This topic discusses using
a bottle to feed formula to your baby. To learn about using a bottle to feed
breast milk to your baby or to learn about breast-feeding,
see the topic
When is bottle-feeding with formula the best choice for your baby?
If you are having a hard time
breast-feeding and are trying to decide whether to switch to using formula,
know that the first few weeks of breast-feeding are the most challenging. You
may want to talk to your doctor to help you make your
choice. Some moms choose to both breast-feed and bottle-feed their
You may not be able
to breast-feed for different health reasons, such as if you've had breast
surgery or if you have certain infections. While breast milk is the
ideal food for babies, your baby can get good nutrition from formula. Formulas
are designed to give babies all the calories and nutrients they need until they
are 6 months old. (Babies born early or with health problems may drink formula
What are your choices for infant formula?
There are many types of infant
formulas for you to choose from. Most of the time, parents start with formulas
made from cow's milk.
Talk to your doctor before you try other types of formulas,
Soy formulas may be recommended for babies who are unable to tolerate cow's-milk formulas or for vegetarian parents who don't want to feed their babies animal products. Or soy formulas may be chosen for cultural, ethical, or religious reasons.
Soy formula is not recommended for all infants. It should not be given to any infant who has a soy protein allergy.
These formulas are used for babies who are
lactose-intolerant, which means that they can't digest
lactose, a natural sugar found in foods with cow's milk. Most of the time,
lactose intolerance starts in later childhood or adulthood. It is rare in
Hydrolyzed protein or amino acid
formulas are used for babies who cannot
tolerate formulas made from cow's milk or soy.
Formulas for toddlers are also available. These formulas have extra
nutrients, and you can use them to help your child make the switch to whole
milk. But healthy babies and toddlers don't really need them.
How do you feed formula to your baby?
When you make formula, use safe water and be sure your hands and equipment are clean. Follow the advice of your doctor and read the label on the
formula package. Make sure the formula is not too hot or too cold when you give it to
The length of time between feedings
varies. It depends on the amount of formula your baby drank during the previous
feeding. As you get to know your baby, you will be able to notice his or her
signs of hunger and fullness. Don't hesitate to call your doctor if you are
worried about whether your baby is eating enough.
After formula is mixed, it needs to be used within 24 hours to be safe. Throw away any formula left in the bottle after
you feed your baby, because bacteria can grow in the leftover
formula. Reheating or refrigerating won't kill the bacteria.
When is it okay to start giving your
baby whole milk?
When your baby is 12 months old, he or she can start to drink whole-fat
cow's milk. Other kinds of milk, such as goat's milk, soy milk, fat-free milk, 1% milk, or 2%
milk, don't have as many nutrients as whole-fat milk. It is best not to give
your baby these kinds of milk if you can give whole-fat milk instead.
can start bottle-feeding within hours after birth.
Most newborns feed about 6 to 10 times every 24 hours.
Average feeding amounts will vary depending on your baby's age and how hungry
he or she is at that moment.
This table provides general guidelines for feeding amounts.
Average feeding amounts by baby's age
Age of baby
Formula feedings in 24
Amount of formula in each
Total formula in 24 hours
6 to 8
2 fl oz (60 mL) to
3 fl oz (90 mL)
20 fl oz (600 mL)
6 to 7
4 fl oz (120 mL) to
5 fl oz (150 mL)
28 fl oz (850 mL)
5 to 6
6 fl oz (180 mL) to
7 fl oz (210 mL)
30 fl oz (900 mL)
4 to 5
6 fl oz (180 mL) to
8 fl oz (240 mL)
30 fl oz (900 mL)
4 to 5
7 fl oz (210 mL) to
8 fl oz (240 mL)
34 fl oz (1000 mL)
4 to 5
7 fl oz (210 mL) to
8 fl oz (240 mL)
38 fl oz (1150 mL)
A baby drinks from a bottle of formula for about 5 to 25
minutes at a time. Pay attention to your baby's nutritional needs and cues.
Don't be concerned if your baby doesn't eat much at one feeding. He or she is
likely eating enough over the course of a day or two. Forcing your baby to
drink more formula than he or she needs can cause tummy aches and spitting up.
But don't ever hesitate to call your doctor if you are worried about whether
your baby is eating enough.
You may have the following
concerns about bottle-feeding your baby:
When do I feed my baby? The length of time between feedings varies depending
on the amount of formula your baby drank during the previous feeding. Most
2-week-old babies drink about every 2 hours. Older babies often drink more
formula at each feeding. They often drink a bottle every 4 hours during the
day. Sometimes they go 8 hours or longer between feedings at night. As you get
to know your baby, you will be able to recognize his or her signs of hunger and
How can I breast- and bottle-feed? You may choose to switch between breast-feeding
and formula-feeding. Supplementing breast milk with formula may decrease your
supply of breast milk. But it will not stop your breast milk production. It is
best to wait until your baby has been breast-feeding well for at least 6 weeks
before you offer your baby formula too.
In an emergency, you can give your baby whole milk for a
short time until you can get more formula.
Promoting Healthy Growth and Development
Buying formula and supplies
Try to buy your
formula and supplies before the baby is born. You can buy
infant formula as a liquid
concentrate or a powder that you mix with water. Formulas also come in a
ready-to-feed form, which costs the most. Always use an iron-fortified formula
unless your doctor advises otherwise. If you have questions about which infant
formula is right for your baby, talk with your doctor.
When you buy baby bottles and nipples, make sure you have a supply of small bottles [about
4 fl oz (120 mL)] for your
baby's first few weeks. You may want to buy a variety of different bottle
nipples so you can experiment to see which type your baby prefers.
Preparing infant formula
Some things to keep in
mind when you prepare infant formula:
Powder formula may contain some bacteria. Make sure you have clean,
safe water to prepare infant
formula. Until your baby is 4 months old, boil the water—even bottled water—for 1 to 2 minutes. Let it cool
before you mix it with the formula. You may want to check with your local water
supplier about your water's fluoride level.
Wash your hands
before you prepare formula. And make sure the equipment you use,
including the mixer and the top of a can of powder, are clean.
Add the required amount of water to mix the formula.
If you add too little water, it can upset your baby's stomach and may harm his
or her kidneys. If you add too much water, your baby will not get the nutrition
he or she needs.
Cover the prepared formula and store it in a
refrigerator. It should be used within 24 hours.
Soak dirty baby
bottles in water and dish detergent. Wash bottles and nipples in the upper rack
of the dishwasher or hand-wash them in hot water with dish detergent. Talk to your doctor about whether you need to sterilize the equipment you use for formula preparation and feeding.
In some cases, doctors recommend adding a thickening agent to a baby's formula. Before you use one, talk to your doctor about the risks and benefits. If you have any trouble feeding your baby, talk to your doctor or nurse.
Feeding your baby
Always wash your hands before
feeding your baby.
Warm the formula to room temperature or body
temperature before feeding. It is best to warm it in a pan of heated water
for 5 to 10 minutes before you feed your baby. Don't use
the microwave. Microwaving formula can cause hot spots in the formula that can
burn your baby's mouth. Before you feed your baby, check the temperature of the
formula by dropping a small amount on the inside part of your wrist. It should
be warm, not cold or hot.
Place a bib or cloth under your baby's chin
to help keep his or her clothes clean. Have a second cloth handy to use when
burping your baby.
Hold your baby in a semi-upright position, with
your baby's head resting in the crook of your elbow. Keep your baby's head
higher than his or her chest.
Stroke the center of the baby's lower lip to encourage your
baby to open his or her mouth wider. With an open mouth, the wider part of the
bottle nipple will fit, allowing your baby to make a tight seal between his or
her mouth and the bottle nipple. This helps reduce the amount of air the baby
Angle the bottle so that the neck of the bottle and nipple stay
full of milk. This helps reduce the amount of air your baby swallows while
Do not prop the bottle in your baby's mouth or let him or
her hold it alone. These practices deprive your baby of time when he or she
could be close to you. This may also increase the risks of choking, tooth decay, and ear infection.
During the first few weeks,
burp your baby after every
2 fl oz (60 mL) of formula.
This helps get rid of swallowed air, reducing the chances of your baby
spitting up. Most babies need less frequent burping as
they get older.
You will know your baby is full when he or she
stops sucking continuously. Usually, as babies get full, they pause frequently
during feeding. Also, your baby may spit out the nipple, turn his or her head
away, or fall asleep when full. Throw away any formula left in the bottle after
you have fed your baby, because bacteria can grow in the leftover
Feeding is a good time for social contact with your
baby, so don't rush. Look into your baby's eyes and talk or sing while you are
giving the bottle. This contact helps your baby feel close to you and is
important for healthy growth and development. Wear a short-sleeved shirt to
give more skin-to-skin contact. Sit in a comfortable chair with your arms
supported on pillows.
How to prevent tooth decay. After your baby's teeth start coming in, it is a good idea to
clean them after the last formula feeding at night. Use a soft cloth or gauze
pad at first. As more teeth come in, clean them with a soft toothbrush, using
only water for the first few months. If you are not sure about the
fluoride levels in your drinking water, talk to your doctor or
dentist. Fluoride supplements are sometimes
recommended but must be used with caution. Talk with your doctor
about other ways to prevent tooth decay in your young child. For more information, see the topics
Basic Dental Care.
When to offer liquids from a cup.
You can start offering liquids from a cup when your baby is about 6 months old.
But make sure your baby continues to get nutrition largely from breast milk or
formula until he or she is 12 months old. After that time, try to have your child use a cup instead of a bottle. This can help your child avoid problems such as
bottle mouth tooth decay. And to help prevent injuries from using bottles and cups during unsteady walking, have your child stay seated while drinking.
Whether to give a vitamin D supplement. If you are bottle-feeding formula and your baby drinks at
least 32 fl oz (1 L) each day,
he or she does not need a
vitamin D supplement.1 Most doctors suggest daily
vitamin D supplements for babies who are breast-fed or who get a mixture of
breast milk and formula. Talk with your doctor about
how much and what sources of vitamin D are right for your child.
When to Call a Doctor
doctor if your baby:
Is not growing and gaining weight as expected.
About a 2 lb (1 kg) weight gain
per month is usually expected for the first few months after
Is constipated or if his or her stools are hard and/or
Is vomiting forcefully and seems to be uncomfortable. When
vomiting occurs, all or most of a feeding is thrown up.
For preventive dental care and problems with your child's
teeth, see a
dentist. Pediatric dentists specialize in the care and
problems of children's teeth.
Your baby needs routine medical
checkups. During these checkups (called
well-baby visits), your baby's height, weight, and
head circumference will be measured to find out whether he or she is growing
at the expected rate.
At each well-baby visit, talk to your
doctor about your baby's nutritional needs, which change as he or she grows and
develops. For example, babies between 4 and 6 months of age may start eating
A well-baby visit is a good time to talk about any
feeding problems or developmental concerns that you have. You may want to make
list of questions(What is a PDF document?) before your visit.
Early and regular dental
care is important for your child. Talk with your doctor about how to care for
your child's teeth after they start coming in, which is usually between 6 and
12 months of age. For more information, see the
Basic Dental Care.
Other Places To Get Help
141 Northwest Point Boulevard
Elk Grove Village, IL 60007
This American Academy of Pediatrics website has information for parents about childhood issues, from before the child is born to young adulthood. You'll find information on child growth and development, immunizations, safety, health issues, behavior, and much more.
American Academy of Family
P.O. Box 11210
Shawnee Mission, KS 66207-1210
The website FamilyDoctor.org is sponsored by the American Academy of Family Physicians. It offers information on adult and child health conditions and healthy living. There are topics on medicines, doctor visits, physical and mental health issues, parenting, and more.
American Dental Association
211 East Chicago Avenue
Chicago, IL 60611-2678
The American Dental Association (ADA), the professional
membership organization of practicing dentists, provides information about oral
health care for children and adults. The ADA can also help you find a dentist
in your area.
KidsHealth for Parents, Children, and
Nemours Home Office
10140 Centurion Parkway
Jacksonville, FL 32256
This website is sponsored by the Nemours Foundation. It
has a wide range of information about children's health—from allergies and
diseases to normal growth and development (birth to adolescence). This website
offers separate areas for kids, teens, and parents, each providing
age-appropriate information that the child or parent can understand. You can
sign up to get weekly emails about your area of interest.
U.S. Food and Drug Administration (FDA)
10903 New Hampshire Avenue
Silver Spring, MD 20993-0002
The U.S. Food and Drug Administration (FDA) is an agency within the Department of Health and Human Services. The FDA provides accurate, science-based information about medicines and foods and helps protect public health by assuring the safety, effectiveness, and security of:
Wagner CL, et al. (2008). Prevention of rickets and
vitamin D deficiency in infants, children, and adolescents. American Academy of
Pediatrics Clinical Report. Pediatrics, 122(5):
Other Works Consulted
American Academy of Pediatrics (2009). Feeding your baby: Breast and bottle. In SP Shelov et al., eds., Caring For Your Baby And Young Child: Birth to Age 5, 5th ed., chap. 4, pp. 91–93. New York: Bantam.
Erler C, Novak J (2010). Bisphenol A exposure: Human risk and health policy. Journal of Pediatric Nursing, 25(5): 400–407.
Greer F, et al. (2006). Optimizing bone health and
calcium intakes of infants, children, and adolescents. Pediatrics, 117(2): 578–585. Also available online:
Kirby M (2011). Infant formula and complementary foods. In CD Rudolph et al., eds., Rudolph's Pediatrics, 22nd ed., pp. 99–105. New York: McGraw-Hill.
O'Connor NR (2009). Infant formula. American Family Physician, 79(7): 565–570.
Simmer K, et al. (2011). Longchain polyunsaturated fatty acid supplementation in infants born at term. Cochrane Database of Systematic Reviews (12).
Stettler N, et al. (2011). Feeding healthy infants, children, and adolescents. In RM Kliegman et al., eds., Nelson Textbook of Pediatrics, 19th ed., pp. 160–170. Philadelphia: Saunders.
Trahms CM, McKean KN (2012). Nutrition in infancy. In LK Mahan et al., eds., Krause's Food and the Nutrition Care Process, 13 ed., pp. 375–388. St Louis: Saunders.
U.S. Environmental Protection Agency (2012). Consumer factsheet on lead in drinking water. Available online: http://water.epa.gov/lawsregs/rulesregs/sdwa/lcr/fs_consumer.cfm.
Whitney E, Rolfes SR (2011). Life cycle nutrition: Infancy, childhood, and adolescence. In Understanding Nutrition, 12th ed., pp. 529–568. Belmont, CA: Wadsworth..
John Pope, MD - Pediatrics
Thomas Emmett Francoeur, MD, MDCM, CSPQ, FRCPC - Pediatrics
How this information was developed to help you make better health decisions.