Bottle feeding the breastfed baby… paced and baby-led bottles.

When I was pregnant for the first time, even though I planned on breastfeeding, one of the first things I thought about buying was bottles – I grew up in a bottle feeding culture after all.  I was planning on going back to work when A was 6 months (though I was able to wait until 18 months) and thought I’d need to use bottles from time to time.  She did have bottles a few times over her early months but in the end, I donated our bottles around 9 months or so and she continued our breastfeeding journey for 2 ½ years. I never introduced a bottle at all to S… I found I was able to balance the times I needed or wanted to be away with his nursing sessions and he eventually used a cup at his pace.  Z had a bottle starting at around 2 weeks old until we introduced solids because of his weight gain challenges and he is “still” nursing at nearly 4 years.  (Remember that this is not the typical – please do read my story on pumping for Z before thinking you supplementation is the only option.)

I point out their ages of weaning not to dictate your goals on breastfeeding to a certain age but rather to point out that because we kept the focus on breastfeeding, bottles didn’t have to interfere with it.  You can be a breastfeeding mom and still use bottles or a bottle feeding mom who breastfeeds too!  Don’t let anyone label your experience or box you in with words like “choice” or “confusion” or buy into the media hype of breast vs. bottle.  You have options and can feed with love in the way that works best for you.

What and how I share information about bottles is often geared towards the personal situation… are bottles needed for going back to work or for once in a while?  Is the baby feeding well at the breast?  Are their other challenge such as slow or fast weight gain?  Does mom know about supply & pumping when bottles are being fed? Are you an adoptive parent or perhaps a partner or father? I can most likely create several posts on each of these!

Here I will share the basic links and information and you can gear it to your situation.  I’d also encourage you to speak to a breastfeeding counselor or calling an International Board Certified Lactation Consultant.  You can individualize this information for your baby and your situation.  These tips are using the assumption that you are using mom’s own milk for your baby… if you are using formula please read this as well. https://a2zlactation.wordpress.com/2013/02/03/preparing-infant-formula-safe-water-guidelines/

Mom’s who are heading back to work or who have times when they will be separated regularly from their baby will often ask when they should introduce a bottle.  Some worry that there is a window in which to do so.  I haven’t personally come across a baby who will or won’t take a bottle solely based on the baby age… so don’t stress yourself out about a deadline.  If you can, let it be a fluid experience for you and your baby… don’t try to rush things or force the bottle but keep your time frame in mind so you aren’t waiting until only a day or so before your goal either.  You know the date but they don’t know about calendars yet.  Be gentle with yourself and them. http://www.lalecheleague.org/llleaderweb/lv/lviss1-2009p12.html

Typically we encourage moms to work on breastfeeding for the first 4-6 weeks before adding a pacifier or other artificial nipples.  The reason for this is that this period is the stepping off point for your body’s milk production time. http://www.llli.org/faq/enough.html

It is also the optimal time to work on latch and make adjustments without adding more feeding options into the mix.  Holding off on bottles until breastfeeding is well established isn’t as much about the idea of “nipple confusion” so much as the idea of nipple or flow preference.  Babies are smart and capable little humans. Their instinct is to breastfeed.   http://www.biologicalnurturing.com/video/bn3clip.html

Nipple confusion happens when so many bottles and pacifiers are given that the baby seems to “forget” or unlearn how to breastfeed. Nipple or flow preference happens when baby starts to associate the faster & immediate flow of milk in the bottles with feeding.  They also learn to suck differently than they would suckle at the mother’s breast and this can cause pain for moms as well.  This is why we talk about artificial nipples undermining breastfeeding experience.

So, what can be done to use a bottle for supplementation to breastfeeding?  How can bottles be introduced and not impede breastfeeding?

There have been some research on types of nipples and I’d encourage you to look into this if you can before buying.  Bottle nipples that stimulate similar tongue and jaw movement to breastfeeding are the most advantageous. It may surprise you to learn that you may have registered for or bought one that didn’t actually fit those criteria.

http://www.lowmilksupply.org/nipples.shtml

It is not only about which type or brand of nipple or bottle you use but the WAY you feed with a bottle that matters.  When offering a bottle, know that your human milk is best for your baby.  Feed your baby by watching the same hunger cues you watch for when breastfeeding your baby.  When bottles are new, you may want to try them before baby is overly hungry or tired. Trust the baby to know when they are hungry and when they are full.  I know it is hard to worry that your hard earned pumped (or possibly even donated) milk is going to waste… but know that this doesn’t have to be the case.

http://kellymom.com/bf/pumpingmoms/milkstorage/reusing-expressedmilk/

Hold the baby in a comfortable and loving position.  I have seen some people hold baby facing out… but remember that bottle feeding is just as much about bonding as breastfeeding and try other positions first. Bottle feeding babies need bonding and skin-to-skin or other comforts too. Allow baby to be fairly upright so that baby has some control over the situation and is able to move towards or away from the bottle.  This is more challenging if the baby is younger or has low muscle tone… and becomes easier with practice and as the baby ages and strengthens. Best for Babes has a nice concise piece on this that explains the why and how and included a nice picture of positioning.  http://www.bestforbabes.org/the-babes-guide-to-bottle-feeding

Just as you would bring baby to the breast, the caregiver who is bottle feeding can bring baby towards the bottle… holding the bottle in a more horizontal position.  This way, baby can turn his or her head and come on or off the bottle for swallowing or breathing.  This is the idea of paced bottle feeding.  The baby will often take in a few sucks, stop and swallow and then breath before resuming (very similar to breastfeeding).  If baby is able to get a nice seal on the bottle nipple and is happy, then things are going well.  If baby starts to gulp or fuss, then some adjustment may be needed.  La Leche League has a nice handout to give to caregivers which describes this all in more detail… http://www.llli.org/docs/0000000000000001WAB/WAB_Tear_sheet_Toolkit/22_bfabreastfedbaby.pdf

A little tip for you that I think is neat!  One thing that makes breastfeeding so great for babies is that it enriches eye development.  Breastfed babies have better visual acuity and are more advance in eye development than formula fed babies. One of the reasons for this besides the milk, is the fact that baby switches sides while breastfeeding.  Try as well to make it a habit of switching sides while bottle feeding at the baby’s pace.  You can switch positions for baby’s comfort and for your own.

http://www.askdrsears.com/topics/breastfeeding/why-breast-best/3-little-known-benefits-breastfeeding

Please check out some of my favorite links & resources!

La Leche League International Bottle FAQ

http://www.llli.org/faq/bottle.html

Bottle-Feeding as a Tool to Reinforce Breastfeeding – Dee Kassing, BS, MLS, IBCLC

http://www.bfar.org/bottlefeeding.pdf

The Babe’s Guide to Bottle Feeding – Best for Babes

http://www.bestforbabes.org/the-babes-guide-to-bottle-feeding

Baby-led Bottle Feeding – Nurtured Child

http://blog.nurturedchild.ca/index.php/2010/12/10/baby-led-bottle-feeding/

Tools for Feeding: Alternative Feeding Methods – Bottles & More- KellyMom

http://kellymom.com/bf/pumpingmoms/feeding-tools/alternative-feeding/

Bottles – Low Milk Supply – Diana West & Lisa Marasco

http://www.lowmilksupply.org/bottles.shtm

Paced Bottle Feeding For The Breastfed Baby – video with Jessica Barton, MA, IBCLC

http://santabarbaralactation.com/blog/paced-bottle-feeding-breastfed-baby

The Other Baby Book blog: 3 Tools to Nurse Babies with Bottles

http://theotherbabybook.wordpress.com/2013/04/30/3-tools-for-nursing-babies-through-bottles/

Science You Can Use: Can skin-to-skin and laid-back breastfeeding help older, non-latching babies?

http://www.bestforbabes.org/science-you-can-use-can-skin-to-skin-and-laid-back-breastfeeding-help-older-non-latching-babies

Which method of breastfeeding supplementation is best?  The beliefs and practices of paediatricians and nurses. 2010

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2948774/

50 Ways Dads Can Bond with Babies (Without Giving Them a Bottle)

http://codenamemama.com/2012/11/27/50-ways-dads-can-bond-babies/

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This entry was posted in Bottles, Breastfeeding, Cue Feeding, Employment, Formula, IBCLC, Laid Back Breastfeeding, Media, Milk Supply, Pumping, Uncategorized. Bookmark the permalink.

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