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Formula Feeding: Safe Preparation and Feeding Tips

Choosing formula, preparing bottles safely and responsive feeding.

Before you use this guide: This is general educational information, not an individual medical assessment. We do not identify a clinician reviewer on this page, so please confirm personal health decisions with your doctor, midwife or paediatrician.

Formula is a safe, nutritious option when breastfeeding is not possible or is not what you have chosen. A well-fed, loved baby is what matters, and there is no reason to feel guilty.

Choosing a formula

• First infant formula, based on cow's milk, is suitable from birth until 12 months. All formulas sold in the UK, Ireland, US, Canada and Australia must meet strict nutritional standards, so price is not a measure of quality.
• Follow-on formulas and growing-up milks are not needed. Your baby can stay on first formula until at least 12 months.
• Use special formulas, such as soy, hydrolysed or lactose-free, only on the advice of a doctor.
• Never make homemade formula or dilute formula to make it last longer, and do not use plant milks such as oat or almond as a main drink before 12 months. These can seriously harm a baby.
• Powder, ready-to-feed liquid and concentrate all work. Ready-to-feed is sterile and convenient but costs more.
• It is fine to change brands. Mild changes in poo colour and consistency are normal when you do.

Safe preparation

Powdered formula is not sterile, so how you prepare it matters. Guidance differs between countries and for premature or unwell babies, so follow your own health service's advice. The steps below reflect the general approach, including the advice in the UK and Ireland.

• Wash your hands and clean and sterilise bottles, teats and any equipment before use. Many health services advise sterilising until your baby is about 12 months, while some say hot soapy water or a dishwasher is enough after the first use.
• Make each feed fresh when possible. Boil fresh tap water and leave it to cool for no more than 30 minutes, so it is still at least 70 °C (158 °F).
• Pour the water into the bottle first, then add the powder. Use only the scoop supplied and level it off without pressing down. Too much or too little powder can harm your baby.
• Shake well, then cool the bottle quickly under cold running water.
• Test the temperature on the inside of your wrist. It should feel lukewarm, not hot. Never use a microwave, which can leave hot spots.
• Throw away any milk left in the bottle after a feed. Do not save it for later. A bottle that has been started should be used within about an hour.

If you need to make bottles ahead, cool them quickly, store them in the fridge at the back and use them within 24 hours. Bottled water is not sterile and may contain too much salt or sulphate for babies. Use it only if your doctor advises it, and boil it first.

How much and how often

Newborns usually feed every two to four hours, around eight to twelve times in 24 hours. As a very rough guide, babies take about 150 to 200 ml of formula per kilogram of body weight per day for the first six months, spread across their feeds. Your baby's appetite varies from day to day and during growth spurts, so use the guide on the tin as a starting point and follow your baby's cues.

Responsive feeding tips

• Look for hunger cues: turning the head, sucking on hands, lip smacking and rooting. Crying is a late sign.
• Hold your baby close and semi-upright, with their head slightly higher than their stomach, and make eye contact.
• Use a slow-flow teat and pause during the feed (paced bottle feeding) so your baby can control the flow.
• Stop when your baby shows they have had enough, by turning away, closing their mouth, relaxing their hands or falling asleep. Do not force them to finish the bottle.
• Never prop up a bottle or leave your baby alone with one, because they could choke.
• Burp your baby during and after feeds.
• Let others feed too. Skin-to-skin contact during bottle feeds helps bonding.

Travelling with formula

When you are out, ready-to-feed cartons and pre-measured powder in a dispenser make feeds simpler. If you need to make up a feed on the go, ask your health service how to do it safely, because the water temperature rules above still apply.

What's normal

• Spitting up small amounts after feeds is common and often settles by 12 months.
• Formula-fed babies often have firmer, tan or yellow-brown poo. Occasional constipation is common, but hard, pellet-like poo or blood should be checked.
• At least six wet nappies a day from about day five is a good sign your baby is getting enough.

Call your doctor if

• Your baby vomits repeatedly, especially if it is green or forceful, or you see blood in the vomit or poo
• You have fewer wet nappies than usual, or your baby has signs of dehydration such as a sunken soft spot on the head, a dry mouth or few tears
• Your baby has a rash, swelling or wheeze after feeds, which could be a cow's milk allergy
• Your baby refuses feeds, is unusually sleepy, has a fever, or is not gaining weight

Some families use a mix of breast milk and formula. That is fine, and it can help if you are going back to work or need support with feeding.

Where to check current advice

Guidance differs a little between countries, so check the latest advice from your own health service: the NHS in the UK, the HSE in Ireland, the CDC and the American Academy of Pediatrics in the US, the Canadian Paediatric Society in Canada, or the Raising Children Network in Australia.

This content is for general information only and is not medical advice. Every pregnancy and every baby is different. Always talk to your doctor, midwife or paediatrician about your own situation, and seek urgent care if you are worried.