Formula feeding when you cannot provide breastmilk for your baby

Newborn being bottle fed  

There may be a reason why you can't breastfeed or provide breast milk for your baby. Once this informed decision has been reached, you should feel comfortable, supported, and equipped with the correct information to safely provide your baby with appropriate infant formula for their health and well-being.

What is formula made of?

Commercial infant formulas are usually derived from cow's milk and are designed to closely resemble the amount of nutrients found in human milk. They contain a balance of proteins, fats, carbohydrates, vitamins, minerals, and other nutrients to help your healthy, term baby (i.e., not premature) grow and develop properly. All formula-fed infants should be given a formula that is iron-fortified. Babies who do not drink at least 1 litre of infant formula per day need an extra supplement of vitamin D (400 IU).

Rarely, an allergy to the protein in cow's milk or lactose intolerance can develop. If you are concerned about this possibility, speak to your doctor to find out which type of formula would be best for your baby. Special formulas, such as soy-based, lactose-free, or thickened formulas, should be used under medical supervision.

Types of formula

Powdered formula is the least expensive and keeps for up to one month after opening. It needs to be measured accurately using the scoop provided to prevent errors in preparation. Powdered formulas are not a sterile product. There is a risk of bacteria developing if preparation instructions are not followed carefully.

Liquid concentrate is more expensive than powder and must be used within 48 hours of opening the can. It is easier to measure and mix, but there is still a risk of a measuring error if preparation instructions are not followed carefully.

Ready-to-feed formula is the most expensive, but also the most convenient, especially when travelling. It does not require mixing with sterile water and must be used within 48 hours of being opened.

Safe preparation and feeding of formula

  • Prepare formula according to the specific directions on the can.
  • Clean kitchen surfaces and wash hands thoroughly with soap and warm water.
  • Measure formula and water accurately to prevent under- and over-dilution.
  • Wash all parts of the feeding system in warm soapy water, rinse well, then place in boiling water for at least 2 minutes.
  • Sterilize the bottles, nipples, rings, and caps before preparing any form of formula until the baby is 4 months of age.
  • Mix formula in a glass measuring cup for accurate measuring.
  • Use glass bottles or bottles labeled "BPA-Free" (marked with numbers 2,4,5 recycling symbol).
  • To sterilize water, bring an open pot of clean, cold water to a rolling boil for 2 minutes. Allow water to air dry and cool before mixing it with formula.
  • Cool the bottle under cold running water before feeding (to prevent scalding) and before storing in the refrigerator.
  • Check the temperature of the milk by putting a few drops on your wrist. It should feel warm or even cool; not too warm or hot.
  • If you are warming a cold bottle, hold the bottle under warm running water or place it in a bottle warmer. Mix the formula well and test the temperature of the formula before giving it to your baby. Do not warm bottles in the microwave as hot spots may occur that affect the nutrients and can burn your baby's mouth.

Powdered infant formula

  • For term infants younger than two months of age or for all infants if the powdered infant formula is not going to be used right after mixing: Boil the water for at least two minutes. Mix the formula powder with water that is at a temperature of at least 70 degrees Celcius.
  • For term infants two months or older if the powdered formula is to be used right after mixing: You can use previously boiled water that has been cooled to room temperature to prepare the formula. Previously boiled water can be stored at room temperature in a sanitized covered container for up to 24 hours or in the refrigerator for up to 48 hours.

Important storage information

  • Powdered infant formula: Open cans should be stored in a cool dry place and used within one month. Storage of powdered infant formula at refrigeration temperatures is not recommended, as it may increase the moisture content and may result in clumping and spoilage.
  • Liquid concentrate or ready-to-feed formula: Store open cans in the refrigerator and use within 48 hours.
  • Store unopened cans of infant formula in a cool dry place.
  • Refrigerate prepared bottles and use them within 24 hours.
  • Discard any formula not consumed by the infant within two hours.
  • Do not freeze formula.
  • Do not use formula after its expiry date.

How much and how often to give formula to your baby

The amount of formula a baby needs varies day to day and with each infant:

  • The baby who is gaining weight and seems satisfied after each feeding is likely getting adequate amounts of formula.
  • Babies should always be fed on demand, when they are calm but showing feeding cues. Try not to wait until your baby is overly hungry and crying.
  • Formula feeding position
  • Babies should be held in an upright position, supporting the shoulders and neck so that the neck can extend back into the natural drinking position.
  • Use a slow-flow nipple or a stage 1 nipple to start, and increase the nipple number as the baby grows.
  • Your baby will indicate readiness to accept the bottle nipple by opening his or her mouth.
  • Tip the bottle so that there is milk in the nipple.
  • Let your baby decide when he or she is full and satisfied. Do not try to encourage a baby to finish the bottle.
  • After about six months of age, and the introduction of solid foods, you will usually see the frequency of formula feedings decrease.
  • Burping is not a necessity. Air in the stomach does not cause pain, but can increase spit-ups. You should position the baby in an upright position on your lap, or over your shoulder to allow the baby to burp, but this may not happen every time.
  • Once your baby is over a week old, if they are gaining weight well, there is no need to wake your baby to feed at night, unless recommended by your baby's physician.

The following chart shows some average amounts and frequencies for feedings. They are only guidelines because of the variations in babies' weights and growth rates.

​Age ​Number of feedings/day ​Volume of formula/feed
​​0 - 1 week ​6 - 10 Day 1: 5 mL​
Day 2: 5–15 mL​
Day 3: 15–30 mL​
Day 4–7: 30–60 mL (1–2 oz)​
​1 - 2 weeks ​6 - 10 ​60 - 90 mL (2 - 3 oz)
​3 - 4 weeks ​6 - 10 ​90 - 120 mL (3 - 4 oz)
​1 - 2 months ​6 - 8 ​120 - 150 mL (4 - 5 oz)
​2 - 3 months ​5 - 6 ​150 - 210 mL (5 - 7 oz)
​3 - 4 months ​5 - 6 ​​150 - 210 mL (5 - 7 oz)
​4 - 5 months ​5 - 6 ​​150 - 210 mL (5 - 7 oz)
​5 - 6 months ​5 - 6 ​​150 - 210 mL (5 - 7 oz)
​6 - 9 months ​4 - 5 ​180 - 210 mL (6 - 7 oz)
​9 - 12 months ​3 - 4 ​180 - 240 mL (6 - 8 oz)

Preventing baby bottle tooth decay

Liquids tend to pool in the mouth when your baby is sleeping. Do not to give your baby a bottle when he or she is falling asleep. Putting your baby to bed with a bottle of milk or other sweetened liquids is unsafe and can cause tooth decay.​

Laura Coxson, RD

Joyce Touw, BScN, PHN(C), RN, IBCLC, RLC

Andrew James, MBchB, FRACP, FRCPC

Christopher Tomlinson, MBChB, PhD

Georgina MacDougall, RN​

Samantha Sullivan RN, IBCLC



Health Canada. 2014. Recommendations for the preparation and handling of powdered infant formula. Retrieved from

World Health Organization. 2007a. Safe preparation, storage and handling of powered infant formula-Guidelines. Retrieved from

World Health Organization. 2007b. How to prepare formula for bottle-feeding at home. Retrieved from