Bonus Material: Bottle feeding thread

Bonus Material: Bottle feeding thread. Posted to our message boards by a reader, this great thread gives you in-depth advice on bottles and supplies.

BOTTLE FEEDING THREAD   I typed this for another thread and decided to post it more generally, because I want to use my experience with bottle feeding to help another expectant mother (WARNING – this is long but chock full of info). And, boy oh boy, once you formula feed a baby, you have a lot of experience on this. I could not breastfeed due to a medication that passes through breastmilk and could cause brain development defects, so we went with formula from the get go.   

When I was expecting, I searched and searched and could not find here or elsewhere exactly what to do with bottle feeding and how to plan for it.  I was in tears because I felt so unprepared and frustrated. I felt bad enough that I couldn’t breastfeed, but having a lack of information was almost an insult to those among us bottlefeeding. I hope this will help ANYONE WHO IS FORMULA FEEDING since I didn’t have this info and it was SO very frustrating.  I have lots of advice, including on the bottles – and, you should know, we used Avent bottles, but all of the below applies no matter what bottles you use – but I’ll start from the top. REMEMBER, THIS IS JUST MY HUMBLE OPINION AND YOU SHOULD DO WHAT YOU WANT, BUT IF EXPERIENCE COUNTS FOR ANYTHING, HERE GOES:

First, the hospital.   

They will give you tiny, ready-to-serve 2 oz formula bottles to feed your baby. They are awesome and the right amount at that time. You should stock up on them. This is not stealing b/c they will charge you later on your bill, but everytime they bring some, put them in your bag and ask for more. Your baby will use this size for a little bit of time and the only ready-to-serve bottles out there come in 4 oz sizes so you’re just throwing money away (and, you will spend a lot of formula so save it now!) Stock up!!!  You can use these for the first initial, rough nights – I recommend you save them for nights and fix bottles during the day b/c sleep is precious.   Secondly, SEND your baby to the nursery for feedings at night. This sounds cruel and unless you have your heart absolutely set on rooming in, you should get the sleep. You will not get a full night of sleep again for at least 3 – 4 months and you’re body has been through a lot of trauma. We sent our daughter at about 10-11 p.m. and then called for her at about 7 a.m. It is SO key to use the help at the hospital – you’ll wish at home that you could just dial up the nursery and have someone come help you!   Thirdly, unless you are nonconfrontational, you may want to consider putting a sign on your door that says “Bottle feeding” – this will save you two things:

1) heartache – when every nurse and doctor walks in and says, “oh, are you having trouble nursing,” “now let’s get that baby on your breast,” “have you tried nursing?” “why don’t you want to nurse, you know it’s better for reason X,” and “I’m sure the baby could latch on, it’s not too late for you to change your mind” – this is at first gutwrenching and at the end the focus of your wrath; and

2) the knock, knock in the middle of the night when they want you to breastfeed and wake you up even though you aren’t nursing and desperately want the sleep.   Finally, for the hospital, let’s talk about engorgement. If you are bottle feeding, your boobs don’t know it and will get engorged. NO ONE TOLD ME WHAT TO DO ABOUT THIS. You should: not touch them ever even though they burn and get hard, face away from the shower when you take one, wear a sports bra starting IMMEDIATELY after delivery so you keep your breasts compact and less likely to get really engorged (you will sleep and live in this so have plenty clean), get frozen peas (that you’ll put in your sports bra when you lie down for a nap, and be prepared for a lot of discomfort. The good news is it distracts from your “down there” pain and you will feel like a Playboy Playmate, but the bad news is it takes about a week for it to go down.  If you are desperate and they don’t seem to be receding, you should – this is not a lie, this is what they tell you in the hospital – get cabbage leaves and put them in your bra. The cabbage will cook from the heat of your boobs and release some natural chemical that stops your engorgement. Sounds ridiculous, I know, but it works.

———- Now, onto bottles:   

For a newborn, I HIGHLY recommend that you buy enough to get through 2 days (instead of one which most people will tell you). We loved the Avent bottles and had *20* 4 oz bottles for our newborn daughter. Some people will tell you that b/c the baby will only know one kind of bottle, you don’t need to spend on the Avent. This is probably true, but I liked the system and they were about the same price as the Gerber New Traditions and the Playtex ones, and I liked the wide size.   Also, I know many people will advise you to not get all your bottles b/c babies are picky and might not want the bottle you pick. In my experience, all my friends who formula fed, and my pediatrician’s, a bottle fed baby has no preference but the one you initially give them. They learn to feed on that bottle and that one only (after the hospital transition which goes smoothly b/c they are so young and so hungry!)  We got all our bottles and had them ready to go so we didn’t have to bother with unwrapping, assembling, reading directions, etc. once we were home with the baby. Made us feel very ready (my hubby even tasted the formula with an oz or two, but he’s just that way).

If you really want to hedge your bets, I would say get them all and keep a box or two (they usually come in sets – Avents are in sets of 3) wrapped in case you want to return them. Again, it makes sense that they’ll stick to the same bottle. A breastfed baby will have a whole other set of preferences and should rightfully be pickier about which bottle they use.  A formula fed baby is a creature of habit!   Anyway, You will be so exhausted the first couple days and the baby eats about every 2-3 hours – and most likely, it will not be you cleaning the bottles, so have enough that you could go through 2 whole days and run out or – more than likely – you’ll do a batch here and a batch there and be fine all the time.  It will depend on how big your baby is and/or how much they eat (my daughter went from 2 oz in hospital to about 4 within a week and a half! She plateaued there for a while though).

We then got *12* 9 oz bottles for after she was 2 1/2 months (I’m telling you, my daughter is a little piggie!) and that gets us through about a day and a half initially, but now (at 4 months) she’s down to only 4-5 7 oz bottles a day, so we can really go through three days with them (she’s sleeping 12 hours through the night w/no feeding). (By the way, I’m not sure how this is on other bottles, but you COULD use the Avent 9 oz bottles for a newborn, but the disadvantage is that they are much bigger which is not a huge deal except your baby is really floppy and you may want all the hands you’ve got, but more importantly, the 4 oz bottle marks 1 – 4 oz, while the 9 oz starts at 2 oz. You will probably only fix 1 oz at some point or, more likely, want to know that your baby only drank 1 oz, so having that marker is a real advantage.)  You could, however, get a mix if you’d like. I figured that we got the Avent so we could use them with multiple kids and we are really lazy (or efficient my hubby would say!)

Now, unless there are 10 people living in your house, I also recommend getting a bottle sterilizer (Avent makes the best ones and there are two kinds, but I think you can use it for some other wide-mouth bottles). I know that you will think this is a waste of money b/c you CAN run them in the diswasher (be sure to get those little baskets that you can put the nipples in b/c they can’t free float in the diswasher), but we found that we were not running the diswasher often enough to get the bottles clean. To do that, we’d have to run an empty load every night and that was just a waste (plus a pain). We got the plug in sterilizer (b/c it can do 6 instead of 4) and put it on the counter near our “bottle system” – I’ll tell you about that in a minute.  You can do 6 4 oz or 9 oz or a mix in 8 minutes and then, voila!, you have clean bottles. There is a microwave one too, but it only saves a minute and does 4 less bottles. We are very happy with the plug in one.

Also, do not waste money initially getting more nipples than the newborn ones that come with the bottles (there is one they sell for 1 months). First of all, with the Avent system, they all come with newborn nipples (which are interchangeable on the 4 oz and 9 oz bottle). You should use the newborn for a while – our hospital said you can use them forever if it doesn’t bother the baby. Think about it – breast fed babies don’t have “variable speed” nipples, so your baby will get used to one (after a few weeks, in the beginning it’s a little strange for them) and they’ll be fine on it. We made the mistake of buying 6 sets (2 in a pkg) of the 1+ month and we’ve really barely used them.  Our daughter is happy as is. Plus, there is a high risk that a formula fed baby is overfed b/c you can see how much they are eating and want to squeak more in them if you can (I promise – this sounds strange, but you will. In our case, our daughters formula intake = sleep, so 4 oz = 4 hours, etc. you see why we wanted more?!) So, don’t put on the faster flow nipple b/c they will just gorge themselves.


Let’s see, what else…H20   

OH – SAVE YOURSELF LOAD OF TIME: GO ROOM TEMPERATURE. Some people recommend a bottle-prep process that works for them which is to make the bottles ahead, or a pitcher of formula, and put in the fridge until you need it and then warm it. If that works for them, fine, but I’ve got to tell you. There is NO reason that a purely formula-fed baby has to have a warm bottle.  ROOM TEMPERATURE is absolutely fine. This is how they give it to them in the hospital and this is what they know. Unlike a breastfed baby who gets warm milk from their mom (then you really have to warm it), a bottle-fed baby never has the warm milk experience and will love their room temperature bottles. Can I tell you what this means for you? NO warmer, no chilling, no temperature check, no warming in the middle of the night, no warming on the go, nothing! It’s the easiest. You simply mix it up, shake it, and feed!   Unless you have well water or some other freaky kind of water system, you can use tap water for your bottles, so you can save the money.  We were purely lazy and wanted a system that was easier then trying to fill them to the exact mark of oz with a tap and also thought getting the right temperature would be a hassle.

So, here’s our water system: We actually have a room temperature water cooler in our daughter’s room (just one of those ceramic ones) b/c it’s easy to get clean water (easier than modulating room temp out of a tap). We fill 16 oz water bottles (any kind, you just want the bottle) and set 2 out for a day with 4 out waiting on a shelf. Then, just refill periodically. That way, you have an bottle available to pour the water in the bottle (b/c you need to see the exact amount), scoop in the powder (we went powder, it is easiest and, by far, the cheapest and formula ADDS UP!), shake and feed!   

By the way, that is the process- Don’t be scared of powder formula (I certainly was) it’s really easy and is highly portable: 1) water first to the oz mark, 2) pour in formula powder (don’t worry that it makes the bottle higher), 3) shake or mix, 4) serve to baby (if you have a gassy baby, you may want to worry about the bubbles, but with the Avent bottles they really can’t get to the bubbles unless you are holding the bottle incorrectly OR they are finished!)   On another important note, often you’ll make a “full bottle” (whatever that is at the time) and then Dbaby will only eat 1 oz of it. You’ll be very tempted to always keep this b/c formula is so expensive and reuse it later. I’ve heard mixed things from no matter what dump it (the formula company, I wonder why…b/c they want you to use more formula?) to you have ONE hour to reuse this bottle (my pediatrician).

The danger in it is that normal bacteria from the baby’s mouth has entered the rest of the formula in the bottle. Any longer & the bottle could be a breeding ground for little microorganisms and contaminated (doesn’t matter if you fridge it or heat it).  I must admit, b/c I’m trying to be honest here, that I have stretched this a little at times, but generally stuck to it b/c it’s just not worth it. You should also use an open can of powder formula in a limited amount of time – check the back of the can – there is a “use by” date – store it out (not in fridge or damp place) but temp controlled to be normal temp and always with the plastic lid on; we use the value size of S. Advance and it’s one month. Also, we never used Ready-to-Serve formula but once it is opened, it has to go in the fridge immediately and be used within 48 hours (so be sure you know how much that baby eats!)   When I go out with Maeve and need to feed on-the-go, my daughter, I fill the Avent bottle with the right amount of water, I got one of those formula dispensers (three sides that you can fill and pour) and then mix and serve. We use Similac Advance and it doesn’t have the little individual packages yet, but if you go with either of the ones w/Iron, they have them.   I promise – this is not cruel to your baby, this is how they know food and how they do it in the hospital. Our pediatrician absolutely advised us to do this. Save yourself about 6 months of effort…GO WITH ROOM TEMP!

———   Hmmm…moving on.  

Convenience is key:   I don’t know what kind of house y’all have, but we put a can of formula on every floor (we have a three story) and my hubby circulated bottles between the floors as well. This is key b/c you never know when your newborn will have the hunger urge and you won’t want them to cry/scream until you can get up/downstairs to feed them.  Later, as they get more social, you’ll want to feed them in a quiet, undistracting place (in our case, her room) so then you won’t have to distribute as much. You may want to do stair running to burn off the maternal fat, but your body will be in no shape after delivery or especially a c-section.

——- On this same front, HAVE A “BOTTLE SYSTEM”:   You can design your own based on whatever works for you, but our “bottle system” has worked for 4 families and I highly recommend it.  We got two tupperware containers (the high kind about 14×8 – not for food but for storage). Then, we got two of the BRU bottle drying racks (don’t see it on the website – it is really plain with a white bottom and 12 teal sticks that stick up, 6 long and 6 short) and one bottle cleaning brush (can get two if you want to have an extra). Bear with me here b/c it is hard to explain this in words, if you want me to take a digital picture I can later.   Set one tupperware by the sink and put the drying rack in it. This will be for your dirty bottles. You’ll bring them down, rinse them with a tiny amount of soap (if your using a sterilizer) or just water (for the diswasher) using the little bottle brush. It is REALLY important to rinse right away b/c man that stuff clumps and sticks. Then, you turn them upside down on the rack by the sink (there is a little post for the bottle & the nipple, the white ring and the lid can just get tossed in there) and know that these are the DIRTY bottles. If nesting, you can even make a label. We wrote in Sharpie Marker.

Set the other tupperware away SOMEWHERE ELSE and put the drying rack in it (ours is underneath our cabinet with our “big people” glasses which are, of course, clean).  This will be for your clean bottles. Once they are out of the diswasher or sterilizer, they are often still a bit wet. You can turn them upside down in the same manner (bottles and nipples on the posts, rings and lids in the container) and know these are ready to go.  Again, if nesting, label CLEAN   Right now, designate your husband/partner (who is a godsend b/c daddy’s can bottle feed in the middle of the night – which is REALLY important for your recovery, see below) as the president in charge of the system AND teaching one or two members of your family (who are, of course, here to help with the baby when born) how to do the system as well. You will be going through these bottles like water, so teach them ahead of time. Your hubby can do a dry run b/c all the bottles need to be sterilized before they can be used.   If you use this, I promise you’ll always have clean bottles and never go through that, “Oh my god, did I just feed my baby with a dirty bottle that was sitting here on the counter and I’m not even sure when it was rinsed?! Or was it clean? ACK?!” You won’t have a huge pile up of dirty bottles in your sink and a screaming, hungry child in your arms. You’ll be good to go!

———   How the bottle feeding goes with the baby:

At first, they will have a hard time figuring out this but their sucking reflex is strong and natural, so they get it pretty quickly. Our hospital had soft, rubber nipples that my daughter figured out right away. It will NOT be a problem switching to a silicone nipple later, so don’t worry. Also, you should check with your pediatrician, but mine advised me to give my daughter whatever the hospital had while in the hospital and then switch to what we wanted to use (we went with Similac Advance) as soon as we got home. He also advised that unless we experienced problems (allergies, lactose intolerance, other assorted tummy/feeding problems) to only ever switch formulas ONCE. It’s not a good idea to try to use every freebie you got from the formula companies – it will only cause them tummy aches and confusion.   You should be sure to hold the bottle at the correct angle (formula should fill the nipple with no air) and then keep in their mouth at a depth where the baby’s lips can close around it, but not too deep that they are gagging. If it’s too far out, the formula will run all down their face (which is will partly anyway, but you’ll see when their little lips close around it).

Your baby may get a little blister on their top or bottom lip from the rubber/silicone nipple but this is OK – it just has to toughen a little bit.   And, if you can find them, it’s nice to have bibs that are: a) velcro closures on the back, b) cloth on the front (soft), and c) plastic on the back (because that formula runs everywhere & you may have to change the baby’s clothes with diaper changes so you don’t want to have to with diaper change and feeding!)   In the beginning, we burped our daughter every ounce and she never spit up (that also was probably just that we were lucky), but if they get too much in their little tummy, they will spit up and/or stop eating even though they are still hungry b/c their tummy is full. We burped her sitting up b/c it was easier to just flip her up from lying on her back with the bottle (really at an angle, don’t lie them completely flat) to burp and then back down again. She was never really floppy headed though, so this one is personal preference.   Have a cloth diaper or burp cloth on your lap and your shoulder (and you may want one on your arm beneath the baby’s head). You’re likely to get formula all over in the beginning.   All this will depend on the baby, but those were the basics from our front. Also, be sure to know your baby’s hunger cues (vs. soothing sucking). Maeve’s was to suck vigorously but to do this ravenously side to side (sort of like shaking her head side to side). When she wanted soothing sucking, her tongue went more front to back. B/c your baby is formula fed…trumpets playing…you can give him/her a pacifier right away (or your pinkie) for soothing sucking, so TAKE ADVANTAGE OF THIS!  You do not want to overfeed the baby and they want soothing sucking a lot.

The great part about bottle feeding is that the baby gets nutrition and calories from minute one, so they are more likely to sleep at bit more between feedings. But, this ALL depends on the baby. Keep track of the amount of time between bottles b/c this is how you’ll know if he/she is sucking b/c of hunger or for soothing (and, obviously, keep track of how much they eat b/c you can and only prepare that much until you think they may be growing through a growth spurt.)   Last thing on this front is this: It IS better for a baby to be breastfed immediately b/c of the immunities and other nutrients in breastmilk. BUT, all babies catch up to each other at 6 months, some earlier. So, do not berate yourself on this decision. We used Similac Advance b/c I felt so guilty and it has the closest formula to breastmilk (along with Enfamil Lipil) so the baby catches up at 3 months, but any formula will get your baby to the same place at the same time. In my case, because of my medication, my pediatrician refused to let me try to breastfeed b/c he did not want to treat my child later for a defect or brain development problem (b/c of the medication is my breastmilk) when I would have a happy, healthy child just as equally if I formula fed. This made me feel very confident in my decision. If you ever need reassurance, just email me.

——— Now, onto Daddy’s role in bottle feeding – HE IS YOUR EQUAL!

On the Daddy front, as much as it is hard b/c you want to hold, snuggle, and spend special time with your new baby, you SHOULD ABSOLUTELY LET YOUR HUBBY FEED THE BABY!  Especially during the middle of night the first few days. If you sleep, you will recover more quickly. My hubby and I had a “every other night” system down – he let me sleep a whole night while he fed Maeve, then I did the next night. This meant one of us was never exhausted and could always have a lot of energy for the baby. Also, we both felt completely bonded with her (unlike breastfeeding where the baby naturally bonds more with the Mom).  If you are ever really exhausted (b/c you’ll still have him/her more during the day) ask him to do a bottle and you go nap.   — MY SAPPY POINT OF VIEW ABOUT BOTTLE FEEDING AS A TEAM   This brings me to my last point about bottlefeeding. Despite how much I agonized over not being able to breastfeed, I now believe that bottle feeding has made my marriage and parenting relationship with my husband stronger. From the minute she was born, we were a team. We shared feeding her and planning her activities. We were both completely bonded with her and knew the system to keep her fed & happy.

When I was down, he was happy to step in. When he was exhausted (esp when he went back to work), I could step up. We were both rested enough that we could ENJOY our newborn (where many parents are so exhausted they see the first few weeks through bleary eyes). We had FUN!  We laughed and felt like we were, together, entering a new phase of our lives.  Even today, my hubby still brings the bottles up to her room for her good night and good morning bottle. And, he packs the diaper bag when we go out (by the way, I really love my Avent backpack – it is so handy to have both arms free and everything fits well).   You have no idea how much this partnership will mean to you. It will make the difference between a miserable first weeks/month and a parenting team that is problem solving but always together. Make your husband read this posting if you don’t think you can talk about it. I now think that bottle feeding was right for us, despite how much I wish I could for all of the reasons that I know (and, believe me, people will tell you over and over and over again – if you want advice on that, just email me). Both hubby and I have loved our baby experience from night one and we credit a lack of total exhaustion due to teamwork as a large reason why.

As much as I longed for the special moment that I was able to bring my baby to my breast, I found that it was replaced by the special moment of seeing my husband give my daughter a bottle, whisper and sing in her ear, and the big crocodile tears streaming down his face at how much he loved her. And, that wasn’t just the first time, it is virtually every day. It brings tears to my eyes right now. It was irreplaceable and the first time I watched it was the moment I knew in my heart that bottle feeding was the right decision for us, not only because of the circumstances, but becuase of the reality that is our lives now as we both feed her and look into her eyes knowing she is going to be a happy, healthy baby.


Another reader, pediatrician Dr. S. Martin, wrote in with a few comments on this article: Hi Denise and Alan -

My name is S. Martin and I am a Pediatrician. I love your series
(used Bridal Bargains for my wedding, will buy Baby Bargains hopefully
later this year!). I’ve read your website with interest, and find that most
of your recommendations are valid. However, I wanted to point a few
things out on the “Bottle Feeding Thread” posted in your Bonus Materials
section. Breast is best, obviously, but there are many parents who, for
whatever reason, formula feed. That’s fine, and this is not what this email
is about. In the section section, first paragraph, the author recommends
sending the newborn to the nursery for overnight care. While this may
sound ideal (for those last few nights of uninterrupted sleep), many
nurseries are not able to care for multiple newborns at night. As hospitals
increasingly move towards “baby friendly” status (basically babies room-in
with mom and go to the nursery at initial “check in” and then only for
medical procedures), there is no longer room or staff available to feed
babies overnight. At the two hospitals where I cover the NBN (newborn
nursery), we actively encourage and support mothers/parents to care for
their newborn in the room. A mother who sends her newborn to the nursery every night sometimes causes us concern that she may be overwhelmed and not ready to care for her child at home by herself. Obviously, a brief break to shower, etc is fine. But for 8+hrs every night? Not a good suggestion and no longer possible at many nurseries.

Otherwise, I agree with the “bottle feeding” sign and the recommendations
about treating engorgement. Cabbage leaves are proven and I’ve suggested them to many post-partum moms.

Other comments: don’t waste money on a sterilizer. Regular hand
washing in hot, soapy water is both effective and MUCH cheaper. Powder
formula is THE CHEAPEST option (ready to feed liquid is the priciest).

And, last but not least, a mother should NOT feel guilty about her decision
to formula feed. I often know the reasons mothers choose to formula feed (medical or otherwise), but a stranger berating a mom for not breastfeeding is cruel. That’s why I always try to empower parents and support their decisions as opposed to guilting them.