Formula (Infant)

How to choose, prepare and store commercial formula

Breastfeeding is the normal and healthiest way to feed your baby and is the first step in a lifetime of healthy eating. In fact, breast milk is the best food for optimal growth. Health Canada recommends that healthy full-term infants be exclusively breastfed for the first six months of life with the appropriate introduction of complementary foods, and continued breastfeeding for up to 2 years and beyond.

However, if you’re thinking about using infant formula, your health-care provider can help you decide if it’s right for you and your baby. You can also read, Feeding Your Baby “So… You have a Decision to Make” (PDF), BabyFriendlyNL.

If you have made an informed decision to use infant formula, your health care provider will support you and provide appropriate information on how to prepare, store and feed your baby infant formula. You can also find information in Infant Formula: What You Need to Know (PDF).

NOTE: When you read the words “infant formula” on this page, it means “commercial infant formula.”

What type of infant formula should I give my baby?

Use a commercial infant formula. There are three types of infant formula:

• Ready to feed
• Liquid concentrate
• Powdered infant formula
  • Not recommended for babies who:
    • Are premature
    • Had a low birth weight and are under 2 months of age
    • Have a weakened immune system

Each type of infant formula needs to be prepared differently. Always follow the directions on the label. For more information, visit Health Canada’s Milk and Infant Formula web page.

Soy infant formulas are not appropriate for most babies. Only use a soy infant formula when directed by your health-care provider.

Homemade formula made using evaporated milk formula is not recommended as it does not have the nutrients your baby needs to grow and develop.

What should I look for when I buy commercial infant formula?

• Always buy commercial infant formula.
• Check the expiry date or best before date. Do not use infant formula which is out of date.
• Brand name and store brand “generic” infant formulas are suitable infant formulas.
• Make sure the formula can is not dented or bulging.

How long do I need to give my baby infant formula?

Give your baby infant formula until he or she is 9 to 12 months old and is eating a variety of iron-rich foods.

What type of baby bottles should I use?

Glass or plastic bottles are fine. While rare, some plastic bottles can contain Bisphenol A (BPA), which at high levels, can be harmful, especially to babies. To ensure your plastic bottle does not contain BPA, look for a recycling symbol (three-sided triangular arrow) on the bottom of the bottle. Ensure that a number other than seven is in the centre of the triangle. For more information, visit Health Canada’s Bisphenol A web page.

NOTE: It is important to check the bottle nipples for signs of wear before each use. Nipples that are cracked can break off while the baby is feeding and can cause choking. Nipples which are sticky or have cracks or tears should be thrown away.

Do I need to boil the water to mix with liquid concentrate or powdered infant formula?

It is important to use sterilized equipment and water in formula preparation.

Sterilize all water used for formula for babies of any age. There is no research that says when to safely stop sterilizing. That means it is safest to sterilize water and bottle-feeding supplies as long as your baby is using formula.

To prepare water for formula:

• Bring water to a rolling boil in a pot, on the stove. Continue to boil for two minutes. Do not use kettles that shut off before the water has boiled for two minutes.
• If you are using liquid concentrate formula:
  • Boil water for two minutes and cool it before mixing it with formula.
  • Water may also be sterilized by boiling for two minutes and then stored. Sterilized water may be kept in a sterilized, closed container for 24 hours at room temperature or unopened for 2 – 3 days in the fridge. Feed your baby formula that is close to body temperature.
• If you are using powdered formula:
  • Bring your water to a rolling boil for two minutes. Then mix it with formula when the water is at least 70°C (1 litre of water cools to about 70°C after about 30 minutes, but it is different for different types of pots and amounts of water). When water is less than 70°C it is not hot enough to kill harmful bacteria in the formula. Cool the mixed formula quickly to body temperature before feeding your baby.
  • For babies not “at risk” as written on pages 5 and 12, you can mix powdered formula with water that was sterilized, cooled, and stored in a sterilized, tightly closed container as above. This must be fed to your baby right away

NOTE: Use water from the cold water tap only. Lead and copper may build up in the water in the pipes overnight. Let the cold water tap run for two minutes each morning to flush out any overnight build-up of lead and copper in the water.

How do I choose safe water?

• Municipal tap water is the best choice for your baby because it is tested regularly to make sure that it’s safe.
• Well water should be tested regularly to ensure that it is safe.
• Use caution when using home water treatment equipment. If you use charcoal water filters, be sure to change the filters as recommended by the manufacturer, to reduce the risk of bacterial growth.
• Bottled water must be boiled. Only bottled water that has no added minerals or vitamins is safe to use.

Do NOT use these waters for formula:

• Softened water which is high in sodium.
• Mineral water which is high in sodium and other minerals.
• Carbonated water: Carbonation and added flavours are not appropriate for babies. Carbonated water may also have added salt.
• Roadside spring water.
• Waters in areas that have naturally occurring high levels of contaminants such as arsenic, fluoride and uranium

The safety of the following types of water for formula is not known so do NOT use:

• Purified water.
• Distilled water.
• Water treated by reverse osmosis.
• Deionized water.
• Demineralized water.
• Specialty nursery or baby waters.

NOTE: If you do not have a safe water source, use ready-to-feed liquid formula.

How often should I feed my baby infant formula?

While every baby is different, for the first few months of life, babies usually feed at least eight times in 24 hours. It is normal for babies to feed during the night for many months. Older babies usually feed less often.

How much infant formula will my baby drink?

• It is normal for babies to drink different amounts at each feeding.
• It is ok if your baby does not finish all of the infant formula in the bottle.
• Your baby may drink more formula during hot weather or growth spurts. Growth spurts can happen at any time but usually occur at two weeks, between four to six weeks, three months and six months.

Every baby is different. Let your baby’s appetite guide you on how much infant formula to offer. Feed your baby when you notice these early cues for hunger:

• Brings their hands to their mouth.
• Makes sucking motions or sounds.
• Turns their head toward the person holding them, often with their mouth open (called rooting). They may reach their hands towards whoever is holding them.
• Makes fists over their chest or belly.
• Crying is a late sign of hunger.

Let your baby decide how much they want to drink at every feeding. They will show you they are full by doing any of these things:

• Closing their mouth.
• Sucking less often.
• Turning away from the bottle or arching their back.
• Pushing away from the bottle or the person feeding.
• Relaxing their body, looking sleepy or falling asleep.

Throw away any leftover infant formula in the bottle after each feeding.

How do I know if my baby is getting enough infant formula?

Feed your baby when you see early signs of hunger such as:

• Stirring, moving arms.
• Rapid eye movements under the eyelids.
• Mouth opening, yawning, lip smacking.
• Turning their head towards you or something that is touching their cheek, with their mouth open (rooting).

This is a good time to feed your baby.

Your baby is much hungrier when you see:

• Hands going to their mouth.
• Sucking or licking movements.
• Restlessness.
• Soft cooing or sighing sounds, getting louder

Stop the feeding when your baby shows signs of having had enough. These include:

• Slowing down or stopping sucking.
• Closing their mouth.
• Turning their head away.
• Pushing away from the bottle or the person feeding them.
• Falling asleep and no longer interested in feeding.

Do not pressure your baby to finish a bottle. Pay attention to your baby’s feeding cues and let your baby decide how much or how little to eat. Be responsive to your baby.

Your baby may still have small sucking movements after a feed. This is normal baby behaviour.

What is the best way to feed my baby from a bottle?

• Always hold your baby when feeding. Cuddle, talk to and look at your baby while feeding.
• Hold your baby in an upright position, keeping their head supported
• Do not prop the bottle or put the baby to bed with a bottle since this may cause the baby to choke.
• Do not let your baby fall asleep with the bottle in his or her mouth. It can cause the baby’s teeth to rot and may increase the risk of ear infections.

Does my baby need to take vitamins?

Babies fed infant formula do not usually need to take vitamins. Vitamins should only be given to a baby if prescribed by a doctor for special needs.

Does my baby need fluoride drops?

The use of fluoride drops is not recommended for babies less than six months of age. Some babies may need fluoride drops after six months of age.

Fluoride drops should only be given to a baby upon the advice of a dental care provider.

Should I use a follow-up infant formula?

Follow-up infant formula is not recommended for babies under six months of age. Follow-up infant formula is made for older babies who are eating a variety of solid foods. There is no nutritional benefit in switching to a follow-up infant formula. You can keep giving your baby the infant formula you have been using until your baby is switched to whole milk.

Mother Baby Nutrition Supplement

Healthy eating is important for you and your baby. The Mother Baby Nutrition Supplement is a monthly benefit provided by the provincial government to eligible low income expectant women and families with children under the age of one. It will assist you with the extra costs of eating healthy during pregnancy and throughout your child’s first year.

Visit the Mother Baby Nutrition Supplement website to find out if you are eligible or call 1-800-508-4788.