Preparing a bottle (formula) feed

1. Preparing a bottle (formula) feed

2. Responsibilities regarding feeding • The right feed – type/amount • The right child • The right time • Involve parents • Evaluate effect (e.g. still hungry) • Keep the child safe • Record feed • Evaluate nutrition

3. Feed requirements Energy requirements • Premature infants 114-180 kcal/kg/day • Breast-fed infants 56-152 kcal/kg/day • Term to 6/12 110-120 kcal/kg/day • 1 year 95-100 kcal/kg/day Glasper, E., G. McEwing, et al. (2007). Oxford handbook of chidlren's and young people's nursing. Oxford, Oxford University Press. The data here should be subject to clinical judgment and at best only regarded as a general guide. Behrman, R. E. (1992). Nelson textbook of paediatrics. London, Saunders.

4. Sterilising equipment Watch the video http://www.cowandgate.co.uk/feeding_and_nutrition/formula_bottle_feeding/article/how_do_i_sterilise_my_babys_bottles

5. Preparing a bottle feed Click to go to video http://www.cowandgate.co.uk/feeding_and_nutrition/formula_bottle_feeding/article/how_do_i_prepare_a_bottlefeed

6. Storing artificial (milk) feed Parents may want to store feeds for up to 24 hours. This is acceptable, though it increases the risk of contimination (infection) and the feed should be sored at 5 degrees Celsius (RCN 2007) How? Make up your formula feed according to the instructions on the pack Store below 5oC (i.e. in the main compartment of your fridge, not the fridge door which doesn’t stay as cool) Use as soon as possible, but always within 24 hours 2 ways to make up feeds ‘on the go’ One • Chill your made up feed in the fridge for at least one hour • Pack in a cool bag with an ice pack • Use within 4 hours Two • Put freshly boiled water in a clean, sealed vacuum flask kept for this purpose only • Measure scoops of formula into a sterile container • Remember to pack sterilised bottles • Use the water to make up a fresh feed when needed, make sure the water is still hot and be careful • Test the milk temperature by shaking a few drops onto the inside of your wrist http://www.smanutrition.co.uk/know-how/bottle-feeding/storing-formula/information-511.aspx

7. Weaning From 0-6 months • Breast milk or infant formula. Not advised to introduce solid food before six months but in any case avoid - wheat, gluten, nuts, peanuts, peanut products, seeds, liver, eggs, fish, shellfish, cows’ milk and soft or unpasteurised cheese. From 6 months • First foods: can include mashed or soft cooked fruit and vegetables like parsnip, potato, yam, sweet potato, carrot, apple or pear, all cooled before eating. Or soft fruit like peach, melon, soft ripe banana or avocado as finger foods or mashed. Or baby rice or baby cereal mixed with your baby’s usual milk. Keep feeding them breast milk or infant formula as well. • Next foods: soft cooked meat such as chicken, mashed fish , pasta, noodles, toast, pieces of chapatti, lentils, rice and mashed hard boiled eggs. Also full-fat dairy products such as yoghurt, fromagefrais or custard. From 8-9 months • Move toward eating three meals a day. It will be a mixture of soft finger foods, mashed and chopped foods. • Diet should consist of a variety of the following types of food: fruit and vegetables; bread, rice, pasta, potatoes and other starchy foods; meat, fish, eggs, beans and other non dairy sources of protein and milk and dairy products. From 12 months • Will now be eating three meals a day, chopped if required, plus breast milk or whole cows’ milk and healthier snacks like fruit, vegetable sticks, toast and rice cakes. • Can now drink whole cows’ milk. Choose full-fat dairy products because children under two need the extra fat and vitamins found in them.  • Can give • Three to four servings a day of starchy food such as potatoes, bread and rice • Three to four servings a day of fruit and vegetables • Two servings a day of meat, fish, eggs, dhal or other pulses (beans and lentils) http://www.nhs.uk/Conditions/pregnancy-and-baby/Pages/solid-foods-weaning.aspx#close

8. Further reading The RCN guide on bottle-feeding The Unicef/NHS guide to bottle-feeding First Steps Nutrition Trust - Infant milks in the UK Unicef – Introducing solid foods