Formula feeding is a form of supplementary or substituted feeding given instead of breastfeeding.
Indications (May be Absolute or Relative)
- Insufficient breast milk
- Death of the mother
- Working mother
- Pregnancy
- Diseases of the breasts, for example, mastitis
- Mother who is on any medications incompatible to breastfeeding, for example, sulfonamides
- Infectious disease of the mother, for example, tuberculosis (TB) and HIV
- Chronic diseases, for example, heart and kidney diseases, communicable diseases, and major injuries.
- Mental illness
- A child with poor sucking reflex, for example, prematurity and birth trauma
Feeding Volumes & Schedule
| Age | Typical Volume per Feed | Frequency |
|---|---|---|
| 0–1 week | 15–60 mL (0.5–2 oz) | Every 2–3 hours |
| 1–4 weeks | 60–120 mL (2–4 oz) | Every 3–4 hours |
| 1–6 months | 120–180 mL (4–6 oz) | 5–6 times/day |
| 6–12 months | 180–240 mL (6–8 oz) | 4–5 times/day + solids |
On average, infants consume 2.5 oz (75 mL) per pound of body weight per day, but needs vary.
Procedure for Formula Feeding
Formula Feeding Preparation
- Check the doctor’s order and do the calculation accordingly.
- Collect the necessary equipment.
- Wash hands with soap and water.
- Measure the required amount of water and milk and pour in saucepan.
- Add 1 teaspoon of sugar to 90 ml. of liquid.
- Boil the milk until it reaches boiling point.
- Cool the milk in the bowl of water till it is warm enough for the child to drink.
- Strain the milk into a cup.
- Pour into the feeding bottle.
- Place teat, cover the bottle, and take it to bedside.
Feeding
- Wash hands and wear gown.
- Make sure that the baby is dry and clean.
- Place a macintosh and a draw sheet under the infant buttocks to prevent soiling of cloth as a result of gastrocolic reflex that is stimulated by feeding
- Mummify the infant if needed.
- Put towel or bib under the chin to prevent the soiling of infant’s dress.
- The nurse or the mother should sit comfortably on a chair with legs crossed.
- The infant should be held in semi-of the arm. Fowler’s position with head on the crook of the arm
- Test the temperature of the milk and rate of flow. Drop a few drops on the inner aspect of the palm.
- The size of the teat hole must be according to the formula (rice porridge-big hole, newborn-small hole).
- Place the entire nipple tip in the infant’s mouth.
- Bottle should be held in upright throughout the feeding to prevent air entering.
- The nipple should be always filled with milk otherwise the infant will suck in air.
- In between and after feeding, the baby should be burped and cuddled.
- Place the baby in bed in right lateral position to facilitate gastric emptying.
- Wash and replace the articles.
- Record accurately the amount offered, amount taken, any vomiting, etc.
Special Considerations
- Avoid cow’s milk before 1 year—it lacks essential nutrients and may cause anemia.
- Watch for signs of formula feed intolerance: vomiting, diarrhea, rash, or poor weight gain.
- Do not microwave bottles—use warm water baths to heat safely.
- Educate caregivers on hunger cues and avoiding overfeeding.
REFERENCES
- Annamma Jacob, Rekha, Jhadav Sonali Tarachand: Clinical Nursing Procedures: The Art of Nursing Practice, 5th Edition, March 2023, Jaypee Publishers, ISBN-13: 978-9356961845 ISBN-10: 9356961840
- Omayalachi CON, Manual of Nursing Procedures and Practice, Vol 1, 3 Edition 2023, Published by Wolters Kluwer’s, ISBN: 978-9393553294
- Sandra Nettina, Lippincott Manual of Nursing Practice, 11th Edition, January 2019, Published by Wolters Kluwer’s, ISBN-13:978-9388313285
- Marcia London, Ruth Bindler, Principles of Paediatric Nursing: Caring for Children, 8th Edition, 2023, Pearson Publications, ISBN-13: 9780136859840
- Ernstmeyer K, Christman E, editors. Nursing Fundamentals [Internet]. 2nd edition. Eau Claire (WI): Chippewa Valley Technical College; 2024. PART IV, NURSING PROCESS. Available from: https://www.ncbi.nlm.nih.gov/books/NBK610818/
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