Baby Formula Guide: Types, Safe Preparation and Storage

Types of Formula

Always check labels carefully to make sure you are buying a milk that is suitable for your baby. This is how the NHS describes the main types:

• First infant formula (first milk) — suitable from birth and based on whey protein, which is considered easier to digest. The NHS says it should always be the first formula you give your baby and that it can be used throughout the first year.
• Goats' milk formula — suitable from birth and produced to the same nutritional standards as cows' milk-based formula. The NHS says it is not less likely to cause allergies and is unsuitable for babies with cows' milk allergy.
• Comfort formula — contains partly broken down proteins. The NHS says to get professional advice first, that there is no evidence it helps with digestive problems, and that it is unsuitable for babies with cows' milk allergy.
• Hypoallergenic formula — contains fully hydrolysed proteins and is suitable from birth under medical supervision. A GP prescribes it for a diagnosed cows' milk allergy.
• Anti-reflux and lactose-free formula — the NHS says both are for use from birth only under medical supervision.
• Soya formula — the NHS says it is suitable from 6 months, under medical supervision.
• Follow-on formula — the NHS says it is suitable from 6 months and gives no benefits for your baby compared with first infant formula.

If you think a particular formula disagrees with your baby, talk to a midwife, health visitor or GP rather than switching on your own.

Safe Preparation

The NHS says that even sealed tins and packets of powdered infant formula can sometimes contain bacteria, so making up the feed correctly matters. Its steps include:

• Boil fresh water, then use it within 30 minutes — use fresh tap water (not water that has been boiled before) and leave it to cool for no more than 30 minutes, so that it stays at a temperature of at least 70C.
• Water in the bottle first — always put the water in the bottle first, while it is still hot, before adding the powder.
• Level the scoop — loosely fill the scoop, then level it with the flat edge of a clean, dry knife (or the leveller provided). Only use the scoop that comes with the formula.
• Do not add extra powder or extra water — and do not add sugar or cereals to your baby's formula.
• Cool and test — cool the formula by holding the bottle (with the lid on) under cold running water, then test it on the inside of your wrist. It should feel warm or cool, but not hot.
• Sterilise feeding equipment — the NHS says to sterilise all your baby's feeding equipment, including bottles and teats, until they are at least 12 months old, and that it should be washed and sterilised before each feed.

If you use a formula preparation machine, the NHS says to make sure the water that comes out is at least 70C when it is mixed with the powder. Tins differ, so follow the manufacturer's instructions on your tin; if they differ from the NHS steps above, ask your midwife or health visitor. The NHS says that if you cannot follow its advice for feeding away from home, you should use a carton of ready-to-feed liquid formula.

How Much Formula by Age

The NHS says newborn babies need quite small amounts of formula to start with, that the amount varies from baby to baby, and that you should feed your baby when they seem hungry and not worry if they do not finish the bottle. The American Academy of Pediatrics (AAP) gives these guides:

• First week — no more than about 1 to 2 ounces (30 to 60 ml) per feed.
• By the end of the first month — at least 3 to 4 ounces (about 90 to 120 ml) per feed, about every 3 to 4 hours.
• By 6 months — 6 to 8 ounces (180 to 240 ml) at each of 4 or 5 feeds in 24 hours.
• Per day, by weight — NHS 111 Wales says that by the end of their first week most babies need around 150 to 200 ml per kilo of their weight a day until they are 6 months old. The AAP gives about 2½ ounces (75 ml) per pound of body weight a day.

The NHS says your baby's weight gain and the number of wet and dirty nappies tell you whether they are getting enough: around 6 wet nappies a day from a few days after the birth, and at least 1 poo a day. See our baby weight tracking guide and is my baby getting enough milk? For an ounce-based breakdown alongside breastfeeding volumes, and step-by-step bottle positioning and paced-feeding technique, see how much a baby should eat by age and how to bottle-feed the right way.

Storage Rules

The NHS says bacteria multiply very fast at room temperature, and that even when a feed is kept in a fridge they can still survive and multiply, although more slowly. To reduce the risk of infection, it says it is best to make up feeds one at a time, as your baby needs them.

• Leftover formula from a feed — the NHS says to throw away any made-up formula left in the bottle after a feed.
• Opened powder tin — follow the label on your tin. The Aptamil and SMA UK product pages both say to use the powder within 4 weeks of opening, and Aptamil says to store it in a cool, dry place and not in the fridge.

Signs Formula May Not Be Agreeing with Baby

Talk to your health visitor or GP if you see any of these, or if you are worried for any other reason:

• Blood or mucus in stools
• Skin rashes that appear consistently after feeds
• Vomiting after every feed, beyond the small amount of milk that babies often bring up
• Poor weight gain
• Crying and fussiness that continue despite feeding and burping

For families considering combination feeding with breastfeeding, our breastfeeding guide and increasing breast milk guide cover how formula fits into a mixed feeding approach.