Feeding baby bottle breast milk

Feeding expressed milk | introducing bottle

When can you start feeding your baby expressed breast milk? What’s the best way to do it? And should you be concerned about ‘nipple confusion’? We answer your questions about expressed milk feeding

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When should I start giving my baby expressed milk?

If your baby is healthy and breastfeeding is going well, there’s no need to rush into giving her expressed milk. For the first four weeks, you’re working together to initiate and build your breast milk supply while she learns to breastfeed efficiently. While there is limited data,¹ it is thought that unnecessarily introducing bottles during this crucial first month could interfere with these processes.

But if your newborn struggles to latch or suck for any reason, then start expressing milk as soon as possible after the birth. Read our articles on overcoming problems in the first week and feeding breast milk to your premature baby or infant with special needs for more advice, as well as getting support from your healthcare professionals.

How can I feed expressed milk to my baby?

There is a range of expertly designed feeding solutions that can help you give expressed milk to your baby, depending on your and her needs.

For example, Medela’s innovative Calma teat will only allow milk to flow when babies create a vacuum by sucking. This means they can feed from a bottle using the same technique, tongue motion and jaw movement they would at the breast.^2,3 Developed with breastfeeding experts from the University of Western Australia, Calma allows your baby to suck, swallow, pause and breathe just as she does when breastfeeding.⁴ By maintaining babies’ natural sucking behaviour, Calma is designed to make it easy to switch from breast to bottle-feeding and back again.

Medela also makes conventional bottle teats in two flow versions. And all our teats can be attached directly to the bottles you express milk into, minimising the risk of spillages.

If your newborn needs expressed milk, but you don’t want to offer her a bottle until she’s become used to breastfeeding, you could use a baby cup designed for short-term feeding. This allows your baby to sip or lap your expressed milk – be careful to avoid spills! It’s advisable to have a healthcare professional on hand the first time you use the baby cup, to make sure you’re both getting the hang of it.

For babies who need expressed milk supplements in addition to regular breastfeeding, a supplemental nursing system (SNS) can be helpful. This has a thin, flexible feeding tube that can be fixed alongside your nipple to give your baby expressed milk while you’re breastfeeding her. This allows your baby to stay at your breast longer, which further stimulates your breasts to help maintain your milk supply, and also helps improve her breastfeeding skills. It can be useful for mums with low milk supply or with adopted or surrogate babies.

If your baby can’t create the suction needed to breastfeed – perhaps because of a disability, congenital condition or weakness – you could try a feeder designed for babies with special needs. These allow infants who can’t suck to feed using gentle compression instead.

What’s the best way to introduce a bottle?

If breastfeeding is going well and you’ve decided it’s the right time to give your baby a bottle of expressed milk, follow these tips:

Take your time

Don’t wait until your big night out or first day back at work to introduce your baby to the bottle. Start trying with a small amount of expressed milk, in a relaxed and unhurried way, a couple of weeks beforehand. Gradually build up to giving a full feed of expressed breast milk from a bottle.

Pick your moment

Ideally your breastfed baby should be alert, but not too hungry, the first time she has a bottle of expressed milk, so that she is as relaxed as possible.

Delegate feeding duties

Your baby may be confused or frustrated when you offer a bottle, as she’s used to your breast. It might be easier if someone else gives the first bottle, and you stay out of the room so your baby can’t see or smell you.

Not too hot, not too cold

Your baby may be more likely to take the expressed milk if it’s around body temperature, 37 °C (98.6 °F).

Dip and sip

Try dipping the bottle teat into some expressed milk before offering it, so it tastes and smells of your breast milk. Then gently stimulate your baby’s top lip with the teat to encourage her to open her mouth.

Positioning for bottle-feeding

Feed your baby on demand and cuddle her in a semi-upright position. Never bottle-feed her while she’s lying flat or prop her up with the bottle, in case of choking. Go at her pace, with as many pauses as she needs – you can even try switching sides during the feed.

Be patient

Don’t worry if she doesn’t take to the bottle straight away – it may take several tries. If she pushes the bottle away or becomes upset, comfort her and wait a few minutes before trying again. If she still won’t drink from the bottle, wait a few more minutes and then breastfeed her as normal. Try again with the bottle at a different time of day.

How much expressed milk should I give my baby?

Every baby is different. Research shows that in babies aged one to six months, one baby may take as little as 50 ml during a feed while another may take as much as 230 ml. Start by preparing a bottle with around 60 ml, and see if your baby needs more or less. You'll soon learn how much she typically takes – but don’t ever pressure her to finish the bottle.

How can I ensure bottle-feeding is safe for my baby?

Always clean and sanitise your breast pump set and bottles according to the instructions, and wash your hands before pumping, handling milk or feeding your baby. Follow our guidelines for storing and thawing your expressed milk safely.

If warming your breast milk, place the milk bottle or bag into a bowl of warm water or a warmer, or run it under a warm tap (max 37 °C or 98.6 °F). Never warm breast milk in the microwave or on the stove top.

Will my baby cope with switching from breast to bottle?

Mums sometimes worry that if they introduce a bottle too soon, their baby will get accustomed to the artificial teat and struggle to return to breastfeeding. Others are concerned about the opposite problem – if they don’t get their baby used to a bottle early she may never accept one later. Both of these problems are commonly referred to as ‘nipple confusion’.

Experts disagree on whether nipple confusion is really an issue.¹ Certainly sucking from a conventional bottle teat that doesn’t require a vacuum to be created is less effort for a baby than sucking from mum’s nipple, as the milk flows more freely and gravity lends a hand. And some babies do seem to have a preference for breast or bottle, and never take to the other. But many babies switch happily between the two.

If you’re still struggling to feed your baby expressed breast milk, speak to a lactation consultant or breastfeeding specialist.

References

1 Zimmerman E, Thompson K. Clarifying nipple confusion. J Perinatol. 2015;35(11):895-899.

2 Geddes DT et al. Tongue movement and intra-oral vacuum of term infants during breastfeeding and feeding from an experimental teat that released milk under vacuum only. Early Hum Dev. 2012;88(6):443-449.

3 Segami Y et al. Perioral movements and sucking pattern during bottle feeding with a novel, experimental teat are similar to breastfeeding. J Perinatol. 2013;33(4):319-323.

4 Sakalidis VS et al. Oxygen saturation and suck-swallow-breathe coordination of term infants during breastfeeding and feeding from a teat releasing milk only with vacuum. Int J Pediatr. 2012;2012:130769.

How to combine breast and bottle feeding

It can take several weeks for you and your baby to feel happy and confident with breastfeeding.

Once you've both got the hang of it, it's usually possible to offer your baby bottles of expressed milk or formula alongside breastfeeding.

This is sometimes called mixed or combination feeding.

Why combine breast and bottle?

You may want to combine breastfeeding with bottle feeding if you:

are breastfeeding and want to use a bottle to offer your baby some expressed breast milk
want to breastfeed for some of your baby's feeds, but give bottles of formula for 1 or more feeds
are bottle feeding your baby and want to start breastfeeding
need to leave your baby and want to make sure they have some milk while you're away

Introducing formula feeds can affect the amount of breast milk you produce. There is also a small amount of evidence to show babies may not breastfeed as well because they learn to use a different kind of sucking action at the bottle than at the breast.

Introducing formula feeds

If you're combining breastfeeding with formula feeds both you and your baby can carry on enjoying the benefits of breastfeeding.

If you choose to introduce infant formula:

it's best to do it gradually to give your body time to reduce the amount of milk it makes – this helps lower your chance of getting uncomfortable, swollen breasts, or mastitis
if you're going back to work, start a few weeks beforehand to give both of you time to readjust
if your baby is 6 months old or more and can drink milk from a cup, you may not need to introduce a bottle at all

For more information, see drinks and cups for babies.

Giving your baby their first bottle

It may take a while for a breastfed baby to get the hang of bottle feeding.

it usually helps to give the first few bottles when your baby is happy and relaxed – not when they're very hungry
it may help if someone else gives the first bottle feeds, so that your baby is not near you and smelling your breast milk
you might want to try using a different position for bottle and breastfeeding

See more advice on how to bottle feed.

Breastfeeding more and giving fewer bottles

If you want to start breastfeeding more and give your baby fewer bottles, it's a good idea to ask your midwife, health visitor or breastfeeding supporter for support.

These tips may help too:

Hold and cuddle your baby as much as possible, ideally skin to skin. This will encourage your body to make milk and your baby to feed.
Express your breast milk regularly. Expressing releases the hormone prolactin, which stimulates your breasts to make milk. About 8 times a day, including once at night is ideal. It may be easier to express by hand to begin with – your midwife, health visitor or breastfeeding supporter can show you how.
Try bottlefeeding while holding your baby skin to skin and close to your breasts.
If your baby is latching on, feed often. Do not worry if your baby does not feed for long to begin with. See tips on how to get your baby properly positioned and attached.
Choose times when your baby is relaxed, alert and not too hungry, and do not force your baby to stay at the breast.
Decrease the number of bottles gradually, as your milk supply increases.
Consider using a lactation aid (supplementer). A tiny tube is taped next to your nipple and passes into your baby's mouth so your baby can get milk via the tube as well as from your breast. This helps to support your baby as they get used to attaching to the breast. Your midwife, health visitor or breastfeeding supporter can give you more information.

See more tips on boosting your milk supply.

Help and support with mixed feeding

If you have any questions or concerns about combining breast and bottle feeding:

talk to your midwife, health visitor or breastfeeding supporter
call the National Breastfeeding Helpline on 0300 100 0212 (9.30am to 9.30pm, every day)
find breastfeeding support near you

Video: why combine breast and bottle feeding?

In this video, 3 mothers discuss ways to combine breast and bottle feeding.

Media last reviewed: 14 March 2023
Media review due: 14 March 2026

Community content from HealthUnlocked

Page last reviewed: 30 March 2023
Next review due: 30 March 2026

Feeding with expressed milk | breastfeeding

When can I start breastfeeding my baby with expressed breast milk? How to do it right? Is it worth worrying that the child will confuse the pacifier with the breast? In this article we will answer your questions.

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When can I start breastfeeding my baby?

If your baby is healthy and breastfeeding well, there is no need to give him expressed milk. For the first four weeks, you work together to start and increase milk production, and your baby also learns to suckle properly at the breast. There is not enough scientific data on this yet, ¹ but there is an opinion that bottle feeding in the first month may adversely affect the process of establishing breastfeeding.

However, if the newborn is unable to latch on or suckle for some reason, start expressing milk as soon as possible after delivery. Read more about this in our articles on coping with problems in the first week, breastfeeding premature babies and babies with special needs, and seeking help from your healthcare provider.

How can I feed my baby with expressed breast milk?

There are many expert feeding solutions that allow you to give your baby expressed milk in a variety of ways, depending on your and your baby's needs.

For example, the innovative Calma smart pacifier only lets milk through when the baby creates a vacuum by suckling. This means that when feeding from a bottle, he will make the same movements with his tongue and jaws as when sucking at the breast. ^2.3 Calma was developed with the help of breastfeeding experts from the University of Western Australia. When using this pacifier, the baby can suck, swallow, pause and breathe in the same way as when breastfeeding. ⁴ Preserving natural sucking habits allows baby to transition easily from breast to bottle and back.

In addition, Medela also offers regular bottle teats* in two versions that produce milk at different rates. All Medela* nipples can be placed directly on bottles used for expressing milk, minimizing the risk of spillage.

If you need to feed your baby with expressed milk, but you do not want to bottle feed him until he is learning to breastfeed, you can use a sippy cup* for temporary feeding. The baby will be able to drink milk from such a mug, but you should be careful not to spill the milk. For the first time, it is advisable to feed the child from a drinking cup under the supervision of the attending physician in order to learn how to do it correctly.

If your baby needs to be supplemented with expressed milk in addition to regular breastfeeding, the Supplementary Feeding System (SNS)* can be used. It is equipped with a thin, flexible capillary that can be clipped close to the nipple to give your baby expressed milk while breastfeeding. Thanks to this, the baby suckles the breast for longer, thereby developing sucking skills and stimulating the production of milk from the mother. This can be helpful when there is a shortage of breast milk, as well as when feeding adopted or surrogate children.

If the baby is unable to breastfeed because he is too weak or has a congenital disease, you can use the Special Needs Cup*, which releases milk with gentle pressure, making it suitable for feeding these babies.

How to teach a child to bottle feed?

If breastfeeding is going well and you decide to start bottle feeding your baby with expressed breast milk, follow these guidelines.

Start early and take your time

Don't wait until the first day of work or the first time you leave the house to start bottle feeding your baby. Start accustoming your baby to small portions of expressed milk a couple of weeks before the desired date, calmly and without haste. Gradually build up to one full serving of pumped milk from a bottle.

Choose a time

Ideally, at the first bottle feeding, the baby should be hungry, but not too hungry - in this state, he is as relaxed as possible.

Let others feed

Your baby is used to feeding from your breast, so when you offer him a bottle it can be confusing. The process can go faster if the first time the baby is bottle-fed by someone else while you are not in the room, so that your sight and smell do not embarrass the baby.

Maintain optimal temperature

Your baby will be more willing to eat expressed milk if the temperature is around 37°C, close to body temperature.

Dip the nipple in milk

Try dipping the nipple in expressed milk before offering it to your baby. This way it will taste and smell like your breast milk. Lightly touch the baby's upper lip with the nipple to open the mouth.

Choose the right position for bottle feeding

Feed your baby on demand and keep him reclining during feeding. Never bottle feed your baby when he is lying or sitting, otherwise he may choke. Listen to the wishes of the child - take as many pauses as he needs. You can even try to shift it from one hand to another during feeding.

Be patient

Don't worry if your baby doesn't take the bottle right away - it may take several tries. If he pushes the bottle away or starts crying, calm him down, wait a few minutes and try again. If he still doesn't want to bottle feed, wait a few more minutes and breastfeed him as usual. Repeat the bottle experiment at a different time of day.

How much pumped milk should I give my baby?

All children are different. Research shows that between the ages of one and six months, a baby can consume between 50 and 230 ml of milk per feeding. To start, prepare about 60 ml and observe how much your baby needs - more or less. You will soon realize how much milk he usually eats. Just never force him to finish the cooked portion.

How can I keep my baby safe when bottle feeding?

Always clean and sterilize your pump and bottles according to the manufacturer's instructions. Wash your hands before expressing, pouring milk, and feeding your baby. Follow our instructions for safely storing and thawing your expressed milk.

If breastmilk needs to be warmed, place the bottle or bag in a bowl of warm water or a heater or under running water at a maximum of 37°C. Never heat breast milk in the microwave or on the stove.

Will the baby be able to transition from breast to bottle?

Some mothers worry that if they start bottle feeding too early, the baby will get used to the artificial nipple and not want to breastfeed. Others, on the contrary, are worried that if the child is not immediately accustomed to the bottle, then he will no longer eat from it. In general, in these cases, they say that the child confuses the nipple with the breast.

Experts disagree on whether such confusion is a problem. ¹ Without a doubt, it is easier for a baby to suckle milk from a regular bottle with a nipple, which does not require a vacuum, than from the breast, since the milk flows faster, also under the influence of gravity. And some babies really have clear preferences: only the breast or only the nipple. However, many babies are comfortable suckling both the breast and the pacifier.

If you are unable to feed your baby with expressed breast milk, seek help from a lactation consultant or specialist.

Literature

1 Zimmerman E, Thompson K. Clarifying nipple confusion. J. Perinatol. 2015;35(11):895-899. - Zimmerman I., Thompson K., "On the issue of breastfeeding." Zh Perinatol (Journal of Perinatology). 2015;35(11):895-899.

2 Geddes DT et al. Tongue movement and intra-oral vacuum of term infants during breastfeeding and feeding from an experimental teat that released milk under vacuum only. Early Hum Dev . 2012;88(6):443-449. - Geddes D.T. et al., "Language Movements and Oral Vacuum Generation in Term Infants During Breastfeeding and Feeding from an Experimental Vacuum-Delivery Teat". Airlie Hume Dev. 2012;88(6):443-449.

3 Segami Y et al. Perioral movements and sucking pattern during bottle feeding with a novel, experimental teat are similar to breastfeeding. J. Perinatol. 2013;33(4):319-323. - Segami I. et al., "Perioral movements and sucking during bottle feeding with a new experimental nipple are very similar to sucking from the breast." Zh Perinatol (Journal of Perinatology). 2013;33(4):319-323.

4 Sakalidis VS et al. Oxygen saturation and suck-swallow-breathe coordination of term infants during breastfeeding and feeding from a teat releasing milk only with vacuum. Int J Pediatr. 2012;2012:130769. - Sakalidis V.S. et al., "Oxygenation and Coordination of Sucking, Swallowing, and Breathing in the Term Infant During Breastfeeding and Feeding from a Purely Vacuum Teat". Int J Pediatrician 2012;2012:130769.

Read instructions before use. Consult a specialist about possible contraindications.

* RC № ФСЗ 2010/07353 of 07/19/2010

Feeding a baby with breast milk from a bottle

Establishing breastfeeding is one of the most significant processes for a mother in the first month after the birth of a baby. This is a sacrament in which a lot of important moments for the development of the baby are hidden: ideal food for the baby, contact between the baby and the mother, normalization of sleep. In addition, for many mothers, this is a very pleasant and healing process in the postpartum period. The release of the hormone oxytocin contributes to the contraction of the uterus and the restoration of its former shape. The production of milk by the body helps mom lose extra pounds. Long-term breastfeeding acts as a prophylactic against a number of female diseases.

However, not everyone succeeds in easily coping with this process (albeit natural). In the first month, many women may experience difficulties: unprepared nipples, irregular or insufficient milk production, etc. These problems are the norm and should not become a reason for the growth of anxiety and self-blame. Most likely, in a month the process will improve. But even if this is not the case, alternative options can be used, for example: feeding with expressed milk from a bottle or supplementing with formula. In any case, it is worth remembering: you are the best mother for your child.

At what age can you bottle feed your baby with expressed milk?

If there is significant difficulty in breastfeeding, you can use the bottle almost immediately. Today, a feeding bottle with a teat labeled "0+" is available in every pharmacy or baby store. There are bottles of foreign and domestic manufacturers on sale (for example, DINO & RHINO bottles are produced in Russia).

Bottle feeding may also be recommended if the baby is not suckling well at the breast, has a weak latch on the nipple, and is not gaining weight (this is sometimes the case with babies who were born a little early).

In other cases, in the first month it is recommended to establish a natural process of breastfeeding. In the future, you can use the bottle as an aid, for example, if you need to go away on business, and leave the child with dad, grandmother, nanny.

How to feed your baby with expressed milk?

To begin with, the bottle must be sterilized. How to do it correctly, you can read in our other article. Then fresh or thawed, warmed to body temperature (37 ° C) expressed breast milk is poured into a bottle, and the baby sucks it out through the nipple.

Modern bottle nipples are designed so that when sucking, the baby must make the same movements and efforts as when sucking milk from the breast. The nipples have a flow rate close to the anatomical shape and the actual age of the baby. They are made from safe and hypoallergenic BPA-free materials, so you don't have to worry about your child's health.

How to offer the baby a bottle for the first time and teach the child to eat from it?

Usually this does not cause difficulties, many children begin to actively drink from a bottle the first time. But sometimes it takes several tries. The baby may push the pacifier away, crying is normal. Try again and again.

To offer a bottle for the first time, wait until the baby is hungry (but not too hungry) and bring the nipple to the mouth in the same way as you do with the breast nipple, at the same angle. Lightly touch her lips to the child so that he opens his mouth. The optimal position of the baby when feeding is reclining.

If up to this point you have been breastfeeding for a long time and the child has a clear connection in the head (mother - breast), ask one of the relatives to offer him a bottle, so he will not be distracted by your smell and expect the usual way of feeding.

If the baby does not want to take the nipple in any way, dip its tip in expressed milk, perhaps he will readily react to the smell.

If he wants to pause, listen to his desire.

How much expressed milk should you give your baby?

There are norms recommended by pediatricians: how many ml of milk a child of one age or another should eat. For example, at the stage of 1-6 months, the average child should eat 50-230 ml of milk per meal (you can find a detailed table by month in the relevant reminders). But there is also an individual norm. If your child eats less or more than the average amount, but is healthy and developing well, there is no reason to worry.

How to make bottle feeding as safe as possible?

Choose a nipple with an age-appropriate flow and ensure your baby is in the correct feeding position to prevent choking.
Sterilize the nipple, bottle, and pump before each feeding during the first few months of your baby's life.
Be sure to wash your hands before feeding and pumping.
Store expressed milk correctly: no more than 4 hours at room temperature. If you need to store longer, use the refrigerator or freezer.