Bottle feeding advice

It is recommended to exclusively breastfeed your baby until around 6 months of age and there is no alternative to breastmilk that will provide the same optimal balance of nutrition and protection during a baby’s growth and development. However, sometimes breastfeeding may not be possible for a variety of reasons including illness, or the mother’s return to paid work.  At such times when breastfeeding is not possible, the practice of breastfeeding at some feeds and bottle or cup feeding with expressed breastmilk at others, known as ‘mixed feeding’, may be used.

Many mums who choose to practice mixed feeding are able to express and store enough breastmilk to meet their baby’s requirements. Expressing your milk means you can continue to give your baby the benefits of breastmilk even when you are absent.

For mums who are unable to breastfeed or express breastmilk to meet all of their baby’s requirements, mixed feeding with infant formula may be considered. The decision to use infant formula is an important and complex one with many considerations. Once babies are on formula and their reliance on breastmilk is being reduced it can be difficult to reverse this feeding style, particularly if breastmilk is not being expressed to maintain supply, as your own milk supply will diminish.

It is important to seek advice from your health care professional in advance of making a decision to transition from breastfeeding to either partial or total infant formula feeding.

Whether you choose to mix feed with expressed breastmilk or with infant formula, here are some tips to assist.

Tips for mixed feeding with expressed breastmilk or infant formula

• Wait for breastfeeding to become established, at least 6–8 weeks before introducing a bottle.
• When possible always offer the breast first for a feed, followed by the bottle if you are doing top up feeds.  Breastfeeding is nutritionally superior to expressed breastmilk.
• Adopt the practice of expressing at least the same amount of breastmilk your baby takes from a bottle to keep up your supply.
• If you are using a combination of expressed breastmilk and infant formula, offer the breastmilk first.
• If your baby is being bottle fed whilst you are away from your baby and your circumstances allow it, try to express at feeding times to maintain your supply.

If you intend to bottle feed your baby you will need to buy appropriate infant feeding equipment, including bottles, teats and sterilising equipment.

Baby bottles

You will need to have between 2 to 6 bottles. If you intend to use a bottle for all your baby’s feeds, it will be ideal for you to have around 6 bottles as babies typically feed around six times per day for the first four months. As babies grow, the volume of breastmilk or infant formula which is needed to meet their nutritional requirements increases and by four months, babies typically drink around 220mL at each feed. Therefore, whilst baby bottles are available for purchase in a range of sizes and smaller bottles are most suitable for young babies, by the time your baby is four months of age larger bottles capable of holding 220mL will be necessary.

When selecting baby bottles look for:

• Bottles with leak proof caps, discs and teats.
• Whilst plastic or glass bottles are a matter of choice, plastic bottles are less likely than glass to shatter or break (ensure plastic bottles are labelled ‘BPA-free’).
• Bottles with clearly marked measurement guides that will endure over time.
• Bottles with a wide rather than a narrow opening can be more easily cleaned with a brush.

Teats

If you intend to use a bottle for all your baby’s feeds, a minimum of 6 teats will be necessary. There is no one teat that will suit all babies and over time you will discover which teat works best for your baby.

When selecting teats:

• Check the product label to confirm that the teat design is appropriate for your baby’s age as different teats will have different flow rates and it is important that the flow rate is comfortable for baby.
• Check and replace teats regularly. Discard as soon as you notice any signs of deterioration including discolouration, stickiness, swelling or cracking.

Sterilising

The National Health and Medical Research Council (NHMRC) recommend that all infant feeding equipment be sterilised until the infant is at least 12 months old. Bottles and teats should be sterilised after each use and stored safely for as long as you use them.

Choosing the right formula

Breastfeeding is best for mother and baby and support should be accessed early if difficulties exist with feeding, attachment, low supply, or any other aspect of feeding. The National Health and Medical Research Council (NHMRC), recommends exclusive breastfeeding to around 6 months, while the World Health Organisation (WHO) and UNICEF recommend exclusive breastfeeding for the first six months, with continued breastfeeding up to two years of age and beyond.

If breastfeeding cannot be used as the sole form of nutrition for infants, a2 Platinum® Premium infant formula will be the formula of choice for families choosing a2 Milk^TM for overall wellbeing. It can also be used for infants with unsettled behaviour, colic, or digestive discomfort who do not have symptoms to suggest a cow’s milk allergy, gastroesophageal reflux or other conditions (as assessed following a medical review). If after two weeks on a2 Platinum® Premium infant formula, unsettled behaviour persists, medical advice should be sought. In addition, if you are still breastfeeding, your diet should be reviewed by an Accredited Practising Dietitian (APD), experienced in the area of allergy and intolerance. To find an Accredited Practising Dietitian in Australia, visit Dietitians Association of Australia or in NZ visit Dietitians NZ.

For infants over six months of age through to 12 months, a2 Platinum® follow-on formula can be used either as a follow-on from a2 Platinum® infant formula, or introduced to your child for the first time if transitioning from exclusive breastfeeding. For active toddlers from 1 to 3 years whose intake of nutrients and energy from their usual diet may be inadequate for growth and development, a2 Platinum® Premium toddler milk drink may be used to supplement the diet.

Find out more at:

• Australian Government Department of Health and Ageing – Get Up & Grow: Healthy Eating and Physical Activity for Early Childhood – Family Book
• New Zealand Ministry of Health – Eating for Health Babies and Toddlers 
• Australian Government Department of Health and Ageing – Breastfeeding
• In New Zealand, to find and accredited practising dietitian in your area, visit Dietitians NZ.

Preparing formula

Please refer to the product page under our products for safe preparation information.

Storing Formula

• Check expiry date of formula on base of can to ensure the formula has not passed its expiry (use-by) date
• Keep the scoop in the can when not in use. There is no need to wash the scoop after preparing a bottle. However, if the scoop gets wet accidentally, you will need to wash and dry it thoroughly before putting it back in the can
• Always keep formula in its original can and cover with the plastic lid to prevent contamination of the powder. Do not transfer the powder to another container because this is a high risk of contamination
• Once a can of powdered formula has been opened, it can be kept safely for four weeks if stored in a cool dry place. Discard any unused formula after four weeks

The National Health and Medical Research Council (NHMRC) recommend that all infant feeding equipment be sterilised until the infant is at least 12 months old. Bottles and teats should be sterilised after each use and stored safely for as long as you use them.

There are several safe and reliable ways to sterilise infant feeding equipment.

First wash the feeding equipment in hot water with a bottle or teat brush before sterilisation to ensure no traces of milk or milk residue remain, rinse with hot water and air dry, or alternatively dry with a clean paper towel.

Sterilise bottles and feeding equipment with one of the following methods:

Boiling

Fully submerge all infant feeding equipment in boiling water for 5 minutes. Remove from heat and allow to cool. Wash hands before removing the feeding equipment. Dry and store in a clean and dry location.

Steam steriliser (electric)

Ensure that all feeding equipment is dry and free from residual water before placing in the steam steriliser with teat and bottle openings facing down. Use the steriliser according to the manufacturer’s instructions. Wash hands before removing all items and store safely in a clean and dry location.

Sterilising solution

Follow the manufacturer’s instructions for preparing the solution, combining the correct amount of sterilising solution or tablet with the correct volume of water in a clean, plastic container. It is important that you fully immerse the bottles and teats in the container and ensure that no air bubbles are trapped inside them. Leave the bottles and teats in the solution for the required amount of time. Wash your hands before removing the infant feeding equipment from the solution. Do not rinse off the sterilising solution or there will be a risk of re-contamination. Drain the bottles and teats well on a clean dry surface. Bottles and teats can stay sterilised in the sterilising solution until needed for up to 24 hours.

After sterilising

• After sterilising your feeding equipment store any equipment not being used immediately in a clean container in the fridge.
• Re-sterilise all infant feeding equipment every 24 hours whether used or unused.

Find out more at:

• Raising Children Network

The Feeding Guide provided on each can of a2 Platinum® Premium infant formula, follow-on formula, and toddler milk drink, is there to guide you on how much and how often to feed your baby. Different mixing ratios and scoops may be used for other infant formula products, so it is important to specifically follow the instructions on the can when preparing a2 Platinum® Infant Formula.

There is much individuality in how much each baby will drink and variation in the amount that the same baby will drink from day to day. The following is a guide to how much babies of different ages will need to drink and the frequency of consumption. It is important to always be guided by your baby and allow your baby to drink to satiation point, even if this means discarding any unused formula in the bottle. Unlike breastmilk which changes composition as baby grows, infant formula concentration remains constant so it is only the volume consumed which changes as baby grows.

It is important to prepare the infant formula with the right amount of powder and water, as per the instructions provided on the can.  This will help ensure your baby’s nutritional requirements are being met. If you add too much powder to your baby’s bottle your baby’s feed will be too concentrated. This can lead to constipation, causing your baby abdominal pain, bloating and discomfort when trying to do a poo. If you add too much water, your baby’s feeds will be too dilute and they will not receive enough nutrition to help them grow well.

Do not prepare formula with a different concentration to that which is prescribed on the can, unless under the specific guidance and instruction of a qualified health care professional such as your GP or paediatrician.

Guidelines aside, around 6 wet nappies daily, as well as a developmentally growing and thriving infant indicate that your baby is likely to be receiving enough infant formula.