Formula - Questions, answers, ingredients: Part two.

Q. What’s the best way to offer a bottle?

A. Babies need to be held securely and my son liked to be held as closely as possible, like when I was breastfeeding him – this helps to build your relationship with your baby, and it’s good for your baby to enjoy comfort and closeness when feeding. Babies are different in how often they feed, and the amounts they take so let your baby set the pace they prefer.

Q.  Does formula make a difference to my baby’s health?

A. Formula fed babies have a higher risk of infections and medical conditions - my little man after I cu our breastmilk completely due to supply issues was forever ctaching colds and tummy bugs, the best health outcomes are seen in babies given nothing but breastmilk for the first six months however this doesn't mean that they are completely immune to catching bugs. So the answer is ‘yes, it does make a difference.’ However, formula doesn’t ‘wipe out’ the positives of breastmilk, and whatever breastmilk your baby gets is good for him/her.

Q. If I use formula, how can I continue to breastfeed?

A. Generally speaking, milk supply is driven by frequent, effective breastfeeding.  Giving formula can mean your baby comes to the breast less often. Result? You make less milk because the production isn’t stimulated. However if you breastfeed or express at certain times of the day, your supply will adjust to the new demand. If you do decide you want to do mixed feeding or solely breastfeed - whatever you do, don't offer formula after you have breastfed as this can fool your body into thinking doesn't need to make as much milk - keep your baby to the breast as much as possible. If you have to, alternate between formula and breastfeeds but don't mix them in the same feeding if you can help it. this was a big mistake I made and why I couldn't keep my supply up, then eventually my little man just preferred the bottle anyway because ti was easier.

Q. What about negative feelings towards formula?

A. If you planned to fully breastfeed, you might feel unhappy about using formula, and even guilty or angry, or become depressed - if this happens talk to your health professional. You might think people are criticising you.  In fact, you deserve the same support as any other mother, something most sensitive people understand.  Breastfeeding can be a real challenge, and there are times when mothers and babies need the option of formula.  If you’re feeling low about using formula, share this with someone who can help you feel more positive. Whoever that might be. Remember, you can put your baby to your breast whenever you want, even if you decide breastfeeding isn’t for you, and whether or not your baby actually breastfeeds; you can give your baby the closeness of skin to skin contact, and give the bottle like that, too. Retaining these special moments with your baby may help ease your feelings. Breastfeeding can be stressful and alot of people think that your baby wanting to breastfeed all the time means you don't have enough milk and start hassling about giving formula instead - Usually this around the time of a baby growth spurt so if you can talk to your health professional before giving formula as they will be able to tell you the facts. Ultimately the decision is yours, no-one elses. If you don't want to give up breastfeeding then don't, or vice-versa, if you do decide you don't want to anymore, or never intended to in the first place, give formula.

Tips

* Avoid using the water as soon as it has boiled, in case of scalds.  The general consensus on formula instructions is to leave the water to cool for half an hour (30 minutes)

• Use the right amount of powder and water, to avoid problems with constipation or dehydration (too much powder) or poor weight gain (too much water), or sodium posioning (again too much water). Your baby may need a smaller feed than the guidance on the pack if he also has breastmilk, so consult your midwife or health visitor.  

* Discard unused feed within two hours; don’t reheat or re-use.

*  The safest way to make up feeds is one at a time with water that has cooled to no less than 70ºC. If you need to make feeds in advance, put some boiled water into a sterilised vacuum flask. When away from home, take the flask, together with the right amount of powder in a cleaned, sterilised and dry plastic container and the cleaned, sterilised bottle. Or use a bottle warmer bag that is good for boiled water for upto four hours, and made up feeds for upto two hours. Make up the feed, and cool the bottle before feeding it to your baby.

Preparing Formula

1. Firstly, clean and sterilise bottles and teats, and leave to drip-dry.

2. Boil enough tap water and leave to cool to no less than 70oC - no more than 15 mins for half a litre - check on the isntructions of the formula if you're not sure. This is important in order to kill germs that may be present in the powder.

3. Clean your working surface and wash your hands with soap and water.

4. Pour the correct amount of boiled water into the sterilised bottle.

5. Using the scoop provided, add the correct amount of powder, levelling with the spatula provided. Count out loud when you are adding the scoops (so as not to miscount), or count on your fingers (so that you can be sure how much you have added if you get distracted).

6. Mix by gently shaking the bottle side-to-side to prevent scalds with hot milk.

7. Cool to the right temperature by holding the bottle under cold running water. It should feel lukewarm on the inside of your wrist.

Formula Dos and Don'ts

DO'S

• Do use formula before the expiration date on the label.

• Do prepare formula exactly as stated on the label. Formula that is too weak or diluted can stunt growth or lead to nutritional deficiencies. Formula that is too strong can lead to dehydration or kidney problems.

• Do wash your hands before handling baby bottles or feeding your baby.

• Do sterilise bottles and equipment.

• Do use refrigerated ready-to-feed formula within 48 hours of opening.

• Do throw away any formula left in a bottle after a feed. Germs and bacteria from your baby's saliva will live and breed in the warm liquid.

DON'TS

• Don't retain or refrigerate unused, prepared formula.

• Don't heat formula in a microwave. The temperature of the liquid may be uneven, and could scald your baby even if the bottle feels cool to the touch.

• Don't put cereal in a bottle - it makes choking more likely.

• Don't prop up your baby's bottle - it increases his/her risk of choking.

Formula brands available in UK

Just what goes into your babies formula?

Cow & Gate

Types of formula available:

Only in hospitals/via prescription

Nutriprem Breast milk fortifier

This is used in special care baby units to fortify expressed breast milk for preterm babies. It contains extra energy, protein, minerals and micronutrients for improved growth and bone mineralization.

Available in 2.1g sachets.

Nutriprem 1

This is a low birth weight formula that's used in special care baby units. It's nutrient-dense to provide the required nutrition in small volumes.
Available in 60ml ready-to-feed bottles for hospital use only.

Nutriprem 2

Cow & Gate Nutriprem 2 is nutritionally tailored to meet the needs of preterm and low birth weight babies to help support catch-up growth, once they’ve been discharged from hospital. It is specially designed to help bridge the gap between a hospital preterm formula and a standard infant milk, and can be used up to 6 months corrected age. Cow & Gate Nutriprem 2 is available on prescription and stocked by most large pharmacies in 200ml tetrapacks and 900g EaZypacks for home use.

Pepti-Junior
Only available in powder form

Cow & Gate Pepti-Junior is suitable from birth and is specially formulated for babies with a cows' milk protein allergy and lactose intolerance, and babies who need a milk-free diet. It contains MCT oil for those babies who have impaired digestion or malabsorption.

Cow & Gate Pepti (Aptamil Pepti from July 2009*)

Cow & Gate Pepti is suitable from birth for babies diagnosed with a cows’ milk protein allergy or intolerance to the proteins found in other baby milks based on standard cows’ milk. Cow & Gate Pepti has been specially prepared to make the cows’ milk proteins easier to digest.

Cow & Gate Pepti also contains prebiotic oligosaccharides, special nutrients similar to those found naturally in breast milk. Breast milk strengthens your baby’s natural immune system, helping to fend off everyday bugs so your baby is healthy and happy.

Available on prescription in 900g EaZypacks. For use only under medical supervision.

Available in stores:

Comfort 1 for comfortable digestion - From birth onwards
Produced in the EU
Only available as a powder.

Ingredients:

Hydrolysed Whey Protein Concentrate* , Glucose Syrup , Vegetable Oils (including Structured Vegetable Oil) , Starch (Gluten free) , Prebiotic Fibres (Galacto-Oligosaccharides*, Polyfructose) , Potassium Hydrogen Phosphate , Sodium Chloride , Calcium Chloride , Vitamin C , L-Arginine , Taurine , Choline Chloride , Inositol , Iron Sulphate , Zinc Sulphate , Vitamin E , Niacin , L-Carnitine , Pantothenic Acid , Folic Acid , Copper Sulphate , Vitamin A , Manganese Sulphate , Biotin , Beta-Carotene , Vitamin D , Riboflavin , Thiamin , Vitamin B6 , Potassium Iodide , Vitamin K , Sodium Selenite , Contains: *Milk .

Comfort 2 for comfortable digestion - Follow on milk from 6 months onwards
Produced in the EU
Only available as a powder.

Ingredients:

Hydrolysed Whey Protein Concentrate* , Vegetable Oils (including Structured Vegetable Oil) , Glucose Syrup , Starch (Gluten free) , Prebiotic Fibres (Galacto-Oligosaccharides*, Polyfructose) , Calcium Phosphate , Calcium Chloride , Potassium Hydrogen Phosphate , L-Arginine , Vitamin C , Taurine , L-Histidine , Iron Sulphate , Choline Chloride , Zinc Sulphate , Inositol , Vitamin E , L-Carnitine , Niacin , Pantothenic Acid , Folic Acid , Copper Sulphate , Vitamin A , Manganese Sulphate , Beta-carotene , Biotin , Vitamin D , Thiamin , Vitamin B6 , Riboflavin , Potassium Iodide , Vitamin K , Sodium Selenite , Contains: *Milk .

Infasoy - From birth onwards
Produced in the EU
Only available as a powder

Ingredients:

Glucose Syrup , Vegetable Oils , Soya Protein* , Calcium Carbonate , Potassium Chloride , Calcium Phosphate , Magnesium Hydrogen Phosphate , Potassium Citrate , Choline Chloride , Vitamin C , Emulsifier (Soya Lecithin)* , L-Tryptophan , Taurine , L-Methionine , Inositol , Iron Sulphate , L-Carnitine , Zinc Sulphate , Sodium Chloride , Niacin , Pantothenic Acid , Biotin , Vitamin A , Vitamin B12 , Folic Acid , Vitamin E , Riboflavin , Beta-Carotene , VItamin D , Thiamin , Vitamin B6 , Copper Sulphate , Manganese Sulphate , Potassium Iodide , Vitamin K , Sodium Selenite , Contains: *Soya .

Stage 1 first infant milk - From birth onwards
Produced in the EU
This is also available ready made, and has a newborn starter pack available which contains 12 100ml sterilised ready made feeds - what hospitals have if you decide to formula feed.

Ingredients:

Demineralised Whey* , Vegetable Oils , Lactose* , Skimmed Milk* , Dietary Fibres (Galacto-Oligosaccharides*, Poly Fructose) , Whey Protein Concentrate* , Calcium Carbonate , Fish Oil , Potassium Chloride , Potassium Citrate , Magnesium Chloride , Vitamin C , Emulsifier (Soy Lecithin) , Choline Chloride , Taurine , Iron Sulphate , Uridine 5'-Monophosphate , Zinc Sulphate , Cytidine 5'-Monophosphate , Vitamin E , Inositol , Adenosine 5'-Monophosphate , Inosine 5'- Monophosphate , L-Tyrosine , Niacin , Guanosine 5'- Monophosphate , L-Carnitine , Pantothenic Acid , Folic Acid , Copper Sulphate , Vitamin A , Biotin , Thiamin , Vitamin B12 , Vitamin D , Vitamin B6 , Manganese Sulphate , Potassium Iodide , Viamin K , Sodium Selenite , Contains: *Milk, Soya, Fish .

Stage 2 for hungrier babies - From birth onwards
Produced in the EU
Also available ready made

Ingredients:

Lactose* , Skimmed Milk* , Vegetable Oils , Dietary Fibres (Galacto-Oligosaccharides*, Poly Fructose) , Calcium Carbonate , L-Cysteine Hydrochloride , Choline Chloride , Vitamin C , Emulsifier (Soya Lecithin) , Taurine , Iron Sulphate , Inositol , Vitamin E , Uridine 5'- Monophosphate , Cytidine 5'-Monophosphate , Zinc Sulphate , Adenosine 5'-Monophosphate , Niacin , Guanosine 5'- Monophosphate , Pantothenic Acid , Folic Acid , Copper Sulphate , Vitamin A , Biotin , Vitamin B12 , L-Carnitine , Thiamin , VItamin D , Vitamin B6 , Manganese Sulphate , Potassium Iodide , Vitamin K , Sodium Selenite , Contains: *Milk, Soya .

Stage 3 follow on milk - From 6 months onwards
Produced in the EU
Also available ready made

Ingredients:

Vegetable Oils , Demineralised Whey* , Maltodextrin , Skimmed Milk* , Lactose* , Dietary Fibres (Galacto-Oligosaccharides*, Poly Fructose) , Whey Protein Concentrate* , Calcium Carbonate , Sodium Citrate , Calcium Phosphate , Calcium Chloride , Vitamin C , Magnesium Chloride , Choline Chloride , Emulsifier (Soy Lecithin) , Taurine , Iron Sulphate , Inositol , Vitamin E , Uridine 5'- Monophosphate , Zinc Sulphate , Cytidine-5'-Monophosphate , Adenosine 5'-Monophosphate , Inosine 5'- Monophosphate , Niacin , Guanosine 5'- Monophosphate , Pantothenic Acid , Folic Acid , Copper Sulphate , Vitamin A , Biotin , Thiamin , VItamin D , Vitamin B12 , Vitamin B6 , Manganese Sulphate , Potassium Iodide , Viamin K , Sodium Selenite , Contains: *Milk, Soya .

Goodnight milk follow on milk with cereal - From 6 months onwards
Produced in the EU
Only available as a powder

Ingredients:

Lactose* , Skimmed Milk* , Vegetable Oils , Prebiotic Fibres (Galacto-Oligosaccharides*, Polyfructose) , Rice Flakes , Potato Starch , Calcium Carbonate , Vitamin C , Magnesium Citrate , Emulsifier (Soya Lecithin) , Taurine , Choline Chloride , Iron Sulphate , Zinc Sulphate , Cytidine 5'-Monophosphate , Adenosine 5'-Monophosphate , Uridine 5'-Monophosphate , Inosine 5'-Monophosphate , Vitamin E , Niacin , Guanosine 5'-Monophosphate , Folic Acid , Copper Sulphate , Pantothenic Acid , Vitamin A , Vitamin D , Beta-Carotene , Biotin , Vitamin B12 , Vitamin B6 , Thiamin , Manganese Sulphate , Potassium Iodide , Vitamin K , Sodium Selenite , Contains: *Milk, Soya .

Stage 4 growing up milk - From 1 year +
Produced in the EU
Also available ready made

Ingredients:

Demineralised Whey* , Vegetable Oils , Skimmed Milk* , Maltodextrin , Dietary Fibres (Galacto-Oligosaccharides*, Poly Fructose) , Lactose* , Whey Protein Concentrate* , Calcium Phosphate , Calcium Carbonate , Potassium Citrate , Sodium Citrate , Vitamin C , Magnesium Chloride , Emulsifier (Soy Lecithin) , Choline Chloride , Taurine , Vanilla , Iron Sulphate , Zinc Sulphate , Potassium Chloride , Vitamin E , Niacin , Folic Acid , Vitamin D , Pantothenic Acid , Copper Sulphate , Vitamin A , Biotin , Thiamin , Vitamin B12 , Vitamin B6 , Potassium Iodide , Manganese Sulphate , Viamin K , Sodium Selenite , Contains: *Milk, Soya .

Aptamil

Only available on prescription:

Aptamil Pepti (formerly cow & gate pepti) for infants with cow's milk protein allergy

Suitable from birth, Aptamil Pepti has been specially developed for bottlefed babies who have been diagnosed with cows' milk protein allergy. Its unique formula makes cows' milk proteins easier for your baby to digest so that they don't trigger an allergic reaction.

It also includes nucleotides, LCPs and prebiotic oligosaccharides (OS), providing them with the goodness they need, without upsetting their allergies.

Aptamil preterm

Aptamil Preterm is for bottle fed premature babies who are born with an immature organ system and require a specialist formula with a higher nutrient density. Suitable from birth onwards, Aptamil Preterm is nutritionally complete, making it ideal for premature babies who aren't being breastfed or to complement breastfeeding.

It contains nucleotides, LCPs and IMMUNOFORTIS®, our own patented mix of special ingredients similar to those found in nature.

Available in stores:

Aptamil Easy digest - From birth onwards
Produced in the EU
Only available as a powder

Ingredients:

Hydrolised Whey Protein Concentrate* , Glucose Syrup , Vegetable Oils (Including Structured Vegetable Oil) , Starch (Gluten Free) , Dietary Fibres (Galacto-Oligosaccharide*, Polyfuctose) , Potassium Hydrogen Phosphate , Sodium Chloride , Calcium Chloride , Vitamin C , L-arginine , Taurine , Choline Chloride , Inositol , Iron Sulphate , Zinc Sulphate , Vitamin E , Nicotinamide , L-carnitine , Pantothenic Acid , Folic Acid , Copper Sulphate , Vitamin A , Manganese Sulphate , Biotin , Beta-carotene , Vitamin D , Riboflavin , Thiamin , Vitamin B6 , Potassium Iodide , Vitamin K , Sodium Selenate , Contains: *Milk .

Stage 1 first - From birth onwards
Produced in the EU
Available in powder and ready made form

Ingredients:

Demineralised Whey* , Vegetable Oils , Lactose* , Skimmed Milk* , Prebiotic Fibres (Galacto-Oligosaccharides*, Polyfructose) , Whey Protein Concentrate* , Calcium Carbonate , Fish Oil , Potassium Chloride , Citrate , Potassium , Magnesium Chloride , Vitamin C , Emulsifier (Soya Lecithin) , Choline Chloride , Taurine , Ferrous Sulphate , Uridine 5'-Monophosphate , Zinc Sulphate , Cytidine 5'-Monophosphate , Vitamin E , Inositol , Adenosine 5'-Monophosphate , Inosine 5'-Monophosphate , L-Tyrosine , Nicotinamide , Guanosine 5'-Monophosphate , L-Tyrosine , Nicotinamide , Guanosine 5'-Monophosphate , L-Carnitine , Pantothenic Acid , Folic Acid , Copper Sulphate , Vitamin A , Biotin , Thiamin , Vitamin B12 , Vitamin D3 , Vitamin B6 , Manganese Sulphate , Potassium Iodide , Vitamin K1 , Sodium Selenite , Contains: *Milk, Fish, Soya. .

Stage 2 extra hungry - From birth onwards (This is the one I chose when I needed to switch brands as Hipp didn't do extra hungry at the time and it was the only other brand he would put up with, we tried cow and gate but it was a no-go)
Produced in the EU
Available in powder and ready made form

Ingredients:

Lactose* , Skimmed Milk* , Vegetable Oils , Prebiotic Fibres (Galacto-Oligosaccharides*, Polyfructose) , Calcium Carbonate , Fish Oil , L-Cysteine Hydrochloride , Choline Chloride , Vitamin C , Emulsifier (Soya Lecithin) , Taurine , Ferrous Sulphate , Inositol , Vitamin E , Uridine 5'-Monophosphate , Cytidine 5'-Monophosphate , Zinc Sulphate , Adenosine 5'-Monophosphate , Inosine 5'-Monophosphate , Nicotinamide , Guanosine 5'-Monophosphate , Pantothenic Acid , Folic Acid , Copper Sulphate , Vitamin A , Biotin , Vitamin B12 , Thiamin , L-Carnitine , Vitamin D3 , Vitamin B6 , Manganese Sulphate , Potassium Iodide , Vitamin K1 , Sodium Selenite , Contains: *Milk, Fish, Soya .

Stage 3 follow on milk - From 6 months onwards
Produced in the EU
Available in powder and ready made form

Ingredients:

Vegetable oils , Demineralised Whey* , Maltodextrin Skimmed Milk* , Lactose* , Dietary Fibres (Galacto-Oligosaccharides*, Polyfructose) , Whey Protein Concentrate* , Calcium Carbonate , Sodium Citrate , Calcium Phosphate , Calcium Chloride , Vitamin C , Magnesium Chloride , Choline Chloride , Emulsifier (Soya Lecithin) , Taurine , Ferrous Sulphate , Inositol , Vitamin E , Uridine 5'- Monophosphate , Zinc Sulphate , Cytidine-5'-monophosphate , Adenosine 5'-Monophosphate , Inosine 5'- Monophosphate Nicotinamide , Guanosine 5'- Monophosphate , Pantothenic Acid , Folic Acid , Copper Sulphate , Vitamin A , Biotin , Thiamin , Vitamin D3 , Vitamin B12 , Vitamin B6 , Manganese Sulphate , Potassium Iodide , Vitamin K1 , Sodium Selenite , Contains: *Milk, Soya .

Stage 4 growing up milk - From 1 year +
Produced in the EU
Available in powder and ready made form

Ingredients:

Demineralised Whey* , Vegetable Oils , Skimmed Milk* , Maltodextrin , Dietary Fibres (Galacto-Oligosaccharides*, Poly Fructose) , Lactose* , Whey Protein Concentrate* , Calcium Phosphate , Calcium Carbonate , Potassium Citrate , Sodium Citrate , Vitamin C , Magnesium Chloride , Emulsifier (Soya Lecithin) , Choline Chloride , Taurine , Vanilla (Flavouring) , Ferrous Sulphate , Zinc Sulphate , Potassium Chloride , Vitamin E , Niacin , Folic Acid , Vitamin D3 , Pantothenic Acid , Copper Sulphate , Vitamin A , Biotin , Thiamin , Vitamin B12 , Vitamin B6 , Potassium Iodide , Manganese Sulphate , Vitamin K1 , Sodium Selenite , Contains: *Milk, Soya .

Part one

Part three