfeeding is much more strenuous for the baby than taking in the bottle, you should initially seek advice from your midwife when adding the bottle. Some babies can easily alternate between breast and bottle, while other babies quickly prefer the bottle and then refuse to breast.
This confusion, called nipple confusion, can result in the baby being weaned earlier than originally intended. If you do not want to replace breastfeeding with the bottle, but only want to supplement it, you should use the bottle carefully.
Mothers who produce little breast milk often have to feed baby formula from the bottle so that the baby can be satisfied. There are various alternatives available in addition to the vial, which reduce the risk of nipple confusion.
Dispense breast milk from the bottle
In the first few weeks after birth, breast milk changes its composition several times. So-called colostrum is produced immediately after birth. This form of breast milk is thicker and more yellowish than normal breast milk. Their nutritional composition also differs.
The breast milk from the time of the puerperium is therefore only suitable to a limited extent for pumping it off in advance and storing it or freezing it, for example. However, once the composition has stabilized, expressing breast milk regularly is no longer a problem.
Anyone who wants to feed breast milk from the bottle on a regular basis will appreciate the advantages of a breast pump very much. With this device, filling the milk is quick and easy. There is a choice of manually operated or electric models.
We report on the advantages and disadvantages of breast pumps and their use in another blog article. Here we also explain which model is best for which needs.
Expressed breast milk can only be kept for about four hours at room temperature. Food can be kept in the refrigerator for about 72 hours. Breast milk is also suitable for freezing.
In a freezer with a temperature of -18 ° C (*** – freezer) it can be stored for up to six months. Smaller quantities of breast milk can be frozen directly in a freezer-proof bottle.
Alternatively, so-called breast milk bags are available. If you want to pump and freeze larger quantities, this space-saving and cost-effective solution is best.
Frozen breast milk must be thawed before feeding. The most gentle way to do this is in a water bath. In this the milk can quickly be brought to the desired temperature. Alternatively, a bottle warmer is also suitable for thawing breast milk.
You should stay away from the microwave when defrosting breast milk. There is a risk that the food will lose valuable ingredients such as lysozyme or IgA (immunoglobulin A). These nutrients are important for building the immune system and are one of the greatest benefits of breast milk.
As with all food: once thawed, breast milk must not be frozen again. Repeated warming up can also encourage the formation of bacteria and should be avoided.
Baby formula from the bottle
If feeding breast milk is not an option for mother and baby, powdered milk for mixing is the best alternative for the baby. Even if baby food does not have the same health benefits for the baby as breast milk, it is sufficient as a stand-alone solution and in all cases there is no alternative .
For hygienic and nutritional reasons, the baby should not be fed with self-made formulas. A vegetarian or vegan diet for babies with, for example, soy, almond or rice milk is also strongly advised against.
At least one pack of baby food should be part of the initial equipment. In this way you are prepared for an emergency, should the mother fall ill spontaneously and the baby can no longer breastfeed.
Anyone who buys milk powder for the baby for the first time will be overwhelmed by the large selection. Different types, pack sizes and brands fill entire meters of shelves in supermarkets and drugstores. However, the right choice of the optimal baby food is not that difficult.
All milk powder is subject to the same strict controls and its ingredients are regularly examined and evaluated. Various quality seals also promise that the minimum requirements have been met in certain areas.
Many milk powders have had this quality feature since the introduction of the organic label in 2001. The organic seal is awarded by the Federal Ministry of Food, Agriculture and Consumer Protection to those products that meet the requirements of organic farming.
State controls ensure that baby food with an organic seal is free from artificial fertilizers, chemical pesticides and genetic engineering. Farm animals, which play a role in the production of milk powder with the organic seal, are also kept in a species-appropriate manner.
The seals of associations such as Bioland or Demeter are only awarded to manufacturers who meet particularly strict requirements for the production of baby food. Products that have been awarded the association seal meet – depending on the association – quality requirements that go beyond the organic seal.
These strictly controlled milk powders are considered to be of particularly high quality and well controlled. The following association seals guarantee the high quality and safety of the food that has been awarded
- Organic land
Different types – which milk powder does my baby need?
All major brand manufacturers have several worries of milk powder in their range. With a few special exceptions, milk powder is offered in five different varieties. They differ in their nutritional composition and are therefore not all equally suitable for every baby and all ages.
However, the large selection makes it possible to find the optimal starter or follow-up formula for every baby. The best thing to do here is to seek advice from your midwife or pediatrician.
All infants can be fed with PRE food from the first day of life. The milk powder contains lactose as the only carbohydrate and is therefore most similar to breast milk. PRE food has a similar consistency and its protein content is also tailored to the needs of the infant.
The baby can be fed with PRE milk for the first five months of life. It is also suitable for supplementary feeding when breastfeeding alone is not enough. According to the Federal Center for Nutrition, PRE food is suitable for the entire first year of life. Switching to follow-on formula is not absolutely necessary.
Babies who find it difficult to gain weight should not be switched to 1er food early on, but should continue to be fed PRE food. This does not stay in the gastrointestinal tract as long, so the baby can absorb more of it in 24 hours.
This makes sense because the energy content of both types is almost identical (approx. 70 kcal / 100 ml). However, because the PRE food does not fill you up for as long and is digested more quickly, the baby can drink a larger amount of it during the day and use more calories.
Allergy-prone babies should be fed HA food. These milk powders are hypoallergenic and thus reduce the risk of allergies in babies. HA food is required whenever a midwife or pediatrician recommends its use.
If one of the parents or siblings is allergic and the baby is not breastfed, HA food is the right choice in many cases. HA food is available as PRE milk and as 1er food, so that the baby can easily be fed hypoallergenic food in the first year of life.
In contrast to the PRE food, the 1er food or starting milk contains several different carbohydrates. Due to the higher starch content, it is a little thicker and is digested more slowly by the intestine.
Although 1er food has almost the same number of kilocalories as PRE food, it saturates longer and is therefore particularly suitable for babies who are not satisfied with PRE food.
However, the fact that the baby wants to drink frequently in the first few months of life is not a sign that it is not filling up. Because baby’s stomach can only hold small amounts of food, it has to be fed correspondingly frequently.
Only if the baby permanently needs more than one liter of PRE food in 24 hours should you consider switching to 1 food. The change of the variety should be coordinated with the pediatrician or midwife so that the decision optimally meets the needs of the baby.
As a rule of thumb, the baby should be fed PRE food for as long as possible because it is most similar to breast milk. In contrast to breast milk, 1er food contains starch, which the baby needs certain digestive enzymes to digest.
The formation of these digestive enzymes is accelerated by the administration of 1er food. The advantage of the starch content is that the food makes you full longer. PRE- and 1er-food can be fed from the first day of life up to the completion of the first year of life.
The 2-pack or follow-on milk contains even more starch than the 1-pack milk and can be fed from the age of six months. It can contain additives and flavorings and is only suitable for babies who are already receiving complementary food.
The 2-pack no longer bears as much resemblance to breast milk as the infant formula. It is still popular with parents who have the impression that their baby is not getting full.
A 2-pack diet contains only slightly more calories than a PRE or 1-pack diet, but more proteins and various carbohydrates such as glucose, maltose and, under certain circumstances, granulated sugar.
Anyone who decides to feed two foods should choose a product that uses as few additives as possible. The age information should also be carefully observed. Many manufacturers state that a 2-pack is suitable from the sixth to seventh month of life.
However, this does not mean that a changeover has to take place at this point in time. On the contrary, follow-on formula is only suitable for the baby when it is ready for complementary food. The indication of age therefore rather represents the earliest possible point in time for a switch to follow-on formula 2.
The food industry recommends the 3-pack diet for babies from the age of ten months. This variety also shows differences to breast milk in terms of its composition. The list of ingredients often contains a larger amount of kilocalories (up to 80 kcal / 100 ml) and proteins, as well as added sugar and flavors.
The biggest advantage of the 3-pack is the baby’s even better feeling of satiety. The triple food is significantly more creamy, contains more starch and remains in the gastrointestinal tract for a long time. Many parents report that 3-packs make their baby happier.
When buying follow-on milk 2 and 3, parents should keep in mind that the nutritional composition of breast milk often does not change or changes only minimally for months. A constantly changing nutritional composition of the diet, as it is caused by the switch to 2 and 3-part foods, is not necessary for the baby .
Many paediatricians and experts therefore agree that follow-on formula is not necessary even for pure bottle-fed children. Ideally, children who are not breastfed should be fed PRE and 1er food and gently accustomed to complementary foods from the second half of their first year of life.
The goal should be to enable the baby to participate in the family dinner by the first birthday. Because 3 follow-on foods are only suitable for babies from the age of 10 months, they can delay the full introduction to the family mixed diet. It also has a disrepute for increasing the risk of obesity.
The “Healthy Into Life” network of the Federal Center for Nutrition (BZfE) even goes so far as to describe follow-on formula 3 as completely undesirable.
Prepare milk powder
The EC directive stipulates that the preparation of ready-to-eat meals from all baby milk powders only requires the addition of water. Because tap water is a strictly controlled food in Germany , with very few exceptions it can be used to prepare baby food.
If you still want to use bottled water for baby milk, you should use a non-carbonated or still mineral water that is labeled “Suitable for the production of baby food”.
The upper limits for numerous minerals are listed in the ordinance on natural mineral water, spring water and table water. Baby water must not exceed the following limit values
- Sulphate: 240 mg / l
- Sodium: 20 mg / l
- Nitrate: 10 mg / l
- Nitrite: 0.02 mg / l
- Fluoride 0.7 mg / l
- Manganese: 0.05 mg / l
For the preparation and feeding of baby food, in addition to the powder itself and water, you need a way to heat the water, a bottle with a suitable teat and a measuring spoon to dose the powder.
Hands should be washed thoroughly before mixing. The work surface should also be cleaned before preparation. Whether the water has to be boiled before use depends on the water quality and the condition of the water pipes and fittings.
Bottled water should always be boiled after opening. It is also important that each bottle has to be freshly prepared. A thermos bottle with hot water is therefore suitable for on the go or for the night. So only the hot water has to be put into the bottle before feeding.
Attention: Only pure water may be kept warm in the thermos. Under no circumstances should ready-mixed baby food be stored in your thermos for several hours. They can form dangerous germs in the milk that is kept warm, which can cause serious gastrointestinal infections in the baby.
The powder, on the other hand, can be portioned into the clean, dry bottle beforehand. In this way, water and powder can be mixed quickly and easily in the bottle by shaking it, even when on the move.
The instructions on the package tell you how much milk powder needs to be mixed with what amount of water. Most packs contain a measuring spoon with which precise mixing is possible without any problems and without any further aids.
Before feeding, the finished bottle must cool down to drinking temperature. Ideally, the baby food has the same temperature as breast milk (37 ° C) when it is being fed. The ideal temperature can be set precisely with a thermometer.
Alternatively, you can test the vial on the inside of your wrist. The milk should feel warm but not hot. The vial must be easy to grip by hand.
The microwave is less suitable for preparing baby bottles. It heats the contents of the bottle unevenly and can lead to a misjudgment of the actual temperature. Scalding can result here.
If you want more convenience when preparing bottle food, you can use a bottle warmer. These practical, electrical devices are suitable for warming up breast milk, mixed milk powder and porridge jars and, thanks to a temperature display, allow all foods for the baby to be heated to the exact degree.
Bottles and teats
Suitable bottles and teats are required for bottle feeding. These are available in different sizes and made of different materials and must match the needs of the baby.
While you can indulge your personal preferences in terms of shape or color, you should trust the manufacturer’s information when choosing the right teat.
Glass or plastic bottles?
Some bottles and teats should already be part of the initial equipment. If the mother falls ill and cannot breastfeed, the baby’s nutrition is secured for the time being.)
Whether the bottles should be made of glass or plastic is primarily a question of personal preference. Vials made from both materials are available in different sizes.
Baby bottles made of glass are highly heat-resistant and almost always suitable for both the dishwasher and the microwave. Breast milk can also be frozen in some glass baby bottles without any problems.
With glass bottles you can also be sure that they are free of harmful substances and contain no plasticizers. The biggest disadvantage of baby bottles made of glass, however, is that they are not break-proof.
They should therefore be checked for chips before each use. Glass bottles are also heavier and therefore less comfortable when the baby is a slow eater.
Plastic baby bottles make up the largest proportion of bottles available on the market. They are light, unbreakable and therefore particularly suitable for on the go. When the baby begins to want to hold the bottle, it should always be made of plastic.
Baby bottles made of plastic scratch more easily than glass bottles and thus offer bacteria an easy attack surface. They must therefore be disposed of when they are visibly scratched.
When buying, you also have to make sure that the plastic is free of harmful substances. Plasticizers and BPA (bisphenol A) in particular can migrate from the bottle into food.
It has not yet been conclusively clarified whether they are harmful to health. Nevertheless, BPA has not been allowed in baby bottles since 2011.
The right shape and size for baby bottles
Commercially available baby bottles made of glass or plastic are available in many different sizes and shapes. Because newborns can only consume around 50 – 70 ml of food with each meal, the smallest bottle size is initially sufficient for them. However, if you only use the small bottles in the initial equipment, you have to switch to the following bottle size pretty quickly.
If the bottles are too big, the milk cools down too quickly in them. That is why we recommended vials with a capacity of 250 ml in our article for initial equipment. These are suitable for newborns and infants up to about five months of age.
Anyone who decides on this bottle size has already made provisions for the next few months with the initial equipment and thus achieves a very good price-performance ratio even when buying more expensive, high-quality bottles.
The bottle size should therefore always be selected depending on the amount of drink per meal. Depending on your age, you can expect the following amounts to be consumed per meal
- 1st day: approx. 30 ml
- 2nd day: approx. 40 ml
- 3rd day: approx. 50 ml
- 5th day: approx. 70 ml
- 6th day: approx. 80 ml
- 1st – 8th week: 100 ml
- 2nd – 3rd month: 130 ml
- 4th month: 170 ml
- 5th month: 200 ml
- From the 6th month: max. 400 ml
As soon as complementary foods are offered with milk food, the amount of milk per meal varies greatly and also depends on whether porridge or other food is offered with each meal. The amount of complementary foods offered also has a strong influence on the amount consumed per meal.
Because the amount of food required depends on the individual needs of the baby, these amounts should only be used as a guide. If you are unsure whether the baby is drinking enough or too much, the midwife or pediatrician is always the right contact.
The shape of the bottle can be chosen according to personal preferences. When buying, you can be guided by your personal preferences. It is important that the bottle lies comfortably in the hand and that it can be cleaned without any problems.
The only problem here are the bottles, the sides of which are shaped into handles. These vials are popular with babies who want to hold their own bottle while drinking. The disadvantage, however, is that these bottles induce constant sucking and thus increase the risk of tooth decay.
In addition, the curved handles are very difficult to reach from the inside, so that food residues can quickly settle here. These provide a breeding ground for germs and bacteria and can thus endanger the baby’s health.
The bottle neck is also shaped differently depending on the bottle. Models with a wide opening are particularly easy to fill and are also very practical for cleaning.
The right vacuum cleaner
In addition to a leak-proof closure, every milk bottle also has a teat. These are also available in different sizes and made of latex or silicone.
For newborns and babies up to the age of six months, a teat is the size. 1 sufficient. This size is characterized by a relatively small suction opening, so that the baby has to use some force while drinking to absorb the milk from the bottle.
If the opening in the teat is too large, there is a risk that the baby will take in too much air while drinking. Colic can be the result here. In addition, a drinking opening that is too large increases the risk that the baby will choke while feeding.
Only when the baby becomes impatient while drinking and is visibly frustrated with the small amount of food should you switch to the next larger teat. This is usually the case from the fifth or sixth month of life.
In addition to the size, the material of the teat also plays a decisive role. Latex and silicone teats are basically both equally suitable for babies and both have their advantages and disadvantages.
Babies with a latex allergy have no choice here, however: they can only use the silicone variant. For all other babies, they usually develop a preference for one of the two materials. The favorite usually goes particularly well with the anatomy of the mouth and satisfies the baby’s need to suckle.
Latex teats are considered to be a bit more durable, but can become sticky over time when they are boiled or sterilized. The material ages faster than silicone and is also perceived by many parents as less attractive.
Silicone teats, on the other hand, are usually made of clear, transparent plastic and are less susceptible to changes caused by light. They age more slowly than latex teats, but are more sensitive to mechanical influences. The hypoallergenic material is preferred by many parents for its softness and appearance.
These teats get cracked and punctured faster when they come into contact with baby’s first teeth. As a result, silicone teats usually have to be replaced a little more frequently than latex teats.
Give other useful accessories around the bottle
Even if a bottle warmer is not absolutely necessary, it can be of great service, especially at night, and is valuable for the reliable and quick preparation of an ideally temperature-controlled bottle.
Just like a manual or electric pump for obtaining breast milk, the convenience of recurring tasks related to feeding with the bottle can be significantly increased.
The same applies to a sterilizer. Of course, the milk bottles and teats can also be sterilized in the conventional way in the saucepan. A wash cycle in the dishwasher is not enough, even at 65 ° C.
Dishwasher-safe bottles can, however, be put in the dishwasher for cleaning. Then you boil them conventionally in a saucepan. Alternatively, the bottles can be made sterile in a special sterilizer.
It is important that all drinking utensils, pacifiers and all objects that the baby puts in their mouth are sterilized. This is not about excessive hygiene, but a necessary measure to protect the baby from pathogenic germs.
From the age of about six months, the immune system has matured enough to better protect the baby from infections. At this point it is sufficient to sterilize the vials after every second or third use.
Giving bottles made easy
In contrast to breastfeeding, mother and baby are not so restricted in their freedom of movement when giving a bottle. This offers more space for variety and also the possibility that the father or grandparents can take over the feeding.
Parents can also strengthen their bond with the baby by bottle feeding. With a lot of eye and body contact, bottle feeding is by no means inferior to breastfeeding.
With the right posture, you can initially orientate yourself on the classic breastfeeding positions. For example, the cradle position with the head slightly raised offers extensive body contact and at the same time reduces the risk of the baby choking.
Many parents switch sides when feeding when the bottle is half empty. This prevents the parent from becoming tired and at the same time simulates – as with breastfeeding – the change from one breast to the other.
At the beginning you can also trigger the baby’s search reflex by not simply putting the teat in his mouth, but instead, for example, gently stroking it over the cheek. If the baby turns its head and shows signs of hunger, you can touch the lips with the teat.
The baby will now open its mouth and start sucking. Now it is known that it is ready to be fed. The teat is carefully pushed into the baby’s mouth. The baby usually decides how far.
Under no circumstances should you try to push the teat further than the baby wishes. With its powerful suction movements and its tongue, it can decide for itself which position the teat should ideally assume in the mouth.
When giving the bottle, you should make sure that the teat is completely filled with the milk. This prevents too much air from getting into the teat and thus into baby’s stomach. The bottle must therefore be held upright accordingly.
When the baby is a few months old, he will begin to actively reach for the bottle. Even if it is then able to drink from the bottle on its own, it should not go unnoticed.
Constant sucking on the bottle should also be avoided. The baby needs sufficient time to eat, especially when drinking larger amounts. However, when it is full and only sucks the bottle a little, it is time to end the meal.
Typical signs of defense indicate that the baby has finished eating. For example, it turns its head away or tries to push the teat out of its mouth. Falling asleep is also a sure sign that the baby has had enough to drink.
By the way: while breastfeeding mothers have a legal right to the help of a midwife until the end of the breastfeeding period, the care paid for by the health insurance company ends much earlier for bottle-necked children.
However, the midwife can still be a valuable contact for problems with giving bottles. Parents should therefore know that they can get up to eight further appointments with a midwife paid for by the health insurance company in addition to the statutory entitlements.
Anyone who also needs advice from the midwife can still have care prescribed by a doctor. Then the health insurance company will continue to pay for the care and advice