Infant formula is nutritious and your bottle-fed baby can grow and be healthy. All products with the words 'infant formula' on the label provide adequate nutrition for your baby.

Infant formulas are made to be as close to breast milk as possible. The most important difference between infant formula and breast milk is that formula does not have the protective factors that breast milk has. Milk, either breast milk or infant formula, is all the food your baby needs for the first six months.

Types of Infant Formula
1 Cow's milk-based infant formula. This is the most common type of infant formula. It is used for babies who are not allergic to cow's milk and who can digest lactose (milk sugar).

2 Soy-based infant formula. This type of infant formula is suitable for babies whose families follow a vegetarian or vegan diet. Soy infant formula can also be used for babies who cannot digest lactose (milk sugar). Soy-based infant formulas are not recommended for babies with a family history of cow's milk allergy. These babies are as likely to be allergic to soy protein as well as cow's milk protein.

3 Special infant formulas. There are other types of infant formula for babies with special needs. Only use special infant formulas with the advice of your baby's doctor.

Whatever type of infant formula you give your baby, iron-fortified infant formula is recommended.

Some brands of infant formula offer added fatty acids. These fatty acids, AHA and DHA, are naturally present in breast milk. They play a role in brain and eye development. Health Canada permits AHA and DHA to be added to infant formula in the amounts present in breast milk, although health benefits from this have not been proven. AHA and DHA-enriched infant formulas are more expensive than regular infant formulas.

Infant formulas come in three forms:

• Liquid concentrate
• Ready-to-feed
• Powder

It is very important to read the labels on cans of infant formula and to prepare the formula using the correct measures, exactly as described. Instructions are different for mixing each kind of formula. Formula that is mixed incorrectly or diluted (watered down) can harm your baby.

Once you have chosen a brand of infant formula, changing the form from liquid concentrate to powder or ready-to-feed will not affect your baby.

Changing Infant Formula
If you want to change the brand of infant formula you give your baby, discuss it with your baby's doctor first - especially if your baby is younger than four months of age. If you do change formula, do it gradually by mixing some of each kind together for a few days so your baby can get used to it.

How to Prepare Instant Formula
For at least the first four months, sterilize the equipment you use to mix your baby's infant formula.

You will need:

• A large pot with a lid.
• A nipple brush and a bottle brush.
• A set of tongs.
• A can opener.
• A glass measuring cup.
• A knife and fork (if you are using powdered formula).
• Bottles, nipples, caps and rims, if you are using bottles OR bottle holders and disposable liners, rims, caps and nipples if you are using a disposable system. If you use disposable bottle liners, you just need to sterilize the nipple, rims and caps.
  

How To Sterilize The Equipment

• Wash your hands with soap.
• Wash all the equipment in warm, soapy water. Use brushes to clean inside bottles and nipples.
• Make sure the holes in the nipples are not clogged.
• Rinse well.
• Put items in a large pot and cover with water.
• Boil for five minutes.
• Remove the items with tongs.
• Set the items on a clean paper towel to cool.
  

Throw out bottle nipples when they become soft and sticky.

Tips for Mixing Formula

• Wash your hands with soap.
• Check the 'use by' date on the can. Do not use after that day. Make sure the cans are clean and have no dents.
• Wash the top of a can of liquid formula before you open it.
• Make sure the countertop is clean and all your equipment has been sterilized.
• Mix the formula, following the directions exactly, and fill the bottles. Make sure the bottles are the correct size - about one ounce more than your baby usually drinks.
• Make just enough bottles to last one day.
• Refrigerate the bottles.
  

What about the water used to mix infant formula?

• If you have municipal water supply, use plain water from the cold water from the cold water tap. Do not use softened water or filtered tap water.
• Well water is fine, as long as you have it tested for bacteria and nitrates. To have your water tested, contact your local public health unit.
• Until your baby is four months old, boil the water for two minutes. If you have an electric kettle that switches off as soon as the water boils, boil the water in a pot. Let the water cool before you add it to powdered formula or liquid concentrate.
• Do not use carbonated water or mineral water for your baby's formula.
  

How To Store Infant Formula

• Keep prepared bottles in the refrigerator and use them within 24 hours.
• Open cans of powder should be kept covered with the lid. Use within one month.
• Keep open cans of ready-to-feed or liquid concentrate formula in the refrigerator. Use within 24 hours of opening.
• Do not freeze any kind of infant formula. Freezing changes the fat in formula.
  

How To Warm Your Baby's Bottle

• Put the bottle in a container of hot water for a few minutes, or hold it under warm, running tap water. Test the temperature by putting a few drops on your wrist.

Can I use the microwave oven to warm my baby's formula?

Warming infant formula or baby food in the microwave can be risky. Microwaves can cause 'hot spots' that could burn your baby's mouth. Some babies have been so seriously scalded that they needed treatment in a hospital. The hot spots can develop even when the bottle feels cool to the touch. Some plastic bottle liners break if their contents become too hot. Therefore, many baby experts recommend against using the microwave oven to warm a baby's formula.

Some parents choose to use the microwave oven anyway. If you do use your microwave oven to warm your baby's formula, follow these guidelines:

• Warm the formula to body temperature by heating it only a few seconds at reduced power.
• Shake the formula thoroughly after heating it to even the temperature.
• Check the temperature of the formula before giving it to your baby.

How To Feed Infant Formula To Your Baby
Hold your baby close when you give her (or him) a bottle. Hold your baby's back and neck straight, just as you would if you were breastfeeding your baby. Holding and cuddling your baby is important for her to know she is loved. Her head should be tipped back, just a bit, and her head held higher than her body so that formula doesn't get into her inner ear when she swallows.

Brush the bottle nipple against your baby's cheek or lips. She will open her mouth. You don't need to pry her lips apart or force the nipple in her mouth. Hold your baby still while you feed her, without checking how much formula is still in the bottle. Hold the bottle on an angle so that the nipple is always full of milk and so that your baby doesn't suck in air.

When everything is going well, your baby will suck and swallow easily without coughing, gagging, or coming off the bottle to cry. If you see any of these behaviours, something is wrong. It could be that the milk is coming out of the nipple too fast or too slow.

When you hold the bottle upside down, the formula should drip out at about one drop per second. It is normal for a baby to bring up a little formula during or after a feeding. Burp your baby after the feeding.

Your baby should not be lying down to feed. This could give him an earache, or he could choke. Older babies who have a habit of falling asleep holding a bottle can develop early tooth decay.

How Much Formula To Offer Your Baby
This table is only a guide. The amount of formula needed varies from baby to baby, and from day to day. Let your baby decide how much to eat and how often.



How to Know When Your Baby Is Hungry
Your baby knows how much she needs to eat and how often she needs to eat. It's your responsibility to understand what your baby is telling you. When she is hungry, her eyes may be open more than usual and her face will look bright.

When you touch your baby's mouth, her cheek or her chin, she will turn toward your touch; this is called the rooting reflex.

She may bring her hands up under her chin or suck on her hands. Eventually she will fuss, but this is a late sign of hunger. When you learn to read your baby's earlier hunger signs, she won't have to fuss to let you know she's hungry.

How To Know Your Baby Has Had Enough Formula
Let your baby have as much or as little formula as she wants, and to stop the feeding when she shows she is full. Your baby has had enough formula when her sucking slows, when she turns her head away, or when she falls asleep. Your baby will stop showing the rooting reflex.

Some babies will stop feeding for a little bit and socialize. When you offer the bottle again, just offer it to check if she wants more. Some babies get full suddenly and don't want another mouthful. Other babies gradually slow down and lose interest. Always respect your baby's signs and don't try to get her to finish the bottle.

Throw out any formula left in the bottle within one hour after the feeding begins. BCCE