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Bottle feeding safety tips fact sheet

Bottle feeding safety tips

If bottle feeding your baby breastmilk or formula, holding your baby close during feeding builds a close, loving bond between you. Your baby can feel, smell and see you and this is when a strong attachment can develop.

Bottle feeding gives you freedom to express breastmilk if you are working or away from your baby.

Safety is paramount; here are some handy care tips:

  • Before feeding your baby, check the temperature of the feed by letting a little breastmilk or formula drop onto the side of your wrist. It should feel just warm, but cool is better than too hot.
  • Never microwave breastmilk – this heats bottles unevenly, which can scald your baby or damage the milk. Stand the bottle of breastmilk in a container of warm water for a few minutes (no more than ten).
  • Discard any warmed breastmilk that has not been offered to your baby and/or formula which has been consumed within one hour. Do not reheat half-empty bottles.
  • All teats and bottles should be cleaned well with a bottle/teat brush and sterilised correctly, using boiling or steaming methods or cold sterilisation, until your baby is 12 months. Teats need to be checked and replaced regularly.
  • Transport bottle feeds in an insulated bag with ice bricks and use within two hours. Place the feeds in the refrigerator at the destination and use within 24 hours of the time of preparation.

How to feed with a bottle

  1. Seat yourself comfortably and hold your baby in your arms while giving the bottle. Hold the bottle tilted, with the neck and teat filled with breastmilk or formula. If your baby does not firmly grip the teat, gently press under their chin with your middle finger and slightly withdraw the teat to encourage sucking. This method will help to prevent your baby from swallowing air, which can cause wind pain.
  2. Check the bottle flow. When the bottle is upside down, the milk should drop at a steady flow from the teat. Sometimes the teat gets clogged when a powdered formula is used. Check teats often.

Even when fed properly, a baby swallows some air. Hold your baby upright over your shoulder or upright on your lap with your hand supporting under their chin. Pat or rub the middle of their back gently until they burp. If the baby is feeding happily, don’t stop until they are ready! Watch for signs that your baby has had enough.

The dangers of prop feeding or bottle propping

Prop feeding is when a baby’s bottle is propped against a pillow, rolled-up blanket or other support, rather than a carer holding their baby and a bottle for each feed.

This is dangerous for your baby and increases their risk of:

Choking: When being prop fed, your baby can’t control the flow of milk and the bottle will continue to flow even if your baby isn’t ready to swallow. Choking can be ‘silent’ and if you aren’t near your baby, you might not notice it.

Aspiration: This is when food or drink goes into the lungs (instead of the stomach). This can make babies unwell and lead to chest infections and hospitalisation. Babies are more at risk of aspiration when fed lying flat on their back (instead of upright). If you have left your baby by themselves to prop feed, you won’t necessarily notice that they have choked on the milk.

Suffocation: Using pillows, rolled up blankets or soft toys to support the bottle increases your baby’s suffocation risk because these items can fall over your baby’s face and smother them. At all times when your baby is in their cot, you should be following safe sleeping guidelines which include keeping your baby’s head and face uncovered and ensuring there are no pillows, toys, cot bumpers or doonas in the cot (https://rednose.com.au/resources/education).

Ear infections: If your baby is bottle-fed lying flat on their back, they are more prone to ear infections. This is because milk and bacteria can pool at the back of their mouth and enter the ear via the eustachian tubes. Holding your baby in an upright position during feeds reduces this risk.

Tooth decay: Bottle propping can lead to tooth decay as milk can stay in your baby’s mouth and combine with the saliva in your baby’s mouth to create acid which damages their teeth.

Over feeding: If your baby can’t push the bottle out of their mouth then they have to drink all of the milk even if they don’t want it. This can lead to increased risk of obesity and can cause them to vomit and/or choke on their vomit. Babies show cues which can help you to work out if they have had enough to drink, such as stopping sucking and letting the teat fall out of their mouth. If you are not holding your baby for a feed, you won’t see these cues.

Under feeding: If the bottle falls out of your baby’s mouth before they have finished drinking it, they won’t be getting the full amount of milk that they need to grow and develop.

Important

You should always supervise your baby to keep them safe. If there is something that you need to do while bottle-feeding your baby, it is much safer to stop the feed and go back to it afterwards then to leave the bottle propped in their mouth.

If you have other children, try to involve them in feeding time by reading a book or telling them a story, asking them to draw a picture or singing some songs. It can be a way to create a special time for everyone.

Contact us

Lady Cilento Children’s Hospital
501 Stanley Street, South Brisbane
t: 07 3068 1111 (general enquiries)

In an emergency, always call 000.

If it’s not an emergency but you have any concerns, contact 13 Health (13 43 2584). Qualified staff will give you advice on who to talk to and how quickly you should do it. You can phone 24 hours a day, seven days a week.

Resource No: FS236. Developed by the Division of Medicine, Lady Cilento Children’s Hospital. Updated: June 2017. All information contained in this sheet has been supplied by qualified professionals as a guideline for care only. Seek medical advice, as appropriate, for concerns regarding your child’s health.

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