There are temporary or longer-term situations in which direct breastfeeding or providing human milk is not possible or does not fully meet an infant's needs. In those circumstances, the parent may need to choose an appropriate infant formula with healthcare guidance.
The type and method of feeding chosen for a baby are personal decisions for the mother, informed by her circumstances and appropriate clinical guidance. Early motherhood can be a particularly sensitive period, shaped by physical and hormonal changes as well as the transition into a new role. It is therefore important to understand and support each person's individual situation.
The source gives approximate bottle-feeding volumes: usually 10 ml per feed on the first day, increasing by 10 ml per day to 90 ml per feed in the second week; 100-150 ml per feed, or 600-750 ml per day, from three weeks to two months; and around 150-180 ml per feed at three months. It says that bottle feeds may gradually decrease from about 6-8 per day between one week and one month to 5-6 per day in the second and third months. It stresses that these figures are only estimates because intake varies between babies and feeds, and that a baby should never be forced to drink more than they want. Feeding should be calm and responsive, offering the baby warmth, closeness and opportunities for eye contact.
With first infant formula, the risk of overfeeding is lowest because this type of milk is best suited to feeding 'on demand'. This means that if you feed your baby when they want to eat, they will not gain excessive weight. Responsive feeding involves correctly recognising and interpreting a baby's behaviour in relation to their needs. Understanding that not every cry signals hunger helps avoid one of the more common mistakes in formula feeding: providing too much milk.
A change of infant formula should be made gradually. On the first day, one feed is replaced with the new formula. Gradually introducing formula into a child's diet while continuing to breastfeed is known as mixed feeding. Always observe the child's response. If nothing concerning has been noticed, two feeds of the new formula can be given after 2 days, followed by one additional portion on each subsequent day.
Changing formula gradually can give a baby's digestive system time to adjust to the new food and allow the parents to observe how the baby tolerates it. The source advises against combining two different formulas in the same bottle. Every infant formula undergoes extensive testing before it is placed on the market, although formulations differ in their ingredients.
You must not concentrate formula milk or dilute it with water on your own either. Remember always to discard any formula the baby has not finished. Under no circumstances should it be offered again. If the baby has been exclusively breastfed, they may smell their mother’s breast and expect her to put them to the breast. In that situation, the father can offer the baby a bottle because the baby will not associate him with breastfeeding.
Every infant-formula product has a different taste, and a child may not like it, especially if they were previously exclusively breastfed. In this situation, introduce the new milk gradually too. You can add expressed breast milk to a portion of formula prepared according to the manufacturer's instructions, gradually reducing the amount of breast milk at subsequent feeds. If the little one firmly refuses the new milk, consider whether they may be going through a developmental leap. After such a leap, the child may tolerate food quite differently. Teething is another time when a young child's appetite changes. Warm milk does not soothe swollen gums. You must then show a great deal of understanding and help soothe the child's discomfort.
After switching to formula, you may notice that your baby's stools become greenish-black. This is related to the amount of iron with which the formula is fortified. Iron from breast milk is more bioavailable, so supplementation is not necessary. Your baby's bowel-movement pattern may also change. Although bowel frequency is an individual matter from the fifth week of life onwards, a formula-fed baby tends to have bowel movements more regularly. Not passing a stool does not always mean constipation. Constipation is characterised by abdominal pain, straining during a bowel movement and, ultimately, hard stools. After a few days, once the baby's body has adjusted to the new milk, everything will return to normal. Formula takes longer to digest than breast milk, which results in longer intervals between feeds. The amount of milk a baby consumes depends primarily on age, but also on whether solid foods have already been introduced. You will be able to see clearly whether and how much your baby drinks from the bottle; continue to monitor the number of wet and soiled nappies as well as weight gain. Breast milk also satisfies a baby's thirst, whereas a formula-fed baby needs to be given low-mineral spring water.
Midwife Emilia Adamczyk