Further advice
Further advice
Breastfeeding is the best nutritional start for infants. You can offer practical advice and tips to support parents with decisions about infant feeding. Whether it be breastfeeding, or if they want to introduce formula milk alongside breastfeeding, if they cannot or decide not to breastfeed, and alongside weaning.
There are various reasons why someone may consider introducing formula milk. Always approach conversations with these parents with empathy and without judgement.
If formula feeds are to be introduced alongside breastfeeding, this should be done gradually to lower the changes of getting uncomfortable, swollen breasts or mastitis.22
It may take babies a while to get the hang of bottle feeding. Giving the first few bottles when the baby is relaxed and happy may help; do not try when they are very hungry.22
Remind parents that powdered formula milks are not sterile products and that it needs to be prepared according to specific instructions on the pack otherwise it may make their baby ill
- Pull the safety seal and open the lid. The scoop is provided under the lid. Lift the tab, pull on the foil seal, carefully and safely remove the seal and dispose of it
- Wash hands well. Wash and sterilise all utensils according to manufacturers’ instructions
- Boil 1 litre of fresh tap water. Allow boiled water to cool for no more than 30 minutes. Measure the required amount of water (see feeding guide) into a sterilised bottle, carefully – the water is hot. Do not use artificially softened, bottled or repeatedly boiled water
- Using only the scoop provided, add the correct number of scoops of powder (see feeding guide) levelling off each scoop with the back of a clean dry knife. Store the scoop in suspension inside the can and replace lid
- Place the sterilised teat and cap on the bottle and shake well until powder is fully dissolved. Cool bottle under cold running water or in a bowl or jug of cold water until lukewarm, do not immerse the teat. Test temperature by shaking a few drops on to the inside of your wrist.
DO NOT give cows', goats' or sheeps' milk to babies under 1 year.1
*These instuctions are only relevant to SMA® PRO and SMA® Advanced range.
Other brands may require different preparation methods.
From 6 months old, babies may be able to drink milk from a sippy cup. Therefore, when introducing follow-on milks, it may not be necessary to use a bottle.
To learn about common infant feeding issues
that your customers may ask for advice on, check out this module:
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1. British Nutrition Foundation. Introducing solid foods to your baby. 2018. [Online.]
Available at: https://www.nutrition.org.uk/life-stages/baby/introducing-solid-foods-to-your-baby/
2. World Health Organisation. Breastfeeding. 2023. [Online.] Available at: https://www.who.int/health-topics/breastfeeding#tab=tab_1
3. British Dietetic Association. Omega-3 Food Fact Sheet. [Online.] Available at: https://www.bda.uk.com/resource/omega-3.html
4. Huang Z, et al. Role of Vitamin A in the immune system. J. Clin. Med. 2018; 7(9):258.
5. Scientific Opinion on the substantiation of health claims related to vitamin C and protection of DNA pursuant to Article 13(1) of Regulation (EC) No 1924/2006. EFSA Journal 2009; 7(9):1226.
6. Scientific Opinion on the substantiation of a health claim related to Vitamin D and contribution to the normal function of the immune system pursuant to Article 14 of Regulation (EC) No. 1924/2006. EFSA Journal 2015; 13(5):4906.
7. Calcium and contribution to the normal development of bones: evaluation of a health claim pursuant to Article 14 of Regulation (EC) No 1924/2006. EFSA Journal 2016; 14(10):4587.
8. Scientific Opinion on the substantiation of a health claim related to iron and contribution to normal cognitive development pursuant to Article 14 of Regulation (EC) No 1924/2006. EFSA Journal 2013; 11(7):3335.
9. Iron and contribution to the normal function of the immune system: evaluation of a health claim pursuant to Article 14 of Regulation (EC) No 1924/2006. EFSA Journal 2016; 14(7):4548.
10. Scientific Opinion on the substantiation of health claims related to zinc and function of the immune system pursuant to Article 13(1) of Regulation (EC) No 1924/2006. EFSA Journal 2009; 7(9):1229.
11. Bosheva M, et al. Infant formula with a specific blend of five human milk oligosaccharides drives the gut microbiota development and improves gut maturation markers: a randomized controlled trial. Front. Nutr. 2022; 9:920362.
12. NHS. Types of formula. 2023. [Online.]
Available at: https://www.nhs.uk/conditions/baby/breastfeeding-and-bottle-feeding/bottle-feeding/types-of-formula/
13. Commission Delegated Regulation (EU) 2016/127 of 25 September 2015 [Online.] Available at: https://www.legislation.gov.uk/eur/2016/127
14. Dommelöf M, et al. Iron requirements of infants and toddlers. J PGN. 2014; 58(1):119-129. DOI: 10.1097/MPG.0000000000000206
15. Hardwick J and Sidnell A. Infant nutrition – diet between 6 and 24 months, implications for paediatric growth, overweight and obesity.
Nutrition Bulletin. 2014; 29:354-363. DOI: 10.1111/nbu.12118.
16. Alexander DD, et al. Growth of infants consuming whey-predominant term infant formulas with a protein content of 1.8g/100kcal: a multi-center pooled analysis of individual participant data. Am J Clin Nutr 2016; 104: 1083–1092
17. Kirchberg FF, et al. Dietary protein intake affects amino acid and acylcarnitine metabolism in infants aged 6 months. J Clin Endocrinol Metab. 2015;100(1):149-58.
18. Nestle data on file, 2018: Batch analysis of amino acid composition in SMA PRO First Infant Milk, Human Milk and Aptamil First Infant Milk, 2018
19. SMA Professional. SMA® ADVANCED Product Range Data Card. 2023. [Online.] Available at: https://www.smahcp.co.uk/formula-milk/
20. Czerkies LA, et al. A pooled analysis of growth and tolerance of infants exclusively fed partially hydrolyzed whey or intact protein-based infant formulas. Int J Pediatr. 2018; 2018: 4969576.
21. SMA Professional. SMA® ADVANCED Product Range Data Card. 2023. [Online.] Available at: https://www.smahcp.co.uk/formula-milk/
22. NHS. How to combine breast and bottle feeding. 2019. [Online.]
Available at: https://www.nhs.uk/conditions/baby/breastfeeding-and-bottle-feeding/bottle-feeding/combine-breast-and-bottle/
Online sources last accessed July 2023.
We believe that breastfeeding is the ideal nutritional start for babies and we fully support the World Health Organization’s recommendation of exclusive breastfeeding for the first six months of life followed by the introduction of adequate nutritious complementary foods along with continued breastfeeding up to two years of age. We also recognise that breastfeeding is not always an option for parents. We recommend that healthcare professionals inform parents about the advantages of breastfeeding. If parents choose not to breastfeed, healthcare professionals should inform parents that such a decision can be difficult to reverse and that the introduction of partial bottle-feeding will reduce the supply of breast milk. Parents should consider the social and financial implications of the use of infant formula. As babies grow at different rates, healthcare professionals should advise on the appropriate time for a baby to begin eating complementary foods. Infant formula and complementary foods should always be prepared, used and stored as instructed on the label in order to avoid risks to a baby’s health. The product be used only on the advice of independent persons having qualifications in medicine, nutrition, pharmacy, or other professionals responsible for maternal and child care. ●SMA® PRO Follow-on Milk/SMA® ADVANCED Follow-on Milk is only suitable for babies over 6 months as part of a mixed diet. It should not be used as a substitute for breast milk during the first 6 months of life. The decision to start weaning or to use this product before 6 months, should be made only on the advice of a doctor, midwife, health visitor, public health nurse, dietitian or pharmacist, based on baby’s individual needs. ●SMA® PRO Growing Up Milk /SMA® ADVANCED Growing Up Milk is suitable for young children from 1-3 years, as part of a healthy balanced diet and it is not a breast milk substitute.