5 tips for safe and effective bottle feeding.

Breast is best. However for a lot of mothers this isn't the way things worked out. No matter the reason, many parents find themselves faced with the task of using a bottle to feed their baby. Though there are some benefits, there are also many drawbacks to using the bottle. Whether you are using breast milk or formula in the bottle there are a few simple things you can do to make it a lot easier on yourself and your baby.

1. Be sure you are using the right speed nipple flow.
All bottles initially come with a stage 1 nipple. This slow-flow nipple is usually good for a couple of months. However, the age suggestions for increasing the speed of nipple flows are general at best. Every baby is unique, often even identical twins will not advance at exactly the same time to a higher flow. Some of the ways you can tell if your baby is ready for the next stage of nipple are: if your baby is losing suction pretty often while eating, becoming frustrated after eating for just a few minutes, eating a lot less but becoming hungry much more often, a sudden increase in the amount and intensity of gas, and a lot of chewing on the nipple during meal times. If you see any of these signs, or a combination of them it is time to get a faster flow bottle nipple.

2. Choose a non-toxic bottle.
BPA's and PVC's have been shown (to my satisfaction) to be dangerous as containers for baby's milk, unfortunately most bottles on the market still contain these chemicals. Also, plastic containers that advertise as BPA and PVC free have often replaced these unsafe chemicals with chemicals which have little or no research available on them. The best materials for containing your baby's milk are glass and stainless steel. Kleen Kanteen makes a wonderful stainless steel baby bottle, which is not only safe for your baby's milk, but easy on the environment. I have not personally used this bottle, so I cannot attest to how effective it is at reducing gas, but purely from a green and chemical-free perspective, it is the best choice. As far as glass baby bottles, you have many options, however my personal favorite is Dr. Brown's glass baby bottles. In my opinion, Dr. Browns is hands-down the best baby bottle for reducing gas. There were many times when I used this brand of bottle that the baby I was feeding would not only not have a burp, but also sleep peacefully without any of the usual discomfort that can result from not burping after a meal. The only drawback to the glass Dr. Brown's is that the production of glass is very hard on the environment. However, some families may not be able to afford to buy only the most non-toxic and environmentally safe bottles. For these families, the best ways to reduce the leaching of chemicals from your baby's bottles into milk and formula are: choose bottles that are colored, and not see-through; and do not warm your baby's milk or formula, but serve it at room temperature. Babies usually are not particular about the temperature of their meals (especially if they have never been breastfed), and there are no reasons why the milk or formula should be served at any particular temperature besides your baby's willingness to drink it. Chemicals do not leach into milk and formula as much from cool bottles or from plastics that are an opaque color.

3. Try to keep air out of the nipple during feeds.
As your little honey-suckle downs a big bottle of creamy goodness, try to keep the bottle at such an angle that air does not get into the nipple. If your baby takes in a big mouthful of air during a feed, the easiest thing for her to do with it is to swallow it and continue eating. This is very bad for gas. If that bubble is swallowed near the beginning of a meal, it could be forced through the stomach and into the intestines by the time your baby is finished eating. A large bubble of air going through your baby's intestinal tract is very uncomfortable for her, and though it will eventually be expelled at the diapered end, sleep may be difficult in the meantime. If your baby does swallow some air during a feed, try to get the burp up right away. If it does not come up, I recommend giving your baby a "bicycle legs" massage or regular clockwise stomach massage about 30-40 minutes after eating.

4. Sterilize your baby bottles and nipples regularly.
It is true that as soon as you touch a baby's bottle or nipple it is no longer sterile, however, regular sterilization cuts down the risk of getting thrush or a bacterial infection drastically. The only time when it is shown to be consistently safe to go without regular sterilization is if you are only using fresh breast milk in the bottles. Fresh breast milk has antibacterial properties that render it very resistant to thrush and the risk of infection (thank you @katrinayellow from twitter for reminding me to include this information). For the first two months you should sterilize the bottles every day, for months 3-6 twice a week is sufficient, from 6 months to 1 year, I recommend trying to do it at least once a month, and after 1 year it is usually fine to completely discontinue sterilization. The reason I recommend continuing with the occasional sterilization at this pace is based on the general ability of babies to fight off infection. If your baby is more prone to bacterial infection, or would be more adversely affected by an infection than most other babies, I would continue with at least bi-weekly sterilization for as long as your baby is using the bottle. Also remember to wash and sterilize pumping equipment after each use. To sterilize your baby's bottles, you can use a Medela microwave bag, which is handy and easy, you can boil them, or run them through the dishwashers heating cycle. Washing the bottles and nipples with soap and water is important as well, this should always be done before using the bottle and nipple again for another feeding.

5. Make sure your baby's milk and/or formula is fresh.
Fresh pumped breast milk can stay out in a bottle at room temperature for about 10-12 hours before it begins to have a risk of growing bacteria. Fresh mixed formula can only be out for about 1-2 hours before it begins to develop a bacterial risk. Fresh pumped breast milk can be refrigerated for up to a week (though sometimes as little as 2 or 3 days. A sterile container helps retain freshness in refrigerated breast milk.) with no significant bacterial growth risk, and fresh mixed formula can be refrigerated for up to 2 days. Breast milk can be frozen for 3 months in a soft-freeze, 6 months in a hard freeze and 1 year in a deep freeze. Thawed breast milk (and sometimes even refrigerated breast milk) is nearly as susceptible to bacteria as fresh mixed formula is, and should be held to a minimum of the same standards. If you pre-mix a large amount of formula, refrigerate the bulk of it for up to 2 days. If you have thawed breast milk, it should be served within 48 hours as well. For night feedings, you can pre-mix or thaw your formula or milk and keep prepared bottles in the refrigerator. Leave out the first bottle for up to an hour before it is used for the first feeding, then take out a bottle for the next feeding to warm over 2-3 hours. By the time it reaches room temperature, it will probably be within an hour of your baby's next feeding time. If you prefer to mix your baby's formula by the bottle rather than all at once, keep sterile bottles of pre-measured water with pre-measured formula to mix just before each feeding (the only drawback to this is the bubbles that are caused by shaking formula can cause severe gas in some babies). It is very important to keep in mind that once your baby's mouth has touched the bottles nipple, that formula or breast milk will only be safe for 1 hour, TOPS. I know it is hard to throw out breast milk, and formula can be expensive, but if your baby only eats half a bottle and refuses to finish it, throw the rest away. Also, it is a good idea to familiarize yourself with the smell of fresh formula and breast milk, as well as the smell of breast milk and formula that has "turned", because if you are in a pinch and need to offer your baby some milk that you are unsure of, you will be able to use your nose to warn you of bacteria growth.

Feeding a baby is both a joy and a chore, but with these 5 tips you can be more confident that your baby is getting the best from each feeding (for more information on how to make good choices for your baby's things read this). I hope that these tips have been helpful. If you know any new or expecting parents, please don't hesitate to forward them my site address. I also love questions and comments. If you have a topic that you'd like some tips on, feel free to ask, and I will credit you when I write them. Happy parenting!