Many parents will choose to bottle-feed their babies. Some women fear they will be unable to produce enough breast milk. Some lack emotional support from their families, and some simply find breastfeeding foreign to their culture. Others who are employed or involved in many activities outside the home find bottle feeding more convenient. Either way of feeding is acceptable provided the infant is given love and attention during the feeding.
The infant should be cuddled and held in a semi-upright position during the feeding (Figure 12-4). It appears that babies fed this way are less inclined to develop middle ear infections than those fed lying down.
It is believed that the upright position prevents fluid from pooling at the back of the throat and entering tubes from the middle ear. During and after the feeding, the infant should be burped to release gas in the stomach, just as the breast-fed infant should be burped (Figure 12-5). Burping helps prevent regurgitation.
If the baby is to be bottle-fed, the pediatrician will provide information on commercial formulas and feeding instructions. Formulas are usually based on cow’s milk because it is abundant and easily modified to resemble human milk. It must be modified because it has more protein and mineral salts and less milk sugar (lactose) than human milk. Formulas, such as soy formula, are devel-oped so that they are similar to human milk in nutrient and caloric values.
When an infant is extremely sensitive or allergic to infant formulas, a synthetic formula may be given. Synthetic milk is commonly made from soybeans. Formulas with predigested proteins are used for infants unable to tolerate all other types of formulas.
Formulas can be purchased in ready-to-feed, concentrated, or powdered forms. Sterile or boiled tap water must be mixed with the concentrated and powdered forms. The most convenient type is also the most expensive.
If the type purchased requires the addition of water, it is essential that the amount of water added be correctly measured. Too little water will create too heavy a protein and mineral load for the infant’s kidneys. Too much water will dilute the nutrient and calorie value so that the infant will not thrive, and also it could lead to brain edema or seizures.
Infants under the age of 1 year should not be given regular cow’s milk. Because its protein is more difficult and slower to digest than that of human milk, it can cause gastrointestinal blood loss. The kidneys are challenged by its high protein and mineral content, and dehydration and even damage tothe central nervous system can result. In addition, the fat is less bioavailable, meaning it is not absorbed as efficiently as that in human milk.
Formula may be given cold, at room temperature, or warmed, but it should be given at the same temperature consistently. To warm the formula for feeding, place the bottle in a saucepan of warm water or a bottle warmer. The bottles should be shaken occasionally to warm the contents evenly. Warming the bottle in the microwave is not advisable because milk can heat unevenly and burn the infant’s mouth. The temperature of the milk can be tested by shaking a few drops on one’s wrist. The milk should feel lukewarm.
Infants should not be put to bed with a bottle. Saliva, which normally cleanses the teeth, diminishes as the infant falls asleep. The milk then bathes the upper front teeth, causing tooth decay. Also, the bottle can cause the upper jaw to protrude and the lower to recede. The result is known as the baby bottle mouth or nursing bottle syndrome. It is preferable to feed the infant the bedtime bottle, cleanse the teeth and gums with some water from another bottle or cup, and then put the infant to bed.