Baby feeding cups newborn
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By Philippa Pearson-Glaze IBCLC
Cup feeding is an alternative to bottle feeding if a baby can’t latch to the breast and needs to be given some milk. It can also be used for supplementing a baby who is not getting enough milk or for a baby who is separated from his mother for a while. It is thought to be a useful short-term alternative to using a bottle teat as it avoids a baby getting confused by the different sucking action required on an artificial bottle nipple (nipple preference/confusion). However, there are disadvantages as well as advantages to cup feeding. This article looks at the pros and cons of cup feeding and how to cup feed a newborn baby.Baby must be awake and alert to cup feed
Pros and cons of cup feeding
Advantages of cup feeding
- Better oxygen saturation and heart rate. A premature baby can feed at his own pace which may improve his oxygen saturation and heart rate making him more physiologically stable123
- Cup feeding may help preserve breastfeeding by avoiding bottles. Studies show cup feeding premature babies instead of using bottles can increase the number of babies who breastfeed and increase the length of time they breastfeed45
- Cup feeding can prepare a baby for breastfeeding. Feeding technique (use of muscles) while cup feeding is thought to be closer to breastfeeding than using a bottle6 and may help prepare a baby for breastfeeding by encouraging the tongue to come forward for lapping/sipping
- Open cups are easily available, inexpensive and very easy to clean in resource poor areas or emergencies compared with teats, bottles or feeding tubes
- Suitable for very young babies. Cup feeding can begin from as early as 29 weeks gestational age.7
Disadvantages of cup feeding
- There is a risk of aspiration or choking if cup feeding is not done correctly
- Feeds can take a long time
- There can be a lot of spilled and wasted milk compared with bottle feeding or tube feeding 8
- Long term cup feeding can dampen the sucking reflex or create a preference for the cup
- Not suitable for sleepy babies as there is a risk of choking.
Can cup feeding help preserve breastfeeding?
One review found cup feeding had no significant benefit in maintaining breastfeeding after discharge from hospital and that the length of hospital stay was likely to be a lot longer with cup feeding in some settings. 9 However more recent studies have found the opposite —more cup fed babies were exclusively breastfeeding at discharge, and beyond, with no apparent increase in hospital stay for term10, late preterm11 and premature babies (Penny et al. 2018). The Academy of Breastfeeding Medicine12 states cup feeding may help preserve breastfeeding and the World Health Organisation13 recommends cups or spoons rather than bottles and teats for premature babies.
How to cup feed a baby
Cup feeding is best taught by a demonstration from your experienced health care professional if possible. They will advise you whether the technique is suitable for your baby. To cup feed a baby needs to be awake and alert, and in an upright position. Never cup feed a sleepy baby or a baby who is lying flat and never pour milk into a baby’s mouth as these all increase the risk of your baby choking.
Cup feeding videos
Global Health Media has a lovely series of videos about breastfeeding, the first clip below (9 minutes long) discusses how to safely cup feed a small baby who isn’t breastfeeding yet and includes spoon feeding, using a paladai (see below) and using a nifty cup:
Cup feeding description
The following description is summarised from the video above. Use a small cup with a smooth edge such as a medicine cup, sherry glass or shot glass—your maternity hospital may give you one. You can also buy little plastic cups specially for the purpose which can be shaped slightly during feeding. You may need a cloth under baby’s chin in case any milk spills.
- Half fill or two thirds fill a small cup with slightly warmed breast milk or infant formula
- Ensure your baby is fully awake, alert and interested in feeding. Never cup feed a sleepy baby
- If needed, wrap your baby to prevent him knocking the cup out of your hands
- Sit your baby in a comfortable, upright position on your lap. Never cup feed a baby who is lying flat on their back
- Rest the rim of the cup lightly on your baby’s lower lip or their lower gum ridge
- Tip the cup just enough so that milk reaches the rim of the cup, don’t put the cup too far into baby’s mouth
- Your baby will quickly learn to sip or lap milk from the rim of the cup with his tongue
- DO NOT pour the milk into his mouth, go slowly always keeping the milk just at the rim of the cup
- Leave the cup in position when baby pauses to rest between swallows and is not drinking, avoid putting pressure on the lower lip
- Continue to tip the cup enough to keep the milk at the rim of cup resting lightly on baby’s lower lip
- Burp baby if needed during the feed.
Short film clips of cup feeding
In the following short clip from Global Health Media, a premature baby is cup feeding. Notice how the baby’s tongue extends to lap the milk.
Jack Newman is a Canadian paediatrician and breastfeeding expert. Here is a clip of cup feeding from his International Breastfeeding Centre:
Using a paladai
Mothers in India have used a small spouted cup called a paladai for centuries. One study compared the use of a bottle, cup and a paladai in 100 newborn babies. Infants took the most milk in the least time and stayed calmest with the paladai 14. However a more recent pilot study comparing the paladai with bottle feeding in preterm infants found increased spillage, longer feed times and more stress cues 15.Traditional paladai (left) as part of a baby set
Alternatives to cup feeding
Alternatives to cup feeding for the breastfed baby who needs supplementing include:
- Supplementing at the breast. A breastfed baby who is latching well to the breast but who needs additional milk can be supplemented while they are breastfeeding by way of a small feeding tube alongside the nipple. The free end of the feeding tube is placed in a container of milk and provides milk when baby suckles with a good seal around breast and tube. For much more information about the pros and cons of this system see Supplementing at the Breast.
- Finger feeding. Finger feeding is another method of providing supplemental milk to a breastfed baby by way of a feeding tube (above). In this case the feeding tube provides additional milk while the baby suckles on a clean finger. For more information on the pros and cons of finger feeding see What is Finger Feeding?
- Bottle feeding. A traditional way to provide supplemental milk is by bottle and teat. Feeding from an artificial teat has a number of differences to breastfeeding which could cause nipple preference or confusion in some babies. However there are several ways to reduce the differences to help preserve breastfeeding, see Tips to Bottle Feed a Breastfed Baby and Best Bottle for a Breastfed Baby?
Used correctly, cup feeding can be a useful way to give a newborn baby supplementary milk for short term feeding. Other options for supplementary feeds include using a supplemental nursing system at the breast, or a bottle using our tips to minimise nipple confusion. Your breastfeeding specialist or health professional can help you decide which option is best for you and your baby.
- ABM Clinical Protocol #3: Supplementary Feedings in the Healthy Term Breastfed NeonateAcademy of Breastfeeding Medicine, 2017
- Cup Feeding Versus Other Forms of Supplemental FeedingCochrane Database, 2010
- Protecting, Promoting and Supporting Breastfeeding in Facilities Providing Maternity and Newborn ServicesWHO, 2017
- What is Finger Feeding?Breastfeeding Support 2018
- Finger and Cup feedingJack Newman, 2009
This article should not be construed as medical advice. Information found online should always be discussed with your own IBCLC lactation consultant and doctor to ensure it is appropriate for you and your baby’s situation. Contact your doctor, paediatrician or health care provider with any concerns about your baby’s health and welfare.
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Babies are tiny humans. Their main job in early life is to eat, sleep, and poop. While the latter two of these activities may come pretty naturally, the feeding part may be interrupted for a variety of reasons.
Cup feeding — providing milk to your baby with a small medicine cup or similar device — is a temporary alternative to breast or bottle feeding.
Cup feeding is a method that may be used as a temporary feeding option when:
- Babies are born prematurely and are not yet able to nurse.
- Babies are temporarily unable to breastfeed due to separation from mother.
- Babies are ill or have certain medical conditions.
- Babies are refusing the breast.
- Mothers must take a break from breastfeeding for some reason.
- Mothers must supplement feeding and want to avoid using bottles or causing “nipple confusion.”
While the idea of feeding your baby using a cup may sound tedious or daunting, it’s actually a simple option that is used, according to the World Health Organization, in developing countries where items for feeding are less readily available. Cup feeding requires very few pieces of equipment — items that can be more easily cleaned and sterilized than bottles.
Here’s more about how cup feeding might benefit your baby, challenges you might encounter, and some practical instructions to get you started.
Related: I never understood the pressure to breastfeed
Babies need breast milk or formula for their bodies and brains to grow. If your baby won’t or cannot take the breast or bottle for some reason, cup feeding is a solid alternative.
Other benefits of cup feeding:
- It’s appropriate for the youngest babies. In lower-resource countries cup feeding is often used with babies born prematurely, as early as 29 weeks gestation. This method may also helpful for babies who have low birth weight or have certain medical issues, like a cleft palate.
- It may work for babies who are temporarily unable or unwilling to take the breast or bottles for some other reason (e.g. issues with sucking, nursing strike, mastitis).
- It allows for paced feeding. In fact, you should let your baby feed at their own speed throughout the process and not pour the milk down their throat.
- It’s relatively inexpensive compared to other methods. All you need is a plastic medicine cup, or something similar, and your milk or formula. The rest is about learning technique and patience.
- It’s easy to learn. The process itself is relatively intuitive and both baby and caregiver can get into a good rhythm with enough practice.
Related: The best and worst natural supplements for your milk supply
As you can imagine, the first few times you attempt to cup feed your baby, you may lose some milk. While this is a disadvantage to this style of feeding, you’ll likely develop better technique with time. That said, losing milk in the process can also make it hard to track how much your baby is getting.
Another concern with this method is that cup feeding takes sucking out of the equation. Instead, babies sip or lap up the milk. If your baby has issues with sucking, ask your doctor or lactation consultant for suggestions on other ways to support and develop this important skill.
Last, there is a chance your baby may aspirate the milk while cup feeding. Symptoms of aspiration include things like choking or coughing, rapid breathing during feeds, wheezing or issues with breathing, and slight fever. Contact your baby’s pediatrician if you have any concerns. Untreated, aspiration may lead to dehydration, weight loss, or nutritional deficiencies, among other complications.
Making sure that you’re using the correct method during all cup feedings can help to avoid aspiration.
Related: 13 best baby formulas
The first few times you cup feed your baby, consider asking an expert for help. Again, this may be your child’s pediatrician or a lactation consultant. You might also watch this video for tips.
Once you learn the basics you should get the hang of this method with a little practice.
Step 1: Gather your supplies
To feed your baby using a cup, you can use a basic medicine cup or even a shot glass — both may have the measurements printed on them. Other options include a Foley cup (a cup developed specifically for feeding infants that has a channel that works similarly to a straw) or a paladai (a feeding vessel traditionally used in India that has a reservoir for the milk and a cone-like tip that reaches baby’s mouth).
- Warm breast milk or formula. Don’t use a microwave to warm the milk. Instead, place a bottle or ziplock baggie of it in a bowl of warm water.
- Burp cloths, washcloths, or bibs to catch any spills, drips, and spit-up.
- Swaddle blankets to help secure baby’s arms so they don’t interfere with feeding.
Step 2: Hold your baby
Before feeding, make sure your baby is awake and alert, but also calm. You’ll want to hold your little one in an upright position so they don’t choke on the milk as they drink. If they’re fidgeting or moving their hands in the way, consider swaddling or wrapping their arms in a blanket, but not too tightly.
You may also place the burp cloth or washcloth under your baby’s chin before beginning.
Step 3: Feed your baby
Now that you’re set up for success, the best way to describe how your baby will drink from a cup is that they’ll “slurp” or sip the milk. Resist pouring the milk into their mouth, which may cause them to choke.
- Try to stimulate your baby’s rooting reflex before feeding. This is the same reflex they have when feeding at the breast or bottle. Simply tap their lower lip with the edge of the cup. This should help signal to them that it’s feeding time.
- You may further stimulate this reflex by touching the edges of the cup to their upper lip, grazing the bottom lip as well. You’ll want to make sure your baby’s tongue can move easily at the cup’s lower edge.
- Gently tip the cup to allow the milk to flow closer to the cup’s edge. You’ll want to stay in this position even if your baby isn’t actively drinking. This way, they’ll more easily return to their sipping after short breaks.
- Allow your baby to use their tongue to lap the milk from the cup.
- Stop feeding occasionally to burp your baby (after about every half ounce consumed). Then continue this process as needed.
Note: How much milk you’ll feed your baby depends on their age, weight, and other factors. In other words: It is up to you and your doctor to discuss specifics.
Step 4: Pay close attention
Watch your baby closely for cues that they’re done eating. In general, cup feeding shouldn’t last longer than 30 minutes total. (Fun fact: This is around the same length of time babies spend at the breast, 10-15 minutes on each side.)
How often you cup feed throughout the day will depend on your reason for doing it in the first place. If it’s to supplement, you may only need to do it a few times a day. If it’s your baby’s sole source of nutrition, you’ll need to work closely with their doctor to determine an appropriate schedule.
Related: “Breast is best”: Here’s why it mantra can be harmful
Cup feeding may feel slow and unnatural at first, but your baby should get more efficient with time. While this method may be new to you and perhaps feel unusual, rest assured that cultures across the world appear to have been cup feeding infants for hundreds to thousands of years. It’s just another way to get your baby the nutrients they need to grow and develop.
It’s always a good idea to consult with your child’s pediatrician or even a certified lactation consultant if you have questions or concerns about feeding practices. A specialist can help diagnose issues with feeding or illnesses, provide tips on technique, and give you the support you need in real time.
Cup feeding versus other forms of supplementary enteral nutrition for neonates who cannot be fully breastfed
We set out to determine the best method of supplementation for both term and preterm infants, and whether cup feeding is the best way to feed newborn infants who cannot be fully breastfed than bottle or using a probe.
Most babies born at or slightly before term can breastfeed immediately after birth. However, for a variety of reasons, some full-term and many preterm infants cannot be fully breastfed and require supplemental feeding using alternative feeding methods such as a cup, syringe, bottle, or feeding tube until infants are able to switch to full breastfeeding.
Our search for relevant studies on 31 January 2016 identified 5 studies comparing cup and bottle feeding to newborn infants that we were able to include in this review. These studies were conducted in neonatal and maternity hospitals in Australia, the UK, Brazil and Turkey. The mean gestational age of infants in most of the studies at study entry was the same. In four studies, the intervention (cup or bottle feeding) began at study entry, when infants first needed supplemental feeding, at 30 weeks gestational age. In the Turkish study, supplementary feeding was not started at study entry and at the time of the first supplementary feeding, but was delayed until the infants were 35 weeks old.
For some of the outcomes, results from different studies cannot be pooled. These included not breastfeeding at hospital discharge; non-exclusive breastfeeding at 3 and 6 months; the average time it takes to feed; and the number of days spent in the hospital. For each of these outcomes, some studies favor cup feeding, while others favor bottle feeding.
For some outcomes, results from different studies can be pooled: there was no difference in weight gain or gestational age at discharge for infants who were supplemented with a cup compared with those who were bottle-fed. However, those infants who were supplemented with a cup were more likely to be exclusively breastfed at hospital discharge and more likely to remain breastfed until three and six months of age.
Since most of the studies involved preterm infants and only a few term infants, no recommendation can be made regarding cup feeding of term infants.
Quality of evidence:
The quality of the evidence for weight gain, length of stay in hospital, no breastfeeding at discharge and at 6 months of age, and exclusive breastfeeding at discharge and at 6 months of age is rated as low to very low. The studies included in this review report that many infants who were supplemented by cups were supplemented by other means because either parents or nurses did not like cup feeding.
Translation: Alekseeva Anastasia Andreevna. Editing: Kamalova Aelita Askhatovna and Ziganshina Liliya Evgenievna. Project coordination for translation into Russian: Cochrane Russia - Cochrane Russia (branch of the Northern Cochrane Center on the basis of Kazan Federal University). For questions related to this translation, please contact us at: [email protected]; [email protected]
Cup feeding. Your baby from birth to two yearsCup feeding. Your baby from birth to two years
Your baby from birth to two years old
Cup feeding is an easy and safe way to supplement breastfeeding without using nipples. Cup feeding has been used for newborns and even premature babies.
If medical conditions temporarily delay breastfeeding, or if the baby needs to be supplemented in the early days of his life when he is learning to suckle effectively, cup feeding is a good alternative to bottle feeding. This method can be used for older children who refuse to take a bottle.
Take a small cup that only holds 30-60 g of milk or formula. (Special flexible plastic cups are available from lactation consultants and La Leche League.) Fill the cup at least halfway. Put a bib or tuck a towel under your chin to prevent leakage. Hold the child upright on your lap. Swaddle him if his arms interfere with the process. Bring the cup to your lips and tilt it so that the liquid touches the child's lips. The baby will lap and swallow milk. Do not pour milk into the baby's mouth. Let him set the pace. Refill the cup or have 2-3 filled beforehand ready.
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Baby cup streams
Flows from a baby cup Since the tongue-pulling reflex may not completely disappear in the child at this stage, the protruding tongue may prevent the lips from sealing the cup, and therefore some of the liquid will flow over the tongue and out of the corners of the mouth.
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