Guide to

bottle feeding
 contents
In this booklet:

About this booklet 2

What infant formula should I choose and how long do 3

I need to use first infant formula for?

What you need for formula feeding 4

How to sterilise feeding equipment 5

How to make up a feed 6

Sterilising methods 9

Ready-to-feed liquid infant formula and storing a feed 11

Feeding your baby 12

How do I know if my baby’s getting enough infant formula? 14

Breastfeeding and giving infant formula and choosing to 15

restart breastfeeding

The information in this booklet comes from Public Health England

and the UK Committee for UNICEF (UNICEF UK) Baby Friendly
Initiative. It will help you bottle feed your baby responsively and
as safely as possible. If you need more information about feeding
your baby, speak to your midwife, health visitor or GP.
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What infant formula
should I choose?

Use a first infant formula throughout the

first year. It doesn’t matter which brand
you choose as they are all very similar.
Talk to your midwife or health visitor if
you have any concerns.

How long do I need to use

first infant formula for?

Stick to a first infant formula throughout

the first year. Only breastmilk or formula
milk should be given as a drink to babies
under 12 months of age. When your baby is
six months old, it’s okay when cooking and
preparing foods to use small amounts of
pasteurised whole cows’ milk.
When your baby is one year old, they will
be getting more of their energy, vitamins
and minerals from food, and then full fat
cows’ milk can be their main milk drink.
There is no need for follow-on formula.

3
 What you need for
formula feeding
You need to make sure you clean and sterilise
all equipment to prevent your baby from getting
infections and stomach upsets. You’ll need:

Bottles with teats and

bottle covers Bottle brush and teat brush

Sterilising equipment (such as a

cold-water steriliser, microwave Formula milk powder or
or steam steriliser) ready-to-feed liquid formula

4
 How to sterilise
feeding equipment

The following instructions apply to all feeding equipment

you use for your baby, whether you are using expressed
breastmilk or first infant formula.

1. First, wash your hands well with soap and water.

2. Clean the work surfaces with hot, soapy water.
3. Check that the bottle and teat are not damaged, then clean the bottle
and teat in hot, soapy water using a clean bottle brush – a dishwasher
will clean the bottle feeding equipment but won’t sterilise it.
4. Rinse all your equipment in clean, cold running water before sterilising.

1. 2.

3. 4.

5
 How to make up a feed
Use fresh water from the cold tap to fill your kettle every time you
make up formula. Do not use water that has been previously boiled
or artificially softened water. Bottled water is not recommended to
make up a feed as it is not sterile and may contain too much salt
(sodium) or sulphate.

1. Fill the kettle with at least 2. Boil the water. Then leave the
1 litre of fresh tap water water to cool in the kettle
from the cold tap (don’t for no more than 30 minutes
use water that has been so that it remains at a
boiled before). temperature of at least 70oC.

1. 2.

3. Clean and disinfect the 4. If you are using a cold-water

surface you are going to steriliser, shake off any excess
use. It’s really important solution from the bottle and
that you wash your hands the teat, or rinse the bottle with
to stop bacteria spreading. cooled boiled water from the
kettle (not the tap).

3.

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5. Keep the teat and cap on the
upturned lid of the steriliser. Avoid
putting them on the work surface.
5.
6. Follow the manufacturer’s
instructions and pour the correct
amount of water into the bottle
first. Double check that the water
level is correct.

7. Loosely fill the supplied scoop

with the formula and level it 7.
off using either the flat edge
of a clean, dry knife or the
leveller provided. Follow the
manufacturer’s instructions and
only put the suggested number
of scoops in the bottle.

8. Holding the edge of the retaining

ring, put it on the bottle and 8.
screw it in. Cover the teat with the
cap and shake the bottle until the
powder is dissolved.

9. It is really important to cool the

formula so it is not too hot to
drink. Cool the formula by holding
the bottom half of the bottle 9.
under cold running water. Move
the bottle about under the tap to
ensure even cooling.

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 10. Test the temperature of the
infant formula on the inside of
your wrist before giving it to
your baby. It should be body
temperature, which means it
10.
should feel warm or cool, but
not hot.

11. If there is any made-up infant

formula left in the bottle after
a feed, throw it away.

12. To reduce the risk of infection,

make up feeds as your baby
needs them. One at a time.

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Sterilising methods

Steam sterilising – electric steriliser or microwave

1. Follow the manufacturer’s 2.

instructions.
2. Make sure the openings of
the bottles and teats are
facing down in the steriliser.

Cold-water sterilising

1. Follow the manufacturer’s

instructions.
5.
2. Change the sterilising
solution every 24 hours.
3. Leave feeding equipment in
the sterilising solution for at
least 30 minutes.
4. Make sure that there is no
air trapped in the bottles or
teats when putting them in
the sterilising solution.
5. Keep all the equipment
under the solution with a
floating cover.

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 Sterilising by boiling

1. Never leave hot pans and liquids unattended.

2. Make sure that whatever you sterilise in this way

is safe to boil.

3. Boil the feeding equipment in water for at least

10 minutes, making sure that all items stay under
the surface of the water. You may need to use a
small plate to keep the bottles under the water.

4. Remember that teats tend to get damaged faster

with this method.

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Ready-to-feed liquid
infant formula
Ready-to-feed liquid infant formula is sterile until opened. All
feeding equipment will still need to be sterilised. Once opened,
any unused liquid infant formula that remains in the carton
needs to be stored at the back of the fridge on the top shelf
with the cut corner turned down, for no longer than 24 hours.

Storing a feed
A feed should be freshly made up when it is needed to
reduce the risk of making your baby ill. If you have no
choice and need to store a feed, please speak to your health
visitor about the best way to do this. Leftover formula
should be discarded at the end of a feed. Unused bottles of
formula should be discarded if they have been kept at room
temperature for over 2 hours.

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 Feeding your baby

The early days with your baby are a great time to get to know and love
each other. This can be done by keeping your baby close to you, enjoying
skin contact and feeding according to these tips. Babies will feel more
secure if most feeds are given by parents or main caregivers, especially in
the early weeks, as this will really help you bond with each other.

1. Feed your baby when they show signs

of being hungry - look out for cues
(moving head and mouth around,
sucking on fingers). Crying is the last 1.
sign of wanting to feed, so try and
feed your baby before they cry.

2. Hold baby close in a semi-upright

position so you can see their face and
reassure them by looking into their
eyes and talking to them during the
feed. Begin by inviting baby to open 2.
their mouth - gently rub the teat
against their top lip.

3. Gently insert the teat into baby’s

mouth keeping the bottle in a
horizontal position (just slightly
tipped) to prevent milk from flowing
too fast. 3.

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4. Watch your baby and follow the cues
for when they need a break; these
signs will be different from one baby
to the next. They may splay their 4.
fingers and toes, spill milk out of their
mouth, stop sucking, turn their head
away or push the bottle away. Gently
remove the teat or bring the bottle
downwards to cut off the flow of
milk.

5. If the teat becomes flattened while

you are feeding, pull gently on the
corner of your baby’s mouth to
release the vacuum.

6. Your baby may need short breaks

during the feed and may need to burp
sometimes. When your baby does
not want any more feed, hold them 6.
upright and gently rub or pat their
back to bring up any wind.

7. Never use a prop for the bottle or

leave your baby alone with a bottle
as there is a risk they might choke.

8. Your baby will know how much milk

they need. Forcing your baby to finish
a feed will be distressing and can
mean your baby is overfed.

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 How do I know if my
baby is getting enough
infant formula?
Your baby’s weight gain and the number of wet and dirty nappies will
help to tell you if your baby is getting enough formula.

A few days after the birth, your baby should be producing around six wet
nappies a day. These nappies should be heavy with clear or pale yellow
urine.

For the first few days after birth, your baby will pass dark, sticky stools
(known as meconium). However, after the first week, your baby should
pass pale yellow or yellowish-brown stools.

Your baby should have at least six wet nappies a day, and at least one
soft stool a day. If you are concerned your baby is not getting enough
milk, speak to your midwife or health visitor.

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Breastfeeding and giving
infant formula

If you are combining both breastfeeding and formula feeding and

would like to discuss any changes, such as increasing your milk supply,
remember to talk to your midwife or health visitor. You can also call the
National Breastfeeding Helpline on 0300 100 0212 to speak to someone,
often local, about breastfeeding your baby.

Choosing to restart
breastfeeding

If you decide not to breastfeed or have stopped breastfeeding, it is

possible to restart. This can be difficult because your milk supply will
naturally reduce once you are not breastfeeding, but it can increase again
to meet your baby’s needs. Giving infant formula to a breastfed baby will
reduce your breastmilk supply. If you need more information about bottle
feeding or breastfeeding your baby, speak to your midwife, health visitor
or GP.

More information is also available on nhs.uk/start4life

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The information in this booklet was prepared in consultation
with Public Health England and the UK Committee for UNICEF
(UNICEF UK) Baby Friendly Initiative

© Crown copyright 2021.

Product code 2903779
Produced by APS for Public Health England