Does anyone know how to make a bottle of formula?

I've mix fed both my children (long story, read past posts if interested) and though number two is coming up to a year I still don't really know how to make a bottle of formula.

The instructions on most boxes of formulas in the UK say to boil water in a kettle and then let it cool for half an hour before using it to make up the formula. Clearly the person who came up with this has not held a screaming, hungry baby in the middle of the night, let alone tried to handle boiling water while doing so, and certainly not for half an hour. Do any parents use this method I wonder?

There's a story about Prince Charles, which he denies, about how he likes to have his boiled eggs just so, so his staff cook seven a few minutes apart when he is expected to come for breakfast so there is always one just right for him. Jeremy Paxman wrote about it in On Royalty in 2006 and Clarence House refuted it in 2012 in a Frequently Asked Questions section of their website. That's what the formula advice reminds me of - I feel like I should have several kettles always boiling so one has been cooled for half an hour at exactly the moment I need it.

During the course of feeding two babies, born two years apart, I have tried many methods. I have used cooled boiled water from the fridge, at room temperature, warmed in the microwave and warmed in a bowl of boiling water. I have used tap water and bottled water. I have pre made and rapidly cooled bottles before keeping them in the fridge and I have topped up boiling water with cool water to try to get the right balance. And I have only come to two conclusions - the first is using boiling water to do anything when exhausted and holding a baby is a bad idea, and the second is that no one seems to know how to make a bottle. Even developed countries with clean water supplies seem to disagree with each other - in Spain the advice seems to be not to bother boiling the water. And in America people seem to put their bottles through the dishwasher to sterilise them, something advised against in the UK.

Science journalist and author Linda Geddes wrote a great blog about this subject when my second baby was just weeks old. It reassured me that the advice really is unrealistic and confusing, but didn't actually help me work out how I should make a bottle in the middle of the night. That is probably because my baby was too young for me to make sense of anything at the time it was written - reading it back now I can see exactly what I should have been doing this past year, which will be handy for the next few weeks only as we're coming up to the end of the formula riddle, this time round at least, as we approach the day that cow's milk is officially allowed as our baby's main drink.

Still, just in case we ever have another, and so I can be the irritating one dispensing advice to friends having babies a few years after us, I'd love to know what other people really do at 3am when their baby is crying. Do please tell me in the comments section.


Here's a little plug for my Kickstarter crowdfunding project for a book about elections aimed at toddler. Here's the link - every pound or dollar helps, and I have until Nov 21 to get to the £2000 total. And here's my previous blog post explaining what I'm doing. 

The formula for life

Save the Children launched a report today on breastfeeding, Superfood for Babies, in their words calling the report "a global call to action to rediscover the importance of breastfeeding and to support mothers to breastfeed their babies – especially in the poorest communities in the poorest countries." Now I'm all for public health messages that ensure we're all well informed about the choices we make, but the report's recommendation that made the headlines in the UK, that there should be cigarette style health warnings on boxes of formula, made my blood boil.

Parents (that's right, parents, not just mothers, not that you'd believe it from reading the press around this that fathers are also involved in decisions about caring for their children), choose to formula feed their babies for many reasons, none of which are anyone else's business. And I just don't believe that any of those people do it because they don't want the best for their children.

What such a recommendation does is make parents feel guilty for decisions they have made when trying to do this best. That's why the breast is best slogan is wrong. Best in what way? Better than a mother so exhausted she has a breakdown? Better than infected cracked nipples? Better than slow decline into malnourishment? Better than being able to leave your baby and go out and earn a living? Sod it, who has the right to say it's even better than being able to wear an outfit with the confidence you won't leak all over it? We make decisions as individuals to suit our specific circumstances, and I just don't believe most people make decisions for anything other than the greater good of their family.

What's more, the recommendation is ridiculous. Once you have decided, or realised, that formula will be part, or whole, of your baby's diet, there is only a small window in which you can change your mind. Milk supply is difficult enough to establish in the first place, but almost impossible to re-establish. Do Save the Children really want people who stopped breastfeeding a week ago, a month ago, six months ago, to feel shit every time they give their child food?

I owe many people in the National Health Service a debt of gratitude for the care they have given me and my children. Midwives, surgeons, radiologists, fetal medicine experts, cleaners and so on. But one that sticks in my mind is the paediatrician who told me kindly when my daughter was (literally) slowly starving, that we don't actually have an obligation to breastfeed our children, but we do have an obligation to feed them. What did we do in the end? You can find the answer elsewhere on the blog. For the purposes of this post it's irrelevent. Not that you'd believe it from the headlines, or the parenting forums, but it's not us v them when it comes to breastfeeders and formula feeders. We're all parents, all muddling through, all trying our best, all hoping to keep our children safe. And fed.

Because that's the thing about formula - it feeds children safely. Contrary to popular belief, there were no halycon days in the past when all women contentedly breastfed their happy chubby babies. No, the past is littered with dead or malnourished children who may have survived had formula been on offer. Lack of milk, inability to breastfeed or circumstances that make breastfeeding difficult are not another kind of yuppy flu that only exist in modern times. They have always existed, but the outcomes were far worse than today. Cigarette style warnings Save the Children? Don't be ridiculous - bottlefeeding doesn't kill, it actually does the opposite. Sure, put large public health messages on boxes of formula, but make them accurate. 'Formula saves lives', that's what they should say.


Related post: The great unsaids - bottle feeding

The truth about breastfeeding

A lot of articles and blogs I have read about breastfeeding difficulties are either defensive or apologetic. I am going to attempt to be neither.

Both my baby and I struggled with breastfeeding. Hand problems (Carpel tunnel syndrome followed by tenosynovitis) meant I struggled to hold my baby to the breast. Post birth surgery meant my body was tired and full of drugs. My baby was a little poorly and also a little sleepy. Sucking was difficult. Even without all of this we may have found breastfeeding hard. Many mums and babies do. 

But when the paediatrician said yes, breast is best but really the key thing is to feed your baby, we had no choice. We gave her formula. This gave her the strength to learn to breastfeed. But my supply was low. The way to raise it, said the health visitors and midwives, is to feed the baby at least every three hours and express in between. As each feed could take an hour this left very little time for anything else. I gave up on it quickly. 

A health visitor told me to massage my breasts while feeding to encourage milk flow. I was already tired and emotional with low milk supply. After that I was tired and emotional with low milk supply and bruised breasts. 

The baby lost weight. Lots of weight. Then we started formula feeds as a matter of course, starting with breast and 'topping up' with formula. The baby started to put on weight. Since then in fact we have mix fed. At nearly ten months we still do. It works for us. 

Breast is best. I get that. It has huge benefits for the baby and it's convenient. When it works that is. But the adverts that say this, the ones with peachy looking breasts and rosebud nipples attached to a perfect baby looking blissed out, they do us a huge disservice, because they make it look so easy that if we struggle we think we've failed. Far better a campaign that says breast is best but boy is it hard and please persevere anyway. Have a picture of a mum with bags under her dull sleepless eyes and bulgy veins on her breasts and raised nodules on her nipples and a slogan that says 'It might be shitty but it might get better if you carry on.' Such ads might stop women feeling like failures. 

We're led to believe that breastfeeding is so natural that it's like one of those crafts we've lost in the modern age, like thatching a roof, painting frescoes and making our own soap from horses hooves. We feel that before formula existed women must surely have found it easy because they had no choice. 

Actually here's what I think happened to those women and babies for whom it wasn't easy.  Women whose babies had died acted as wet nurses for some babies. Other babies were fed cow's milk, water and other liquids and some of these got ill and others didn't. Some women had the village wise woman or an older relative sit with her day in day out helping her, tweaking the nipples into shape and helping her hold the baby, until they could do it alone. And some babies, well some got weaker and weaker and died. We're lucky to live in a time where there is an alternative. 

The more people who, head held high, say breastfeeding is difficult and you are not a failure if you struggle and you are not a failure if you stop, the better. Breastfeeding rates in the UK are low and I know the authorities are keen to increase them. But lying to us about breastfeeding and pretending it is easy and pretending it works for everyone is, I am sure of it, the wrong way to encourage people to do it.