When can you start bottle feeding a breastfed baby

Introducing Bottle Feeding to Breastfed Babies

Lansinoh Moms' Club

Introducing bottles to breastfed babies can be a stressful and emotional time for both mom and baby.

Some moms feel guilt when introducing bottle feeding because it’s a huge change for baby, while some moms worry about nipple confusion (also known as nipple preference). And some moms are overwhelmed by the amount of information and advice on what bottles to use, and when to start using them.

Take a deep breath! It is important to remind yourself – and remind yourself OFTEN – that you are a great mom. Teaching a breastfed baby to take a bottle is like many of the other milestones you’ll encounter in parenting: it will be tricky at first, but you’ll find the solution that works best for baby and you.

Here are some tips we find helpful when introducing bottle feeding to breastfed babies:

Try to wait until baby is 4-6 weeks old before introducing bottle feeding. This is enough time for baby to establish good breastfeeding habits, and for your body to establish a good milk supply.
Have someone else feed baby the bottle. It is best if someone other than the mom gives baby the bottle because it minimizes confusion for baby. Teach baby early that mom breastfeeds and other caregivers bottle feed.
Don’t skip a feeding session when baby is being bottle-fed. This is where your breast pump comes in! It may seem like a luxury to have a moment to yourself when someone else is feeding baby, but it’s critical to keep providing breastfeeding cues to your body. Mom should pump at the same time she would normally feed baby. This ensures her body doesn’t get the wrong message and reduce milk production.
Give yourself time to find the nipple that works best. Many parents find that they need to try multiple nipples to find the one that works best for baby. It is important to have enough time to figure it out before hitting a firm deadline, like returning to work. The Lansinoh® NaturalWave® Bottle Nipples are designed especially for breastfed babies and allows baby to use the same feeding actions as when at the breast, and is clinically proven to reduce nipple preference..
Try Paced Feeding. The way you bottle feed baby is also important. “Paced feeding” is when the caregiver invites the baby to draw the nipple into their mouth, paces the feed to ensure baby is not forced to feed more than she wants, and recognizes baby’s cues when she has had enough. This method most closely resembles baby’s feeding behaviors at the breast, and can reduce the risk of overfeeding and symptoms associated with colic like stomach upset, gassiness, and fussiness.

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Introducing a Bottle to a Breastfed Baby

The information in this post is also contained in our Working & Breastfeeding.

Here is one approach to beginning pumping and introducing bottles that has worked well for many mothers as they prepared to return to work:

Once breastfeeding is well established – usually after about four weeks – begin pumping after one feeding a day where your breasts still feel a little full. Remember you are pumping “leftovers” and should only expect a small amount.
Freeze that first pumping immediately. You can add other pumpings to it after they have been cooled in the freezer.
Your pediatrician may have given you a total number of ounces your baby may feed in a day or a range from the smallest probable amount to the largest, based on your baby’s weight.
- If dealing with a total volume over a 24-hour period, divide that by the typical number of times your baby feeds for a target volume for the first bottle.
- If dealing with a range, store volumes of the lower amount.
- Store some extra small volumes in case baby is hungrier than expected.
- When you have enough stored to equal the expected volume and a bit more, you can begin to plan a time to introduce a bottle.
- EXAMPLE for offering the first bottle:
  - Your pediatrician suggests that your baby probably takes about 24 ounces a day.
  - You know that he feeds between eight and 12 times a day.
  - That means he could take anywhere from 2 to 3 ounces.
  - You pump until you have a 2-ounce bottle and then have several 1/2 ounce bottles to equal at least three ounces or more saved.
  - Choose a day that your primary support person will be available and a feeding time where baby tends to be more pleasant and patient for his feeding.
  - Baby may accept a bottle more easily from someone other than you. He knows milk comes from you and may not understand why he’s not going there instead of to this foreign object.
  - Thaw out the 2-ounce bottle in the refrigerator overnight.
  - When baby begins to stir, place the bottle from the refrigerator in a bowl of warm water (bath temperature) or a bottle warmer while the person offering the bottle goes to get baby from his bed, changed and ready for the feeding.
  - Often it helps to run the bottle nipple under warm water, if it was also in the refrigerator, to make it more acceptable to the baby.
  - Baby should be held in an upright, almost sitting, position that is similar to the position usually used by the support person.
  - The warmed bottle should be held at an angle tilted just enough to fill the nipple to allow baby to keep control of when and how fast the milk comes.
  - Tickle the baby’s mouth to encourage an open mouth then bring baby up onto the bottle nipple, aiming the nipple toward the palate.
  - Some have found that it can help to have an article of clothing you have worn, like a nightgown or t-shirt, to place on their arm, shoulder, or chest where the baby can smell your scent.
  - It is usually best if you are close but not present in the room during this first “experiment” with bottle feeding. Your baby is very wise and will wait for you to come feed her if she knows you are nearby.

Once the feeding is completed, you will pump to create a bottle equal to what the baby consumed. Remember that the baby is always better than a pump! If you do not pump as much as the baby took, it is more likely a pump issue than an issue of not enough milk. Just pump after another breastfeeding and add that amount to what you pumped to get the amount baby took.

You will continue this pattern until you have enough milk stored in your freezer to get you through a normal work day plus a few extra for any hectic day at work where you may not have been able to pump as often. Plan to fully breastfeed for all feedings when not separated from your baby.

Working and Breastfeeding
Feeding Breastmilk From a Bottle
Pumping
Cleaning and Sanitizing Pumping Accessories
Hand Expressing

Published August 2018.

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.

* RU № ФСЗ 2010/07353 dated 07/19/2010

we tell you how easy it is to feed a baby with expressed milk

One of the most common arguments people oppose breastfeeding in public is that feeding an infant with expressed milk from a bottle is just as easy, convenient and much less embarrassing than breastfeeding directly from the breast.

Yes, in general bottle-feeding is often seen as an affordable and equal alternative to breastfeeding, which can be used when the mother needs to go away on business or just take a break from the baby. Is it really so? We figured out how to offer a bottle to a baby, and what can go wrong with this.

We have repeatedly said that we support any method of infant feeding, as long as it is beneficial for the child and his parents. Any method of feeding has its pros and cons, and choosing the most suitable option (or options) for yourself, it is important to take them into account.

Feeding a baby with expressed milk from a bottle cannot be considered as a complete replacement for breastfeeding, which is suitable for all nursing mothers, and here's why.

This is one of the most obvious problems. Many babies, especially those who are breastfed from birth, simply refuse to take anything other than their mother's breast.

This is the other side of "bottle training" - lactation consultants strongly advise against feeding breastfeeding babies from a bottle with a nipple without good reason, because even if they agree to such a replacement, then they may completely or partially refuse from the chest.

Switching to bottle feeding with a nipple can also negatively affect how the baby latch on. Milk from a bottle flows faster and more forcefully than from a mother's breast, the baby has to put in less effort to obtain it, and the grip required for feeding from a nipple is different from that needed for painless and effective sucking of the mother's breast.

One of the absolute advantages of breastfeeding is the ability to always have milk at the right temperature and in the right volume without any effort.

Feeding a baby with expressed milk requires a lot of things: a breast pump, milk storage and freezing bags, a bottle sterilizer, the nipple bottles themselves, a cooler bag (if you plan to feed your baby outside the home) and a bottle warmer. Yes, you can probably do without something from this list, but you are unlikely to be able to even switch to periodic feeding with expressed milk without special equipment.

Not all women find it easy to express milk, especially if they have to do it on a regular basis. For example, in the United States, only 47 percent of babies are exclusively breastfed during the first three months of life (according to CDC 2017). There are many reasons for this, but a very short decree is one of them.

Expressing milk frequently is hard and time-consuming work, and it can also negatively affect lactation.

If difficulties do not frighten you, and your child does not demonstrate a categorical dislike for the bottle, then this is what lactation specialists recommend.

Attempts to bottle-train an infant should begin after they are four weeks old. It is believed that by this time the mother has time to establish lactation, and the child gets used to taking the breast correctly.

The best time to offer a bottle to a baby for the first time is when he is calm, content, and not very hungry—hungry does not help in learning new skills. For starters, treat bottle feeding like a game, not like a meal.

Despite the fact that babies seem to understand very little, they already know how to recognize people around them and know roughly what to expect from these people. A baby is more likely to take a bottle from a person who has never breastfed than from a mother.

When you bottle feed your baby, do not put him on his back - the milk will flow too fast and the baby may choke or swallow air.

Babies up to six weeks old can be laid slightly on their side, and older babies can be held in a semi-sitting or upright position, while the bottle should be placed horizontally.

To maintain a proper grip, bottle feed your baby the same way you would breastfeed him. First, gently touch the baby's lips with the pacifier so that he reflexively opens his mouth, and then place the pacifier in the baby's mouth. It is important that the baby grabs the nipple completely, and not just the tip - just like he does with the breast.

Take small breaks during feeding by tilting the bottle so that milk does not flow out of it - this makes bottle feeding more like breastfeeding, in which the flow of milk is constantly changing its intensity.

As we wrote earlier, not all babies are happy to exchange their mother's breast for a plastic bottle with a nipple.

If the baby is not being fed by the mother, try wrapping the bottle in a piece of clothing that smells like the mother.

Some babies are more likely to take a bottle when they are in close skin-to-skin contact with the person who feeds them.

Other babies may find it more interesting to feed in a position that does not remind them of breastfeeding at all. Take the baby under the chest, sit him down - maybe it will be more pleasant for him to drink milk, looking around.

Try feeding your baby while moving in a rhythmic way: you can walk, rock, sit in a rocking chair, or roll back and forth on a chair with wheels.

Try different types of nipples, since there are a lot of them now, and they differ in size, length, thickness and stiffness.

Try changing the teat temperature. Some babies (for example, those who are teething) will prefer a nipple that has just been taken out of the refrigerator, while others, on the contrary, will enjoy drinking from a nipple that resembles their mother’s breast in temperature (for this you can hold the nipple under warm water).

Try changing the temperature of the milk: your baby may like cool or cold milk more (no, it's not bad).

If your baby doesn't take a bottle on principle, even after you've tried all of these suggestions, you can try feeding him expressed milk from something else. Here are the most common options that breastfeeding consultants offer.

According to the La Leche League experts, even a newborn baby can be fed from a cup, and this process is comparable in time to breastfeeding. Just sit the child down, put a cup of milk to his lips and let the child sip it on his own.

A regular medical syringe without a needle or with a long cannula is often used to give an infant milk or liquid medicine. Draw milk into the syringe and either squirt it little by little into the corner of the child's mouth, or let the child suck it, gently and intermittently pressing the plunger.

Lactation consultant-approved method that requires some manual dexterity and firmness.