The transition from solely breastfeeding to including a bottle can be a difficult time for parents, especially mums who need their baby to take a bottle so that they can return to work, spend a night away or even just have a break for a few hours to rest and recharge. Experienced mum and paediatric doctor Kerry Jeevanthan (also known as Doctomum) offers some practical tips on easing the introduction of a bottle to an exclusively breastfed baby. Whether you plan to move to bottle feeding entirely, or offer a mixture of both breast and bottle, read on for some words of wisdom that will make the journey a little easier.
The question of when to start introducing a bottle is one we hear often. If you try too early, you are at risk of nipple confusion - which is when switching between bottle and breast prevents your baby from establishing an efficient latch. Newborns need a few weeks to perfect their latch and develop the facial muscles required for feeding effectively. If you are hoping to continue to breastfeed, nipple confusion can interfere with your baby’s ability and inclination to feed effectively. Dr Kerry suggests that between 2-8 weeks old is the optimum time for introducing a bottle, and once you get past 8-12 weeks old you’re more likely to encounter resistance. The other important factor to consider is the time of day that you attempt a bottle feed. Choosing a time when your baby is relaxed will help make the process easier, and you should be flexible about this as babies are (as you know) very unpredictable. Dr Kerry advises that attempting a bedtime bottle, which many might assume is an ideal time, can sometimes backfire when all your baby wants is the comfort of your breast to get them to sleep. Time your bottle feed in a way that suits you and your baby best.
In addition to timing your bottle feeds correctly, it is important to give yourself plenty of time to do it as well. Rushing a bottle feed right before you need to run out the door will not give you or your baby enough time to explore different feeding positions in a calm environment. Instead, set aside plenty of time to ease into it. Babies will pick up on your energy if you are stressed, so taking your time will help both of you stay relaxed. If your baby is disinterested in feeding, but not distressed, you can try different feeding positions, in various environments around the house, to see what works best. However, Dr Kerry suggests that if you have tried for five to ten minutes, and your baby starts crying, the best thing to do is to stop, and try another day.
Forcing a bottle feed when your baby is upset can cause negative associations to the bottle, which can easily be avoided. If you do decide to offer a breastfeed instead, Dr Kerry advises waiting a few minutes for baby to calm down, to avoid an association between refusing the bottle and receiving a breastfeed “reward”.
3. HAVE SOMEONE ELSE TRY
Babies are very instinctive in their behaviour, and a baby who has been breastfed from birth will be automatically looking for and expecting the breast at feeding time. They will be less interested in a bottle when they can sense the breast nearby, which is not only a source of food but also a source of comfort to them. It is therefore a good idea to have someone else try offering the bottle, such as dad, a grandparent, a sibling if they are old enough, or a friend. If they have trouble, Dr Kerry suggests that they try holding them the way you would usually hold them for a feed, or even having a muslin that smells like you on them, to help the baby feel more relaxed. You can also try leaving the house while someone else offers the bottle, so that your baby can’t sense you in the next room (babies are surprisingly intuitive!). Whoever attempts the feed, make sure that they remain calm, take their time, and stop the attempt if the baby becomes distressed.
4. CHANGE POSITIONS
Something as simple as the way you hold your baby can have a big impact on how successful you will be with introducing a bottle. It is important to make sure you always feed your baby in a semi-upright position, to avoid reflux or ear infections. Other than that, you can try anything that works for your baby. Some options include cradling the baby like you would for a breastfeed, sitting the baby up on your lap, using a breastfeeding pillow to support baby, or propping them up against your elevated knees. If your baby likes movement, Dr Kerry suggests walking around the house, with your baby facing outwards so they can’t see you. You might end up in uncomfortable or strange positions, but the key is to find what works best for you and your baby. Don’t be concerned about getting into bad habits. Dr Kerry assures that if you do have to get your baby into a strange position for feeding to begin with, over time you can slowly move them back into a more “normal” feeding hold. The most important thing is finding a way for your baby to successfully take a bottle when you need them to.
5. CHANGE THE CONTENTS OF THE BOTTLE
Every baby is different, and while some will happily take breast milk or formula from a bottle, others will only take one or the other. Experiment with what your baby likes – so if you try formula and they won’t take it, next time try expressed milk, and vice versa. If you would prefer baby to take formula and you’re having trouble, Dr Kerry suggests trying different formulas until you find one that your baby likes. To avoid the expense of buying several types of formula, she recommends asking a friend for a few scoops of theirs to try before you buy – and make sure you follow the directions on the back of the packaging. If you are trying expressed milk, some babies will only take freshly expressed milk, as opposed to previously expressed milk that has been defrosted, so you may need to experiment with both. Finally, Dr Kerry advises trying bottles at a variety of temperatures. Some babies prefer warm milk; some prefer cold, so find a temperature that works for you. When you’re heating a bottle, make sure not to use the microwave, as you can end up with an uneven temperature and hot spots. Use a bottle warmer or a bowl of hot water instead to heat the milk evenly. Don’t be overwhelmed by all the options – you don’t need to try everything all in one go. Take your time and experiment with breast milk and formula over several days until you find something that your baby loves.
6. CHANGE THE BOTTLE
Changing bottles can be an expensive and frustrating practice. There are a huge variety of bottle shapes, teat shapes and sizes on offer, and it can be overwhelming to choose something that you aren’t sure will even work for your baby. Dr Kerry advises considering the shape and material of the teat first and foremost. For breastfed babies, teats that mimic the natural shape of the breast are usually the most successful, and silicone tends to be softer and more similar in texture to a breast than latex. After trying 2 or 3 bottles, Dr Kerry had success after just ten minutes with the Minbie bottle, which is designed specifically to support an instinctive breastfeeding latch and motion. It is always more helpful to start with a bottle that is designed this way, but if you’ve first tried other teats without success, switching to a bottle with a teat that closely matches the shape of a breast can be the key to transitioning between breast and bottle without nipple confusion.
The final and most important thing to remember when offering your baby a bottle is to relax. You can experiment with timing, positions, bottle types and contents, and who is offering the bottle, as long as you are persistent and take your time. Dr Kerry recommends attempting a bottle feed every day, and working up to full feeds as your baby starts to accept small amounts. You can even try replacing a feed once a week or once a month if your timeframe allows. There are always other options if your baby will not take a bottle, like cup feeding or beaker feeding, but it is likely that if you relax and keep trying, your baby will eventually accept and enjoy taking a bottle from you and others.