FAQs about baby formula
If you can’t breastfeed or you’re ready to wean your baby before twelve months of age, then you’ll need to buy and feed your baby formula. But what kind? Here are our answers to the most common formula questions parents ask:
When should we introduce formula?
If you stop breastfeeding before twelve months of age, then formula should be your baby’s primary source of nutrition.
Is it okay to breastfeed my baby and also feed him formula?
Feeding your baby formula may cause early weaning. That’s because human milk is produced according to the baby’s demand, and when your baby is getting nutrition from other sources besides nursing, his demand will begin to diminish, as will your milk supply. Early introduction of formula may set some babies up for allergies, particularly if your family has a history of asthma or other allergic reactions. So if you’re committed to breastfeeding and delivering its health benefits but want to use bottles, it’s better to pump and store your own milk for baby to drink.
Does it matter what brand I buy?
When it comes to baby formula, all brands have to meet basic FDA requirements for nutrition. Your baby’s doctor may have specific recommendations based on his or her experiences with various brands. Though companies may use different ingredients, the basic nutritional content should be the same. A store brand will be just as healthy as a more expensive brand, so carefully compare the ingredients lists. Check the formula’s expiration date, and make sure it contains iron.
What’s the deal with soy formula?
Soy formula is for babies who have very specific conditions, such as galactosemia, an inherited inability to break down a component of milk because of a missing liver enzyme, a hereditary lactase deficiency, or a reaction to milk sugars, or lactose, (though a lactose-free formula might be a better alternative), or babies who have an allergic reaction to cow’s milk proteins. Some nutritionists express concern about the estrogen-like effects of soy, and the potential relationship between soy ingestion in infancy and later nut allergies. A baby should not be switched to a soy-based formula simply because he has colic or a stomach virus, neither is it considered a preventive measure against food allergies. Prescribed hypoallergenic formula, although more costly, is considered a better option for these babies, and some health insurance policies may pay for it.
Do I need to sterilize water, bottles, or nipples?
No, it’s not necessary, unless your water comes from a well, cistern, or other untreated supply. If that’s the case, then sterilize your water, bottles, and nipples by boiling them in water for at least 10 minutes.
How long does formula keep?
You can keep mixed formula in the refrigerator (make sure the temperature’s between 35° and 40° F) for up to 48 hours. It’s safe to premix your day’s formula in advance if you need to save time.
Are bottle proppers safe?
No. Even though they seem convenient, since you can just pop the bottle in your baby’s mouth and walk away, they are dangerous. Babies can choke when they’re drinking, and need an adult to hold them to make sure they’re okay. Your baby needs the physical closeness while feeding, just as breastfed babies do.
Between five and six months of age, your baby will likely be ready for trying solid foods along with continuing to nurse or to drink formula. When a baby is ready to start solids depends on the baby, and not on age or weight.
WARNING! Don’t Prop the Baby or the Bottle
Some parents believe that the sooner their baby can hold his own bottle and feed himself, the smarter and more independent he is. And every year, another couple somewhere in the United States invents a contraption for holding a bottle in a baby’s mouth so parents don’t have to do it. Not only do these less-than-loving contraptions not work, they can also be dangerous if your baby begins to spit up or choke on formula and you’re not there to help. Your bottle-fed baby deserves the same loving closeness and attention during feeding that breastfed babies get each time they nurse. So relax in a comfortable rocker or recliner, hold your baby close, and don’t get distracted by the telephone or television. Now, take a deep breath, soften your shoulders and arms, and just savor these precious and fleeting moments with your baby.
WARNING! Don’t Start too Soon
Sometimes parents make the mistake of forcing solid foods on their babies when they’re still too immature because they think it will help to fatten the baby up (a dubious sign of cuteness), or that it will encourage a night-waking baby to sleep through. However, giving a baby solid food before four months of age can be risky. First, your baby’s intestinal tract is still maturing, and his body may react to foreign proteins by establishing allergies that can cause problems later. Second, your baby’s kidneys are still primitive and may not be able to adequately remove excess waste products from foods such as meats. But most important, you may be trading off the valuable nutrients found in breastmilk or formula for less adequate foods at the very time when your baby’s body needs maximum nourishment.
Your baby’s physician may also suggest delaying solids if your baby was low birthweight or premature, or if your baby has a serious medical condition, such as neuromuscular development delays, Down syndrome, cerebral palsy, or a condition that has required multiple hospitalizations.
Babies have a tongue-thrusting reflex that makes them automatically push food back out of their mouths if they’re not ready to begin solids. Some signs of food readiness are being able to accept a spoon, and then to swallow food without choking. Your baby may also have an increase in the demand to nurse or drink formula that’s not related to being sick, to changes in his daily routine, or to teething troubles.
Other signs of readiness include being able to sit up on his own with some support, and being able to hold his head steady. Mouth and lip skills include being able to chew food and having the ability to draw his lower lip in as a way of keeping food inside his mouth as you pull the spoon out rather than pushing it back out onto his chin.
Your baby will probably give you clear signs that food’s becoming interesting. He’ll try to grab foods from you and mouth them, will pick up food pieces and try to put them in his mouth, or lean forward toward food like a baby bird and open his mouth.
On the other hand, if your baby spits the food out or clamps his jaws shut and turns his head to the side, he’s signaling he doesn’t want to start. So ease back and wait a few weeks before trying a different food. The rejected food may be accepted by your baby later on, when it’s mixed with other food flavors.
Stages for starting different foods
Your baby’s physician is the best source of information about when to start solids and what foods to introduce to your baby. The reason for this care is to lessen the possibility of causing your baby’s body to have an allergic reaction to foods. Allergy symptoms include a nose that runs clear mucus or other cold-like symptoms; wheezing (chest rattling) and asthma-like symptoms; frequent ear infections; red, itchy eyes; vomiting, constipation, or diarrhea; skin rashes, hives (swollen welts), or a sore bottom.
While some babies do better with trying out new eating skills during a quiet, restful time of day, others become more eager when their high chairs are pulled up to the dinner table so they feel like a part of the family. Initially, you might want to try covering your front with a towel and feeding your baby while he sits in your lap so you have better control of him and the feeding process.
It makes sense to nurse your baby first, and then top his early meals off with spoonfed food. A really hungry baby isn’t going to be very cooperative; plus, breastmilk or formula should continue to be the mainstay of your baby’s diet during that first critical year or growth and brain formation. Set your sights low: just a quarter of a teaspoon full of the new offering several times a day, then gradually increase the amount each day.
Your baby’s doctor will probably suggest starting with iron-fortified baby cereals mixed with breastmilk or formula at around five or six months of age. It’s a good idea to start with a single, pure food, not a mixed stew or variety, and stay with that food for a week so you can tell if anything causes your baby stomach upsets or other allergic reactions. By six months of age, most babies’ bodies will have begun to produce enough protective immune substances that the chance of having a serious allergic response to foods is lessened.
First solids should be perfectly smooth, with no lumps for the baby to choke on. If you use baby food jars, remove the portion for your baby from the jar and serve it in a separate container. Never reuse a jar that’s had the chance to get contaminated with the baby’s saliva.
Later, when your baby gains more mouth mastery, you can simply mash foods such as potatoes, bananas, or carrots. After that, you’ll find that using a food processor, blender, or baby food grinder and adding liquid will make unseasoned family foods smooth and palatable for baby, too.
Between eight months to one year, your baby’s body will be able to handle finely chopped meat and other high-protein foods such as legumes and cheeses, as well as grain products such as crackers and breads.
Juices are overrated
The nutritional value of fruit juices are mostly overrated. According to the Food and Nutrition Service of the USDA, apple, pear, cherry, peach, and prune juice contain a lot of sorbitol, a type of carbohydrate sometimes called “sugar alcohol,” that is hard to digest and can cause babies to experience diarrhea, abdominal pain, and bloating.
Citrus fruits are high on the list of allergy-causing foods, and so orange juice, or juices containing ascorbic acid made from citrus products as a way of bumping up your baby’s vitamin C intake, may cause your baby to have allergic reactions, such as rashes.
Juices are acidic and if you give them to your baby in a bottle at naptime or bedtime, the acid from the juices may pool in your sleeping baby’s mouth, causing baby bottle mouth.
In addition, fruit juices aren’t nearly as nutritionally complete as breastmilk and formula. If your baby has a lot of juices in his diet, he will naturally cut back on drinking the breastmilk and formula that are so important to his nutrition. So, it makes sense to offer your baby juices very sparingly and only toward the later part of his first year, when his body is mature enough to handle them.
Finger foods
By the time your baby reaches about eight months of age, he’ll be eager to feed himself with his own hands. The food you let him munch on should be small enough that his little hands can manage it, and soft enough that he can chew on the bits without choking.
Here are some suggestions: cooked macaroni or noodles; small chunks of ripe fruit such as bananas or cooked apple pieces; soft-cooked carrots, potatoes, or other easy-to-chew vegetables; small slices of mild cheese; crackers, teething biscuits, or breakfast cereal.
Avoid round, coin-sized foods such as hot dog pieces or carrot silices, which can form a perfect plug that can stop up their throats when swallowed whole. Round-shaped foods should be cut into thin strips instead. Whole grapes, cherries, or berries need to be quartered and any seeds removed. Chopped or ground meat is safer than hot dogs or stew pieces.
Some types of food should be completely avoided because of their history of choking babies (see below).
Basic equipment
Soft-tipped spoons with padded bowls are great for feeding new eaters because they help to protect baby’s gums. A soft, flexible plastic bib with a trough in the bottom is good for catching spills. High-sided baby dishes are great, too, especially those that can be filled with warm water and have a suction cup on the bottom to hold them onto baby’s tray. A large bathtub mat is a good catchall for under baby’s high chair.
Note: A feeding toddler is NOT a pretty sight! Remember that when relatives invite your baby to the family table. And don’t make a big scene about your baby’s eating. Mealtimes should be relaxed and fun. It’s not your place to decide whether your baby’s full or not. He’ll know. And don’t worry if your runaround toddler doesn’t appear to eat anything in his hurry to explore the world. Amazingly, these toddlers keep on growing and gaining weight in spite of their flighty eating habits.
WARNING! The No-No List of Foods to Avoid
Do not feed your baby: tough meat; peanuts or other nuts and seeds; hard candy; marshmallows; popcorn; hot dogs; sausage or toddler sticks; potato chips or corn chips; plain wheat germ or whole wheat kernels; fish with small bones, such as trout; raisins and other dried fruits if they’re uncooked; peanut butter; raw fruits and vegetables if they’re hard; whole pieces of canned fruit, or fruit that has seeds.
Pacifiers
Babies have a natural instinct to suck, even when they’ve had enough to drink. And pacifiers are thought to help satisfy a baby’s innate sucking urges. Just as with bottle nipples, pacifiers come in a variety of materials and shapes. The nipple part can be made of the familiar amber or colored latex or clear silicone, and the shields are usually molded of plastic. Some models have airholes to make sure the baby can breathe. Pacifiers come in a variety of sizes for different baby needs.
Getting your baby accustomed to using a pacifier as a self-calming device can be a mixed blessing. Some babies simply don’t like them and will spit them back out. And pacifier use is thought to interfere with vigorous nursing for babies who are breastfed, but some mothers find it’s a godsend when they’ve got sore nipples and need a break from their suckling.
On the positive side: Most babies seem to enjoy mouthing them, and a recent British study appears to show that regular use of a pacifier can strongly reduce a baby’s risk of dying from sudden infant death syndrome (SIDS), as though the sucking helps to regulate the baby’s breathing.
But caution is in order. As with most other devices for babies, there can be serious product flaws that may even be life threatening. Over the years there have been numerous pacifier recalls from unsafe designs, broken parts, and as the result of pacifier-related infant deaths.
Tip
If you decide to use a pacifier with your baby, try out a variety of styles to see which one suits your baby best. Then, buy a handful of them and create a special bowl where clean ones reside. Boil your pile of new pacifiers for five minutes to remove any chemical residues. Be sure to collect them every day and wash them in warm, soapy water, then rinse them well to keep germs at bay.
A typical pacifier accident happens when the nipple section of the “passy” breaks off from its plastic ring and the baby chokes on the rubber nipple or a part of the ring segment. Other pacifier-related deaths have occurred when parents have tied the pacifier around the baby’s neck using a ribbon or string, which has then looped around a knob or other protrusion and formed a deadly noose. Pacifier use has also been associated with a higher incidence of inner-ear infections in babies and toddlers.
In addition to the safety issues, there’s the annoyance of having a baby so attached to his pacifier that he cries in the night when he can’t find it or the endless stream of lost pacifiers that gather dust under the couch or in the crease of the backseat of the car while your unsettled baby cries for his “best friend.” It’s also hard to read the expressions on the face of a plugged-up baby or to see him smile.
How to Handle Choking
Most babies choke on food at one time or another. That’s why it’s important to stay right with your baby while he’s eating so you can step in to help if something happens. (See Clearing Airway Obstructions in 6. Medical and Safety Guide.) If your baby begins to turn blue and doesn’t seem to be able to breathe, then it’s time to apply first-aid measures. (In fact, just for safety’s sake, consider signing up for a baby-first-aid course with your local Red Cross or emergency squad.)
If your choking baby can still breathe, then call 911, but don’t slap him on the back or hold him upside down. This may only cause the object to move so it seals off your baby’s throat.
If your baby’s choking and can’t breathe, cough, speak, or cry, call 911 and immediately place your baby facedown on top of your forearm, supporting his head and neck with your hand and supporting your arm with your thigh as you lean over so your baby’s buttocks (next to your waist) are high and his head (at your knee) is low.
Give five sharp back blows between your baby’s shoulder blades with the heel of your hand. The choking object should pop out, but if it doesn’t, then sandwich your baby between your forearm and hand and turn him over, head still down and bottom up, while supporting his head and neck, using your thigh to help. With your fingertips, give five strong chest thumps on the center of your baby’s breastbone. Repeat if necessary.
Don’t practice this on your baby. It’s only for serious emergencies and may cause bruising. Even when your baby recovers and can breathe again, take him to see his doctor to be sure he’s all right and nothing has lodged in his lungs.