Mixing infant formula can become so routine, it’s easy to lose sight of what a baby bottle contains.
But that formula, designed to meet an infant’s nutritional needs, should never be taken lightly, say pediatric experts with Spectrum Health Helen DeVos Children’s Hospital.
“You have to be precise in mixing the formula,” says Lana Gagin, MD, the medical director of the hospital’s Well Baby Unit. “If you mix formula incorrectly―if you water it down or make it too concentrated―it disturbs the electrolyte balance, which may lead to serious neurological consequences.”
The wrong balance of formula and water can cause nutritional deficiencies or dehydration. In the most severe cases, it can lead to a stroke, seizure, coma or even death for an infant.
Ask questions. Don’t be afraid to speak up about anything when it comes to your baby.
Getting nutrition right, day in and day out, is crucial for rapidly growing babies, says Daniel Fain, MD, a pediatric neurologist.
“Babies’ nervous systems are developing at an astounding rate,” he says. “If they are iron-deficient, or deficient in trace minerals, or especially deficient in protein or fats, that’s going to lead to nutritional problems.”
In the first two years of life, for example, a child develops most of the myelination of the neurons in the brain.
Myelin, a fatty coating on the axon of each neuron, “is crucial for proper information transmission and storage in the brain,” Dr. Fain says. “It’s important for memory, for fast reactions, for processing information and acting on it in the environment. It’s just vital.”
Follow directions
The use of infant formula affects families across the country. Although 79 percent of newborns in the U.S. breastfeed, only 49 percent still breastfeed at 6 months, according to the Centers for Disease Control and Prevention.
Pediatricians do not advise giving cow’s milk to children until they are at least 1 year old. So, a lot of babies rely on infant formula for their nutritional needs.
“Unfortunately, mistakes happen―not very often, but they do happen,” Dr. Gagin says.
First-time parents, overwhelmed with advice, education and the demands of caring for a newborn, are especially vulnerable, she says. She encourages parents to reach out to their doctors for additional support or to alert them if they suspect any problems.
Dr. Gagin offers the following tips in preparing formula:
- Be sure to check the directions on the can. Most have the same powder-water ratio―one scoop to 2 ounces―but parents should make sure they know the correct mix.
- Use the scoop that comes with the can. Other scoops might be slightly different.
- When measuring the powder, scoop it up and use a clean knife to scrape away excess powder. Don’t pack the formula into the scoop.
- Add the powder to the water and mix well.
- Never water down formula.
- If you have any questions about how to mix formula, ask your child’s pediatrician or primary care provider.
Standard infant formula delivers 20 calories per ounce.
“That is close to the calorie load in breast milk,” Dr. Gagin says. “This is what a healthy term baby needs.”
In some cases, with babies who are premature or have special needs, a pediatrician might recommend a slightly different mix of formula―one that would deliver 22 or 24 calories per ounce.
Parents with any questions or concerns should not hesitate to go over the directions carefully with their physician, she says.
Early signs of problems
The physicians also advised parents to be alert to signs of nutritional problems in their babies.
“If a child has a nutritional issue or is dehydrated, they are going to be lethargic, typically,” Dr. Fain says. “Excessive sleeping, inactivity, regression of development―those would be the big concerns.”
If a baby’s fontanelle―the soft spot on the skull―looks sunken, that also can be a sign of problems.
Often, a decrease in wet diapers can be a first sign of dehydration.
If parents struggle to afford infant formula, Dr. Fain encourages them to seek help. WIC, the federal Special Supplemental Nutrition Program for Women, Infants and Children, may provide assistance.
Dr. Gagin also urges parents to get medical advice if they see signs of problems―or even if a caregiver accidentally mixed the formula wrong.
“Parents need to be proactive,” she says, urging caregivers to call their pediatrician or specialist any time, day or night, if there is a concern. “We would much rather hear from our patients if they are ever in doubt.”
“I want parents to know they are not alone,” Dr. Fain adds. “There is help. If they are struggling to provide nutrition or if they have questions, they can reach out to their providers.
“Ask questions. Don’t be afraid to speak up about anything when it comes to your baby.”
I have wrongly given formula milk to my newborn infant as one scoop per ounce for 16 days…what is the side effect of it…
She is diagnosed with klebeiselle pneumonia bacteria and is undergoing antibiotic treatment..of .piperacieline injections 3 times a day…plz help I am worried…she is not taking enough milk now and is vomiting…is it because of wrong concentration…
I’m sorry to hear you baby is sick.
I checked with Dr. Gagin about your question. She advises you to check with your pediatrician right away. Mixing formula incorrectly can lead to serious electrolyte disturbance, which in turn can cause serious health issues, including neurologic damage.
She says a doctor will do a physical exam and determine if your baby needs to have labs done or another intervention.
She adds: Always follow the manufacturer instructions on the can when mixing formula.
Hello I’ve been feeding my baby 4 onz of water and scoop of formula can that affect him
Hi Skylene, We recommend you talk about your baby boy’s nutritional needs with your pediatrician. He/She will have the best suggestions to offer you.
I measure the formula and water exactly. 7 oz of water then add 3.5 scoops of formula. The final outcome comes out to a bottle that has more then a 7 oz bottle. Is this normal. By husband thinks you should put formula in first then fill the water to make an exact 7 oz bottle. Pleas help clarify who is right?
The institutions on the can say water first the. Powder. Because then you are taking out volume out of the 7 oz.
Hi in my feeding bottle 3 oz and 90 ml are marked at different levels.what to do.Iam always taking water at 3 oz level ,not at 90 ml.pls help
I use formula to mix with breakfast rice cereal. I was using 4 scoops for 120ml water instead of the correct measurement 2 scoops for 120ml. Baby was 7 months when started and stopped at 9 months when I realised. She takes breastmilk and not formula for drinking. Few sips of water with meals. Please advise. Thanks.
Hi Sharon – Please discuss your baby’s nutritional needs with your pediatrician as He/She will be able to give you the best advice. Best wishes to you and your little bundle! 🙂
I accodentally added pit 6 instead of 3 scoops to my 1 month old bahy. 🙁 what will happen?
Hi Mica – If you are ever in question about something your baby/child has consumed, please do call the poison control hotline at 800.222.1222. Also, if this is well after the fact, please check with your child’s pediatrician about formula needs for your baby. Best wishes to you both.
I did the same. What action did you take?
If I’m using powder formula for my 4 week old, but he’s not yet taking 4 oz – he takes 3 oz (which mathematically would work out to 2 oz = 1 scoop, 1oz = 1/2 scoop, therefore 3oz that I mix is done with 1.5 scoops). What do you suggest for parents who are neither using 2oz or 4 oz? Do I prepare 4oz and only feed baby 3 oz and dump the remaining oz?
Hi Stephanie – Please do connect with your baby’s health care provider to make sure he’s getting the best nutrition that’s right for him. Best wishes to you both. 🙂
If your baby is taking 3 oz, mix 6 then divide into two bottles and place one in the fridge for up to 24 hours
Hi there
I have an 8 day old baby boy who also drinks 3oz and I mix his formula with 1.5 scoops. that is correct ratio. I are doing good don’t worry! ☺️
I have wrongly given formula milk as 2 scoops and 2 once to my 2and half year boy for about 1 and half month any side effects for that ….
Hi Tin, We’re so glad you’ve discovered this. It’s easy to mistakenly give the wrong formula. Please discuss this with your child’s pediatrician. They should be aware and be able to give you the best answers to your questions. Best wishes to you both.
I have wrongly given formula milk as 1 scoop per oz to my baby instead of 1scoop into 2oz bottle. My baby started when he is only 3day old😟 any side effects for that ? I feel bad , im worry for my baby he’s turning 2months old this september 8😞
Hi Judy – Formula can be tricky. We suggest discussing the concentration of formula with your baby’s pediatrician. (S)he will be able to help. Best wishes to you both.
Hi just looking for an update on your issue, I did the same thing to my newborn for 6 days, she has really bad constipation. Was everything fine with your son??
i just mistakenly put 3 ounce water and 6 scoops of formula.. but the baby didn’t finish her milk.. i am very worried.. what might happen to her? she just had 1 ounce of milk..
Hi Pam, If you’re ever concerned, please contact the Poison Control Helpline – 800.222.1222.
So my baby was born June 4th original due date was June 24th. So she is technically 2.6 months old well she is on soy and they wanted her started on a higher calorie so they have me doing 5oz water and 3 scoops of formula. And it seems like my daughter’s soft spot is a little sunken in. Also they have me useing gelmix to thicken her formula since she spit up a lot. And zantac for gerd
Hi, so my fiancé mistakenly put 1scoop in a 4oz bottle vs the correct way 2 scoops to a 4oz bottle. Should I be worried?
Can putting too much formula in a set amount of water cause some constipation? For example 1.5 scoop for the 2 ounces recommended for only 1 scoop. Got my scoops mixed up and im wondering if it may of caused the tummy issues we are having right now. Thanks for the info
Hi Lina, Inaccurate mixing may cause issues for your baby. Please discuss your concerns and baby’s symptoms with your pediatrician. Best, Cheryl
Hi . I bought the wrong formula without knowing until about 3 days later . I got the 12 month instead of the new born . My daughter is only a month old
Hi Christine, This can easily happen. So glad you caught the mistake. Best wishes to you and your little one.
Hi I’m just wondering if someone could help me,, I’ve been giving my baby formula since she was born but all of a sudden it’s like the powder isn’t mixing properly and it’s getting stuck in the teat of the bottle and around the neck of the bottle,, I clean and sterilise them to perfection but it’s still happening,, she takes 6 ounces so 6 scoops to 6 ounces of water, I’ve tried so many things to try and stop it from happening but so far haven’t managed to figure it out, and because it’s not mixing properly she can’t be getting the full 6 ounces of milk! Has anyone ever had a similar problem?
Hi Jessica – We’d suggest inquiring with your pediatrician about any concerns related to your baby’s nutrition. They will be able to provide the best guidance. Best wishes to you and your little one. 🙂
Are you sure about the 6 scoops for 6 ounces math for your formula? Usually it’s 1 scoop for 2 ounces. That means 3 scoops for 6 ounces. Please check the formula container for the right ratio and consult your pediatrician. Best wishes to you and your little one.
Ive mixed formula with some little bit amount of water more than required for my infant anything happens due to this
Ni Nikitha! If you’re ever in doubt, please do discuss your child’s nutritional intake with your physician. While diluting the formula with more water than required isn’t as dangerous as having the formula too highly concentrated, you’ll still want to make sure your infant is getting enough nutrition. Best wishes to you both!
Hi my baby is about 6 weeks old, she was born 6lb and has only gain 12oz more so far. So our pediatrician has suggested to increase the calories from 22 to 24. I am struggling with correct amount of ration of water and power to make 2 oz and 3 oz for 24 calories. my baby takes 2 oz sometime and 3 oz sometime. Can anyone suggest
The best suggestion is to call your pediatrician’s office, share which type of formula you’re using, and ask them for their assistance. They’ll be able to help. Best wishes to you and your little one as she continues to grow and thrive. 🙂
My baby’s formula it just started to get separated . I though it was because of the hot water but no. I just made him one it was a room temp water and the same thing happened. The milk is not expired . I don’t know what to do
Hello i have been used the formula milk for my baby as she is 2 month 20 days old, making it inappropriate manner like 90ml with 2.5 scoop powder, her weight is not up to mark in one month 400 grm increased only, now i m Making it properly manner, will she gain a good weight in next month? Please tell me..
Hi Zeba, We recommend you talk with your local clinic, nurse or doctor, about your baby’s growth and the proper formula mix. If you’re mixing the formula according to the formula instructions for her age and weight, and giving it to her in the timing suggested, and you’re not seeing the growth you’d expect, please do seek additional help from your medical experts who can examine your daughter and provide personalized guidance. Best wishes to you both.
I just realized that for the past day I’ve been giving my 2 month old 3 scoops of powder milk with 6 ounces of water. She has become very fussy and had a lot of gas. Is there anything I could do to give her relief? Do I need to seek medical attention for her?
Hi Claudia – Please do inquire with your pediatrician’s office. They’ll be able to provide the best advice for you. 🙂
my daughter is 8 months old and is currently taking a prescribed laxative to help. It appeared to be working until after she stayed with my in laws on 3 occassions. She normally takes 8 scoops in 240 ml water, but I found out my in laws had been halving her formula to 4 scoops and estimated half the water as they thought it was wasteful she wasnt finishing the bottle from time to time. Is it quite possible that doing this is what caused her to be constipated again during what appeared to be a promising treatment?
My baby weighed 8lbs 11oz when he was born so he was born bigger. He always like eating. He is 6 months now so I make his bottles completely different. I put 4 ounces of water in his bottle then 2 scoops of formula then I put 4 scoops of baby cereal (to thicken it up) and I had a jar of baby food. It all adds up to 8 ounces in his bottle and he eats every last drop. He holds the bottle himself in his high chair. Am I making his bottle right? I spoon feed it to him for lunch and between lunch and dinner. But breakfast and dinner I put in a bottle. Is this okay?
Hi Alexis, Thank you for your question. We recommend you check with his pediatrician regarding his dietary needs and nutritional intake. She/he will be able to provide you with the best advice regarding your baby’s individual needs. Best wishes to you both.
I have a 1week old and mixed 1.5 scoops of formula to 2 1/2 oz. Of water….. Is that ok?
Hi Silvana and Valerie. We recommend you speak with your baby’s pediatrician about your formula mixing questions. He/She will be able to provide the best advice based on your child’s needs. Best wishes to you both.
My baby’s fathers accidentally added an extra scoop to the baby’s bottle when getting it ready. So it was two scoops for 2 oz of water. So I be worried? He is a week old. So I worried? Bc I’m worried, even tho it’s my natures.
I add 5 spoon in 50ml by mistake. It’s will cause to baby health?
Hello,
I wasn’t aware of the incorrect formula mix.
My child is 6 months old and started solid food. Since, he doesn’t like bottle feed formula , these days I used to mix formula with solid foods like banana purée+formula powder 2 scoop, arrowroot biscuit+formula powder+enough water to dissolve the biscuits.
Is it okay to Mix as per above ratio or it should be exactly 2 scoop +water consistency even with solid foods?
Please advice.
Thanks.
I accidentally put twice the amount of the formula vs water to my 9month old baby boy ☹️and i am very much worried on the side effect that might happen.. pls enlighten me ..pls advice me on what will i do thank u
3 months old drink unshaken formula milk and finished it. What will happen?
I give 7 ounces and 3.5 scoop of formula. But my formula suggests to give 7 in 7. Can i still stick with 7:3.5???
Hello Bees, We suggest you follow the formula instructions unless your pediatrician or dietitian expert specifically recommended a different formulation.
My name is charity. My doughter is very low in taking formula,now i have a problem because it shouldn’t be last more that an hour I’m giving her Simalac total comfort what must I done then to save milk
Hi, I have a 10months old daughter and I usually mixed her formula for 3scoop to 180ml but day before last night I accidentally add 2 and half scoop for 180ml and eversince she’s been loosing weight and having yellowish diarrhea. It’s been almost two days now and I’m getting worried. She also hasn’t been eating well too and refused the milk.
Hi Daniella, It may be wise to call your little one’s health care provider as she may be ill, unrelated to the formula mixture. Best wishes to you and yours.
I accidentally put two scoops in 6oz of water. Would I see the effects immediately?
Can I fix the problem if the baby already consumed the formula ?
Hi. My son is 1.4 years. He has been having severe constipation ever since his formula milk brand increased the DHA frm 40% to 60%. With the 40%,he was constipated too but this time it seems just too bad and he is constantly constipated. The company nutritionist suggests to use 1 scoop to 4 oz of water instead of the recommended which is 1 scoop to 2 oz. Please let me know if it is alright or might lead to health issues in future. Thank you in advance
Hi! My son when he was newborn drunk 2scoops in 2 ounces water and already consumed 1 pack of the formula when we discovered that it was concentrated. Will it cause harm to my child even we discovered it early? We also stopped giving him formula milk when he was 2 weeks old and start to feed him with pure breastmilk. Thank you
Hi there I have been giving my premiture baby 6mils and 2 scoops and he has been sleeping all the time and very difficult to keep awake during feedings is there anything I can do at home to help I have talked to his doctor and they told me to take him to the emergency room but I have no way of getting him there
Hi Kristen, if you don’t have transportation, I’d urge you to find a neighbor or friend who could drive you and your son to the emergency room, as your doctor suggested. Or call 911 for an ambulance for transportation. Wishing you and your little one the very best.
Hello! I read all the comments here snd very sd to see to all of them have been responded to and hope mine is too. My niece is 90 days old and we have been giving her formula ffrom day one. Some times ky mixes really well and there isn’t any powder sticking to the sides of the bottle. But mostly their is some residue even after the correct amount of water and formula have been mixed. How do I prevent it? How do I mix correctly? Does it have any side effects? Please help me.. Please. Thanks and regards.
Hi
Could you please advise on formula feeds for 1 year old? Package suggest I should give two bottles of 150ml milk a day. Is it alright to give more than that?? My little one is demanding his milk way more than recommended. He’s eating lots of solid foods as well, drinks water too. Many times he gives preference to milk instead of water. Thank you
Why do people ask for advice here every answer is the same . Ask your doctor ask for profesional help. To be honest don’t waste your time asking under an articles comment section when clearly the answer will be to contact your doctor
Hi I just fed my 2 month old a 2 oz bottle of formula and accidentally put 1 and a half scoops of formula in it this is the first and only time this happened should I be worried
Hello, my wife has been giving the kids (1 & 2) formula to eat. Not in a bottle mixed with water, just the powder by itself with a spoon. Should I be concerned?
Yes you should be concerned. That is a choking hazard and not safe at all. The formula does have vitamins in it. That’s why the directions tell exactly how much to mix. You can overdose your child off iron which is in most formulas. Please do not allow your children to ingest any formula powder form. It can cause seizures, stroke, choking or even death. Hope your spouse stops giving this to your children immediately.
What all all the problems long term effects that can happen years later after a 4 week could be even earlier up to 4 months old That the mother took the baby off of formula and gave him coconut water from a coconut? She had him every 48 hours and I had him the other 48 hours. I knew something was wrong but I didn’t know what! When he was 2 months old as soon as he came to my home I told my son that something bad was wrong with him. That the baby needed to go to the ER. He was admitted in the ER. His levels was all over the place. She said that she wasn’t going to stop give him it. Thank God he was getting it every 48 hours. He is now 5 years old and is having serious mental health issues learning disability possibly Asperger syndrome. I haven’t been able to get him diagnosed yet as I am the grandmother that has raised him since birth more than the mother. I need to know what all damaged he may have.
Hi i did wrong but only once i give 1scoop in 1ounce i forgot that 1ounce is just half of scoop and my baby already drink it.. is it dangerous already? Only once i did mistake 🙁 i did not mean it.. then i remember that 2ounce for 1scoop so i give him water half of 1 ounce is it ok? Hope you answer me please 🙁 im really worried if its already dangerous to my baby? If he will get sick already?
My baby is 3months and 22 days now..
Hi i did wrong but only once i give 1scoop in 1ounce i forgot that 1ounce is just half of scoop and my baby already drink it.. is it dangerous already? Only once i did mistake 🙁 i did not mean it.. then i remember that 2ounce for 1scoop so i give him water half of 1 ounce is it ok? Hope you answer me please 🙁 im really worried if its already dangerous to my baby? If he will get sick already?
I HAVE CHOOSE ENFAMIL STAGE 2 FOR MY BABY OF 7 MONTH ,LATER I USE STAGE 1, BUT NOW ,WHEN I MIX STAGE 2 IN WATER AS PER PROCESS OF MAKING . ITS NOT COMPLETELY MIX IN WATER ,ITS SHOWS SOME PARTICALS THAT NOT COMPLETELY MIX,
IS THIS STAGE 2 NOT MIX PROPERLY MIX ,PLEASE GUIDE,PRODUCT EVEN NOT HAS EXPIRED AND MILK BOX IS OPEN BEFORE 5 DAYS ONLY
My friend is putting in formula before water to feed her baby. Baby is overweight. I’ve tried to tell her that you’re always supposed to put in water first but she just gets real defensive and tells me you don’t have to. What do I do?
Hey I’m really worried as we have a 26 day old baby and as I’m trying to breast feed we have been having to supplement…now the worry i have is that we have been using a Baby Breeza Pro …formula mixing machine and wasn’t aware until today that you can change the dial inside the machine for different formulas….and ours WAS set at a #3 and was supposed to be set at a #4 …. our son seems fine but I’m really worried that his bottles where being diluted or mixed improperly for the past 26days …what do I do ???
Hi Debra – We suggest you discuss supplemental needs with your baby’s pediatrician’s office or your OB/GYN’s office. They’ll alleviate your concerns and make sure your little guy has a healthy mix moving forward.
Hi. My spouse accidentally added an extra half scoop for feeding twice last night and I caught the mistake when I woke up. Should I be concerned if it only happened once or twice and not constantly.
Hi Chris – Glad you caught it early. For peace of mind, we suggest you inquire with your pediatrician’s office.
My pediatrician recommended that I mix formula powder with breast milk as a base to help my 5 month old gain weight. He has only been breast fead up to 10 days ago. I have given 3 bottles of two ounces of breast milk every day now. I’m wondering if this is normal or I need a new pediatrician. I’m freaking out reading all of this stuff…
Can I use the same scoop for both formulas if the ounces to scoops ratio is the same in both formulas?
Hi Brittany,
Thank you for your question. We recommend you reach out to your child’s pediatrician for any questions about formula and mixing. They’ll be the best source to help you.
Best,
Shawn
What will happen if the baby intake wrong formula milk? My mother accidentally adult milk to my baby, it measures 4 onces.. what are the possible side effect of it.. I’m so worried.
My daughter is 3 1/2 months. For awhile now I haven’t been scraping the extra formula from the scoop and I tap it on the side of the can to make sure there’s no air pockets. I’m worried I’ve been giving her too much formula for a long period of time. For the past week now she hasn’t been herself. She’s been sleepy, not very playful, and not eating how she usually does. She could be teething and hopefully that’s all it is but now I’m worried it could be something else!
hey
my baby is 5 months and I was asked to cut down his forumla to 4 scoops to a bottle of 125ml instead of 5 scoops reasons his overweight, Its been 10 days and I feel he dropped quite abit of weight can this be an issue? what do I do
Hi Priyanka, Thank you for reading and for your question! We would recommend reaching out to your child’s pediatrician for the best possible guidance on this.
Hello.
By mistake I gave my 3 months old baby Stage 2 instead of Stage 1 Kendamil just for 3 days. Will it affect my baby?
Hi there,
Thank you for the question. We would recommend reaching out to your child’s pediatrician for guidance on this.
Wishing you the best,
Shawn
I am giving formula powder in wrong ratio to my baby from 1 month. Will it cause any problem to my baby in future. Till now he is fine alhamdulillah
Nargis,
Did you get any kind of response to your question? I was just reading thru all of the above entries, and it looks as tho as I got closer to the end, more and more don’t seem to have responses. And that prior to you’re me entry, the latest entry is dated Dec. 12, 2022. Idk if someone forgot to close the feed for comments, or if the person in charge just had gotten used to receiving no further questions for so long between yours and the most recent one before yours so hasn’t realized there’s a new entry. I’m hoping everything is now fine with you and your baby, but I would say that if you you haven’t ran the situation you’ve had going on with your baby’s pediatrician, that you do so, even if you’re now sure you’re mixing formula correctly as he/she may see a need for certain testing or medication to minimize or correct any negative affect the incorrect mixing may have caused.