Advantages of breastmilk over infant formula

• Powdered infant formula is not sterile so can be contaminated with pathogenic microorganisms
• Formula-fed babies do not receive the immunological benefits of breastmilk and are more likely to become ill and require hospitalisation
• The growth pattern of formula-fed infants is different to that of breastfed babies - formula-fed infants lose less weight in the first few days following birth and they gain weight more quickly from around 4-6 months, which may increase their risk of cardiovascular and other non-communicable diseases in the future
• Infant formulas are made to standard recipes and the constituents do not vary with the differing needs of infants over time as breastmilk does

Safe formula preparation

1. Clean bottles and teats
2. Sterilise bottle with boiling water, steam (electric or microwave), or chemical sterilisation
3. Make up formula feed with formula and boiling water (above 70℃)
   1. Boiling water should cool no more than for 30 mins before use
   2. Better to use tap water, can use bottled water if needed but check labels as might contain sodium and sulphate levels which are too high for babies
   3. Ensure formula is made up according to instructions - can cause e.g. constipation, over or under-nutrition, vomiting, hypernatraemia and excess weight gain
4. Shake bottle
5. Cool bottle under running cold tap and test temperature by dropping some on your wrist
6. Leftover milk should be discarded after 2 hours and feeds should be prepared one bottle at a time

Storing and reheating formula

• Storing prepared infant formula is not recommended as it increases the risk of bacterial growth
• If feeds do need to be prepared in advance parents/ carers need to:
  • Keep them constantly at 5℃ or below
  • Use them within 24 hours
  • Use a cool box with an ice brick to carry prepared feeds that need to be transported
• Refrigerated feeds can be warmed to room temperature by standing in a jug of hot water for a few minutes immediately before feeding - reheating by microwave is not recommended

Responsive bottle feeding

• Feed baby when they show signs of being hungry - look out for early cues such as moving head and mouth around and sucking on fingers (crying is the last sign)
• No need to develop a routine - feed baby when showing cues
• Hold baby semi-upright during feeding