Bottle feeding

Find out how to feed your premature or sick baby expressed milk or formula in a bottle.

Some parents feed their premature or sick baby expressed milk or formula in a bottle. Some babies will transition to bottle feeding after being tube fed.

You may prefer to feed your baby expressed milk and/or formula in a bottle alongside breastfeeding. This is called mixed or combination feeding. If you are thinking about mixed or combination feeding, talk to your neonatal team, feeding specialist, midwife, health visitor or GP.

Like other types of feeding, it is important to recognise the signs that your baby is hungry (feeding cues) before bottle feeding. Your baby may demonstrate early feeding cues by putting their fingers into their mouth, making sucking motions (rooting) and becoming restless.

Your baby will want to be close to you while being bottle fed, so this is a great time to have skin-to-skin. When possible, it is best for you or your partner to give bottle feeds so that your baby can learn with you. Doing the following while bottle feeding your baby can help them to feed successfully and be more comfortable:

  • Make sure you are close to your baby and hold them in the best position suited to your baby, with their head supported. This may be upright or elevated on their side. Some units may advise you to try different positions.
  • Offer the bottle when your baby shows feeding cues.
  • Gently invite your baby to take the teat.
  • Avoid forcing your baby to take the teat or finish the feed.

If the milk comes too quickly, it can be difficult for your baby to coordinate their sucking, swallowing and breathing. A nurse or feeding specialist on the unit will show you teats, bottles and positions that can help your baby to do this more effectively.

Some babies have periods of low oxygen (desaturations) and/or low heart rate (bradycardia) when they are starting to bottle feed or breastfeed. This is normal in some cases and will improve with time, but can be a sign that your baby is not ready for feeding yet. If this happens, it may need to be looked at by a doctor or a speech and language therapist who specialises in swallowing.

Low oxygen and heart rate while feeding can also be a sign of reflux. Reflux happens when some of the partly digested milk or food in the stomach comes back up the tube from the mouth to the stomach (oesophagus). This is common in all babies, but is more common in babies born premature or sick. We have more information about reflux here.

Staff on the neonatal unit should support you and show you how to make feeds and clean and sterilise your baby’s bottles (see below). They could also encourage you to bring bottles in from home so that your baby can get used to them. For more help and support with bottle feeding, speak to your neonatal team, feeding specialist, midwife, health visitor or GP.

If you have twins or multiples, Twins Trust has some information about how to bottle feed multiples.

Looking after yourself

It is not unusual to find feeding your baby a difficult experience. In our survey of over 100 parents, over 60% said that their mental health got slightly or significantly worse during the experience of feeding their premature or sick baby. It is okay to find the experience difficult, no matter your situation. Every parent will have a very different experience of neonatal care.

It is important to talk to someone if feeding your baby is having an impact on your mental health. This could come from your neonatal team, feeding specialist, midwife, health visitor, GP, partner, or friends and family. At Bliss, we have lots of information about the impact having a premature or sick baby can have on your mental health, and where you can get support.

How to clean and sterilise bottles

Cleaning and sterilising your baby’s feeding equipment will kill any germs and make sure it is safe. All of your baby’s feeding equipment must be thoroughly washed, cleaned and rinsed in warm soapy water after it has been taken apart. This includes bottles, teats and rings and caps.

You can then sterilise your baby’s feeding equipment by steam sterilising, sterilising by boiling, or cold water sterilising using special tablets or liquid added to water. You can find out more information about these different methods on the NHS website.