While it may be your plan to care for only pregnant dogs and their puppies and don’t plan on having to bottle feed or tube feed, please don’t skip this section.  The truth is that at some point you’ll have a litter of puppies that, even with a mother, may need some help.  Sometimes moms don’t have enough milk initially.  Or you have a large litter and maybe a smaller weaker puppy that can’t fight their way to the front of the line and get a nipple as often as others.  Supplemental feedings may be necessary.  And while the information that follows around bottle babies is lengthy and detailed, it may prove useful to you in the future.

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FEEDING Bottle Babies – BIRTH TO 3 WEEKS

A reminder again that you are never to feed a cold puppy.  Most puppies that are too cold are not going to suck but if you’re tube feeding, they won’t have a choice as to whether to consume milk or not.  No puppy with a temperature below 93.2 should be fed. 

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Normal Neonatal Temperatures

Wk 1:         95 – 99 F

Wk 2 & 3:  97 – 100 F

Wk 4 -        99 - 101 F

 

How often to feed?

Puppies naturally eat small, frequent meals. Bottle babies will require round-the-clock feedings.  Of course that includes through the night.  As a rule, puppies should be fed on the following schedule.

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Week 1:  Every 2 to 3 hours

Week 2:  Every 3 to 4 hours

Week 3:  Every 4 to 6 hours

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However, like all things puppy, there may be some variations to your feeding schedule.

• Small or weak puppies may need more frequent feedings than larger, healthier puppies

• I find some formulas to be richer and more filling than others.  When I made homemade formula, (Myra Savant’s formula recipe found in Appendix 2) that formula was richer than canned or powdered on the market.  As such, puppies on that formula did not want to eat as often.

• If a puppy over eats at one meal, they may not be hungry at the next scheduled one.  Or may not eat as much as normal.​

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What to feed?

Formula options that I would recommend include:

• Dogzymes PuppyBac – Amazon (my preference)

• Breeders Edge Foster Care - Amazon

• Esbilac – Pet stores, Tractor Supply, PetSmart

• PetLac – Walmart, Tractor Supply, PetSmart

• PetAg Milk Replacer – Walmart

• Goatmilk – in an emergency and short term only

• Homemade – Myra Savant Harris recipe in Appendix B

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Carefully follow the directions for mixing and storing formula that are provided on the label of each.   Unused formula once open, mixed or made should be kept refrigerated and discarded after 24 hours.

At 3 to 4 weeks old, you can usually begin to introduce them to formula at room temperature in a bowl.  You may also try mixing formula with a quality canned puppy food blended into a smooth gruel.

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Feeding Tool Options

• Bottle

  • Animal baby bottle – Pet stores, Tractor Supply, Walmart

  • Human baby bottle – Walmart, online, baby stores

• Tube

• Syringe

• Miracle Nipple on a syringe or bottle - online

• Eye dropper

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Baby Bottle - My preference is a human baby bottle rather than a pet baby bottle because I don’t feel that the shape or feeling of the nipples provided with the pet bottles resemble in any way a mother dog’s nipples.  I find that most puppies tend to latch more readily to a human bottle with a soft silicone nipple.  My current favorite is a Comotomo with a SLOW FLOWING nipple.  But I’ve used many others and you’ll develop your own preference too over time and trial.

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Small Animal Nurser Bottle – These bottles are readily available and can be useful for tiny breed puppies. 

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Figure 15: Comotomo baby bottle                                            Figure 16: Small Animal Nurser Bottle

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Syringe – you may use a syringe to drop feed a newborn puppy in an emergency but keep in mind puppies need to suck and dropping even one drop into their mouths when not sucking could result in aspiration.

 

Syringe w/ a Miracle Nipple –  If you’re having trouble getting a puppy to latch you might try a syringe with a miracle nipple attached (you’ll have to order these online) is a much better option than just a syringe.  It does allow for some sucking and also for you to assist by SLOWLY pushing the syringe plunger to move milk into the baby’s mouth while they suck.

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Eye dropper – Only in a dire emergency when you have nothing else.  Difficult to control the flow or amount dispensed.

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Tube feeding – Tube feeding is the preference when either have many puppies to feed or having puppies that are neither strong enough or inclined to eat.  Premature puppies should only be tube fed. 

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Tube feeding scares many people but truthfully, tube feeding is safer than any of the other options in terms of avoidance in aspiration.  It also allows you to feed a puppy quickly and you can easily control the amount consumed.  Tubes normally must be ordered online from vet supply stores and Amazon, and come in different sizes for different sized puppies.  Don’t rely on your vet in an emergency as most don’t have them in stock in my area.  

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Premature puppies should always be tube fed as they do not have a suck/swallow reflex and aspiration is very likely with any bottle or device other than tubing.

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This is an excellent video on tube feeding. https://youtu.be/Z2sdSSmbDCw

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How do I feed them?

Detailed instructions are provided for bottle and tube feeding only. 

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Bottle Feeding

 

Prepping the Bottle -  Keep in mind that the size of the hole in the nipple is very important.  Baby bottle nipples already have a hole in them, and I only use slow flow nipples.  When filled and turned upside down, the nipple should release a drop of formula one at a time very slowly and often will not release even a drop without a little pressure put on the bottle.  Anything faster, is too fast.

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If you use an animal bottle, you’ll need to poke a hole by heating up a needle and inserting it into the nipple.  You know that you have made the nipple opening just big enough if, when the bottle is held upside-down, the formula drips slowly from it. Too small an opening will make the puppies work too hard to get their formula, tiring them out before they’ve had enough to eat. Too large an opening will force too much formula into them, too quickly.  This can cause a puppy to aspirate.   

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The bottle should require a light squeeze (simulating a puppy suckling) for milk to drip out.

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Formula Prep - The formula should be fed at a temperature similar to the puppy’s body temperature. The best way to warm the formula is by placing the bottle in a hot water bath or using a baby bottle warmer.  If mixing formula from a powder, you may use warm water to make the formula.  Microwaving of formula is not recommended but can be done in an emergency.

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Test the formula temperature by squirting a few drops onto the inside of your wrist; it should feel warm but never hot.   A puppy will tell you quickly if the formula is too cool or too hot by refusing to suckle.

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Positioning the puppy for feeding - People (and puppies) may have different preferred feeding positions. Some people feed on a table or countertop while others feed on their laps.  Puppies should be fed in a position that mimics how they would naturally be nursing from mom; all four feet pointed towards the ground and their heads level or tilted slightly upward to the bottle.  However, some puppies may prefer to nurse pushing up from their hind legs and their front feet up towards the bottle.  

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Regardless, puppies should be kept in a mostly horizontal position with feet towards the ground.  NEVER feed a puppy on its back like a human baby— this is dangerous!

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Some puppies will need little assistance other than you holding the bottle for them while others may need help getting started.  They may need support for their head and encouragement with the bottle to get going. Holding the bottle in your right hand and the puppy in your left on a flat surface, clasp the puppy’s head in the palm of your left hand with your forefinger on one side of the mouth and the thumb on the other. 

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You may apply a little pressure with those two fingers to open the puppy's mouth and place the tip of the nipple on their tongue. If they don’t begin suckling, try petting them down the back; this replicates a mother dog grooming and can be an effective stimulant. Pull lightly on the bottle to encourage vigorous sucking or try moving the nipple back and forth on the puppy's tongue to get them started. 

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Always hold the bottle at a 45 degree angle.  This keeps formula moving down their throats.  Holding the bottle at too low of an angle makes it easier for the puppy to aspirate formula into their lungs.  Go slowly and allow them to suck and swallow regularly.  If they cough, gasp or choke immediately stop feeding, and burp them to clear their lungs. 

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NOTE: If you have a puppy that is interested in eating but does not seem to have a strong latch you can place your forefinger and thumb on either side of the puppy’s open mouth and press in lightly when the nipple is inserted.  Applying a soft pressure to increase the suction around both sides of the mouth can help the puppy create a better latch.

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Burp after feeding by thumping softly on the babies back as you hold them in an upright position.  You can also encourage a burp by holding their back legs and rearend in the palm of your hand and while holding the puppy upright, wiggle the puppies butt back and forth to loosen the stomach and create space for air to move upward and out of the lungs.

 

Tube feeding

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Supplies: 

• Feeding tube

• Syringe (3 to 10 ml)

• Sharpie

• Formula

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Prepping the tube

You’ll first need to measure and mark the tube for the size puppy you’re feeding.  To make certain you have the tube in the stomach, having a visible mark on the actual tube is essential.  But keep in mind if you are feeding puppies for very long, a week or more, you’ll need to remeasure the tube and adjust the mark as the puppy grows.   

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To mark the tube, lay the puppy on their side and lay the end of the tube along the puppy’s abdomen down to the last rib as shown below.  That is where the stomach will be.

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Lay the tube along the puppy’s body, up the neck and to the mouth.   With your right hand, hold the spot on the tube where it meets the mouth, mark there either with a Sharpie or a piece of tape. (Medical or surgical tape works best.)

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This marking is the first key to ensuring you have the tube is the stomach and not in the lungs.  Since the lungs are nearer to the front legs (almost directly behind the puppy’s elbow), if you insert the tube into the puppy and it stops before the mark on the tube reaches the mouth, you very likely have the tube in the lungs.    

 

An additional sign of having the tube in the proper location is that if the puppy can cry or squeal you are in the right place.  You can pinch the puppy’s paw or ear to test for a cry after you’ve inserted the tube. 

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NOTE: Weak puppies may not be able to react to the cry tests.  Thus, the tube marking is key. 

 

Prepping the formula and syringe

Warm formula using a bottle warmer, warm water bath, or mixing dry formula with warm water.  Test the temperatures of the formula by shaking a few drops onto the inside of your wrist.  It should feel warm, not hot.  Close to your body temperature of 98° F.  

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Draw up the required volume of formula based on the weight of your puppy directly into the syringe.

  

Check for air in the syringe by holding it upright (plunger at the bottom, tip towards the sky) and remove any air by pushing the plunger until all air is gone.  Now the syringe can be connected to the feeding tube and the plunger pressed until a small drop of feed comes out of the end of the tube.

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Puppy Position and Feeding

• The puppy should be positioned horizontally either on a flat surface or your lap.  I prefer to use a kitchen counter type height surface and place the puppy on a non-slippery surface by adding a potty pad, towel or blanket under the puppy’s body. 

• Similar to bottle feeding, you’ll use your thumb and forefinger of one hand at the corners of the mouth to gently press to make the puppy open its mouth. 

• Then with the other hand begin inserting the tube tip into the puppy’s mouth.  You may need to use the forefinger holding the puppy’s mouth to help expand the jaw a little to allow you to more easily move the tube into their mouth.

• Try not to extend or bend the puppy’s neck.  But rather keeping it in a natural position as the tube tip is gently inserted into the mouth. If the puppy's neck is extended or flexed, it is much harder to place the tube correctly into the esophagus.

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• The tube should glide easily from the mouth and down into the throat and esophagus.  You may lightly wiggle the tube as you gently push it down until you reach either the mark or tape at the puppy's lips.  Upon reaching the mark, you know you’re in the correct place.

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NOTE:  If you’re gliding the tube along the tongue, it’s more likely to go into the trachea. Attempting to place the tube with the neck flexed will also make tracheal entry more likely.

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• Once the tube is all the way down into the stomach and the marker is at the lips, you can now slide your forefinger and middle finger around the tube at the mark near the mouth to keep it securely in place.  The puppy may be wiggly, so you will need to hold it firmly to keep it from slipping out.

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• Failing to hold the tube in place will permit the tube to work its way back up the esophagus during feeding and risk the milk entering the lungs.

• Now is when you can do a pinch test to see if the puppy can cry or squeal if you’re unsure about if you have the tube in the proper position.

• Squeeze the syringe plunger slowly.  Around 1 ml. per every 10 seconds is a good rate. 

• After the syringe is empty, leave the tubing and syringe in place for a couple of seconds before extracting it to avoid dripping formula from the tube when you pull it out.

• Bend or pinch the tubing during extraction to avoid any formula remaining in the tubing leaking out as you extract it.

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• Burp your puppy.  While you may have done an excellent job of clearing any air out of the syringe and the tubing prior to feeding, it is always recommended to burp the puppy after feeding.  Upright just like a baby with light pats on the back.

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How much?

The rule is 1cc per 1 oz. baby weight.  If you’re bottle feeding you will need to weigh your bottle before and after feeding to gauge how much you puppy has eaten.  It is too hard to gauge the proper amount from the markings on the bottle. With tube feeding you know exactly how much your puppy is receiving.

I usually weigh the puppies every day for the first 2 weeks to help me adjust how much formula they should be getting.

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Overfeeding bottle babies is as dangerous as underfeeding! Neonates are still developing, and their digestive systems can only process so much at a time based on their individual size.  

Refer to the Puppy Bottle Feeding and Stomach Capacity Chart from Maddie’s Fund below for more information.

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Tracking Feeding and Growth

It is important to keep track of their feeding times, amounts, weights and also whether or not they pooped.  It is important to track bowel movements, as there may be instances where knowing the last occurrence is necessary. Documenting this information in a log can be extremely helpful in catching potential issues early.

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You’ll need a scale.  Food or postal scale are inexpensive and readily available at Walmart and online. 

As a puppy grows, you’ll need to up the amount they are fed.  You should expect to see a puppy double their weight in the first 7 to 10 days.  But you may also expect to see a weight loss in the first 24 hours of life.  The loss should not be more than 4% of their total weight.

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Below is a sample of a log that I use routinely to track all this information.

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FEEDING PUPPIES – 3 WEEKS AND BEYOND

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Weaning

Ideally, mother dogs will continue to nurse their babies past the third week of their lives but my experience has been that moms can be unpredictable in this area.  I’ve had mothers stop letting puppies nurse as early as 3 weeks and others who were still willing to feed their puppies at 8 weeks.  I’ve had puppies put their heads into their mother’s food dish and begin eating at 3 weeks on their own accord and others who had to be coaxed to eat from the bowl at 6 weeks and beyond.  

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Regardless of whether they are eating exclusively from mom or a bowl, her contact with them is important for socialization and training.  I always give moms the option to be with their puppies and also a means to get a break from them too.

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As weaning approaches (and after) do not be alarmed by any of the following behaviors that mothers may exhibit, as they are perfectly normal.

• Spending less time nursing them

• Becomes more irritable when they try to nurse. May even growl or nip gently when they attempt to nurse

• Leaves her puppies for longer periods of time

• Actively encouraging them to eat solid food by regurgitating her own meal

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Sorry to report that it is also common that once the puppies are eating food other than milk from their mother, that mom may cease to clean up after them.  Not always, but again this certainly is common.  Enjoy the help while it lasts.

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Puppies weaned from a mom

At the point where the mother dog begins to display some resistance to feeding her puppies, I will begin offering the puppies a bowl.  Normally, I will offer them either formula and canned puppy food made into a thick smooth gruel OR soaked kibble mixed with canned puppy food.   Don’t be alarmed though if puppies find their way into mom’s food bowl and begin eating dry kibble as soon as their first teeth are breaking thru the gums at 3 or 4 weeks. 

Once the puppies have the hang of the bowl and their teeth are fully through their gums, I will give them unlimited access to dry food at all times and be offer wet food multiple times a day.  

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Bottle babies weaned from a bottle

Bottle babies can be a bit more difficult to get off the bottle since they have been raised so far in a very different environment than the norm.  But just like babies with a mom, I will start offering them their formula in a dish as soon as they show the ability to stand up and balance sufficiently to find their way to the dish.

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This is partly for me as I’m certainly ready to get out of the bottle baby feeding schedule after about 3 weeks.  So selfishly I may push up weaning from the bottle sooner with such puppies than I do puppies with a mom.

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Because they don’t have a mom to copy as she eats from a bowl, I often have to show them how to get started. 

1. I’ll do so by putting room temperature formula or formula mixed into a thin gruel with a soft canned puppy food.  I like the Canine Mousse made by Royal Canine because it is very smooth and has a great deal of moisture in it.  But any quality canned puppy food mixed in a blender with formula can be used.  (room temperature) in a shallow small dish.  Small to keep them from walking in it and from tipping it over

2. Use care here to encourage the puppies to lick and not suck the mixture from the bowl.  Normally, I will need to help them get interested in what is in the bowl.  I do so by sticking a finger into the food and offering my finger to the puppy to lick it off.  This may take a few times, even dabbing the formula on the lips of the puppy. 

3. Once they begin licking it off my finger, I will begin moving my finger closer and downward toward the dish of food.  It may take several tries to get them to follow my finger with formula towards the dish but most will do so after just a few tries. 

4. When the puppy’s mouth is near to the dish, I’ll again offer the puppy my finger but leave it in the bowl and hope that puppy begins to lap at both my finger and the bowl of food beneath it.  It’s delightful when they do!

 

All that being said, some will find the bowl and dig right in with little assistance.

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​If you have multiple puppies, you might use a muffin tin for their first bowl.  It can work well to keep them from walking in their food, tipping it over and also helps to separate the puppies while eating.

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Once they’ve gotten the hang of the bowl and are eating their formula readily from it, I’ll start gradually adding more canned puppy food to the formula.  As not to shock their digestive systems, I do so slowly over several days and also, I make sure that the canned puppy food is well blended until smooth and mixed well with the formula.  Always served at room temperature. 

 

After they have gotten very comfortable eating the gruel from the bowl,  usually after 4 or 5 days, I will further reduce the formula in the canned food and begin adding soaked dry puppy kibble to the mix.  Just as I do with  puppies with mothers.  Within a week or two, usually by 5 or 6 weeks, all puppies can be eating dry kibble exclusively.

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NOTE:  Eating may cause a puppy to shiver.  Especially when you are changing their diet.  This is not unusual.  The act of digestion alters the body temperature in general and thus can cause the shiver, which is a mechanism they use to warm themselves.

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MASTITIS

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Causes & Symptoms

Mastitis is an inflammation of the mammary glands and can occur with or without infection but is typically caused by bacterial infection.   Mastitis occurs postpartum and can be the result of weaning the puppies too quickly or because of bacteria getting into the teat.  Most common the result of mom laying in dirty bedding.

Bacteria enters the mammary gland through the opening in the teat and causes infection and often inflammation.  Teets may be red, swollen, hard, hot, and mom may also run a temperature.

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Thus, while the puppies are being weaned, you should be watching and checking mom for possible mastitis daily.  The onset can be sudden and rapid and if not dealt with promptly, become a real problem. 

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Treatment

At home you can begin by using a combination of both warm and cold compresses and either put her puppies on her to nurse or manually express the milk.   It is suggested to do warm compresses, then have puppies nurse or express the teats yourself and then apply cool compresses or cabbage leaves.  See below.

Emptying teats frequently is important.  Encouraging puppies to nurse frequently and even directing puppies towards any teats that show evidence of mastitis.  If the puppies are disinterested, you will need to manually massage and express milk from mom to relieve pressure and backed up milk.  Engorged, hard teats can actually lead to abscesses and rupture. 

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Warm Compresses

• Use a bowl of hot water and 2 handtowels.

• Wring out one towel (not too hot of course) and lay it on the boobs.

• When cool, remove and place the second one on. Then start at the base of the boobs, one at a time and express them into the towel to open them up.

• You may have to do this multiple times.

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Cabbage Leaves

A well-known and common treatment is cabbage leaves.

• Start by putting cabbage leaves in the freezer for five to ten minutes

• Once cooled, lay them flat on the counter and roll over them with a rolling pin, cracking the veins in the leaves so the juice will be able to escape.

• Wrap the cabbage leaves on the affected mammary with ace bandage, do not use vet wrap, use ace bandage. Or hold them yourself for 20 or 30 minutes at a time.

• Do this three or four times per day for 30 minutes.

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Antibiotics

If mom has a temperature or even if not, adding an antibiotic may be wise.  Consult with your vet about which is safe and best for your mother.  Clavamox is commonly used and is safe for nursing mothers.