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Bottle Feeding Advice

The bottle feeding mother has several decisions to make, guided by her common sense, her baby's reactions, her budget, and her pediatrician's advice. There are different types of formulas to choose from, differing not only in chemical composition, but in the amount of preparation necessary. Nipples and bottles differ in size and shape as well as material. While some pediatricians recommend that the formula be placed in clean bottles, capped with nipples, and then placed in a sterilizer to prepare it for use. others believe the water in a dishwasher is hot enough to thoroughly clean bottles before the formula is placed in them and then refrigerated. Some dishwashers have a covered section in the silverware tray especially for nipples. Be sure to thoroughly clean nipples before placing them in this sect ion, as water may not be forced through the hole and clogs can occur. If your dishwasher does not have this section, you can place the nipples, nipple end up, on the bottom of the silverware tray and place utensils around them, securing them to the tray to prevent their floating around. (Do not place nipples loosely in an uncovered silverware tray or on the glass rack, because they will fly around while the dishes are washing and can cause the pump to clog.) Nipples can also be sterilized by boiling them for five minutes. Some doctors believe it is sufficient to wash bottles and nipples by hand in hot soapy water, followed by thorough rinsing.

Formula

The following is a list of the different types of prepared formulas available, starting with the most expensive and ending with the least. As a general rule, the less you have to do to prepare the formula, the more expensive it will be.

1. 4- and B-ounce bottles already filled and sterilized Some come with nipples already in place; others require the addition of nipples. These are good for carrying with you when traveling with the baby, as they require no refrigeration. You also might consider keeping these in the baby's room for middle of the night feedings so you won't have to go into the kitchen to heat a refrigerated bottle. These are usually too expensive to use for all feedings.

2. Ready-to-Pour This comes already prepared in cans and needs to be poured into clean or sterilized bottles-depending on your pediatrician's advice.

3. Concentrate must be diluted as per package directions.

4. Powder must be dissolved with water as per package directions. You can also make your own formula following your pediatrician's directions. This is the least expensive method of formula preparation, but it is also the most time-consuming.

Formula must be handled properly to inhibit the growth of bacteria which can thrive in the sugars present. To avoid spoilage:

1. If you use the cans of ready-to-pour formula, wash the top of the can before puncturing it. Pour the entire can into clean bottles, cover them, and refrigerate. Warm and use as needed. Never store formula in an open can.

2. Do not leave formula in the refrigerator for more than twenty-four hours. Prepare a day's supply at a time – no more.

3. Throw out any formula left in a bottle after a feeding. Some saliva may back up through the nipple and react with the formula in the bottle, causing spoilage.

Different formulas have different chemical compositions. Some are milk-based, others are made of soy bean. Prepared formulas come with and without iron. Iron may cause gastric upset, constipation, or diarrhea. While some infants seem to do well on whatever formula they drink some tolerate a specific formula better than others. This can show up If your baby is given one formula in the hospital and you use another at home.

Bottles And Nipples

At present, plastic and glass bottles are available in different sizes and shapes. Glass bottles can be cleaned the most thoroughly, but can break if dropped or thrown. If you use plastic bottles and they begin to smell sour, even after being thoroughly cleaned, discard them and buy new ones. You will need 8 bottles and nipples to begin with. bottle and nipple brushes, plus tongs and a sterilizer if your pediatrician so advises. I suggest you buy 8-ounce bottles even though initially your child will probably drink 8 four-ounce bottles per day. This saves the expense of buying the 4-ounce size initially and then 8-ounce bottles as the child's appetite increases.

There are several different types of bottles that utilize sterile disposable inserts. The insert is placed in the bottle. formula poured in, and the nipple attached. One medical advisor I consulted prefers these because the insert collapses as the bottle is emptied, thereby lessening the chance that the baby will swallow air. She also prefers the short nipple available with one brand because it is closer in design to the mother's nipple and encourages the baby to suck more actively, as nature intended. Ask your pediatrician which type he or she recommends.

The size of the hole in the nipple can vary. If the hole is too large, the baby may gag as the formula rushes into the mouth. If your child has a particularly strong suck, consider buying a nipple without a hole and making a pin hole or cross-cut with a clean, sharp razor so the milk will flow more gradually. If the baby seems distressed during a feeding, check to see if the nipple is clogged, causing fruitless sucking.

Additional Advice

No matter what type of bottle and/or nipples you select, be sure you can see formula in the neck of the bottle while you are feeding the baby. This helps prevent the ingestion of air which can cause gas.

Never prop a bottle! A baby left with a propped bottle may gag on the liquid and choke. All infants need cuddling to develop normally. Breastfeeding mothers must hold their infants while they nurse, and it is wise for the bottle feeding parent to do so as well.

Your pediatrician will advise you when and how to gradually begin giving your baby solid foods. If you use commercially prepared baby foods , do not feed the baby directly from the jar unless you plan to discard any food left over. The saliva transmitted from the baby's mouth via the spoon can cause spoilage. Also, know that you can prepare your own baby food using a blender or baby food grinder - and freeze the food in portion sizes. This is more economical than using prepared baby foods. There are several cookbooks available that give recipes for baby foods.

How To Handle Middle Of The Night Feedings

Middle of the night feedings can be accomplished with a minimum of disruption. If you are bottle feeding, consider using the prepared bottles of formula that come with the nipple already in place. These do not require refrigeration. Keep them in the baby's room so you won't have to stumble around in the dark to locate them. These do not have to be heated and will save you the trouble of having to rummage around the kitchen while half-asleep, fussing with pans, water, and bottles.

Who should get up to feed the baby? Consider making the decision on the basis of who's the most fatigued. If the new mother is more exhausted, the new father can get up. If he is more exhausted, she can get up. Some couples solve this problem by letting the new father take care of middle of the night feedings on week-ends while his mate handles week night feedings.

lf you are breastfeeding, consider taking the baby into bed with you, either by sharing your bed the whole night or by letting the child join you upon awakening in the middle of the night. Simply attach baby to nipple and go back to sleep. While there is still some controversy about this, the La Leche League manual assures readers that it is safe. Tine Thevenin has written a book called The Family Bed which discusses the advantages of “co-family” sleeping. When asked what he thought about taking the baby into bed, one pediatrician replied, “I have a wife, three children and a dog, and sometimes I wake up in the morning and don't know who is licking my face!” Some couples wonder if this causes dependency problems later, if the child will refuse to “graduate” to a crib or bed or will never sleep through the night. Parents I have spoken with who've tried it said that this does not generally occur - that, eventually, the baby usually does sleep through the night, in his or her own bed. Mothers whose infants sleep with them for the entire night report that they are less fatigued than other mothers they know because they don't really have to awaken fully to care for their babies.

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