What is cup feeding a baby

Cup Feeding - La Leche League International

8 April 20

Categories: News From LLLI

We are delighted to co-publish this new poster about cup feeding.
The poster is intended to help healthcare professionals and organizations working in emergencies and families themselves.
It is also intended to be a useful resource for anyone who needs to feed their own expressed milk or a supplement to a baby.

The poster can be downloaded and printed for use in your communities, or shared on social media.

We are in the process of translating the poster into multiple languages.

Skip to:
COLOR POSTERS TO DOWNLOAD
BLACK AND WHITE POSTERS TO DOWNLOAD
COLOR POSTERS FOR USE ON SOCIAL MEDIA
BLACK AND WHITE POSTERS FOR USE ON SOCIAL MEDIA

A BABY NOT FED AT THE BREAST CAN BE FED WITHOUT A BOTTLE

Cup feeding can be used from birth. It is suitable for both expressed breastmilk and infant formula. You can use any clean, open cup with a smooth surface.

Cup feeding has no notable difference to bottles for average time per feed.

Cups are safer than bottles. Bottle teats and screw tops trap germs that can get into the milk and make babies ill. Cups are easily cleaned with washing in hot soapy water, and do not need sterilizing like bottles.

In emergencies, use disposable cups.

Feeding time is bonding time – lots of cuddles, eye-contact, talking, smiling, humming and singing.

CUP FEEDING IS AS EASY AS 1-2-3!

color posters to download

English pdf
Spanish pdf
German pdf
Greek pdf
Lithuanian pdf
Turkish pdf
French pdf
Russian pdf
Swahili pdf
Traditional Chinese pdf
Simplified Chinese pdf
Arabic pdf
Vietnamese pdf
Romanian pdf
Polish pdf
Ukranian pdf

Black and White posters to download

English pdf
Spanish pdf
German pdf
Greek pdf
Lithuanian pdf
Turkish pdf
French pdf
Russian pdf
Swahili pdf
Simplified Chinese pdf
Traditional Chinese pdf
Arabic pdf
Vietnamese pdf
Polish pdf
Ukranian pdf

COLOR POSTERS FOR USE ON SOCIAL MEDIA

Right click on a desktop, or hold and tap on a mobile device to bring up your options to copy or save the image.

English

Spanish

German

Greek

Lithuanian

Turkish

French

Swahili

Russian

Traditional Chinese
Simplified Chinese

Arabic

Vietnamese
Romanian

Polish

Ukrainian

BLACK AND WHITE POSTERS FOR USE ON SOCIAL MEDIA

Right click on a desktop, or hold and tap on a mobile device to bring up your options to copy or save the image.

English

Spanish

German

Greek

Lithuanian

Turkish

French

Swahili

Russian

Simplified Chinese

Traditional Chinese

Arabic

Vietnamese

Polish

Ukrainian

Adapted from The World Health Organization – Infant Feeding in Emergencies: A Guide for Mothers and UNICEF/WHO 20-hour Baby Friendly Hospital Initiative Course by Magdalena Whoolery (PhD Health Studies, BSc Nursing, Dip HE Nursing) and Julie Fogarty (BFA, GradDipTchg), January 2020 (updated April 2020).

Poster endorsed by the following: International Baby Food Action Network (IBFAN, defending breastfeeding), Safely Fed Canada, Breastfeeding Advocacy Australia, La Leche League International (LLLI).

Cup Feeding a Newborn - Breastfeeding Support

Breastfeeding SupportCreated with Sketch.

Evidence-based breastfeeding tips and resources

Editor in Chief Philippa Pearson-Glaze

Home
Articles
Our Picks
Find IBCLC

About
Contact
Newsletter
Terms & Privacy
Log in

Special Circumstances

Author

By Philippa Pearson-Glaze IBCLC

Last Revised

22 Jan, 2021

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.

Sign Up to the Newsletter

Get breastfeeding articles in your inbox

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?

Summary

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.

Footnotes & References

Penny et al. Cup Feeding as a Supplemental, Alternative Feeding Method for Preterm Breastfed Infants: An Integrative Review. Matern Child Health J. 2018
Rocha et al, Cup or bottle for preterm infants: effects on oxygen saturation, weight gain, and breastfeeding, 2002
Marinelli et al, A comparison of the safety of cupfeedings and bottlefeedings in premature infants whose mothers intend to breastfeed, 2001
Collins et al. Avoidance of bottles during the establishment of breast feeds in preterm infants. Cochrane database of systematic reviews. 2016
Penny et al. Cup Feeding as a Supplemental, Alternative Feeding Method for Preterm Breastfed Infants: An Integrative Review. Matern Child Health J. 2018
Franca et al. Electromyographic analysis of masseter muscle in newborns during suction in breast, bottle or cup feeding. BMC Pregnancy and Childbirth volume 14, 2014
Gupta et al, Cup feeding: an alternative to bottle feeding in a neonatal intensive care unit, 1999
McKinney et al, Feeding Neonates by Cup: A Systematic Review of the Literature, 2016
Han AM, Cup-feeding versus other forms of supplemental enteral feeding for newborn infants unable to fully breastfeed, 2010
McKinney et al, Feeding Neonates by Cup: A Systematic Review of the Literature, 2016
Yilmaz et al, Effect of cup feeding and bottle feeding on breastfeeding in late preterm infants: a randomized controlled study, 2014
ABM Clinical Protocol #3: Supplementary Feedings in the Healthy Term Breastfed Neonate, Academy of Breastfeeding Medicine, Revised 2017
Protecting, Promoting and Supporting Breastfeeding in Facilities Providing Maternity and Newborn Services, WHO, 2017
Malhotra et al, A controlled trial of alternative methods of oral feeding in neonates, 1999
Aloysius & Hickson, Evaluation of paladai cup feeding in breast-fed preterm infants compared with bottle feeding, 2007

Important

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.

Find an IBCLC Read our full disclaimer

CUP FEEDING - La Leche Liga Russia

Diseases and special conditions of the baby, Breastfeeding doctors and specialists, breastfeeding, Books and articles, Childbirth. Starting breastfeeding., Lifestyle and breastfeeding, Pumping, The amazing benefits of breast milk, What to do if ...

01/16/2021

A baby who does not breastfeed can be fed from a cup

Cup feeding can be used from birth. This method is suitable for both breast milk and formula. You can use any clean cup with a smooth surface.

Cup feeding does not have a noticeable difference with bottles in average feeding time.

Cups are safer than bottles. Bottle nipples and screw caps keep germs out that can get into milk and cause illness in babies. The cups are easy to clean with soapy water and do not need to be sterilized like bottles.

Use disposable cups in case of emergency.

Feeding time is a time of togetherness: lots of hugs, eye contact, talking, smiling, humming and singing.

1-2-3 Cup Feeding

Place your baby on your knees and support their back and neck. With young children, loose swaddling can help to keep their hands from rattling on the cup.
Take a small cup of milk and press the rim lightly against the child's lower lip. Then tilt the cup so that the milk stays on the edge of the cup, but so that it reaches the baby's lips. The baby must be awake in order to be able to open its mouth on its own.
Continue slowly. DO NOT pour milk into baby's mouth. Always let your baby lead the pace of sips and pauses. Continue to keep milk only on the edge of the cup. When the baby is full, he will close his mouth and will no longer continue feeding

Babies will suck or drink milk, or may use their tongue to lap it, as in the picture.

Cup feeding gives babies the freedom to move their tongue in a way that is closer to the “sucking” reflex used in breastfeeding.

Did you know that you can restore breastfeeding through a process called relactation?
Breastfeeding saves lives, especially in emergencies.
Contact a La Leche League Volunteer Consultant for more information.

 Adapted from the World Health Organization - Infant Feeding in Emergencies: A Guide for Mothers and a 20 Hour Hospital Course for the UNICEF/WHO Baby Friendly Hospital Initiative by Magdalena Woolery (PhD Health Studies, BSc Nursing, Dip HE Nursing) and Julie Fogarty (BFA, GradDipTchg), January 2020 (updated April 2020). The poster is endorsed by the following organizations: International Infant Food Surveillance Network (IBFAN, breastfeeding advocacy), Safe Feeding Canada, Breastfeeding Advocacy Australia, La Leche League International (LLLI).

Poster also available in PDF format:

Cup feeding

Cup feeding b/w

Cup feeding versus other forms of supplemental enteral feeding in neonates who cannot be fully breastfed

Review question:

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.

Actuality:

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.

Study profile:

Our search for relevant studies conducted 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.

Main results:

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 for cup feeding 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 are rated as low to very low.