There are many reasons why you may want to offer a bottle to a breastfed baby. First, it is a great way to get your partner or another caregiver involved and give you a break. You may want (or need) to supplement with formula. There may be a time that you need to be away from your baby (like going back to work or getting through the holiday season), so knowing they can take a bottle can give you peace of mind. If you’re doing it because breastfeeding hurts (like with a shallow latch), it’s definitely worth working with an IBCLC so that you can make things more comfortable.
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When to Start
There is a lot of conflicting information on when is the best time to start offering a bottle. One concern is that if you offer it too soon, your baby may prefer the bottle and not return to breastfeeding (1). The research on this is conflicting at best. You can probably safely start offering a bottle after a couple of weeks if you and your baby aren’t having any problems with breastfeeding. You definitely want to offer before you need them to take the bottle in case there are any hiccups that you need to address. Waiting too long can lead to bottle refusal which is extremely stressful.
Choosing a Bottle
There are many different bottles on the market in a wide variety of shapes. They all have claims about why they are the best. There is no bottle that will perfectly mimic breastfeeding. During breastfeeding, the baby smashes the breast tissue and reshapes it. That’s just not possible with a bottle.
Generally, you want the nipple to reach back towards the palate of the mouth and you want your baby to be able to close their mouth around it and maintain suction. Generally babies have difficulties with the nipples that are really wide or really thin. The Lansinoh Mommah bottles (affiliate link), or ones that are similarly shaped, tend to work well. As always, start with what you have! You don’t want to see milk leaking from the mouth or hear any clicking sounds during feeding.
Choosing a Nipple Size
Most babies do really well on the slowest flow possible. Just as nipple size doesn’t change that much on a lactating parent, there’s no real need to adjust the nipple size on a bottle. Babies generally will get more efficient at nursing (on the breast or on the bottle) and may feed more quickly, but that doesn’t mean that you need to size up. Keeping the smaller nipple size is one tip to help prevent overfeeding and to help prevent bottle preference.
One exception to this is if you have an overactive letdown. Your baby will get used to receiving milk quickly and can get very frustrated by the slower rate on a bottle.
How to Feed Your Baby
It turns out that it’s not as easy as just putting the bottle in your baby’s mouth. The best way to feed a baby is by using a technique called pace feeding. This technique helps keep your baby in charge of the flow of milk.
When breastfeeding, a baby can alternate between nutritive and non-nutritive sucking. This means sometimes they are sucking just for comfort. With a bottle, they receive milk, even if they don’t want it. This can lead to overfeeding which is a problem for your baby and possibly for your milk supply. One other difference is that when breastfeeding, babies usually get their hydration needs met first with foremilk and then get hindmilk for satiation towards the end of the feed. Bottle feeding is a mix.
Often, when a parent complains that they’re not making enough milk for their baby, it turns out that their baby is actually just being overfed! Pace feeding slows down the amount of milk baby is getting so they have a better idea of when they’re full. It also makes them work a bit harder, so they are less likely to develop nipple preference.
Benefits to Pace Feeding
- Less chance of overfeeding
- Breast milk lasts longer
- Can decrease spit up
- Baby will swallow less air (meaning they are less gassy and uncomfortable)
How to Pace Feed
Time needed: 30 minutes.
Pace feeding a breastfed baby.
- Get baby in position.
Make sure your baby is somewhat upright. This can mean holding them in the crook of your elbow at a recline, they don’t need to be completely vertical, but you don’t want them laying flat. It’s always best to hold your baby during feeds, instead of placing them on a pillow, so that you can control the angle and also for bonding. Breastfed babies are used to getting cuddles while they feed and it’s great to try and recreate that feeling with bottles. Alternatively, you can offer the bottle with baby in a side-lying position. This position better mimic breastfeeding, but can be a but more challenging for parents to learn initially.
- Follow baby’s cues.
Hold the bottle horizontal to get your baby to latch on and start sucking. Once they have started sucking, you can tip the bottle a little more upright. When they start slowing down, tip it back horizontal again. The idea is to try and mimic breastfeeding, where there can be multiple let downs in a feed with little breaks in between let downs. Make sure to tip the bottle horizontal and vertical with regards to baby, not you.
- Switch sides.
Switch sides halfway through the feeding. This will give you a chance to burp the baby and will give your baby a chance to see how full they feel. This can be helpful in preventing things like torticollis as well.
- Take it slow.
If a typical breastfeeding session takes 30 minutes, a bottle session should take just about as long. Give your baby a chance to take little breaks and rest. Allow your baby to determine when they are done eating. If your baby says that they are full (turning head away from bottle, no longer sucking), trust them.
Krystyn Parks is a Registered Dietitian and Lactation Consultant who specializes in feeding children. She has a Master’s Degree in Nutritional Science from California State University Long Beach. She is an International Board Certified Lactation Consultant and has been registered with the Commission on Dietetic Registration since 2013.