Feeding Infant Formula

Provided by USDA

Iron-Fortified Infant Formulas

Iron-fortified infant formula is the best food for the baby when he or she is not being breastfed or when a supplement to breastfeeding is needed. Iron-fortified infant formula is specially formulated to have the right balance of nutrients and to be easily digested by the baby. Iron is a very important nutrient during the baby’s first year and serving iron-fortified infant formula is the easiest way to ensure adequate intake of iron. Some people may avoid iron-fortified formula because they think that the iron causes stomach aches and intestinal problems, but studies show that iron-fortified formula does not cause these symptoms.

Low-Iron Infant Formulas

Formula labels that say "low iron" do not meet the meal pattern. These formulas may be served only as a dietary substitution if an infant is unable to consume iron-fortified infant formula because of medical or other special dietary needs.

Follow-up Formulas

Follow-up formulas are designed for older babies and toddlers who are consuming solid foods and are not intended for dietary use as a sole source of food for babies.

Exempt Infant Formulas

Exempt infant formulas are special infant formulas that are intended for use by babies who have an inborn error of metabolism or low birth weight or who otherwise have an unusual medical or dietary problem. Many of these formulas are iron-fortified, but still require a statement from a recognized medical authority for meals to be reimbursed.

Other Milks

The following milks are not recommended for babies less than 12 months of age and are not reimbursable in the Infant Meal Pattern:

• Cow's milk
• Evaporated cow’s milk or home-prepared evaporated cow’s milk formula
• Sweetened condensed milk
• Goat's milk
• Soy milk (usually called soy beverage), or
• Imitation milks, including those made from rice or nuts (such as almonds) or nondairy creamer

These milks do not contain the right amounts of all the nutrients that babies need and can harm a baby’s health. Breast milk is the most ideal for a baby and iron-fortified infant formula is the best substitute for breast milk.

Purchasing, Storage, Sanitary Preparation, and
Handling of Infant Formula

Infant formula needs to be purchased, stored, prepared, and handled properly in order to be safe for a baby. General tips for use of infant formula follow.

Purchasing Cans of Formula

• Ready-to-feed formula is the most convenient and sanitary.
• If you are preparing liquid concentrate or dry powdered formula, it must be mixed very carefully according to directions on the container.
• Adding too little water to formula puts a burden on the baby’s kidneys and digestive system and may lead to dehydration.
• Adding too much water to formula may interfere with the baby’s proper growth because it does not contain adequate calories and nutrients and can cause water intoxication.
• Instructions on using special formulas should be provided by the baby’s doctor.
• Make sure the label says “with iron” or “iron-fortified.”
• Do not purchase cans of infant formula that have dents, bulges, pinched tops or bottoms, puffed ends, leaks, or rust spots. The formula in such cans may be unsafe.
• Check the formula’s expiration date on the lid or label to make sure the product is not too old. If the expiration date has passed, the nutrient quality of the formula may have deteriorated and you should not select the can.

Storing Cans of Formula

• Before using stored formula, check the expiration date on the lid or label to make sure the product is not too old. If the expiration date has passed, throw out the can.
• Store unopened cans of infant formula in a cool, dry indoor place — not in a refrigerator or in vehicles, garages, or outdoors (in these places, the cans are exposed to water and temperature extremes which can rust the can or affect the quality of the formula).

Preparing Formula

• Clean and sanitize your workspace
• Wash your hands with soap and warm water
• Wash all equipment (nipples, bottles, rings, and caps) in hot soapy water and scrub, using bottle and nipple brushes
• Rinse all equipment well in hot water
• Disinfect nipples, bottles, rings, and caps by boiling for 5 minutes in a pot with enough water to cover, then remove with sanitized tongs, let cool, and air dry

If disposable plastic bottle liners are used:

• Throw out the bag after one use
• Clean and sterilize the nipples, rings, and caps, as described above
• Before opening a formula can, wash can lid with soap and clean water and rinse to remove dirt that could contaminate the formula. Before using, wash the can opener with soap and hot water.
• Before opening a formula can, wash can lid with soap and clean water and rinse to remove dirt that could contaminate the formula. Before using, wash the can opener with soap and hot water.
• Put a clean nipple right side up on each bottle and cover with a nipple cap
• Do not put cereal or other food in a bottle because this interferes with the baby’s natural ability to obtain the right amount of calories, forces the baby to eat cereal, and may cause the baby to choke. Feeding cereal does not affect baby’s ability to sleep.

Storing Bottles of Formula

• Make sure the bottles are labeled with the baby’s name and the date and time the formula was prepared. Use bottles of formula only for the baby for which they are intended.
• Refrigerate prepared bottles until ready to use and use them within 48 hours from the time they were prepared. Store in the back of the refrigerator (colder area).
• To prevent spoiling, do not allow prepared bottles of formula to stand at room temperature. Do not feed a baby a bottle left out of the refrigerator for 1 hour or longer. Throw out prepared formula not used within 48 hours.
• Opened cans of formula should be covered, refrigerated, and used within 48 hours. Throw out formula that is not used within 48 hours.
• Do not freeze infant formula
• Throw out any unused formula left in a bottle after a feeding and rinse the bottle in cool water to remove formula. Do not reuse a bottle containing formula after the baby has fed from it. The mixture of formula with baby’s saliva promotes the growth of disease-causing germs.
• Clean and sanitize bottles and their parts before reusing them

Warming Infant Formula

• For babies who prefer a warm bottle, warm the bottle immediately before feeding by holding it under running warm water. Warm only as much formula as you think the baby will need for a feeding.
• Always test the temperature of the liquid before feeding to make sure it is not too hot or cold. Shake the bottle well and test the temperature by squirting a couple of drops of the liquid onto your wrist or back of your hand. The temperature is correct when it feels neither warm nor cold.
• Never use a microwave oven to heat the bottles — this is dangerous. Liquid may become very hot when microwaved even though the bottle feels cool. The hot liquid could seriously burn babies. Covered bottles, especially vacuum-sealed, metal-capped bottles of ready- to-feed formula, can explode when heated in a microwave.