How to bottle-feed your newborn

Bottle-feeding a newborn

If you're exclusively pumping or using formula, you'll give your newborn a bottle right away. Because of the sucking reflex, they should be able to take it easily. (There are special bottles if your baby is premature or has a cleft palate.)

If you're breastfeeding and supplementing with formula (also called combination feeding), doctors and lactation consultants recommend waiting until your baby is 3 weeks old to give a bottle if possible. That way, you and your baby will be comfortable breastfeeding and your breast milk supply will be synched to your baby's needs. But if you need to give a bottle before then, don't worry – this doesn't mean you can't breastfeed successfully!

Feed your newborn on demand, as soon as they show signs of being hungry. If they get too upset before eating, they might have trouble drinking their formula or breast milk. Baby hunger cues include:

• Licking their lips
• Opening their mouth
• Sticking their tongue out
• Rooting (moving their jaw, mouth, or head looking for your breast)
• Sucking on things
• Fussiness

If you're formula feeding or exclusively pumping, for the first week, offer your newborn 1 to 2 ounces of formula or breast milk every 2 or 3 hours. At first, newborns may only take a half ounce at a time.

Newborns will eat as often as eight to 12 times every 24 hours. After the first week, your baby will likely take about 2 to 3 ounces every 3 to 4 hours.

If your newborn falls asleep during a feeding, you may need to wake them and encourage them to eat so they gain enough weight. And if your baby sleeps longer than 4 hours straight in the first few weeks, you'll need to wake them for a feeding. (This is usually only necessary until your newborn regains their birth weight, unless they were born prematurely.)

How to bottle-feed your baby

The key to bottle-feeding your baby is holding them in your arms at a 45-degree angle. This helps cut back on the amount of air they swallow, which in turn reduces the amount of uncomfortable gas in their tummy.

Make sure the nipple is completely full of formula or breast milk, not partially filled, to reduce the amount of air your baby swallows. If your baby seems squirmy in the middle of a feeding, burp them before continuing.

If you hear a lot of noisy sucking sounds while your baby drinks, they may be taking in too much air. To help them swallow less air, make sure you're holding them at the right angle.

Older babies may be able to hold their own bottle, but never prop a bottle – it can cause your baby to choke.

Paced bottle feeding is one popular bottle-feeding method that puts your baby in control of how much they eat, to help prevent overfeeding. Make sure to choose the right bottle (look for one with a slow-flow, wide nipple), take breaks every 20 to 30 seconds, and watch for your baby's fullness cues (turning their head away from the bottle, for example).

No matter how you bottle-feed, let your baby stop eating when they show signs of being full. Don't encourage them to finish a bottle after they've lost interest or fallen asleep unless your baby is a newborn or is having trouble with weight gain.

Common bottle-feeding questions

How do I make a baby bottle?

Using clean bottles, fill the bottle with formula or breast milk. If you're using formula that you mix with water, measure the water first, then add formula. (See what kind of water is best for making formula.)

You can prepare and store a day's worth of formula bottles in the refrigerator for up to 24 hours.

If you're using breast milk, use "the rule of 4" to remember how long breast milk stays fresh: 4 hours at room temperature and 4 days in the refrigerator. You can also freeze breast milk and use it within 6 months or as long as one year.

How often should I feed my baby a bottle?

Babies differ, but here's generally what to expect:

• For the first few weeks, offer the bottle every two to three hours or when your baby seems hungry. At first, newborns may only take a half ounce at a time, working their way up to around 1.5 to 2 ounces each feeding for the first week. After the first week, they'll typically be taking about 2 to 3 ounces per feeding.
• After about a month, your baby will probably be taking around 3 to 4 ounces every three to four hours. As your baby grows, this amount will gradually increase over the next several months.
• By 6 months, your baby will likely take 6 to 8 ounces four or five times a day.

Your pediatrician will monitor your baby's growth, which is the best indicator that they're getting enough food.

If my baby doesn't finish a bottle, can I save it for later?

Bacteria from your baby's saliva mixes with whatever fluid is in the bottle, which leads to contamination.

If your baby doesn't finish formula within an hour from when feeding began, throw away any that's left over. The antibacterial properties of breast milk give it a shelf life of two hours. After that, throw it out.

What's the best way to warm a bottle?

There's no health reason to warm formula or breast milk before giving it to your baby, but your baby may prefer it that way.

To warm a bottle of refrigerated breast milk or formula, use one of these methods:

• Place it in a bowl of warm – not hot – water until it's warm, up to 15 minutes. The water level should be below the top of the bottle. Gently swirl the bottle a few times to make sure the liquid is evenly heated.
• Place the bottle under warm, running tap water until warm, about one to two minutes. Be careful not to get water on the nipple or into the bottle.
• Use a countertop bottle warmer.

Never use a microwave to heat a bottle of breast milk or formula. A microwave oven heats unevenly, so it can create hot pockets in the liquid that can cause burns. Microwaving can also cause nutrients to break down.

How do I clean baby bottles and nipples?

Whatever cleaning method you use, make sure to wash your hands well before you begin.

Glass, metal, or silicone bottles: Run them through a dishwasher cycle that uses heated water and a hot drying cycle. Alternatively, hand wash them in hot, soapy water and let them air dry on a clean dish towel or paper towel.

Plastic bottles: Because heat can cause plastics to release harmful chemicals, the American Academy of Pediatrics recommends that plastic bottles not be put in the dishwasher or submerged in boiling water. Instead, hand wash them in hot, soapy water and set them to air dry on a clean dish towel or paper towel.

Nipples and rings: Whether you're hand washing or using the dishwasher, take apart the nipples and rings and rinse them under running water. Place them in the dishwasher in a closed-top basket or mesh laundry bag. If they're not completely dry when the cycle is complete, place them on a clean dish towel or paper towel to air dry.

To hand wash, place rinsed nipples and rings in a clean basin of soapy hot water. Scrub with a clean brush that's used only for washing infant feeding items. Squeeze water through the nipples to make sure they get clean. Rinse them under running water, then let them air dry on a clean dish towel or paper towel. Wash the basin with hot, soapy water and let it air dry too.

Do I need to sterilize baby bottles?

Not necessarily. Sterilizing bottles, nipples, and rings is most commonly recommended in the following situations:

• The first time you use new (or hand-me-down) bottles, nipples, and rings
• If you have well water or are concerned about the quality of your water supply
• If your baby was born very prematurely or has a weakened immune system
• If your baby has been sick (to prevent reintroducing bacteria or germs when you feed them)

Talk to your baby's provider if you have questions about whether to sterilize bottles. Here's how to do it:

• Bleach: Soak bottles in a solution of 2 teaspoons of unscented bleach per gallon (16 cups, or 128 ounces) of water in a clean wash basin for at least 2 minutes. Do not rinse. Any remaining bleach will break down as it dries. You can use bleach to sanitize plastic bottle parts, too.
• Boiling water: Submerge bottles in boiling water for at least five minutes.
• Steam: Use a countertop or microwave bottle sterilizer. Follow the manufacturer's instructions.
• Dishwasher: Run bottles through a dishwasher cycle using hot water and a heated drying cycle or a sanitizing setting.

Note: Don't use heat-based methods – boiling water, steam, or the dishwasher – to sanitize plastic bottles. Heat can cause plastics to release harmful chemicals.

If the bottles are wet after sanitizing, let them air dry on a clean dish towel or paper towel.

Learn more:

• Introducing your breastfed baby to the bottle
• How to safely store breast milk