Introducing Bottles to Breastfed Baby
Jack drank from a bottle probably twice in his life.
I mean, I was home with him all the time (the first time I left him overnight was, well, a few weeks before Oliver was born.) He nursed well. I never left him for more than a couple hours at a time (which was fine with me), Forrest didn’t feel like feeding him a bottle would help them bond more…so there wasn’t any reason to.
So when I had to feed Oliver breast milk via bottle during those first few months a couple times a day, I was thrown for a loop! All of the sudden I was trying to find the best bottle for him, make sure he didn’t get a preference for a bottle over the breast, and I was totally stressed out.
Fortunately, I was able to find a lot of great information online, and it helped me immensely. Now that we don’t use bottles anymore, my life is a little bit simpler, but I’m glad I was able to experience a bit of the bottle feeding world – just so I understand it a bit more.
With that said, I know a lot of people want (or need) their breastfed baby to take a bottle – either out of necessity because of work, a tongue or a lip tie, or just because they want to be able to leave their baby with a babysitter for awhile. All of these are good reasons!
However, you should take certain “precautions” when try and mix bottle feeding with breastfeeding. Here’s a little bit about what you should know about bottle feeding a breastfed baby.
When to Give Breastfed Baby a Bottle
Nipple confusion is a real thing. I didn’t know if I believed that before Oliver. We gave Jack a pacifier from the get go, and he never had any issues eating or latching. Oliver didn’t seem to either…but then we did have to give him bottles of pumped milk for awhile in the beginning, and he definitely started to get nipple confusion.
It was not fun.
I realized why they recommended NOT introducing a bottle until about the first four weeks have passed (which is about how long it takes to establish a good breastfeeding routine.)
If you do have to introduce a bottle earlier (and sometimes it is inevitable), then you’ll find some of the next tips helpful!
On the flip side, you don’t want to wait too long to introduce a bottle, especially if you are going back to work. Some babies will refuse to take a bottle after a while if they aren’t used to it. My IBCLC told moms that were going back to work to just enjoy their baby for the first four weeks, and then slowly start to introduce it around that time (aim for 3-4 times a week). Work with a lactation consultant near you if you are having issues.
Paced Bottle Feeding for the Breastfed Baby
Pace feeding is an essential technique, especially if your baby will be regularly fed from a bottle. It’s a way of feeding that tries to mimic how a breastfed baby eats. There are several steps to it, but instead of trying to explain it, here’s a great video:
If your breastfed baby is eating more than 1 to 1.25 ounces per hour between feeding (so if they last ate three hours before, they shouldn’t be offered more than 3.75 ounces – here is a great article on this topic), then they are likely not being pace fed. A baby eating a bottle that is not pace fed doesn’t typically stop when they are full – if the milk is coming, they will keep eating.
If your child’s caregiver is requesting that you give them more ounces than is necessary for the time you are away, you need to make sure they are pace feeding. I see women in the breastfeeding groups I’m in that are distraught because they can’t keep up with the amount their baby is eating while they are away, and it’s often because they are just being fed too much in a non-paced way.
Signs that your baby might be done are if they start pulling away, they are suckling slower, or they start falling asleep. Don’t force them to finish a bottle if they don’t want it!
The recommendation for 1-1.25 ounces per hour is based off of the average intake of a breastfed baby in 24 hours (which doesn’t really change from 1-6 months), and the recommendation to not go much longer than about 3 hours between feeds. With all rules, there are exceptions, but I do encourage mothers to try this out and make sure baby is paced fed.
Experiment with Bottles & Nipples
Not all bottles are created equally. There are some bottles and nipples designed specifically for breastfed babies. I recommend researching the best bottles for breastfed babies. Don’t go out and buy big sets of bottles until you are sure your baby can tolerate that kind. If your baby won’t take a certain bottle, there’s nothing wrong with trying another kind!
Here are some of the top picks:
Click here to read a post I wrote about the best bottles for breastfed babies – I surveyed a bunch of moms, and these were the results!
Use the slowest flow nipple
Jack never used bottles, so I didn’t know much about them. So, imagine my surprise when I realized that there were different flow types for nipples. It was no wonder Oliver seemed to be guzzling down the milk when I first gave it to him.
Babies start to prefer bottles because they are easier to eat from. They really don’t have to work hard to get the milk out, and if the nipple flow isn’t particularly slow, it will just flow right into their mouth!
Use the slowest flow nipple your baby will tolerate. We used a preemie nipple with Oliver, and he never had any issues. Just because a bottle nipple says its for a certain age, doesn’t mean you have to use it. Some babies will stay with a preemie nipple until they no longer use bottles!
In general, aim for a full bottle feeding to take 15-20 minutes. Shorter might mean the nipple flow is too fast, and over 30 minutes means it’s too slow.
Switch sides midway through feeding
This just helps baby not come to prefer a certain side when eating, which can make breastfeeding more difficult. If they are only fed in the right arm, they might only want to eat that way…and if your baby only wants to eat from one breast, that can complicate things!
Have someone else feed them
If you can, have someone else feed your baby the bottle. If your baby thinks that the only way they can eat from you is from the breast, they may be less likely to nurse when they are with you. However, if you are always giving them a bottle, they will know that you can feed them either way, and if they like the bottle, they may demand it!
On the flip side, sometimes a baby will refuse to drink from a bottle if they know mom is nearby, and they prefer breastfeeding. So, in that situation, having someone else feed them might help.
Dealing with Nipple Confusion
Oliver definitely had nipple confusion for awhile, and it was hard! However, we pushed through, and he eventually overcame that and was able to switch from bottle to breast easily (I think a lot of that the confusion was because we were using bottles that were not suited for breastfed babies.)
If you are dealing with this, I know it’s hard! It may take some patience to get them back to the breast completely, and I highly recommend working with an IBCLC to do so. However, here are a few tips:
- As mentioned above, have someone else fed them the bottle. If they don’t think you can feed them with a bottle, they may be more
- Start a feed out with a bottle to satisfy the initial hunger, and then once baby is more satisfied, switch them over to the breast.
- If they are more used to the fast flow of a bottle, try hand expressing a little before latching to induce a letdown. Just having that little bit of a reward right when they latch on can help.
- Change bottles or nipple flow
- Bounce or sing to them – distract them!
Dealing with Bottle Refusal
If your baby has to take a bottle for whatever reason, and they don’t want to, I can only imagine how stressful that is! I’ve heard of some babies who will “reverse cycle” which basically means they refuse to eat while they are away from mom, and then they will eat more of their meals in the evening and in the middle of the night. If that works for you, then great…but it can be exhausting. Here are a few tips:
- Nurse the baby until they get sleepy, and then slip the bottle in their mouth instead
- Distract them
- Leave the room or have someone else feed them
- Find a new bottle that is more similar to the breast
- If you are feeding them formula while you are away, try a different brand that is more similar in taste or composition to breastmilk (I’ve heard good things about Baby’s Only Organic. It says it’s toddler formula, but it can be fed to infants. I also have heard good things about Gerber Good Start Gentle.)
Alternatives to Bottle Feeding
Sometimes bottle feeding might be inevitable during that first month. For us, we didn’t have much of a choice. But if you have to do any supplemental feedings during those first few weeks, consider using a medical syringe without a needle or cup feeding (using a clean medicine cup) A syringe is especially great if you have to supplement while they are in the hospital (sometimes if they are jaundiced or their blood sugar is too low, supplementation is needed. Try and express colostrum for this or see if donor milk is available! They really don’t need much those first few days. Tiny tummies!)
For larger amounts of supplementary feedings, a SNS (supplemental nursing system) is a great option. You put the supplemental feeding (breast milk or formula) into a little bottle, which has a tube that goes from the bottle into the baby’s mouth. This way, you can keep the baby at the breast while they get the supplement, so your supply may be impacted less. SNS can be tricky to use though, so I recommend working with an IBCLC to get started. The Lact-Aid is the most highly recommended one, but there are other brands as well.
Favorite Bottle Feeding Accessories
Although we didn’t bottle feed a ton, I quickly learned that it can be kind of tiring! Here are a few accessories I liked:
- Bottle Sanitizer – some people say these aren’t necessary, but I just never felt like our bottles got clean enough without it!
- Bottle drying rack – I love the kind that looks like grass
- A bottle and nipple cleaning brush
- Bottle Warmer
YOU MAY ALSO ENJOY:
- The Ultimate Guide to Breastfeeding as a Working Mom
- Donor Breastmilk 101: Everything You Need to Know
- The Best Bottles for Breastfed Babies (An Unbiased Report)