I truly believe in support for all families and their feeding choices. It isn't helpful to say 'don't
give your baby a bottle' as that may not be the right choice for certain families. Of course, there are other options and you never have to introduce a bottle, but it's important that you know how to bottle feed a baby. In all my parents I support with infant feeding, I provide individualised and person centered support.
How might bottle feeding impact breastfeeding?
By giving a breastfed baby a bottle, it can negatively impact your breastfeeding journey. This isn't coming from a place of judgment, but information so you can make informed choices. When a baby is bottle fed, the flow of the milk is different to breastfeeding. The milk comes out a lot quicker, with not much effort from the baby and they become accustomed to the flow of the milk by a bottle This can cause the baby to develop a preference to the bottle and start to refuse the breast, become fussy on the breast or not stay on for very long.
Another way it may impact breastfeeding, and something that you may not think about when considering introducing one, is that the process of starting to give them may cause you to doubt your body's milk making skills. Perhaps you focus on the volume of milk given, and you think that there's no way your baby, who feeds for only 5 minutes at a time, gets that much milk each time. Maybe you accidentally don't pace feed, and your baby ends up overfeeding and sleeps for hours after that bottle because it was a bit too much milk. You then think that you must be starving your poor baby because they never sleep for 3 hours between breastfeeds. All these add in to you doubting your own milk supply and body's ability to make milk and impact your breastfeeding journey.
If you have access to bottles easily, you may end up giving them when your baby cluster feeds and goes through a growth spurt, because you think your baby is feeding so much so they must not be getting anything on the breast. In turn, your baby spends less time on the breast, causing your milk supply to drop. Remember that baby's development and growth changes so much in the first year of their life and frequent feeding, fussiness is very normal. Be prepared and know what to expect in your breastfeeding journey.
What is the best way to bottle feed a breastfed baby?
How do you stop your baby from getting a bottle preference? If you choose to offer your breastfed baby a bottle, it's important to understand how you can do this in a way that protects breastfeeding, if continuing to breastfeed is your preference. You can do this by paced bottle feeding. Paced bottle feeding isn't just about winding every ounce, but is actually the whole bottle feeding process. *I do want to caveat as well that this that ALL babies fed via a bottle should be pace fed, even if they have never been breastfed as paced bottle feeding also prevents overfeeding which can easily be done by a bottle*
How do you pace bottle feed a breastfed baby?
So how do you actually pace feed? What does it involve? It's just burping every ounce isn't it? Well, no, there's a little bit more to it.
I'll break this down...
1. Choose a slow flow or newborn teat, this never needs to be increased, regardless of baby's age
2. Sit baby upright rather than lying on their back (or in elevated side lying, on your knees or cushion)
3. Rub the teat along baby's nose and top lip, encouraging a wide mouth for a deep latch, like on the breast
4. Put the teat in to their mouth but with no milk in the end of the teat for the first few sucks to allow baby to work for the milk. Then hold the bottle horizontal, and parallel to the floor, so that the end of the teat is half full of milk - DO NOT FILL THE TEAT FULL OF MILK. Your baby won't get extra windy from this
5. Dip the bottle down or remove the teat whenever baby stops sucking to give them a pause. If baby doesn't take a natural pause, you dip the bottle down for them every 30 seconds to give them a pause and pace the feed. When baby starts sucking again, bring the bottle back up to horizontal
6. Watch your baby for signs of fullness and always stop the feed when they show you they're finished, regardless of how much milk is left in the bottle.
Basically, pace feeding is all about being responsive to your baby, watching them, following their cues, allowing them the control over the flow of the milk and choosing when to drink and when to have a rest, and when they're finished.
When can I introduce a bottle to my breastfed baby?
It's helpful if you can wait until breastfeeding is well established before introducing bottles. While you are still establishing breastfeeding, the introducing of bottles can further confuse baby and more chance of them getting a bottle preference. Establishing breastfeeding happens at difference points for everyone but roughly around 4-8 weeks after birth, however, it may take longer if you had challenges at the start. A good sign of breastfeeding being established is you are able to latch baby well and confidently, without any pain and they are gaining weigh steadily, having plenty of wet and dirty nappies and you're no longer getting engorged. Although, if you need or want to introduce it earlier, it is even more important to follow paced bottle feeding.
In my antenatal feeding sessions, you can get more information on establishing breastfeeding and introducing a bottle, individualsed to you.
How much milk should I give in a bottle?
First things first, ignore the guidelines on the formula tin. They're basically designed to give babies large volumes of milk to ensure more profit for them and aren't based on any evidence at all. Remember that a baby's stomach is roughly the size of their fist, so is very small and they don't need large amounts, but instead, smaller amounts but more frequently. Once they're roughly a month old, 4oz maximum in a bottle at a time is plenty.
Now, I don't mean starve your baby and refuse any more milk than that. What I mean is offer 4oz, using the paced bottle feeding technique, allow baby 5-10 minutes to digest the milk and allow their brain to connect with their stomach and process the milk, and if they continue to show signs of hunger, offer a further 1-2oz. If you think about when you're eating a meal, you have lots of rests to allow your food to 'go down' before you continue eating. Sometimes, if you shovel down your food quickly (parents, you know EXACTLY what I mean here, two minute dinners sometimes!), you do end up overfeeding yourself because your body didn't have that time to process and digest.
A good guideline into how much to give your baby and when is 1-1.5oz for each hour. So if your baby hasn't fed for 2 hours, a good starting point is to offer 2-3oz for that one feed.
How often should I give my baby a bottle?
Because babies tummies are very small, the milk digests fairly quickly, so its really normal for babies to feed frequently, regardless of breastfeeding or bottle, expressed breastmilk or formula. 2 hourly feeding is very normal. It may depend on how much milk your baby is having though, and remember that milk is nutrition and for thirst as well. Follow your baby's feeding cues as to when they're asking for a bottle of milk. If they do end up feeding frequently, it may be that they prefer smaller amounts, which is completely normal and helpful to prevent overfeeding.
Every parent and baby is different, and everyone makes different decisions. I'm here to provide evidence based information to help you with your feeding journey, however that looks, and if you're wanting to continue breastfeeding alongside some bottles, you deserve to have the information to enable you to do so. Each feeding journey is unique.
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