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Bottlefeeding the Breastfed Baby

posted Nov 10, 2014, 12:50 PM by Carolyn Honea, IBCLC, CLC   [ updated Mar 28, 2019, 5:36 AM ]
Every new mom has heard of dreaded "nipple confusion" - where a baby gets a bottle and then begins to have difficulty breastfeeding. In reality, there is a lot more going on than confusion over nipples. And babies can begin to experience difficulty transitioning between breast and bottle at any age, not just during the newborn period. Here are 5 tips to help the breastfed baby go back and forth between breast and bottle, and receive nutrition from a bottle in a nurturing, healthy way. Keep in mind, it is best to wait to introduce bottles until baby is 4-8 weeks old, after breastfeeding is established and going well. After this point, if mother will be returning to work eventually, someone else (such as daddy) should offer baby a bottle once a day to keep baby familiar with bottles.

Encourage baby to latch around the wide base of the bottle nipple. We don't call breastfeeding "nipple feeding" for a reason. When baby has a deep, wide latch at the breast it is more comfortable for mom and more effective for baby. Encouraging this same latch on a bottle will help avoid baby trying to nibble at mother's breast. Look for bottles with a wide, gradually sloped nipple base such as Comotomo or Lansinoh Momma.
Lansinoh Momma Bottle

Slow the flow down
, by holding baby upright and bottle parallel to ground and using a slow flow nipple. It should take baby 
the same amount of time to finish a bottle as it takes him to breastfeed. Or, another rule of thumb is it should take baby at least 5 minutes per ounce. If a baby gets used to the fast and effortless flow of the bottle, he will experience frustration at the slower flow of the breast. This frustration can surface at any age - even as late as 9 months old - and result in breast refusal. Holding the bottle parallel requires baby to exert healthy effort to draw the milk out.






Give baby an appropriate quantity of milk
.
Most breastfed babies age 1-9 months consume a little over 1oz of breastmilk per hour, with a daily total of 27oz. This total volume does not change during the first year. So if baby is getting a bottle every 3 hours, expect baby to need around 3-3.5oz in each bottle. This quantity may be slightly higher in babies who are sleeping long stretches at night. Tanking baby up on extra large bottles (5oz or more) puts baby at higher risk of obesity because it stretches out his/her stomach. Big bottles also result in baby breastfeeding less when you are together which will reduce your milk supply and make it hard to keep up with pumping. One of the most reliable ways to calculate your baby's bottlefeeding needs, is to divide 27oz by how many feedings your baby averages per day. For example, 27 oz ÷ 8 feedings = 3.4 oz per feed.


Follow baby's cues to know when she is full.
While the above 1oz/hour guideline can set expectations, following your baby's individual cues will help you know when she is full. Every few minutes, tip the bottle so that the nipple is empty and watch to see how your baby responds. A hungry baby will continue to voraciously suck at the bottle, but a full baby will allow the bottle to drop out of her mouth. These pauses also mimic the natural ebb and flow of breastfeeding.


Pump every time your baby gets a bottle,
 as close to your baby's feeding time as possible. Pump about the same quantity of milk your baby takes in the bottle. This keeps your milk supply healthy by reminding your body to continue producing the amount of milk your baby needs. When you and baby are together, opt for frequent breastfeeding instead of bottles...then you can skip the hassle of pumping and bottle washing and enjoy the special closeness of nurturing your baby at the breast.

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