By Jennifer Buchanan CNM, WHNP-BC, IBCLC ~
As once a nurse in the Institute for Maternal-Fetal Health at Children’s Hospital Los Angeles and now a nurse midwife working both in out-of-hospital and hospital settings, I meet many moms who are intimidated when it comes to knowing when and how to introduce bottle-feeding to their babies. As much as they want their partners to share in the experience of feeding their babies or mothers preparing to go back to work, it can be especially intimidating because of the many myths associated with introducing a bottle.
There are no mandatory rules about when to add a bottle to a baby’s feeding routine, but here are some expert tips that may make the process easier.
1. Add a bottle after a healthy milk volume is established from your breast.
If you are exclusively breastfeeding and want to keep it that way, then only introduce a bottle after you have established a healthy milk volume and breastfeeding routine. This can take up to four weeks after birth. Anytime before this can cause supply issues – either too much and too little.
2. Continue breastfeeding or pumping to maintain milk volume.
When your baby is feeding from the bottle, make it a priority to pump (and breastfeed when your baby is not using the bottle). Decreasing the amount of times milk is expressed from your breast can lead to a decrease in the volume produced.
3. Nipple confusion versus nipple preference.
Many people believe that babies don’t want to breastfeed after being exposed to bottle-feeding because of nipple confusion. This is not true. Babies do not get confused about the different feeding methods. But they do get accustomed to the breast or bottle and establish a nipple preference, which only means that they prefer one method over the other. See below as a way to help that.
4. Use a bottle nipple that is wide-based, which is similar in size and shape to your nipple.
I recommend wide-based nipples. Purchase a bottle with a nipple that is more similar to the human breast. These nipples are usually wide-based with shorter nipple heights. The nipple requires the baby take a larger amount of the nipple into his or her mouth, which is similar to breastfeeding.
5. Purchase one nipple and bottle style at a time.
Some babies are very picky when it comes to bottles, especially if they have been exclusively breastfed. It is a good idea to buy one set of a certain bottle and nipple style at a time to make sure your baby can feed well before buying a larger supply. Sometimes babies will try out multiple bottles and nipples before they decide on a favorite.
6. Use a slow-flow feeding style.
A slow-flow feeding style with a bottle closely resembles that of breastfeeding. Babies that breastfed are used to working for their food and it comes out at a slower rate. Whereas, bottle-feeding is easy and takes little effort. The rate is much quicker and babies can get used to this fast rate, making breastfeeding more frustrating when returning from bottle-feeding.
If you are using a regular nipple allow the baby to take five to ten sucks and remove the bottle or tip it back up so the flow slows down. Allow your baby to swallow and breathe. Then reinsert the bottle and start again. This process should encourage your baby to slow down their feeding. The feeding should take roughly 15 minutes, similar to that of a breastfeeding session.
Here is a good video on slow paced bottle feeding:
7. It takes time.
Many exclusively breastfed babies do not accept a bottle right away, so it may take a couple of attempts before your baby gets the hang of it. Be patient and continue to offer the bottle to your baby. Since this will be a learned skill, it’s important to keep it up 2-3 times a week, preferably by someone other than the mama who will be breastfeeding. This makes it easier in baby taking the milk because if he or she smells the milk from the breast, he or she may become fussy at the bottle and want to take from breast instead.
8. Introduce bottle-feeding two to four weeks before going back to work.
By doing this, you can establish a pumping routine, allow your baby time to adjust to the bottle and give you a chance to see that your baby is able to feed from the bottle effectively. Also, start pumping once a day so you have a supply built up. Here is a great resource about the inside scoop of stored milk.
The above tips will help you a lot when you begin your journey of bottle-feeding your baby. Most of the time a baby will accept a bottle very well, but there are a few that can really make the transition frustrating. If you are having a difficult time introducing bottles or your baby does not seem to be feeding as well with a bottle, please enlist the help of a lactation consultant.