Bottle Feeding (Nursing)

00:01 Now let's talk about bottle feeding.

00:03 So bottle feeding can be the delivery mechanism for several sources of food.

00:08 One would be donor milk.

00:10 So this is milk that comes from someone else aside from the birthing person, or the birthing person may decide to pump their own breast milk, but use the bottle as a way to deliver it.

00:22 We can also use bottle feeding as a method to deliver formula, which is where we're going to spend our time now.

00:28 So formula can be made up of various substances, including cow's milk protein, soy protein, hydrolyzed protein.

00:37 It could be lactose-free or it could have elemental formulas or a high MCT formula or renal formula.

00:45 And these are all specialized depending on the needs of the newborn.

00:49 Now we're ready to prepare the formula.

00:51 So one of the things we want to really make sure when we are preparing formula is that we have a clean water source, and it's deemed clean by certification from the state or local health department.

01:02 If that's the case, then normal tap water is fine, we just mix the water with the formula.

01:08 If we're in a situation, however, where we can't guarantee the safety of the water, then we can bring cold tap water or bottled water to a roiling boil for about a minute, no longer than that.

01:19 And then let it cool to room temperature for no more than 30 minutes.

01:23 Now, that's because we don't want to wait and then allow the bacteria to regrow before it's used.

01:28 So we have a clean water and an unsafe water strategy.

01:32 Regardless of how we prepare the formula, we always want to test it and make sure it's not too hot.

01:39 So what we'll do is we'll take the formula, sprinkle a little bit on the inside of our wrist.

01:43 And so this is where we're most sensitive to temperature and make sure that it's not too hot.

01:49 Now, we also want to think about the ratio of formula to water, because adding too much water will dilute the formula, and then it won't meet the nutritional needs of the baby.

01:59 On the other hand, if we put too little water in, then this could cause the baby to really have to work hard in terms of digestion or the kidneys to have to work extra hard in order to break it down.

02:11 And overall, the baby may not be getting enough liquid and become dehydrated.

02:16 We never ever, ever want to use expired formula.

02:21 So always make sure that we remind the parents and us too to double check the expiration date.

02:28 Let's talk about storing prepared formula.

02:30 So this is formula that's been mixed.

02:32 So we've gotten the water ratio perfect.

02:35 If we use that, if we prepare it, then it has to either be given to the baby or discarded within one hour of preparation.

02:44 If it hasn't been given to the baby yet, we can put it into the refrigerator and leave it there for up to 24 hours.

02:51 Sometimes formula comes pre mix, so you don't really have to worry about the water ratio.

02:56 If that's the case, once we open it, it can be covered and refrigerated for up to 48 hours if not used or given to the baby.

03:04 In cases where we use powder, we need to make sure that once that containers opened, that it's used within one month.

03:11 Again, always checking the expiration date.

03:13 But once we open it, one month it needs to go in the trash.

03:17 So sometimes it's helpful to write the date and the time on the container to make sure that we don't go past that date and time.

03:25 Now let's talk about the amount that we're going to give the baby.

03:29 Typically, and I want to say typically, because there are some ranges that 1-2 oz of infant formula every 2-3 hours for the first several days of life is pretty normal.

03:39 The baby may eat as much as 8-12 times a day.

03:43 So now you know why parents don't get a lot of sleep.

03:46 We increased that amount to about 90 or 150 ml/day by the end of two weeks.

03:52 And now the baby's feeding every 3-4 hours which is a little less often.

03:56 So a little bit more sleep.

03:58 For infants that are older than one month, then the formula needs to be provided and volumes of about 150-175 ml per kilogram per day.

04:08 We're also going to be taking cues from the baby.

04:10 So again, there's going to be some variation in that slightly.

04:14 We also want to think about the growth spurt.

04:16 Babies typically have a growth spurt at the end of about two weeks.

04:20 They have one at 6 weeks and they have one a few months out.

04:23 And during this particular time, they may be really hungry and eat more than they have in the past and it makes parents nervous when the baby starts to cry.

04:32 But if we provide some anticipatory guidance so parents know these growth spurts are coming, then maybe that will provide some relief.