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Bottle-Feeding

Health considerations when bottle-feeding

If you decide not to breastfeed, or you are unable to breastfeed, commercial iron-fortified formulas can give your baby the nutrition they need. Infant formulas have the right amounts of protein, calories, fat, vitamins, and minerals for growth.

Infants who take enough infant formula fortified with iron usually don't need vitamin and mineral supplements. However, the American Academy of Pediatrics recommends vitamin D supplementation for all babies drinking formula. This is until they are drinking at least 32 ounces a day. Fluoride supplements are recommended for babies whose primary water supply is not fluoridated. Check with your baby's doctor about vitamin D and fluoride supplements.

Benefits of breast milk

Breast milk contains the immune factors that prevent infections and other health conditions throughout a baby's life. Babies who are breastfed have a lower risk for some conditions, such as sudden infant death syndrome (SIDS), allergies, asthma, type 1 and type 2 diabetes, ear infections, respiratory infections, gastrointestinal problems, obesity, and certain childhood cancers. Babies who are formula-fed don't receive this added protection.

Man feeding baby with bottle.

Types of infant formula

  • Cow's milk-based formula. Most infants should be able to tolerate a standard cow's milk formula. Cow's milk formulas are modified to be closer to human milk. These formulas have lactose as the carbohydrate (sugar) source. They are available in ready-to-feed cans, liquid concentrate, and powder. Regular cow's milk is not a correct source of nutrition for a human baby.
  • Soy-based or lactose-free formulas. These formulas are used if an infant can't tolerate lactose. This is rarely a big problem in babies. They don't contain lactose as the sugar source. As many as 50% of all infants who are allergic to cow's milk formula will also be allergic to soy-based formulas. Talk with your baby's doctor before changing formulas. Vegetarian parents may prefer soy-based formulas. But they should be aware that breastfeeding is still the best choice.
  • Special formulas. There are special formulas for babies who are premature or who have certain rare disorders or diseases. These formulas may have special directions for use. They are prescribed by the baby's doctor.
  • Hydrolyzed formulas. Hydrolyzed formulas are easier to digest. They may be used in babies at risk for allergies. They are more expensive than regular formulas. Talk with your baby's doctor before using these formulas.
  • Low-iron formulas. These formulas are not recommended.

Helpful hints for feeding your baby

  • Breast milk only is the ideal food for at least 6 months. This means no water, sugar water, or formula. Breastfeeding is recommended with the addition of solid foods around 6 months of age for 2 years or beyond. This needs to be what both you and your baby want.
  • Wait until breastfeeding is well established before giving your baby breast milk in a bottle. This may help prevent problems with breastfeeding, since some babies have problems going between the breast and bottle.
  • If you work, you can use a breast pump on break time and refrigerate or freeze the milk for later use as a bottle-feeding. Refrigerated breast milk should be used within 4 days after pumping. Frozen breast milk is good for 6 to 12 months in the freezer. This depends on the type of freezer. Your partner or other family members can be involved in feeding time if breast milk is offered from a bottle.
  • Offer cow's milk-based formula with iron as the first choice of formula if not breastfeeding.
  • If you are not breastfeeding, use baby formula until your baby is 1 year old. After this time, you may switch to whole milk. Children under 2 years old should not drink skim or low-fat milk.
  • It's important to follow the formula preparation directions exactly as directed on the packaging. Using too much water can result in poor weight gain. Using too little water can lead to constipation. It's also important to discuss your water supply with your child's doctor. In some areas, water must be boiled first, or bottled water should be used.
  • Bottles should never be propped up.
  • Babies should never be put to sleep with a bottle. This can cause cavities to develop.
  • All babies should be offered a feeding whenever they show signs of hunger. This is true whether babies are breastfed or bottle-fed.
Online Medical Reviewer: Mary Terrell MD
Online Medical Reviewer: Stacey Wojcik MBA BSN RN
Online Medical Reviewer: Tara Novick BSN MSN
Date Last Reviewed: 9/1/2025
© 2000-2026 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.
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