Bottlefeeding

Question 1

Cold water sterilisation

Answer 1

Follow manufacturers instructions
Change sterilising solution every 24 hours
Leave feeding equipment in solution for at least 30 minutes
Ensure no air is trapped in the bottles or teats wen putting them in the solution
Keep all equipment in the solution with a floating cover
Advantages:
+ Cheapest
+ Good for travel
+ Don’t have to wait to cool
Disadvantages:
- Rinsing takes time
- Bulky
NHS guide to bottle feeding

Question 2

Steam sterilisation

Electric or microwave

Answer 2

There are different types; follow instructions 
Make sure the openings of the bottles and teats are facing down 
Manufacturers will guide as to how ling to wait until use after sterilising 
Advantages: 
\+ No chemicals 
\+ Quick and easy 
Disadvantages: 
- Expensive
- Descaling unit 
- Needs electricity 
- Worktop space 
NHS guide to bottle feeding

Question 3

Boiling sterilisation

Answer 3

Ensure safety and prevent scalds and burns; never leave hot pans unattended, especially with children around
Whatever is sterilised needs to be safe to boil
Boil for at least 10 minutes, ensuring the items stay underwater
Wash hands and clean and disinfect surfaces
Remove bottles just before they are used
Disadvantages:
- Teats get damaged faster
NHS guide to bottle feeding

Question 4

Preparing powdered milk

Answer 4

Is not sterile (ready to use cartons are) and can become contaminated by pathogens such as Enterobacter sakazakii and salmonella. Preterm and LBW infants are most at risk.
The Food Standards Agency recommends that healthcare professionals should re-emphasise the importance of good food hygiene practices in the preparation and storage of feeds to reduce the risk of illness.

Question 5

How many bottles should be prepared at one time

Answer 5

The department of health recommends that only one bottle of formula should be made up immediately before a feed, as storage of reconstituted powdered milk may enhance the likelihood of becoming contaminated by pathogens.

Question 6

How to prepare formula feeds?

Answer 6

1. Clean the preparation area and wash hands with soap and water
2. Boil fresh tap water in a kettle and allow it to cool no less than 70 degrees (less than 30 minutes) because at this temperature most bacteria will be killed – don’t use previously boiled water, filtered water or bottled water (may contain high levels of sodium or sulphate)
3. Pour the required amount of water into the sterilised bottle
4. Add the exact amount of formula to the water following instructions. The wrong amount could cause electrolyte imbalance; too much may cause constipation and dehydration and too little could cause malnutrition
5. Reassemble the bottle and shake well to ensure he powder has reconstituted
6. Quickly cool under a running cold-water tap
7. The temperature should be lukewarm; test a few drops on your wrist
8. Discard any formula not used after feed

Question 7

Who should feed baby?

Answer 7

UNICEF recommend that only the parents feed in the early weeks to help the infant feed safe and secure and to build a close, loving bond

Question 8

Responsive bottle feeding

Answer 8

Offer feeds when the infant shows signs of hunger
If crying, try to sooth before the feed, skin to skin contact will help
Hold the infant close and look into the infant’s eyes and talk gently to them
Keep the infant in an upright position with their head supported
Brush the teat over the lips and wait until there is a wide gape and the tongue is in the base of the mouth before putting the teat into the mouth
Position the bottle horizontally and tilt it so that the infant can get the milk from the teat and not air which will cause wind
Bubbles will be seen in the bottle if the infant is feeding well
Allow the infant to have short breaks; they may need to wind occasionally
Never leave the infant unattended with a bottle
Don’t force the infant to finish a feed if they have had enough
Discard any left over milk

Question 9

Amount of milk to feed

Answer 9

In the first few days infants may only take a small amount of formula but at the end of the first week they will require around 150-200mls/kg/day until they are 6 months old. Advise against over feeding baby as the infant will likely vomit and also put on too much weight.

Question 10

The infant formula and follow on milk regulations (2007)

Answer 10

State that no person shall market infant formula which fails to meet the regulations. Also states that if scientific data shows something is beneficial then it has to be put in formula.

Question 11

Unicef advice on advertising

Answer 11

No advertising at all to protect breastfeeding as the healthiest option. This ensures there is accurate and effective information free from influence of marketing campaigns designed to protect profits rather than babies. The global infant formula market is worth approximately $25 billion.

Question 12

Cost of bottle feeding per day

Answer 12

First infant until 2 weeks
Aptamil £14.62 – Cow&Gate £8.68

Formula at 2-3 months
Aptamil £4.60 – Cow&Gate £2.94

Question 13

Infants with the following conditions cannot breastfeed and need specialised formula milk …

Answer 13

• Galactasaemia
• Maple syrup urine disease
• Phenylketonuria

Question 14

Infants may need other food in addition to breastmilk for a limited period if they are …

Answer 14

• Born weighing less than 1500g
• Born at less than 32 weeks
• Those at risk of hypoglycaemia; preterm, SGA, have suffered a hypoxic episode, ill, diabetic mothers

Question 15

What mothers should avoid breastfeeding

Answer 15

HIV positive mothers