Encouraging your breastfed baby to take a bottle

Many parents of breastfeeding babies choose to offer their baby a bottle of breast milk for many reasons, primarily maternal separation.  Cindy Curtis, RN, IBCLC, offers these tips for getting your baby started on the bottle.  I encourage waiting on offering any artificial teats (bottle nipples or pacifiers) until a baby is at least 3-4 weeks of age.

l) To begin, choose nipple with slowest flow. A baby who has been breastfed from birth has a much stronger suck than a baby who has always been bottle-fed.

2) Initially, regardless of positioning used, offer bottle in as close to a sitting position as baby is comfortable getting into. This is to avoid possible choking and/or aspirating.  Don’t frighten the baby.  This can be a reason for bottle refusal.

3) Stroke babies lips with the nipple, using a feather-like touch, to elicit a wide-open mouth - as if the baby were going to breast. Avoid forcing the nipple between closed lips.

4) Encourage baby to take as much of the bottle nipple as possible into the mouth. Generally babies lips should look nicely flanged out and be touching the bottle. Avoid allowing baby to suck only on the tip of the bottle nipple. You don't want baby to try this on mom.

5) Initially, the baby may need to be burped much more often than one might expect.  While he's learning, he may swallow a lot of air.

6) Try different nipples. I recommend the Munchkin clear silicone one.

7) Begin trying bottles at least 2 weeks before returning to work. But not before baby is 3-4 weeks old.  You need to be comfortable knowing how things will go and baby needs time to adjust.

8) Often is best for the person who will be giving the bottle, (baby-sitter?) to be the one to introduce it.

9) Have someone other than Mom offer bottle--baby often associates feeding with mom and is upset when she won't offer the breast.

10) On the other hand some babies will only take the bottle from Mom and refuse from  others. You may be the best one to introduce it, then transfer baby to future care giver. 

11) Some babies won't take it from Dad either; Mom should be near by.

12) Be sure and offer bottle for the first few times when baby is NOT very hungry; e.g. between feedings.  When he's hungry he automatically thinks of mom's breast.

13) Offer it as a toy, something interesting to chew on.  Be happy if that is all baby does with it.  That is progress.  Don't be discouraged if he/she won't take a full feeding.

14) Only put a small amount of milk in the bottle and then be happy if the baby even accepts the nipple in his mouth.  Keep trying daily, but don't pressure the baby for long sessions.

15) If mom is back at work and truly unavailable, be sure sitter has the time and is willing to  offer the bottle very frequently if the baby is only taking snacks of milk.

16) NEVER force the baby to take the bottle.  If it is starting to become a battle, stop, comfort baby and breastfeed or use an alternative method of feeding if mom is not available.  Wait for another time and try again.

17) Remember to do it in a non-stressful way, as a toy or game that, by the way, has some milk in it--surprise!

18) Remember this is a process: don’t demand the baby take an entire feeding via the bottle.

19) Run the nipple under warm water or cold water-- this works for some babies.

20) Stand up, walk around, dance and sing while offering bottle --often works like a charm. 

21) Hold baby with back against your chest --with some, the nursing position reminds them too much of nursing.  Some do better if placed in an infant seat and adult is not even holding them. 

22) On the other hand some babies will accept the bottle if held IN the nursing position --on their side so sitter may have to stick the bottle under his/her arm--looks funny but works sometimes.

23) Use something that really smells like mom to wrap around bottle or snuggle baby close, across sitter's chest while offering bottle--her nightie or cloth that she has expressed some milk on usually works.

24) Sometimes it helps to even look like mom:  I read that one dad put on his wife's fuzzy pink robe, strapped on her nursing pillow and the baby took the bottle after refusing mightily before that.

25) Carry baby in sling in such a way that baby can't see the caregiver/bottle- giver's face.  It helps a lot if the caregiver is already very comfortable using a sling, too. 

Remember the goal: Your baby is happy and fed during your absence and that the bottle is only one method.

*Cup, spoon, dropper, syringe are all feeding methods.  If the bottle just isn’t working try something else.

Cindy Curtis is a registered nurse and International Board Certified Lactation Consultant at a hospital in rural Virginia.  She owns Breastfeeding Online, a website dedicated to promoting, protecting, and supporting breastfeeding.

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