New moms often ask me when it is okay to start bottle feeding a breastfed baby.

Some moms will wonder if bottles are a good idea at all if you are breastfeeding. Nobody wants to have to deal with the dreaded bottle refusal.

If breastfeeding is going well you don’t want to mess it up with bottles. But there is a lot to be said about the benefits of a breastfed baby who will take a bottle when you need them to.

I do believe that it is a good idea for breastfed babies to be willing to take a bottle.

Breast is best, but breastmilk in a bottle is pretty awesome too.

These tips for bottles feeding a breastfed baby should help make this experience a positive one for everyone involved.

There is a reason I feel this way.

There are a few patients from my lactation career that I will always remember. One of those mamas I saw on the surgical floor of the hospital where I worked.

She was the mom of an exclusively breastfed three-month-old baby girl. This patient had just had emergency gallbladder surgery.

As I talked to her, the story became even more interesting, dramatic, and heart-wrenching.

She had come to visit her mother and it was her first trip alone with her baby.

Let’s add this mom’s stress points up:

Stress #1 – Traveling on a plane by herself with her three-month-old

• We all know “those” looks you get when you board a plane with an infant.
• We probably gave “those” looks before we had our own baby.

#2 – Being in a different environment where she didn’t have all the comforts of home for herself and her baby

#3 – The pain of a gallbladder attack

I’ve never had one, but I’ve heard they are pretty awful. They are often ranked right up there with childbirth.

#4 – Needing surgery for said gallbladder attack

#5 – Her baby was in the care of her loving grandma. However, the baby had just met grandma two days before.

#6- Her baby had to get formula, which she has never had before.

#7 – Her baby had never had a bottle before.

It stresses me out just writing all that!

The mom was fine. The baby was fine. The baby took the bottle of formula just fine. I brought mom a pump so she could supply her baby with her pumped milk.

This story had a happy ending, but it easily could have gone south if the baby refused the bottle. At the very least, it would have been one more reason for that poor mom to stress.

• Emergencies – like the story I just shared
• Unexpected delays – For example, you go to get your hair cut. You get caught in a traffic jam and don’t get home in time for your baby’s feeding. (Tip: For your comfort keep a manual pump in your car for this type of emergency).
• Flexibility – date night, anyone?

Start offering a bottle when breastfeeding is well established.

I don’t give a specific age. I don’t believe that the door to bottle-feeding is shut forever if you don’t introduce it by a particular age. The reality is that some babies will refuse a bottle very early on, and others will accept them even if offered at a late age.

Tip: if your baby is older than four to six months, just skip bottles altogether and use a cup. This way, you will have one less thing to wean your child from.

Breastfeeding takes a minimum of two weeks to get established.

I say it is established when you have stopped thinking about all the details.

• You don’t have any pain in your nipples or breasts.
• Your baby is swallowing all the time
• Baby is gaining an average amount of weight
• She is having more diapers than you can count.
• Recognizing her feeding cues are second nature for you.
• You can latch her on easily without paying attention.

When you can check all those boxes, then breastfeeding is well established.

Start slow when offering that first bottle. The first time you offer a bottle, make it an appetizer. Put half an ounce to one ounce in the bottle.

After seeing what your baby thinks of bottle feeding you can finish the feeding at the breast.

The reason for this advice is if your little one takes one look at that bottle, clamps his mouth shut and looks at you like you’ve lost your mind, then you won’t have to throw away large amounts of your precious breastmilk.

If your baby refuses the bottle you should continue to offer small amounts until he is willingly taking it.

If your baby enthusiastically took the bottle, go ahead and offer a full feeding the next time you want to do a bottle feeding.

For a bottle that is in place of a breastfeeding session between 2 and 5 ounces is average. You’re probably thinking, well, that’s a huge range!

How much is a full feeding will depend on different factors.

• How much does your baby weigh?
• How old is your baby?
• How often does your baby eat?
• Is the bottle in place of a breastfeeding, or to supplement breastfeeding?
• If the bottle is to supplement, how much milk is your baby getting at your breast?
• A 7-8# baby, who is six weeks or younger, probably will eat 2.5-3 oz.
• As a baby gets older and larger, he will eat a little more.
• Most breastfed babies top out at 4-5 oz.
  • This amount may be much less than a formula-fed baby.
  • As a baby gets older, your breastmilk changes according to your baby’s needs.

A pediatrician once told a mom who I was working with that if a baby is overfed, he would just spit it back up. Overeating is the most common reason for spitting up, but it is not always what happens.

Can you overeat? Yes, we all can. With a baby, if he eats more than his little tummy can comfortably hold, it can teach him that is what eating should feel like. He won’t feel satisfied unless he feels stuffed.

A baby’s body can also push the food through their duodenum, and the food doesn’t get the time it should have in the stomach for proper digestion.

The ability to overeat is why being able to take a bottle after breastfeeding is not an accurate way to see if a baby is getting enough from breastfeeding.

Just because your baby can eat a certain amount of milk from a bottle doesn’t mean that he should. Think about how you feel when you eat a huge meal. It makes you uncomfortable for a while. Imagine if you felt like that every time you ate. That’s how your baby feels when he overeats.

I know from personal experience that babies, even very young ones, can overeat without spitting up.

When I was a nurse’s aide, many, many years ago, I was sent to work in the nursery. I didn’t know anything about how much babies were supposed to eat.

I was instructed to feed a baby who was 2 or 3 days old. I got a bottle of formula, and I fed him. He took the whole bottle. He just kept sucking the formula down until there was no more. He didn’t spit anything up.

Back then, the ready to feed bottles of formula contained 4 oz. Four! That brand-new baby ate it all.

When I told the nurse, she looked at me like I’d gone crazy. “Uh, they don’t usually eat that much,” she said. Knowing what I know now, I feel terrible for that baby.  He probably had quite a tummy ache!

Here is what the size of a new baby’s tummy is like.

In my experience, giving a bottle once a week is enough to keep it familiar to your baby.

Pick a day of the week, so it is easy to remember. If you go longer than a week, it can be difficult to remember how long it has been. If too much time passes, you may find your baby suddenly refusing bottle.

Some families make it part of their daily routine by having Dad or a sibling give a bottle once a day. 

It is popular advice that a breastfeeding mom should not offer a bottle. For most babies, it won’t matter. If you are the only one who is available to give the bottle and your baby accepts it from you, then go ahead and give it.

There is a debate in the medical community about whether nipple confusion is really a thing.

Babies do suck differently on a bottle than they do on their mom’s breast. Whether it causes them to be confused may or may not be true. I do believe they can have flow preference.

Flow preference is what can happen when a baby gets a bottle before mom’s milk comes in. Instead of getting the drip, drip of colostrum, they get a quick and easy flow of milk.

You can minimize flow preference with the right technique used to give a bottle.

This picture shows a very common way babies are bottle-fed.

• Gravity is helping the milk flow.
• The result can be the baby getting the milk very quickly.
• This can lead to a baby over-eating.
• If mom’s milk doesn’t flow this fast, a baby may get frustrated at the breast.

It takes a little time for our brain to get the message that our tummy is full. When a baby eats very quickly, he may not have gotten that message from his brain and may act like he is still hungry.

Using the paced bottle-feeding technique will help make the feeding last long enough for the baby to realize he is full.

• Baby should be upright – like in this picture.
• The bottle should be perpendicular
• If baby is gulping, slow the feeding down by tipping back the bottle or removing it from baby’s mouth.
• Watch for cues that baby is full.
  • Pushing the bottle out
  • Pursing lips if you try to offer the bottle after taking it out for a break or a burp.
• Resist the urge to get the baby to finish every last drop.
  • You want your baby to recognize when she is full and stop eating.
  • Encouraging overeating can result in problems with obesity.

While most babies will take a bottle without any fuss, some will need some coaxing.

Having a breastfeeding baby refuse to take a bottle can cause panic in even the calmest mama. Let’s face it, bottle refusal is stressful for the mom, baby, and the person offering the bottle.

• Persistence usually pays off by repeatedly offering the bottle.
• Offer the bottle at different times of the day.
• Offer the bottle when baby is hungry
• Feed from the breast for a few minutes to take the edge off her hunger and then offer the bottle.
• Offer the bottle when she is just starting to wake but is still sleepy. Alternatively, offer the bottle as she is getting sleepy.
• Don’t let the baby get worked up. If she starts crying, end the attempt and try again the next day.
• The person offering the bottle should not take it personally if the baby is refusing.
• If you are experiencing bottle refusal with your baby, chances are you have asked everyone for advice. Bottle refusal seems to be one of those things where everyone has an opinion about what caused it or what will cure it.
• The most successful trick I have is to have the baby facing away from the person giving the bottle.
• Walking, swaying, or even gently dancing during bottle feeds can help cure bottle refusal as well.
• Singing will often earn you bonus points with the baby.

I recommend trying this trick for bottle refusal before going out and buying a bunch of bottles.

The reality though, is that some babies will not take a bottle no matter what tricks you try. In a case like this, you have two choices. You can always be present for feedings. You can try alternative methods of feeding.

Some babies will take the bottle initially, but then around three or four months start to reject it. We are not sure why this happens.

If you have not been offering the bottle regularly, start doing that.

If you are not having success, then start offering a cup.

The Munchkin Miracle 360 Trainer Cup is very highly rated on Amazon. It has a 4.7 out of 5 stars from almost 38,000 reviews. That’s a lot of satisfied babies.

This cup is ideal for teaching your little one how to drink from a real cup.

I often get asked which breastfeeding bottles are the best. Because every baby is different, there is not one bottle that is best for all babies.

• Look for a bottle nipple that has a wide base.
• The material should be soft but not so soft that it collapses.
• It should be comfortable to hold.
• It should be easy to wash.

The Comotomo is a favorite of parents. It has a  4.5 star rating from a whopping 6500+ reviews.

It has the wide-based nipple I recommend. The bottle itself is soft. And it has the very important feature of a slow flow nipple. It comes in pink or green.

I have had several parents swear by the Tommee Tippee Advanced Anti-Colic Bottle because of it’s anti-colic valve.

Several speech therapists I have worked with recommend the Dr. Brown’s Slow Flow For Breastfed Babies.

They believe it encourages proper sucking.

The Playtex Baby VentAire has been around for many years and it is still my favorite.

With four solid recommendations and all these tips for bottle feeding a breastfed baby you should be able to find a bottle that your breastfed baby will take.

Have you tried other bottles that you had good success with? Let me know in the comments.

 

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