Bottlefeeding a breastfed baby is sometimes difficult. However much easier and more convenient it would be to be able to nurse your baby from the breast at all times, in our modern world there will come a time when most breastfed babies will need to take a bottle.
There are many situations in which bottlefeeding a breastfed baby might be necessary. Good examples are if the mother needs to return to work, or if the baby needs to be supplemented with donor milk or formula milk. Of course, there are other ways to give milk to a baby – even very young babies can become accustomed to cup, syringe or spoon feeding – but there are some situations in which it is more convenient to give bottles, and so the mother may wish to try this before resorting to a cup or syringe.
Bottlefeeding a breastfed baby, whilst preserving the nursing relationship, is not always possible. Some babies suffer from nipple confusion easily, or become lazy at the breast with only a small amount of bottlefeeding. This risk is something you should take very seriously when making the decision to introduce a bottle to your breastfed baby. If you can get by with another method of feeding, it’s wise to do so. Of course, if your baby does become confused or lazy at the breast, it doesn’t mean that breastfeeding is over and done with – these things can usually be reversed. However, it can be a hard slog, and is aggravation that is easily avoided by not introducing a bottle. If you don’t have to return to work until your baby is older, or if your motivation to introduce a bottle is something that can be postponed, consider waiting until your child is old enough to drink the milk from a sippy cup (of course, by this point, you may end up dealing with nursing laziness but nipple confusion is unlikely).
Although it’s not ideal, there are situations in which introducing a bottle is the most convenient way to deal with having somebody else feed your child. If you have to return to work when your baby is just a couple of months old, and you will be away for extended periods of time, a bottle is the easiest option. Also, if you are forced to substantially supplement with donor or formula milk, using a bottle will certainly be less frustrating for you both – IF you can make it work.
Here are my top tips for successfully bottlefeeding a breastfed baby whilst preserving the nursing relationship.
#1- Pick Your Moment
Guidelines state that it is best not to introduce any artificial teat – bottles, soothers and the like – until breastfeeding is established. At the very earliest, 6 weeks (although most mother and baby pairs are best off leaving it until at least the 8 week mark). Again, I must stress that if it is not vitally important that your baby takes a bottle, it is very wise to leave the bottle introduction until much later. Many babies will happily take a bottle even if it is not introduced until later – and if you struggle, there are many ways you can encourage them to take it.
Of course, if it really is essential that your baby accepts a bottle, introduce one for the first time at around the 4-6 week mark, providing that there are no breastfeeding issues. Just give one, no more. Offer it to your baby when they are relaxed, not too hungry and not tired or cranky. A good time would be half an hour to an hour after a breastfeed. If the baby just chews on the teat, allow them to do so – they may start to suckle spontaneously.
Once the baby is happily accepting the bottle, don’t give them any more than once a week. You want to bottlefeed them enough so that they accept it as an alternative method of feeding, but you don’t want them to become so familiar that they begin to prefer it.
#2 – Choose Your Bottle Wisely
Now; there are a variety of ‘breast-like’ bottles on the market, all of them promising to be ‘just like mum’ and to allow the baby to ‘latch in the same way as with breastfeeding’.
Unfortunately, these companies are often outright liars.
No baby bottle can completely simulate a breast. Sure, some of them look a bit like a breast, but that doesn’t mean that they work like one. Essentially, all bottles work on the same principle – the baby sucks on it and the milk comes out. There’s no jaw action required and no squeezing needed, as in breastfeeding. This is what can cause a baby to prefer a bottle – it’s much easier for them to get the milk out.
When we were dealing with bottle refusal, we tried every single freaking bottle and teat on the market. I actually find it quite amusing that my exclusively breastfed baby owned more bottles than the average bottlefed baby! If you end up dealing with bottle refusal, you will try a myriad of different bottles and teats. However, it is usually wisest to start your baby off on a breast-like bottle to begin with – not only will they usually find it easier to take to, they will probably find it easier to switch back.
The bottle we got the most success with was the BreastFlow bottle by The First Years. The teat has two parts – an inner teat and an exceedingly soft and yielding outer teat – much softer and more breast-like than any other teat I’ve come across. The baby has to squeeze the teat as well as suck in order to get any milk out, which makes this bottle much more similar to the breast than any others I know of. It is a favourite with working, nursing mums for this reason.
#3 – Teat Flow Rate Matters!
When bottlefeeding a breastfed baby, it is important to stick to the slowest flow teat. When your baby breastfeeds, they are completely in control of the milk flow and it certainly doesn’t gush out (other than at letdown of course). Giving the baby a faster flow teat, even if they are old enough for it, is a very good way to end up with a lazy nurser, a fussy nurser or worse – a baby that decides they prefer the bottle over mum’s breast altogether. Monkey, who was partially bottlefed from the age of 4 months, was on the slowest-flow newborn teat until he was past the age of 10 months old – and even then he only went up to the 3+ month size.
#4 – Nurse From the Bottle
Bottlefeeding is very different to nursing in a lot of ways. I know, that’s stating the obvious, right? But it really is, and it’s worth remembering that. The way the baby gets the milk is very different, as is the milk receptacle and the position the baby is held in… the list goes on. One important difference between bottle and breastfeeding is that, with bottlefeeding, the baby has less control over how much milk they receive. It is very easy to overfeed a baby with a bottle without realising you are doing so.
Use the same principles as you would with breastfeeding when bottlefeeding a breastfed baby. Offer the teat as you would the nipple – let it brush against their cheek or top lip, and let them root and ‘latch on’ to it rather than just shoving it in there. Ensure they have a deep latch – the last thing you want is for them to suck on the end of the teat like a straw, and then try to do the same to your boobs next time you nurse!
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Watch them carefully whilst you feed them, and allow them to spit the teat out if they wish. Hold the baby in a slight incline, and if the bottle allows, turn them so they are facing slightly inwards. This makes it a more natural experience for them (although some breastfed babies may not tolerate being quite so close to the real thing!). In addition to this, you (or, if appropriate, the person feeding the baby) can strip your top half and the baby down before a feed so the baby can experience the skin-to-skin contact that they would be getting whilst breastfeeding. This can also help with bottle refusal. Since publishing this post, somebody made a very good point to me that switching sides whilst bottlefeeding, as you would when breastfeeding, is another important part of making the bottlefeeding experience as natural as possible, as well as helping brain development by developing the baby’s left/right coordination.
Remember that, with breastmilk, the amount that they take over time doesn’t change very much at all – the composition does. So if you’re feeding your baby your own expressed breastmilk, don’t expect them to take the same amount that formula fed babies of the same age would. They may do, but they may only take two or three ounces. Let them be the judge of how much they need.
#5 – Remember The Rule of Supply and Demand!
If you are partially bottlefeeding your breastfed baby, it’s very important to remember that if you skip feeds, your supply will suffer. Your body will naturally adjust to the demands of your baby, but in the early months it is very important to feed often and on cue. Make sure that you pump at the time when your baby is receiving a bottle of expressed milk, and offer the breast often when you are able to nurse your baby. I feel like this point is stating the obvious – after all, if you’re feeding your baby a bottle of expressed milk you would have to pump at some point – but it’s an important point worth making.
You may find that your baby is happy to switch from breast to bottle and back again quite happily with no hint of laziness or nipple confusion. However, some babies are far more sensitive and will become confused easily. Do not take your decision to introduce a bottle lightly, and bear in mind that it may cause trouble for your nursing relationship.
What are your top tips for preserving the nursing relationship whilst partially bottlefeeding a breastfed baby?