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.
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.
Of those mums who choose to practice mixed feeding, many 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.
If you do choose to introduce mixed feeding with expressed breastmilk, here are some tips to assist.
If you intend to bottle feed your baby you will need to buy appropriate infant feeding equipment, including bottles, teats and sterilising equipment.
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.
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.
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.
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 recommended by WHO and UNICEF.
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 MilkTM 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.
Although preparing a bottle for your little one isn’t hard, like doing anything new, it may just take a bit of practice. So, to help guide you, we’ve put together a step-by-step guide to preparing a bottle of feed.
If you would like any more help on preparing a bottle feed, you can call our qualified Healthcare Professionals on 1800 22 46 32 (1800a2infant) Australia – Monday to Friday 8.30am to 5pm AEST or New Zealand – Call 0800 22 46 32 (0800a2infant) Monday to Friday 10.30am to 7.00pm NZST.
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.
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.
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.
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.
There are many reasons that may lead you to switch your baby’s current infant or follow-on formula (formula) to another brand or type of formula, but if you are unsure about whether a particular formula is right for your baby, please consult your baby’s doctor, maternal and child health nurse or dietitian. You should also consult your baby’s healthcare practitioner if he or she has any special nutrition needs before switching formulae, including whether he or she was born prematurely or was of low birth weight.
If you have decided to change your baby’s current formula, the transition should occur slowly to allow your baby’s digestive system to adjust gradually. The taste profile will also differ between formulae, so this may be another reason why your little one will need some time to get used to a new formula gradually.
For a general example of how to introduce a new formula by stages and then replace the original formula altogether, refer to the example in the table below. Of course, there are various possible feed volume combinations for making the transition to a new formula and the guide below is just one example. It is based on a 4-6 month old baby who is having four feeds per day, but the example below can also provide an idea of how to introduce a new formula gradually to a baby of any age (i.e. by substituting a new formula for an initially small but increasing volume of the current formula). As feed volumes vary depending on a baby’s age, brand and type of formula, be sure to refer to the feeding guide on the can for age-specific recommendations and follow the preparation instructions carefully.
If you have any concerns about your baby’s tolerance to a new formula, consult your baby’s doctor, maternal and child health nurse or dietitian.
Note: When preparing your baby’s formula, be sure to use the scoop enclosed inside the formula can and use separate bottles for the different formulae in order to ensure the correct preparation of each feed for your baby.
Start by feeding your baby the new formula made up using one scoop of powder plus the correct amount of sterilised water as directed in the preparation instructions, then finish the feed using your current brand with around 50ml less of his/her normal intake.
Continue to use your normal feed patterns for all other feeds during day one.
Continue to feed your baby the new formula made up using one scoop of powder plus the required amount of sterilised water as directed in the preparation instructions, but today do this for two feeds. Finish each of these two feeds using your current brand with around 50ml less of his/her normal intake.
Continue to use your normal feed patterns for all other feeds during day two.
Today, feed your baby the new formula made up using two scoops of powder plus the required amount of sterilised water as directed in the preparation instructions for two feeds, then finish each of these two feeds using your current brand with around 100ml less of his/her normal intake.
Continue to use your normal feed patterns for all other feeds during day three.
Continue to feed your baby the new formula made up using two scoops of powder plus the required amount of sterilised water as directed in the preparation instructions, but today do this for three feeds. Finish each of these three feeds using your current brand with around 100ml less of his/her normal intake.
Continue to use your normal feed patterns for all other feeds during day four.
Today, feed your baby the new formula made up using three scoops of powder plus the required amount of sterilised water as directed in the preparation instructions for three feeds, then finish each of these feeds using your current brand with around 150ml less of his/her normal intake.
Continue to use your normal feed patterns for all other feeds during day five.
Continue to feed your baby the new formula made up using three scoops of powder plus the required amount of sterilised water as directed in the preparation instructions but today do this for four feeds. Finish each of these four feeds using your current brand with around 150ml less of his/her normal intake.
Continue to use your normal feed patterns for all other feeds during day six.
By this stage, you can offer the new formula entirely to your baby for every feed.
Once your baby is tolerating four feed per day, it should be okay to change over entirely to a2 Platinum®.
If you need more specific guidance for your baby, please contact the Australian a2CARELINE on 1800 22 46 32 (1800 a2infant) or the New Zealand a2 CARELINE on 0800 22 46 32 (0800 a2infant).
It is not uncommon for a baby’s bowel motions to change when switching between formula. Stools may become a little firmer or softer, but should not be dry and solid or watery-like in consistency. If your baby’s bowel motions become dry and solid, check that your baby is having the right amount of formula and also that the formula is being prepared correctly (refer to the preparation instructions and feeding guide on the back of the can). Although individual differences will occur, a baby’s bowel motions will usually be loose and mustard-yellow (sometimes with milk curds) in colour, though sometimes they may have a green or orange appearance. If your baby is experiencing frequent, watery bowel motions (i.e. diarrhoea), consult your baby’s GP or healthcare practitioner.
Your baby should have around six or more wet nappies per day. The nappies should be soaked and contain a pale or colourless urine. If your baby’s urine becomes scanty and yellow in colour, check that your baby is having the right amount of properly prepared formula (refer to the feeding guide on the back of the can).
If you have any concerns regarding your little one’s bowel motions or urinating frequency, consult your baby’s GP or healthcare practitioner.
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.
| Age of Baby | Cooled Boiled Water (mL) | Level Scoops of Powder* | Number of Feeds Per Day |
|---|---|---|---|
| 0 – 4 days | 50 | 1 | 5 – 6 |
| 5 days – 4 weeks | 100 | 2 | 6 – 8 |
| 1 – 4 months | 150 | 3 | 5 – 6 |
| 4 – 6 months | 200 | 4 | 4 – 5 |
| >6 months | 200 | 4 | 3 – 4 |
*1 Level Scoop = 7.5g of powder
Note: 1 scoop of powder added to 50mL water yields approximately 56mL of formula. This feeding guide is a general guide ONLY. As every baby is different, your baby may need more or less formula. You should seek advice from your medical practitioner if you have concerns about your baby’s individual needs. Newborn babies may not drink full amount in first weeks. Discard any unfinished formula.
As babies grow the volume of infant formula required to meet their needs increases. Babies will also demand more in times of growth spurts. From five days to four weeks of age, feeding frequency is at its highest, with six to eight feeds daily.
| Age of Baby | Cooled Boiled Water (mL) | Level Scoops of Powder* | Number of Feeds Per Day |
|---|---|---|---|
| 6 – 9 months | 250 | 5 | 3 – 4 |
| 9 – 12 months | 200 | 4 | 3 – 4 |
*1 Level Scoop = 8.5g of powder
Note: 1 scoop of powder added to 50mL water yields approximately 56mL of formula. This feeding guide is a general guide ONLY. As every baby is different, your baby may need more or less formula. You should seek advice from your medical practitioner if you have concerns about your baby’s individual needs. Newborn babies may not drink full amount in first weeks. Discard any unfinished formula. Place greater reliance on solid foods in addition to formula for nutrition from 6 months.
At around six months, when complementary feeding (introduction of solids) is recommended, the amount of formula needed is slightly reduced, however, infant formula still provides the bulk of nutrition for baby until around 12 months
| Age of Baby | Cooled Boiled Water (mL) | Level Scoops of Powder* | Number of Feeds Per Day |
|---|---|---|---|
| 1 – 3 years | 100 | 2 | 2 – 4 |
*1 Level Scoop = 8.5g of powder
Note: 2 scoops of powder added to 100mL water yields approximately 114mL of formula.
After 12 months of age, toddler milk can be used to supplement the normal diet of an active toddler from 1 to 3 years, when their dietary intake may be inadequate. Small serves at spaced intervals allows your toddler to consume other foods in between and not fill up on toddler milk, whilst topping up their nutritional intake.
Breastfeeding is best for babies and provides the optimal balance of nutrition and protection during growth and development.
Good maternal nutrition is important in preparation for and during breastfeeding. If you are considering bottle feeding, always seek professional advice as introducing bottle feeding, either partially or exclusively, may adversely affect breastfeeding by reducing the amount of your own breast milk supply and may be difficult to reverse should you change your mind. Consider the financial and social implications when deciding on a feeding method for your baby.
Improper or unnecessary use of infant formula may affect the health of your baby, therefore, always prepare and use as per the manufacturer’s instructions.
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