Procedures - Bottle Feeding Procedures

Section: Human Resource Procedures 
Procedure Owner: Ignition633 Ministries Nigeria Human Resources 
Procedure Name: Bottle Feeding Procedures
Origination Date: January 2025

Purpose
To ensure the safe, hygienic, and appropriate feeding of infants. These procedures aim to promote the health and well-being of infants by providing clear guidelines for preparing, storing, and administering bottles, as well as supporting proper feeding techniques and maintaining a nurturing environment during feeding times.

Scope
Includes guidelines for safe preparation, storage, and handling of milk; maintaining hygiene; proper feeding techniques; monitoring and documenting feeding schedules; addressing feeding concerns; training staff to recognize feeding cues; and ensuring compliance with health and safety regulations.

Definition
Bottle: is a container with a narrow neck, typically made of glass or plastic, used to hold and dispense liquids.
Feeding: is the process of providing food or nourishment to a person or animal to support growth, health, and energy.

Bottle Feeding Procedures
Feeding a baby with expressed breast milk via a bottle involves some specific considerations to ensure that the breast milk retains its nutritional value and that the baby feeds comfortably. Here are guidelines for proper bottle feeding with breast milk:

Preparing Expressed Breast Milk
Cleanliness:
Wash your hands thoroughly before handling breast milk or bottles. Ensure the bottles, nipples, and other feeding equipment are clean and sterilized.
Storage
Refrigerate or freeze breast milk immediately after expressing it. Follow the recommended guidelines for storage times:
- Refrigerator: Use within 4-5 days.
- Freezer: Use within six months if stored in a standard freezer or up to 12 months in a deep freezer.
Thawing
If using frozen breast milk, thaw it in the refrigerator or under warm running water. Do not use a microwave; it can create hot spots and destroy some of breast milk's beneficial properties.

Cleaning and Storage
Clean Bottles After Use
Wash bottles, nipples, and other feeding equipment thoroughly after each use with hot, soapy water. Sterilize bottles regularly, especially in the early months.
Discard Unused Breast Milk
Discard any breast milk left in the bottle after feeding. Do not save or reuse breast milk from a previous feeding.

Paced Bottle Feeding:
How to hold bottle
Hold the bottle horizontally rather than tilting it upward. This allows the baby to suck and swallow at their own pace, similar to breastfeeding.
Follow Baby's Cues
Pay attention to your baby's hunger and fullness cues. Allow them to suck and pause as needed. Avoid rapid or forceful bottle feeding.
Responsive Feeding
Mimic the natural breastfeeding rhythm. When the baby pauses or stops sucking, gently remove the bottle from their mouth to give them a chance to swallow and breathe. This also helps the baby to recognize their own fullness
Burp as Needed
Burp your baby during feeding, especially if necessary. This can help prevent discomfort and reduce air intake.
Hold Baby Upright
Keep your baby upright during and after feeding to minimize the risk of gas and reflux.
Encourage Sucking Reflex
Encourage the baby to suck actively on the bottle rather than passively receiving the milk. This helps them develop a strong sucking reflex.
Create a Calm Environment
Feed your baby in a quiet and calm environment to reduce distractions and allow them to focus on feeding.

Safe Handling of Infant Bottles in ChildCare
Label all infant bottles with the baby’s name and date
Ask parents to label bottles before bringing them. Have labels and a marker on hand in case they forget.
Store prepared bottles in the refrigerator
Frozen breast milk should be stored in the freezer until feeding and thawed in the refrigerator or under cool, running water. Do not warm bottles on gas or in a microwave.
Cover all bottles during storage.
Wash your hands carefully with soap and water before preparing any bottle.
Do not touch nipples with your fingers.
Clean reusable bottles and nipples thoroughly after each use.
Bottles and nipples may be washed in a dishwasher in very hot water or washed by hand and boiled for five minutes before refilling.

Appropriate Bottle-Feeding in ChildCare
- Feed infants whenever they seem hungry. Babies need to eat frequently, especially if they are breastfed. Expect to feed infants approximately every two to three hours.
- Meet individual infants’ needs. Feed each infant on an individual schedule, and don’t expect all babies to be hungry simultaneously. Babies grow rapidly, and hunger needs to change quickly.
- Hold babies when you are feeding them. Holding infants during feeding helps them feel safer and secure, reducing the risk of choking on breast milk or formula.
- Avoid giving bottles to infants in their cribs. If an infant falls asleep while feeding and an adult does not remove the bottle, milk may remain in the mouth during sleep. The sugar naturally found in this milk can cause cavities in new or forming teeth. Teeth with cavities may hurt or break, making it difficult for a child to chew.
- Never let infants or toddlers carry bottles. They easily can fall and injure themselves. Children who carry bottles may share sips with other children, which increases their risk of sharing infections.

Age-Appropriate Feeding Practices
Infants (0-12 months)
- Follow the infant's feeding cues and ensure they are fed on demand, whether breastfed or bottle-fed with formula.
- With consent from parents, gradually introduce single-ingredient purees or mashed foods around six months, starting with iron-rich options like iron-fortified cereal. Communicate any new developments to parents.
- Pay attention to hunger and fullness cues, allowing infants to eat according to their needs rather than encouraging them to finish bottles or jars.
- Ensure infants are held securely during feedings and that bottles are propped up to prevent choking.
- Refrain from offering honey or foods that pose choking hazards, such as whole grapes or nuts.

Toddlers (1-3 years)
- Offer a variety of foods from all food groups, including fruits, vegetables, grains, protein, and dairy.
- Gradually transition from purees to chopped, mashed, or soft finger foods to encourage self-feeding and oral motor development.
- Supervise meals closely to ensure toddlers eat safely and encourage them to sit while eating to reduce choking risks.
- Offer nutritious snacks and meals, limiting sugary and processed snacks to promote healthy eating habits.
- Allow toddlers to use utensils and try feeding themselves, offering support and assistance.
Typically, a one-year-old child is learning to eat independently, although they will still be breastfed until they are 2; they can chew food as well as you can, so they can eat the same foods as other adults.

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This procedure will be reviewed annually and is subject to change. Any changes will be communicated to all employees promptly. 

For any questions or further assistance regarding this policy, employees should contact the HR department at hr.nigeria@ignition633.org.