Women’s Health Today

Bottle-feeding the breastfed baby.

Sometimes mothers worry about introducing a bottle to their baby, when in fact they may be able to eliminate the need for bottles entirely. Most babies can drink from a sippy cup or an open cup with a little help by around six or seven months, so a breastfeeding mother may be able to save herself the nuisance and expense of bottles if she can continue to breastfeed on cue until then.

Some mothers who return to work are fortunate enough to have their care provider bring their baby to the work place for a feed, so that pumping and bottle refusal are not an issue. Other mothers with older babies breastfeed when they are together and the baby manages without milk during their separations, taking solids and water instead. Often the mother in that situation will breastfeed the child through the night (reverse cycle feeding) to make up for the feeds he has missed during the day.

Babies use a different technique when drinking milk from the breast to when they suck it from a bottle. If a baby hasn’t yet learned to feed well from the breast, he may become quickly accustomed to taking a bottle and be confused about how then to drink from the breast. This is less likely to cause a problem once breastfeeding is well established, although some babies will steadfastly refuse to feed from a bottle. Breastfed babies may be more inclined to accept a bottle from a caregiver other than the mother from whom he will naturally expect the real thing.

When a mother wants to continue breastfeeding, but her circumstances require that she separates from her baby who will need feeding before her return, then these ten tips may help with introducing a bottle.

1. Choose a slow-flow teat that is similar in size to the mother’s own nipples.
2. Avoid “orthodontic” nipples—they can interfere with breastfeeding.
3. Watch for the baby’s early feeding cues (rather than following a rigid schedule) and offer the bottle before the baby is too hungry. A hungry baby will be too upset to learn a new skill.
4. Hold the baby close in a fairly upright position, similar to that he breastfeeds in, to give him control.
5. Place the teat across the baby’s lips, with its tip at the ridge between the upper lip and nose. Don’t push the teat in. Allow the baby to take it into his mouth himself.
6. Tip the bottle just enough so the milk flows but the baby can stop and start sucking when he pleases and isn’t overwhelmed by the milk.
7. Switch his position and hold him on the other side, at least once, to prevent a preference for being on one side.
8. Allow the baby to decide when the feeding is ended, which isn’t necessarily when the bottle is empty.
9. Wrapping the baby in something that smells of his mother, something she has worn, can help to calm him.
10. Move rhythmically as this is comforting.

Facing a work-life balance can be tough for a breastfeeding mother and any separation between a baby and her mother can be an emotional wrench for both. Sometimes there are creative solutions, for instance: negotiating a reduction in working hours, working from home, a career break, or even giving up work and downsizing. Many mothers continue to work and carry on breastfeeding, pumping their milk when away from their baby and nursing when they are with their baby. Nancy Mohrbacher offers lots of practical solutions to help working mothers succeed at breastfeeding in Working and breastfeeding made simple.