Formula Safe Preparation
and Feeding

How do I know if my baby’s formula has been recalled?

Health Canada occasionally recalls infant formula. If you are feeding your baby formula, then it’s a good idea to subscribe to alerts.

Is it safe to use an automatic formula preparation machine?

Automatic formula preparation machines are not safe for preparing infant formula because:

• Powdered formula is stored in a non-sterile container inside the appliance.
• There is a chance of incorrect measurement of formula.
• Water is stored in a holding tank and is not sterilized. Even if it is sterilized prior to adding water to the machine, it will sit at room temperature and could grow bacteria.

What types of water can I use to prepare formula?

It is safe to use:

• Sterilized, cold tap water
• Sterilized, cold bottled water (with low levels of sodium and other minerals)
• Sterilized, cold well water that has been tested regularly (for bacteria at least three times per year, and nitrates once per year)

What types of water are not safe to prepare formula?

Do NOT use these types of water for formulas:

• Softened water that is high in sodium
• Mineral water that is high in sodium and other minerals
• Carbonated water - carbonation and added flavours are not appropriate for babies, and carbonated water might also have added salt
• Waters in areas that have naturally high levels of fluoride (higher than the guideline of 1.5 mg/L)
• The safety of these types of water is unknown, so do not use them.

When can I stop sterilizing formula equipment and water used to prepare formula?

According to Best Start, there is no safe age to stop sterilizing equipment (bottles, nipples, etc.) and water used to prepare formula. Therefore, you must sterilize the equipment and water as long as you are feeding formula to your baby.

Can I switch brands of formula?

Before switching to a different brand or type of formula, get advice from your healthcare provider.

If my baby didn’t finish their feeding of formula, can I save it for their next feeding?

It’s important to follow your baby’s cues and let them decide when their feeding is finished. Throw out any formula left over when your baby is finished their feed, as bacteria might have been introduced from your baby’s mouth.

Can I use a bottle to measure the amount of formula to add?

No, as the measurements on a bottle are not accurate. Using a sterilized measuring cup is the most accurate way to measure formula.

Do I need to burp my baby?

Babies swallow air when drinking from a bottle. You can reduce the amount of air your baby swallows by:

• Using "Paced" or "baby-led" bottle feeding methods
• Pause the feeding and burp your baby every 60-90mls (2-3oz)
• Avoiding over-feeding your baby by following their cues

More details are available in the Infant Formula: What you need to know resource at the top of this page.

How to burp your baby

Hold your baby in an upright position against your shoulder or sitting on your lap. This helps the air bubble to come up more easily. Gently rub or pat baby’s back.

Sometimes a burp brings up some milk as well. Some babies spit up after feedings. This is nothing to worry about as long as your baby is gaining weight.

Your baby will let you know when they are ready to eat and when they have had enough.

View this Baby Feeding Cues chart (external link) and Pre-Term Baby Feeding Cues chart (external link) to learn how your baby will tell you they are hungry.

If you see "late feeding cues", calm your baby before feeding them by trying:

• skin-to-skin holding
• cuddling
• talking
• rocking

It is important to watch your baby for signs that they are full while you are feeding them. Your baby might show you they are full by:

• 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 showing interest in eating

Never force your baby to eat when they don’t want to.

It is also important to watch your baby for signs of stress during a feeding. 
Your baby can become stressed or overwhelmed if:

• the flow of the milk is too fast
• they are full
• they need a break

Signs that your baby could be stressed during a feeding are:

• waving their hands or frantic movements
• frowning or grunting
• pushing away
• arching their back
• crying

If your baby is showing signs of stress while feeding, stop and try again when your baby is calm and shows interest in feeding again.

There are several ways to check that your baby is getting enough formula.

Count your baby’s wet and dirty diapers:

• Expect one wet diaper on day one, increasing to at least six wet diapers in 24 hours by day four or five.  The diapers should be soaked through with clear or pale yellow urine.
• For the first few days after birth your baby will pass dark sticky poops. After the first few days your baby’s poop should become pale yellow or light brown and soft.
• Formula fed babies should have at least one poop a day to feel comfortable.

You will also know your baby is getting the right amount of formula by having your baby weighed and tracked by your healthcare provider:

• The World Health Organization growth charts (external link) are recommended for tracking your baby’s growth. Older growth charts were based on the feeding patterns of bottle-fed babies on a schedule, rather than cue-based and should not be used for breastfed or bottle-fed babies who are fed according to their hunger cues.