The year of firsts
Raising your little one is a time full of firsts, especially along your milk journey .
Whether it is your first time breastfeeding, introducing bottle feeding; first time introducing baby formula; first time switching formulas or first time transitioning from formula to milk nothing can fully prepare you for it.
Although each journey is so personal and different, we thought we will compile some useful information around these topics to get you started.
Please note the below is for information purposes only and includes sharing of our personal experiences and tips as well. Remember to always consult with your registered health practitioner first, when it comes to making feeding decisions and choices for your baby.
Breast is best
The World Health Organisation recommends exclusive breastfeeding until at least six months of age. Most moms set out to breastfeed for as long as possible, although our lifestyle adjustments such as going back to work once our maternity leave is over can often stand in a way of a prolonged breastfeeding routine.
Breastmilk is GOLD and advantages of breastfeeding are well documented:
- Breastmilk is the most complete form of nutrition for young babies, with the perfect amount of fat, energy, water and protein required for our babies' growth and development.
- Breastmilk changes it composition depending on our baby's needs.
- Breastmilk is the only milk that contains antibodies, which help to build our babies immune system.
- Exclusive breastfeeding for the first 4 months of baby's life may also protect our child against allergies, especially allergic skin conditions such as eczema.
- It may also have benefits for us moms. It uses up some fat stores and assists us to fit into that pair of jeans post pregnancy. It also helps our uterus to get back to its original size a lot sooner and reduces the risk of breast and ovarian cancers.
- From the practicality point of view breastfeeding is more convenient as it saves time and money. It's always available at the right temperature and sterile.
The most important thing is that even if we breastfeed for a short period of time our baby will benefit in numerous ways from breast milk
Breastfeeding is one of the most emotionally charged aspects of parenting. The special bond and closeness it creates between us moms and our little ones is indisputable. However our expectations of what it will feel like and how easily it will come can often be unrealistic, simply as nothing can prepare you for it. There are no courses ahead of time to equip you with practical skills. When breastfeeding goes well it fills us with delight and a feeding success, but when things go wrong, frustration and guilt might be the overriding emotion.
Why it might be difficult to breastfeed?
In most cases we didn't have the benefit of watching our mom or sister breastfeed at close proximity, so this skill has not been passed on as naturally as it was for previous generations and in cultures where communal parenting is more common.
There is little or no focus on teaching breastfeeding technique ahead of the birth of our baby.
Advice on feeding routines can be conflicting - advice to have a rigid feeding routine is the early weeks is not conducive to establishing our milk supply.
Our breasts are not calibrated so even if we established a good supply, when our baby is crying we might wonder if we have sufficient milk.
However, with sensible guidance and our own perseverance we can expect breastfeeding to be a very positive experience and breastfeed for as long as we aim to.
Reasons to introduce bottle feeding
Although we all know that breasts are perfectly designed to produce milk and we highlighted the benefits of breastfeeding above, there may come time in your milk journey when bottle feeding becomes your preferred feeding option for either expressed breast milk or formula milk.
There can be many reasons as to why you may choose to bottle feed:
- An alternate method to feed your baby expressed breast milk or when introducing formula milk - perhaps you are going back to work or need some well-deserved break and will be absent for some of the feeds. It is also a great way of empowering dads and other loved ones/carers to join the feeding routine
- To give your baby a top-up feed of expressed breast milk or formula milk if your baby is not gaining weight optimally
- Medical reasons when you can’t feed your baby yourself such as fear of passing HIV or AIDS (although research shows that benefits of EXCLUSIVE breastfeeding outweighs the risks of transferring HIV to your baby), chemotherapy or treatments with certain medications that may make breastfeeding unsafe (please consult with your doctor or lactation specialist if you are concerned about your potential condition)
- Breast surgery and specifically breast reduction where your breast tissue may change resulting in poor milk supply if your milk ducts have been severed (please consult with your doctor/lactation specialist in this regard)
- If you and/or your baby had a very traumatic experience in the initial stages of your milk journey - if you were very ill after the birth or your baby was born very premature and can’t breastfeed initially
- If your baby was not thriving on your breastmilk and feeding became difficult and stressful aspect of your milk journey - you might have tried every method to build your milk supply or perhaps you were struggling with discomfort or repeated infections while breastfeeding
- If bottle feeding is simply your choice and it’s a preferred way of feeding your baby - remember the choice that makes you most comfortable and relaxed is the right choice for you and your baby!
As per the “Feeding Sense” book that promotes sense-able feeding: “Feeding your full-term baby expressed breast milk in a bottle will have the same nutritional benefits as breastfeeding and modern infant formula preparations are a well-researched source of nutrition for your baby”.
Bottle feeding introduction
Sucking on a teat is novel sensory experience for your baby, regardless of whether it’s done soon after establishing breastfeeding or whether it’s done straight after birth.
Even when your preferred feeding choice is exclusive breastfeeding it is still worth introducing a bottle to your baby at 6 weeks and then offer a bottle of expressed breast milk every 2-3 weeks. You might want at some point in your breastfeeding journey have the freedom of bottle feeding and many babies become resistant to new textures or feeding methods as they get older.
“Feeding Sense” book refers to bottle feeding, like breastfeeding, being a sensory and emotional experience and outlines some guidelines on how to establish a good bottle feeding routine that your baby loves:
- Always hold your baby for a bottle feed. Touch your baby and stroke their hair. Allow baby’s hands to be free to touch your face, neck and chest. Skin to skin contact is so beneficial to both your baby and you (all this oxytocin aka happy hormone that’s being released) so parents are encouraged to unbutton or take off their tops so their little ones can touch and feel their skin while feeding
- Talk to your baby in a soothing voice and hold them close so they can hear your heartbeat
- Make eye contact and have your baby focus on your face. It will allow you to read your baby’s signals during feeding
- Hold your baby in a horizontal position, similar to that of breastfeeding
- The smell of ‘your mother space’ will be soothing for baby during feeds. Your own body smell is the most neutral and best for your baby. The less additional stimulation the better especially in the early months so moms are encouraged to not wear perfumes initially. For extra sensitive babies limit any extra-sensory inputs while they’re feeding - keep the environment calm and soothing. If your baby is a difficult feeder swaddling for feeds might help.
For more information on bottle feeding introduction also check this article by New York Times
Once you embark on the bottle-feeding journey you need the right equipment, and a lot of parents would agree that this can be an emotional rollercoaster in itself.
“I remember the day I visited one of the local baby chains for the first time. I was there to choose items for my baby shower gift list. Although I thought I was prepared by having a list of items I needed, the variety in each category from bottles and tits to dummies, wipes etc, was just too overwhelming! I actually walked out in tears and went back with a fellow mama friend who made the trip a lot more successful and enjoyable:)” - Kasia Bergh, MyMilkClub’s founder.
There is a huge variety of bottles to choose from and most of them have a tit and a lid in the pack. Bottles normally come in two sizes: 125 and 250ml and although a smaller bottle might be great for smaller babies right at the beginning, we would suggest buying 250ml bottles from the start as these can be used right until the end of your baby’s milk journey.
Medical experts recommend that for a combination of breastfeeding and expressed breastmilk you need two to three bottles. If you are bottle feeding exclusively you need six to eight bottles. However, our personal experience with exclusive bottle feeding was that 4-5 bottles were manageable enough to rotate between feeds.
Most bottles on the market are made out of BPA-free plastic and are dishwasher safe. They normally come with either silicone or latex teats.
In the recent years glass bottles also made it back into the market with their main benefits being safer and greener than plastic; long-lasting durability; better thermal properties than plastic and easier to clean. Some of these bottles come with natural rubber teats that are softer than silicone, free of all harmful chemicals and more resistant to teething/bites.
However, glass bottles may seem a bit impractical for a baby - they tend to be heavy for little hands (not to mention for carting around too) and more likely to break — but you can purchase protective silicone sleeves, so they are easier to grip and less likely to shatter if (and when!) they drop.
Silicone bottles are the third option. Newer companies are utilizing silicon to avoid lingering fears over plastic as well as the impracticalities of glass. Currently there is one bottle available on the South African market which is made entirely out of silicone - COMOTOMO bottle. With their very wide neck design and super flexible silicone you can clean it by hand without using a brush. They are also more resilient to heat. These bottles are designed to closely mimic the breastfeeding to help babies transition back and forth from nursing to bottle feeding, which can assist greatly with nipple confusion and bottle rejection.
There are also a number of specialised bottles available on the market, most popular being the anti-colic ones that support reducing the amount of air your baby takes while feeding.
If you are breastfeeding and intend to continue with it but want to express for bottle feeds, then you might want to look at bottles that are compatible with your breast pump to pump the milk directly into a previously sterilised bottles, so you don’t need extra breastmilk storage containers. MEDELA breastfeeding bottles are compatible with all the MEDELA pumps. These bottles come with caps so can be easily converted from a feeding bottle to a storage bottle.
Teats are either latex or silicone or in some cases natural rubber.
Latex teats are flesh-coloured, resemble the nipple in the texture and are often more accepted by breastfed babies. However, some babies can be allergic to latex.
Silicone teats are see-through and tend to last longer as they are stronger.
Breastfed babies can control the flow rate (speed at which milk comes out of the nipple) to some extent.
A bottle teat has a continuous flow, but there are different teats for a different flow rate:
- Slow teats - best for newborns as they resemble the natural flow of breastmilk
- Medium teats - for babies 3-6 months
- Fast teats - for babies 6 months and older
The teat’s shape can also vary and can be bell shaped (narrow) or more naturally shaped (wide) to resemble a nipple. It’s best to try between a wide one and narrow one and be guided by the baby as to which one is preferred.
Prior to sterilising the bottles, you will need to clean them with a bottle brush. There are so many on the market but essentially get one that is fitted with a mini brush to clean the tits as well.
Sterilisers and sterilising equipment
Sterilising your baby’s feeding equipment is important up until 6 months of age or if you are exposed to the water that is not clean. From 7 months on, a good wash in hot, soapy water and a proper rinse will be enough to get rid of germs.
Wash your hands with soap or sanitise your hands with an alcohol-based sanitizer (this routine should have been our second nature by now due to COVID protocols anyway) before preparing milk and just before feeding the baby.
There are three main methods of sterilising your baby’s feeding equipment:
- Boiling the bottles and teats in a pot of boiling water for 5 minutes - It might sound old school but it suddenly comes very handy when you just packed half of your house to go away with your baby and only by the time you get to your holiday destination you realise you somehow forgot your microwave steriliser:)
- Placing it all in a tub of sterilising solution. There are a number of those on the market. There are also sterilising tablets and portable sterilisers that you can use while travelling long haul (especially by plane) by submerging the bottle in a portable steriliser filled with water and a dissolved sterilising tablet
- Steaming the bottles on the stove, in a microwave steriliser or even in the dishwasher at the end of washing cycle. Our preferred everyday option is a microwave steriliser as the bottles are contained and the process is quick and reliable.
First time introducing baby formula
If you are exclusively breastfeeding but have already incorporated bottle feeds (with expressed milk) into your breastfeeding routine, then your course of action will be dependent on whether you want to supplement your breastmilk feeds with formula feeds or whether you want/have to switch onto formula completely pretty instantly.
There are three ways to wean your baby:
- Slow process - takes place over months. You breast-feed for nine months or more and slowly introduce your baby to a sippy or straw cup, which will eventually take the place of your breast-feeds. At that time your baby should be down to three feeds a day. The afternoon milk feed can be replaced by a cup feed as this feed will be dropped by a year. Overtime, around 18 months the last feed of the day can also be a cup of milk before bed
- Intermediate process - weaning your baby from breast to bottle over a period of few weeks to months, by replacing one breast-feed at a time. This may be at any stage - form a few weeks old to closer to a year. When returning to work it’s possible to wean you baby off within a week depending on how much you are feeding
On day 1 of weaning substitute a bottle for one breast-feed. Choose a feed that is not so critical to your baby and one that is less special for you at the time when it’s convenient for you to be away from your baby (TIP: mid-morning or mid-afternoon feed work well). Get someone else to give the bottle and ensure the baby can’t see you or smell you. Use a bottle at this feed for at last two days but you can continue for as long as you wish with the one formula feed.
Next, increase the number of bottles to two feeds for two days or as long as you wish to continue. Make your mid-morning and mid-afternoon feed formula feeds.
Thereafter, keep replacing one breast-feed every third day or as long as you wish to continue until your baby is exclusively formula fed.
Use the same method to wean your baby from a bottle to a sippy/straw cup once they are old enough (from 6 months)
Remember that each feed you drop will continue to be produced by your breasts for a few days. This might create a feeling of overwhelming fulness and a great deal of pain. To manage your discomfort, try:
- Cabbage leaves - place a few of them in your bra to manage the pain. Remember to replace them every three hours
- Warm showers - When it becomes painful try to take a warm shower (with your back to the spray for a gentler pressure). You can also express a small amount of milk with your hands. This will relieve some pressure but will not stimulate the milk production as you’re not emptying your breast completely while doing so
- Limit your fluid intake - Decrease the number of fluids you drink by half. This reduces the amount of milk you produce
- Do not pump at all to reduce the milk production.
If you wish to maintain your milk supply while giving formula, you may need to breastfeed or pump frequently, up to 8 to 12 times per day. The exact number of times will depend on your breasts’ storage capacity and the age of your baby. If your baby is older — around 8 or 9 months — you can usually maintain your breastmilk supply alongside formula feeding, as long as you breastfeed every day.
- Cold turkey - Necessary if you need to stop overnight usually for medical reasons. In order to stop breastfeeding overnight you need a solid support structure to manage your baby’s needs (helpful partner to assist with the feeds to meet baby’s need for touch, extra love and contact) and your comfort (you will likely need medication to dry up your milk supply prescribed by your doctor. Such medication will reduce possibility of breast engorgement and infection).
If your preferred feeding choice is baby formula right from the start then follow the guidelines above, specifically in terms of the emotional aspect of bottle feeding in order to create an environment and feeding routine that your baby loves.
For a complete guide on how to approach the process of choosing the right formula for your baby please click here.
Formula preparation, storage and heating
Breast milk being always on tap doesn’t really involve much planning ahead, unlike the formula milk.
Planning is required in order to ensure you don’t run out of your formula product and you have sterile water available and ready to be mixed with the formula powder.
It’s good to pre-boil water and decant the right amount into bottles; keep this water so that you always have cooled water available to mix it with your formula powder. There’s nothing worse than trying to frantically cool the water after a fresh boil at the time when your baby is due for their feed and getting unsettled.
Formula milk doesn’t need to be warm when given to a baby. In fact, if your baby gets used to having cooler feeds it will make your life easier when faced with a situation in which warming up your bottle is not easily possible.
When travelling prepare at least two formula feeds in powder form with two bottles with the right amount of boiled water. For more tips on travelling with formula fed baby please click here .
When making up a bottle of formula please follow the preparation guidelines at the back of your formula tin.
TIP: All our formula products available at MyMilkClub contain preparation guidelines in their respective product sections. Head to MyMilkClub store for more information.
In terms of storage guidelines, a bottle of prepared formula can be stored in the fridge for a maximum of 24 hours and must be used within that period of time. Once reheated if there’s anything left after the feed it must be discarded. You can only heat milk once after preparation.
When heating up formula stand the bottle in a mug of warm water, shake before use and ensure the right temperature by testing it on the inside of your wrist. It should be body temperature - it should feel warm or cool but not hot.
Heating up formula in the microwave is possible too, however:
- Ensure the formula is well mixed before placing it in the microwave
- Only heat for a few seconds to avoid overheating and keeping its optimal nutritional value
- Always give the milk a shake after heating in the microwave to ensure even heating
- As per above test the temperature of the milk before feeding your baby
First time changing formula
Standard cow’s milk formulas are suitable for most babies however if your baby is very irritable, has excessive gas, diarreha, is spitting up, vomiting and shows poor weight gain these might all be the signs that your baby may not be on the right formula.
In that case choosing another type of baby formula, always in consultation with your healthcare practitioner, may help alleviate the symptoms. Self-diagnosing your baby’s problems and switching formulas is rather risky as you are more likely to create further problems.
“When I decided to supplement my daughter with formula (my second pregnancy) I naturally turned to the formula that my son was previously on and thrived. However, I very quickly realised that this same formula that had worked for him so well was a no go with my daughter. She was extremely irritable and very gassy, to the point that she was often crying unconsolably for hours. With the assistance of my baby clinic and paediatrician we tried two more formulas and finally the third product worked well with her. All the formula issues actually highlighted a bigger problem, and she was diagnosed with a combination of a colic and silent reflux” and needed a formula that was very easily digestible, with a low lactose composition since I was still breastfeeding too and that was extensively whey hydrolysed. The assistance of specialists was essential during the formula switching. My baby was carefully monitored with very clear instructions on how to follow this process and it had made me feel very comfortable that I had a source to call upon anytime” - Kasia Bergh, MyMilkClub's Founder.
Please remember that changing formula types and not just the formula brands is what you will need to do if the above symptoms occur.
However, if your reason for changing formula is financial then you can just change a brand and aim for the same type of formula but at a more suitable price.
There are some general rules to follow when switching formulas that you can refer to:
- Always consult with a doctor or paediatrician before switching formulas regardless of the reason for it
- Consider a new formula with the same protein type as this will be easiest on your baby’s digestive system. If you have decided to try a new brand for cost rather than medical reasons, this should be relatively easy. For example, if your baby's current formula uses cows' milk as the protein type, then you should choose a new less expensive formula that also uses a similar ratio of cows' milk. If the protein in the initial formula was hydrolysed or partially hydrolysed, keep this consistent in the new formula
- Choose a formula with a different protein for digestive intolerances - If you are switching formulas because your baby has a digestive intolerance, you will need to choose a formula with a different protein type. See which new formula your doctor thinks will help your baby's digestion
- Read the formula labels - If your baby was previously drinking a formula with iron, DHA, or other additional ingredients, consider selecting another formula with those characteristics. Reading the label will also help you understand the ingredients and you can avoid any ingredients that may cause an allergic reaction in your baby.
The guidelines to follow when switching to a new formula
Switch formula immediately if you are using the same protein. In some instances, your baby will be able to switch formulas relatively easily and will not fuss about a new type of formula. Try giving your baby a little bit of the new formula to see how they react. If there is no issue, then you can switch to the new formula immediately.
- If the baby fusses after trying the new formula, wait a few minutes and try again. Don't offer the baby any other alternatives, and don't give them the old formula again.
- Similarly, if your baby is allergic to their old formula, you may need to switch completely to the new formula with no period of transition
Transition gradually to a new formula if you are changing the main protein. In some cases, your baby may be a little fussy about the taste of the new formula. In these instances, switch formulas gradually. This will mask the flavour of the new formula and make the transition easier.
- Begin the transition by giving your baby ¾ of the old formula and ¼ of the new formula.
- Feed your baby this mixture for one day. Then, try half of the old formula with half of the new formula and feed your baby this mixture for one day
Increase the ratio of new formula to old formula. Continue to increase the ratio of new formula to old formula each day. For example, on the third day feed your baby a mixture of ¼ of the old formula with ¾ of the new formula and on the fourth day give your baby 100% of the new formula.
- By this point your baby should expect the flavour of the new formula.
Monitor your baby’s reaction to the new formula:
- Weigh the baby periodically - consult with your doctor as to what the healthy weight expectation on a new formula should be for your baby’s stage of development
- Watch for digestive problems - Watch for persistent vomiting, diarrhea, excessive gas, or constipation. These are all signs that your baby may be experiencing an allergic reaction. Allergic reactions differ from normal digestive irritation because they are chronic and may impact your baby's ability to gain weight
- For instance, acute diarrhea and gas is common among babies, but chronic diarrhea or constipation often means the child has an intolerance.
- If you believe your baby has an allergy to the new formula, seek medical attention immediately
- Notice hives or a rash - Allergies can also present themselves on the surface of the skin in the form of hives or rashes. If you baby begins to develop a rash, you should take them to a doctor immediately. This could be a sign that they are allergic to the new formula
- Look for blood in your baby’s stool or vomit- If you notice blood in your baby’s stool or vomit, you should take your baby to the emergency room immediately. This is a sign of a severe allergic reaction and needs medical treatment.
First time transitioning from formula to milk
Cow’s milk is not recommended for babies younger than a year as it doesn’t contain enough iron, vitamins A, C and D, is difficult to digest and is too high in protein and sodium.
From 12 months, you can switch from breast milk or formula follow up milk (stage 2) to full cream cow’s milk, or a growing up milk formula (stage 3).
After exclusive breastfeeding full cream cow’s milk is the most popular choice to transition to. If you have been using formula up until now and your baby is happy and thriving, then opting for cow’s milk rather than continuing with formula is a personal choice.
If your child has cow’s milk allergy, doesn’t like to drink cow’s milk or you as parent have a certain preference there are other alternatives to choose from at this stage. These include soy, almond, coconut, rice or goat milks.
The “Weaning Sense” book suggests that when considering one of the above cow’s milk alternatives look out for “enriched” products fortified with calcium, vitamin D and other vitamins.
Drinking water is also very important at this stage and caffeine-free teas can also be given.
As of 12 months, in terms of the daily dairy intake, guidelines in the “Weaning Sense” suggest either:
- 2 breastfeeds or
- 2x 240 ml of formula milk or
- 2 -2,5 cups of full-cream cow’s milk/milk alternatives (as per options mentioned above)
Offer breastfeed/ formula on waking and bedtime. When it comes to cow’s milk and its alternatives you can spread the equivalent of 2-2,5 cups of milk throughout a day with milky tea on waking, some milk at breakfast, dairy serving at lunch and during mid-afternoon snack and a bigger milk feed of 240ml at bedtime to keep our toddlers’ tummies fuller for longer.
We wish you all a smooth transition from one stage of your milk journey to another. Remember the emotional aspects of our parental journey are as important as nutritional choices we make for our families. Ultimately the choice that makes you feel most comfortable and relaxed is the right choice for you and your baby. Stay assured you are doing the right thing by doing what’s right for you, your family and your lifestyle.
Remember to also always consult with a registered health practitioner before you consider the introduction of infant formula product supplementation or changing from one formula product to another.
- “Feeding Sense” by Meg Faure, Kath Megaw and Dr Simon Strachan https://www.megfaure.com/product/feeding-sense/
- “Weaning Sense” by Meg Faure and Kath Megaw https://www.megfaure.com/product/weaning-sense
- “How to Feed a Combination of Breast Milk and Formula” by Amy Kiefer https://www.nytimes.com/article/combination-breast-bottle-feeding.html
- “How to switch baby formula” by Sarah Siebold https://www.wikihow.com/Switch-Baby-Formula
Disclaimer: This is not a sponsored post. MyMilkClub reserves the right to its opinions and fully supports the notion of promotion that breast is best in line with the World Health Organisation (WHO) infant feeding guidelines. The World Health Organization (WHO) recommends exclusive breastfeeding for the first six months of an infant’s life, and continued breastfeeding with complementary foods for up to two years of age. Breast milk is the best food for infants. Good maternal nutrition is essential to prepare and maintain breastfeeding. If breastfeeding is not possible, an infant formula may be used according to the advice of registered health professionals. Preparation and storage of any infant formula should be performed as directed on the tin in order not to pose any health hazards.