When mothers return to work or school, they are oftentimes faced with a new reality: Learning how to bottle-feed their breastfed baby. Ultimately, bottle-feeding a breastfed baby should ensure that the baby gets the nutrients he needs and that breastfeeding is fully supported.
Contrary to product advertisements, there are no bottle nipples that look or feel exactly like a mother’s breast; nor are there any that replicate the shape, or feel, or function of a mother’s breast.
Some companies claim their bottle nipples “make breastfeeding and bottle-feeding work better together” while others profess to “support an easy transition from breastfeeding to feeding breast milk.”
The “best” feeding bottle and bottle nipple is the one your baby will accept. Expect your baby to refuse everything but the real thing (his mother’s breast) at first knowing that over time your baby will be less choosy.
Try one of several different kinds of bottle nipples (slow-flow, fast-slow, wide base, narrow base, firm, flexible) until you find one your baby will accept. Specific flow nipples are designed for certain abilities as opposed to certain ages. If your baby has difficulty coordinating sucking, swallowing, and breathing, you may find that a slow-flow nipple is helpful. While a slow-flow nipple may give a baby more control over the feeding, it may also frustrate a baby who is accustomed to a faster flow. However, flow that is too fast can make it difficult for your baby to breathe. Signs that milk is flowing too fast include: choking, coughing, or sputtering; milk dripping out of your baby’s mouth; creases in your baby’s forehead or clenched fists. Ideally, your baby will take to the flow rate (slow, medium, fast) that matches his sucking skills.
Learn to bottle-feed the “right” way
One study suggests that learning to bottle-feed the “right way” may be more important than choosing the “right bottle nipple.” As long as the flow of milk matches your baby’s ability to suck, swallow, and breathe, your baby will eventually learn to accept milk from something other than your breast. The following bottle-feeding tips should make the transition from breast-to-bottle-to-breast easier for mom, baby, and caregiver:
- Start feeding on cue. Make sure your caregiver is aware of your baby’s hunger cues and urge her to feed your baby on cue rather than on a schedule.
- Hold the baby upright. Babies who drink lying down from a bottle are more likely to develop tooth decay and ear infections. When you place a breastfed baby in the cradle position, he expects to breastfeed and will likely refuse a bottle.
- Stimulate the rooting reflex. Using the tip of the nipple, stroke the baby’s nose and lips from top to bottom. Wait for the baby to open his mouth wide and draw the nipple into his mouth.
- Pace the feeding. Mimic breastfeeding by encouraging the baby to pause following a series of sucks (suck-suck-suck-pause).
- Stop feeding on cue. When the baby hints at being full (falling asleep, releasing the bottle nipple, relaxed fingers and hands) stop the feeding. Don’t wake the baby to finish the bottle.
If all else fails, ditch the bottle and get out the cup, teaspoon, medicine dropper, or hollow-handled medicine spoon.
By responding to a baby’s ability to suck, swallow, and breathe in a coordinated way, your caregiver will be able to satisfy your baby’s nutritional needs and support your continued breastfeeding.
Feeding a baby from the breast and feeding him from a bottle require completely different mouth and tongue motions. Breastfed babies must use different feeding and swallowing skills than bottle-fed babies, and they learn these skills through their experiences during the first weeks of breastfeeding.
For example, breastfed babies must take all of the nipple and as much of the areola as possible into their mouth compressing the breast between the tongue below and the roof of the mouth above. By comparison, bottle-fed babies typically use the lips to grip the tip of the bottle nipple (or a pacifier).
“Nipple confusion” is the term used to describe what happens when breastfed babies are given artificial nipples before their breastfeeding skills are fully developed.
These babies often try to apply the (less complex) movements of bottle-feeding while breastfeeding. Consequently, some of these babies experience confusion and have more difficulty breastfeeding. Most babies can learn to switch between the two feeding methods, but this takes time. While there is no rigorous scientific evidence to support nipple confusion, it is best to avoid introducing bottle nipples and pacifiers until both you and your baby have learned to breastfeed well, after about the first 4–6 weeks.
If a bottle is introduced too early, some babies may choose to ignore their mother’s breast altogether, since milk flows from bottles more easily. If you need to interrupt breastfeeding for any reason, especially during the first 4–6 weeks, you can avoid nipple confusion by using a teaspoon, eye dropper, or cup to feed your baby your expressed milk.