Many wonderful mothers completely or partially bottle feed their babies, and this does not deter in any way from the quality of love and attention you can give your child.

There is no need to feel guilty or inadequate if you choose or need to bottle-feed your baby. Some women find breastfeeding difficult for emotional or psychological reasons and although there are solutions to most breastfeeding problems, it can happen in the end that the best option is to bottle-feed.

Sometimes there is a period of bottle-feeding and then breastfeeding is resumed.This can be done even when breastfeeding has stopped for as long as 6 weeks!

There are many situations where bottle-feeding may be the most suitable way to feed your baby. Babies with certain medical conditions need to be bottle fed or sometimes this is the best option when the mother has to take medications that are not proven safe for newborns (many medications have not been adequately tested and most will pass into the milk. in varying concentrations.)

If the medications are only needed temporarily, then the breast milk can be expressed to keep up the supply, while baby feeds on formula. Breast feeding can then be resumed later.

With some medications, the length of time that the drug remains in the breastmilk is known and feeding can be planned accordingly. Your physician should be able to provide this information.

Mothers who test positive for HIV are advised not to breastfeed as we do know that the virus can be transmitted via the milk. Many questions remain unanswered about this and the research remains inconclusive regarding the actual risks to the baby.

While the recommendation for HIV positive mothers to bottle feed in this country is mandatory and has been enforced by court order on occassion, there is controversy about whether this should be the case or up to the parents to decide.

Bottle-feeds may contain expressed breastmilk or a baby milk formula. Some babies are exclusively bottle-fed and many breastfed babies are occasionally or partially fed with a bottle.

Many breastfeeding mothers choose to introduce a bottle of expressed breast milk or formula Ocassionally or when another person is caring for the baby. The occasional bottle is best given to the baby by someone else, often the father, as the breastfed baby will probably associate his mother with breastfeeding.

I have learned from new mothers at the Active Birth Centre that the best time to introduce an ocassional bottle for the first time to a breastfed baby is around 6 weeks old when breastfeeding is fully established. At this stage this is unlikely to interfere with breastfeeding and most babies happily accept both.

Partially feeding the baby with expressed breastmilk, is a way to have the freedom of bottle-feeding and the continued benefits of breastmilk and is an option many working mothers choose.

Mothers of twins or multiples may find that mixed feeding using a combination of bottle and breastfeeding is a way to manage and may also bottle-feed exclusively.

While full breastfeeding is possible and can be the best way of mothering multiples for some women, other excellent twin mums I know find that bottle-feeding is a way to stay sane in the face of the extra demands of more than one baby.

When bottle-feeding you can encourage bonding through close contact and intimacy, which will promote the secretion of 'mothering hormones'. You and your baby can still benefit from some of the breastfeeding principles such as enjoying direct skin contact sometimes.

So if you are bottle feeding either partially or exclusively, the section on breastfeeding, if not some of the technicalities, is still relevant. You also can give your baby lots of body contact by carrying him. Both you and your partner could use a baby carrier and later on consider a back pack.

You may want to consider sleeping with your baby and regular massage is an excellent way to develop your relationship through loving touch. Above all it's essential to be confident in your choice and to enjoy feeding your baby!

Infant formula

Feeding a baby with infant formula is an acceptable alternative to breastmilk and will ensure adequate nutrition. While commercial formulas cannot duplicate the special properties of breast milk, they are designed to be as close to human breastmilk as possible and do form a reasonable substitute.

There is no alternative to colostrum however, so it is beneficial, if at all possible, to breastfeed for the first few days even if you intend to bottle feed from the start.

Infant formulas are made from either processed cow's milk, goat's milk, soya beans or specialised formulas. One benefit of cow's milk formulas is that they have been shown by scientific studies to contain virtually no pesticides.

This is because the milk fat is replaced with vegetable oil to make it more digestible and is also due to the processing procedures involved. As in breastmilk however, there are inevitably some environmental contaminants in formula.

These may include aluminium, silicon and a variety of other chemicals. While there are many good reasons to bottle-feed, formula milks are not 'pollutant free' by comparison to breastmilk.

The protein in cow's milk used for making infant formula is hydrolysed and partially predigested. As formula does not have the special digestive enzymes that are found in breastmilk, it does take longer for the baby to digest and needs to be diluted in a larger volume of water.

Lactose is added to formula to substitute for the sugar found in breastmilk and so are vitamin D and iron which are both low in breastmilk, so formula fed babies do not generally need extra vitamins or minerals.

It is very important to ensure that the formula you choose for your baby is enriched with essential fatty acids similar to those found in breast milk. The label will state that the formula is supplemented or enriched with LCP's (long-chain polyunsaturated fatty acids). These are needed for optimal growth and are especially beneficial for early brain development.

Several brands of organic formula milks for babies from birth to four months made from organic cow's milk and other ingredients are available from health food shops and also by mail order. The same brands may also produce follow-on milks for use from four months on with weaning cereals.

Formula comes ready made or in powder form. When mixing formula powder with water, its best to use filtered or bottled water. Follow the instructions precisely and avoid adding more or less than the recommended amount. A bottle-fed baby can be overfed if you add extra formula to the mixture. The occasional baby may have an allergic reaction to cow's milk formula. Observe your baby carefully for signs of intolerance.

Soy based formulas

Soy formula is mainly used by vegans and vegetarians or for babies who are lactose intolerant and cannot take cow's milk.

It is made from protein derived from soy beans and sucrose rather than lactose. It takes a little longer to digest than cow's milk formula. As soya is a source of plant oestrogens or isoflavones, there is some concern about high isoflavone levels in babies fed on soy formula and the potential effect on the endocrine system.

Researchers are recommending that more studies are needed. The Department of Health recommends that babies who are advised to use soy based formula for medical reasons should continue to do so, as there is no convincing evidence as yet of risk to babies.

It is interesting to note that in countries such as Japan and China where large quantities of soy are part of the daily diet, no harmful effects have been noted.

Soya allergy is almost as common as milk based allergies. If you observe any possible symptoms of intolerance then you will need to consult a nutritionist who specialises in infant nutrition or your doctor. (see page...). After 3 months babies generally have a higher tolerance for soya formulas.

Cow's milk

Pure cow's milk should not be given to babies under a year old. The contents are suitable for calves and not humans and have a higher protein and mineral content and lower fatty acid levels than human milk to promote body growth rather than brain development.

Full fat organic cow's milk can be given after 12 months as part of a mixed diet. Avoid non organic cow’s milk as it may contain hormones and pesticides.

Some babies are not able to tolerate cow's milk and may show signs of allergic reaction.

Bottle-feeding tips

Respond to your baby promptly when he signals or cries to let you know he is hungry. Bottle-fed babies tend to feed less often than breastfed babies, as cow's milk protein takes longer to digest. You can allow your baby to determine when he wants feeding.

A newborn will take about 2 fluid ounces per feed fairly frequently. As he grows older he will feed less often and take more milk at each feed. Babies know when they have had enough and it doesn’t matter if they don’t empty the bottle.

Throw away the left over milk. As they get older babies may need a little more than one bottle if they still seem hungry after a feed. Let your baby guide you as to how much milk he needs.

Hold your baby while you feed in similar position to breastfeeding but make sure his body is tilted rather than flat to make it easier for him to swallow.

Begin feeds by stroking the baby's cheek closest to you to elicit the rooting reflex and then introduce the teat slowly and not too far back in the baby’s mouth

Pause from time to time. Change sides half way through the feed, holding your baby with the other arm.

Maintain skin contact by bottle feeding your baby undressed to his nappy at times, and holding him against your naked body.

Stroke, caress and cuddle your baby, express tenderness with eye contact and smile, talk or sing to your baby while feeding

End the feed when your baby stops sucking or break the suction by slipping your little finger into the corner of your baby’s mouth

Winding is helpful for most bottle-fed babies, although not every baby needs to be winded. You can prevent air bubbles by tilting the bottle while you feed to ensure that the teat is full if milk and not air. Place a muslin square over you shoulder in case your baby possets.

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