…tips for a breastfeeding supportive style of bottle feeding
PDF version (great for child care providers)
Often, as infant feeding specialists, lactation consultants and other experts in the field of human lactation are asked how to properly bottle-feed a baby. Direct breastmilk feedings from the mother’s breast are always preferred to any artificial source or substance. In addition, there are often alternatives to bottle-feeding, such as cup feeding, which should be explored. For the baby who has to be bottle-fed, following is some information to help make the experience a good one for the baby and also to make sure that breastfeeding is fully supported even when artificial feedings are used.
This information can also be useful in evaluating infant care providers and for instructing them on how to bottle-feed a breastfed infant. Note that when working through any feeding difficulties with an infant, a lactation consultant is an excellent resource for evaluating methods for their appropriateness to the specific situation.
While useful for any bottle-fed infant, this information is particularly targeted towards infants between 12 weeks and 6 months of age.
Babies should be bottle-fed:
- When their cues indicate hunger, rather than on a schedule.
- Held in an upright position; it is especially important to avoid letting the baby drink from a bottle when lying down. Such a position is associated with bottle caries and an increased frequency of ear infections. Note also that babies should be held often at times when they are not being fed, to avoid the baby being trained to eat in order to be held.
- With a switch from one side to the other side midway through a feed; this provides for eye stimulation and development, and thwarts the development of a side preference which could impact the breastfeeding mother.
- For 10-20 minutes at a time, to mimic the usual breastfeeding experience. Care providers should be encouraged to make appropriate quantities last the average length of a feeding, rather than trying to feed as much as they can in as short a time as possible. This time element is significant because the infant’s system needs time to recognize satiety, long before the stomach has a chance to get over-filled.
- Gently, allowing the infant to draw nipple into mouth rather than pushing the nipple into the infant’s mouth, so that baby controls when the feed begins. Stroke baby’s lips from top to bottom with the nipple to illicit a rooting response of a wide open mouth, and then allow the baby to “accept” the nipple rather than poking it in.
- Consistent with a breastfed rhythm; the caregiver should encourage frequent pauses while the baby drinks from the bottle to mimic the breastfeeding mother’s let-down patterns. This discourages the baby from guzzling the bottle and can mitigate nipple confusion or preference.
- To satiation, so that baby is not aggressively encouraged to finish the last bit of milk in the bottle by such measures as forcing the nipple into the mouth, massaging the infant’s jaw or throat, or rattling the nipple around in the infant’s mouth. If baby is drowsing off and releasing the bottle nipple before the bottle is empty that means baby is done; don’t reawaken the baby to “finish.” See Bottlefeeding tips from AskDrSears.com.
The benefits of bottle-feeding in this manner:
- The infant will consume a volume appropriate to their size and age, rather than over- or under-eating. This can support the working and pumping mom who then has an increased likelihood of pumping a daily volume equivalent to the baby’s demand.
- This can minimize colic-like symptoms in the baby whose stomach is distended or over-fed.
- It supports the breastfeeding relationship, hopefully leading to longer durations and increased success at breastfeeding particularly for mothers who are separated from their nurslings either intermittently or recurrently.
Bottle-feeding Myth 1:
Bottle-feeding lets me know how much nutrition the baby has had.
Moms who bottle-feed, whether using expressed breast milk or anything else, should be aware that while artificial feeding may seem to be a very accurate measure of volume consumed, in fact it is often not. Bottle-fed infants more often regurgitate some quantity of a feed, or get a less than perfect balance of fore and hind milk than they might if feeding directly from the breast. If a substance other than breastmilk is used, the increased metabolic workload for the baby, lower digestibility of nutrients and increased waste substantially dilute the benefit of a feed, although it is more easily measured.
Bottle-feeding Myth 2:
It is easy to bottle-feed safely.
Bottle-feeding caregivers face certain challenges in feeding a baby safely. One extra piece of work is sterilizing all infant feeding equipment for at least the first 4 months. And, if artificial substances are used:
- Lot numbers should be kept for any artificial milks fed to the baby, so that parents can determine whether the product was subject to a recall.
- A clean source of water must be available, free from bacteria. If tap water is used, the caregiver must decide whether to boil the water to eliminate bacteria (which may concentrate any heavy metals in the water), or to use unboiled water. If bottled water is used, lot numbers should be recorded. Powdered infant formula should be mixed with water that is at least 70°C/158°F to kill any harmful bacteria that may be present in the powdered formula.
- Quantities the baby will need should be carefully estimated, since unused formula must be discarded. Overestimating can lead to having to throw out the unused amount – and that is quite an expensive piece of waste.
For more information on infant feeding myths, see Dr. Jack Newman’s Breastfeeding Myths
- Tips for bottle feeding the breastfed baby
- Baby-led Bottle Feeding from NurturedChild.ca
- Boosting Bottle Feeding Bonding – 5 top tips… from AnalyticalArmadillo.co.uk
- New thoughts on using bottle nipples with breastfed babies from Lactation Education Resources
- Bottle-feeding as a tool to reinforce breastfeeding by Dee Kassing, from J Hum Lact. 2002 Feb;18(1):56-60.
- Tips for encouraging your baby to accept a bottle
- Offering Your Breastfed Baby a Bottle by Becky Flora, BSed, IBCLC
- Tips on Offering Bottles by Paula Yount
- Guidelines for Introducing a Bottle to a Breast-Fed Baby by Marianne Neifert, MD, et al.
- Introducing Bottles and Pacifiers to a Breastfed Baby by Anne Smith, BA, IBCLC
- Helping a Breastfed Baby Accept a Bottle from Lactation Education Resources
- Tips for combining breast and bottle feeding
- Combining breast and bottle feeding by Anne Smith, BA, IBCLC
- Partial Weaning & Combination Feeding @
- Should I use a bottle if baby is refusing to nurse? from “Help — My Baby Won’t Nurse!” @
See also Alternative Feeding Methods @