Infant Formula

Making an Informed Decision About Infant Feeding

Choosing how to feed your baby is an important and personal decision. Having access to reliable, evidence-based information can help you feel confident in the choices that are right for you and your baby. The Thunder Bay District Health Unit offers support for all families, no matter how they choose to feed their infants. If you are using infant formula, it’s important to learn how to prepare and store it safely.

Infant Formula Availability in Canada

One possible concern when using infant formula is product availability. Formula can be affected by recalls or supply chain issues, which may result in temporary shortages—especially for specialized products. For the most up-to-date information, visit Health Canada’s website at ___

Sterilizing Water and Equipment

Sterilize all formula preparation equipment, bottles, and water for babies of all ages for as long as you offer formula to your baby. There is no research that says when it is safe to stop sterilizing.

For instructions about sterilizing water and equipment view BFI Ontario’s Getting Ready to Make Formula – Tip Sheet

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Safe Formula Preparation

There are three different forms of formula:

1. Powder (mix with water)
2. Liquid concentrate (mix with water)
3. Ready-to-feed (no water needed)

Powdered formula is not sterile. Harmful bacteria can be found in powdered formula and can cause food related illness. This is rare and is less of a risk for babies that are healthy and were born full term.

If your baby was born prematurely, had a low birth weight and is under two months of age, or has a weakened immune system, your baby is more likely to get sick from drinking powdered infant formula. It is best to feed these babies liquid infant formula, such as liquid concentrate or ready-to-feed. If powdered formula must be used, it should be prepared in a specific way to lower the risk of your baby getting sick. 

Check out Health Canada's tips for preparing and handling powdered infant formula to make it as safe as possible for your baby.

Baby-Friendly Initiative Strategy Ontario (adapted with permission from York Regional Public Health)

Tip Sheets accompanying this video are available in multiple languages including English, French, Cree, Ojibway, Arabic, Spanish and more.

Note:  Always follow the preparation directions on the infant formula packaging. Using too little or too much water can lead to health problem for baby.

Automatic Formula Preparation Machines

Automatic formula preparation machines are not recommended for use in Canada. These machines pose potential safety risks, such as improper mixing, insufficient sterilization of water or the machine itself, and the potential for bacterial growth in the water or formula. 

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Warming Formula

Babies may drink formula warm or cold. Warm a bottle of formula by:

• Putting the bottle in a container of warm water or using a bottle warmer
• Warming it for no more than 15 minutes
• Shake the bottle a few times during warming
• Once the formula is warmed, shake the bottle
• Put a few drops of formula on the inside of your wrist to make sure it is not too hot. It should feel slightly warm, not hot
• Do not heat formula in the microwave as it can lead to “hot spots” and uneven heating of the product

For more information about How to Bottle Feed and Transport Formula see BFI Ontario’s Tip Sheet.

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When to Feed Your Baby

Feeding cues are the signs your baby gives to show you when they are ready to feed and when they have had enough to eat.

How often and how much to feed your baby is determined by your baby’s needs and cues.

These cues show that your baby is ready to feed:

• Baby’s eyes are open wider than usual
• Baby curls arms and legs up
• Baby turns toward a touch on the mouth, cheek, or chin
• Baby makes sucking movements
• Baby tucks hands under chin or sucks on them

Crying is a later sign of hunger. If you wait until your baby cries when they are hungry, they may be too upset and not feed well.

Feeding Cues Chart (PDF): pictures that show how your baby will tell you they are hungry.

These cues show that your baby is satisfied and full:

• Baby falls asleep and is no longer interested in feeding
• Baby turns head to side
• Baby stops sucking and lets go of the nipple
• Baby purses or pinches lips together

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How to Bottle Feed Your Baby

• Hold your baby close during feeds to make it a bonding time
• Keep your baby upright with their head supported
• Gently touch the bottle nipple to the lower lip and wait for baby to open wide
• Make sure most of the nipple is in the baby's mouth
• Keep the bottle nearly flat to help control the flow
• Never prop the bottle or let baby sleep with it—this can lead to choking, cavities, or ear infections
• Switch arms during feeds to support muscle development
• Talk, smile, and cuddle—feeding is a chance to connect
• Practice skin-to-skin frequently

Paced bottle feeding is a technique that slows down the flow of milk, allowing babies to drink at their own pace and take breaks during feeding.

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Safety and Recalls

Formula Safety Tips

• Prepare formula as instructed and store it in sterilized bottles
• Cool quickly and refrigerate at 4°C or lower
• Use within 24 hours (or as directed)
• Warm using hot water or a bottle warmer for no more than 15 minutes—never use a microwave
• Throw away the formula in the bottle:
  • When your baby is finished drinking from that bottle
  • When the bottle has been out of the fridge for two hours, including heating and feeding time
• Do not use the formula after the expiry date
• Know about Infant Formula Recalls and Safety Alerts

Recalls and Safety Alerts

Infant formula is a processed product, and although safety standards are in place, issues can sometimes occur during manufacturing or packaging. The Government of Canada regularly updates recall notices and safety alerts online.

It’s a good idea to:

• Record the lot number from each formula container so you can check it against any posted recalls
• Always inspect packaging to make sure it is sealed and undamaged before use

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