Health considerations when bottle-feeding
If you decide not to breastfeed, or you are unable to breastfeed, commercial iron-fortified
formulas can give your baby the nutrition they need. Infant formulas have the right
amounts of protein, calories, fat, vitamins, and minerals for growth. However, formula
doesn't contain the immune factors that are in breastmilk. The immune factors in breastmilk
help prevent infections and other health conditions throughout a baby's life.
Infants who take enough iron-fortified infant formula usually don’t need vitamin and
mineral supplements. However, the American Academy of Pediatrics recommends vitamin
D supplementation for all babies drinking formula until they are drinking at least
32 ounces a day. Fluoride supplements are recommended for babies whose primary water
supply is not fluoridated. Check with your baby's healthcare provider about vitamin
D and fluoride supplements.
Types of infant formula
Cow's milk–based formula. Most infants should be able to tolerate a standard cow's milk formula. Cow's milk
formulas are modified to be closer to human milk. These formulas have lactose as the
carbohydrate (sugar) source. They are available in ready-to-feed cans, liquid concentrate,
and powder. Regular cow's milk is not an appropriate source of nutrition for a human
Soy-based or lactose-free formulas. These formulas are used if an infant can’t tolerate lactose, which is rarely a significant
problem in babies. They don’t contain lactose as the sugar source. As many as 50%
of all infants who are allergic to cow's milk formula will also be allergic to soy-based
formulas. Talk with your baby's healthcare provider before changing formulas. Vegetarian
parents may prefer soy-based formulas. But they should be aware that breastfeeding
is still the best option.
Special formulas. There are special formulas for babies who are premature or who have certain rare
disorders or diseases. These formulas may have special directions for use. They are
prescribed by the baby's healthcare provider.
Hydrolyzed formulas. Hydrolyzed formulas are easier to digest. They may be used in babies at risk for
allergies. They are more expensive than regular formulas. Talk with your baby's healthcare
provider before using these formulas.
Low-iron formulas. These formulas are not recommended.
Helpful hints for feeding your baby
Breastmilk only is the ideal feeding for at least 6 months. This means no water, sugar
water, or formula.
Wait until breastfeeding is well established before giving your baby breastmilk in
Working mothers can use a breast pump on break time and refrigerate or freeze the
milk for later use as a bottle-feeding. Refrigerated breastmilk should be used within
24 hours after pumping. Frozen breastmilk is good for several months in the freezer.
Fathers and other family members can be involved in feeding time if breastmilk is
offered from a bottle occasionally.
Offer cow's milk–based formula with iron as the first choice of formula if not breastfeeding.
Keep your baby on breastmilk or baby formula until they are 1 year old. After this
time, you may switch to whole milk. Children under 2 years old should not drink skim or low-fat milk.
It’s important to follow the formula preparation directions exactly as directed on
the packaging. Using too much water can result in poor weight gain. It's also important
to discuss your water supply with your child's healthcare provider. In some areas,
water must be boiled first, or bottled water should be used.
Bottles should never be propped up.
Babies should never be put to sleep with a bottle. This can cause cavities to develop.
All babies, whether breastfed or bottle-fed, should be offered a feeding whenever
they show signs of hunger.