Formula Feeding FAQs: Getting Started

Whether you've decided to formula feed your baby from the start, are supplementing your breast milk with formula, or are switching from breast milk to formula, you're bound to have questions. Here are answers to some common queries about formula feeding.

What supplies do I need?

From formula to bottles, from nipples to sterilizers, the choices can seem endless. But before your baby is born, it's a good idea to hold off buying — or registering for — too much of any one type of feeding product. After all, you may end up having to return them when you find that your baby doesn't like what you've chosen.

To get you through the first week or so, you'll need to have enough formula, water, bottles, and nipples. Burp cloths and a bottle/nipple brush will also come in handy. 

Once you get in the swing of feeding your baby, you may find it's worth investing in more or different kinds of bottles, or items that can make the feeding process go a little smoother (like a bottle drying rack). A bottle sterilizer is not necessary, but you should sterilize all feeding supplies before the first use. 

What type of formula should I use?

Many different formulas (at a wide variety of prices) are available these days, which can make the process of choosing one a little overwhelming at first.

Ask your doctor about which brands might be best for your baby. You also can talk to other parents of infants about what they use and why. But remember, it's ultimately up to your baby.

The many kinds of formula available today include:

• Cow's milk-based formulas, which make up the vast majority of formulas. Most milk-based formulas have added iron, which babies need. Use only iron-fortified formula, unless advised otherwise by your doctor.
• Soy-based formulas, for parents who do not want their babies to eat animal protein, or for the very rare babies who cannot digest lactose. Many babies who are allergic to cow's milk also are allergic to the protein in soy formulas, so soy-based formulas generally don't help with milk-protein allergies. Use only iron-fortified formula, unless advised otherwise by your doctor.
• Hypoallergenic formulas for babies who can't tolerate the basic formulas, like those with allergies to milk or soy proteins. The proteins in these hypoallergenic formulas are broken down to their basic components and so are easier to digest.
• Specialized formulas designed for premature, low birth-weight babies.

Most formulas comes in three basic forms:

1. Powders that require mixing with water and are the least expensive.
2. Concentrates, which are liquids that require diluting with water.
3. Ready-to-use (or ready-to-feed) liquids that can be poured right into bottles. These are the most expensive but are convenient if you're traveling or can't get to a sterile water supply quickly.

All formulas manufactured in the United States have to meet strict nutritional standards from the U.S. Food and Drug Administration (FDA), so just because a formula is name brand (versus generic) doesn't necessarily mean that it's the best for your baby.

Whatever kind you choose, make sure to check the expiration date on all cans and bottles of formula, and don't use formula from leaky, dented, or otherwise damaged containers.

What about formula with DHA or ARA?

DHA (docosahexaenoic acid) and ARA (arachidonic acid) are ingredients that can be found in some, but not all, formulas.

DHA and ARA are polyunsaturated fatty acids (considered the "good" kinds of fat) that may be linked to brain and nerve development and can be found naturally in fish oils and eggs. The fatty acids are also found in breast milk. By putting DHA and ARA in infant formulas, the manufacturers are attempting to imitate breast milk.

But is it beneficial to buy an infant formula with these ingredients? The jury still seems to be out on that. Some studies have indicated that formulas supplemented with DHA and ARA benefit visual and cognitive development. But others haven't shown any significant improvement with DHA and ARA formulas.

What kind of bottle should I use?

Bottles come in different shapes and sizes, can be made of glass or plastic, and may be reusable or have disposable liners inside. Some babies do better with certain shapes or bottles with liners on the inside. You may need to try a few different brands before you find the one that works best for you and your baby.

It's important to note that some plastic bottles are labeled "BPA-free"— meaning that they do not contain the chemical bisphenol A, which is found in some plastics and may affect kids' health. Glass bottles are free of BPA and can last for a long time, but can crack and chip, so they need to be checked often to avoid harm to your baby.

What kind of nipple should I use?

Walk down the nipple aisle in your local baby center and it's easy to be completely overwhelmed. For starters, nipples come in silicone (clear) or latex (brown). But the options don't end there.

The many different varieties include orthodontic nipples, rounded nipples, wide-based nipples, and flat-top nipples, just to name a few. And some are advertised as "being closer to the natural shape of a mother's breast." But which kind is best really depends on your baby and what he or she seems to prefer. After all, every baby is different.

Nipples also often come in different numbers, "stages," or "flow rates" to reflect the size of the nipple's hole, which affects the flow (i.e., slow, medium, or fast) of formula or breast milk. For example, fast flows may cause younger babies to gag or may simply give them more than they can handle, whereas slower flows may frustrate some babies and cause them to suck harder and gulp too much air.

But whether these different flows are necessary depends on each baby. Your little one may seem to prefer variety or may be content throughout infancy to use the same kind and size of nipple. If your baby seems fussy or frustrated with the nipple, you can certainly try a different kind (like one with a larger hole) to see if it makes any difference.

How often should nipples be replaced?

That depends on how the nipples you're using hold up to cleaning, sterilizing, and everyday use. Be sure to check them regularly for signs of wear and replace them often. Also, as your baby grows, he or she might prefer nipples that come in different sizes and flows (the holes get bigger as babies get older and are ready to handle faster flows of milk).

Formula can be pricey. Any way to cut costs?

Just as you may do already for your groceries and other baby supplies, shop around for the best deals on the formula you've chosen:

• Take advantage of all of the free samples and coupons you get in the mail the first few months after your delivery. Many times, new moms are placed on mailing lists for everything baby-related, from children's book clubs to formula companies.
• Clip coupons. You may even want to save some for different kinds of formula, in case you end up changing your baby's formula for some reason.
• See if your child's daycare has a coupon exchange program in which parents bring in their coupons and other moms and dads take what they need.
• Sign up for online coupon clubs that allow you to print and save coupons for only the things you indicate you need.
• Sign up for formula companies' clubs and special programs (through the mail or online) that may offer discounts, coupons, and/or free formula and other products.
• Compare prices on formula at online retailers. Some online stores have special "mom" clubs that allow you to save regularly on certain products every month, especially if you join a subscription service.
• Check for specials at your local grocery stores and/or baby retailer.
• See if your local wholesale/bulk items store offers your baby's formula for cheaper than local grocery stores. But don't automatically expect it to be less expensive in the long run just because it comes in a bigger container. When you're buying in bulk — or in bigger sizes — be sure to do the math on how much you're spending per ounce. Sometimes, it may seem like a deal when it really isn't.