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Clinical Reference Systems: Pediatric Advisor 10.0

Guidelines for Introducing a Bottle to a Breast-Fed Baby

Ideally, breast-feeding mothers would be able to nurse their babies at every feeding and never need to give a bottle. Certainly bottles should be avoided until breast-feeding is well established (usually 3 to 4 weeks after your baby's birth). However, once breast-feeding is going well, many mothers want their babies to drink from a bottle occasionally. Women who are going to work outside the home want their babies to become familiar with bottle-feeding so others can feed their babies during the workday. Mothers may choose to have their partners or other relatives occasionally feed pumped breast milk with a bottle. Rarely, mothers and babies need to be separated as a result of illness.

Some breast-fed babies readily accept a bottle, while others are very resistant to new methods of feeding. Many breast- feeding mothers become frustrated and discouraged when their baby refuses to drink from a bottle. The following suggestions have been found to be helpful in encouraging breast-fed infants to accept a bottle.

  1. The most important thing to remember is to stay calm when you offer a bottle to your baby. Your baby probably will resist a bit at first by turning away, grimacing or making a face, or pushing the nipple away with her tongue. Don't force the bottle at any time and stop your efforts right away at the first sign that your baby is becoming unhappy with this lesson.

  2. Plan a time when you can devote 10 to 15 uninterrupted minutes to try the bottle. Your baby will feel the pressure if you are rushed.

  3. Choose a time when your baby is alert and perhaps slightly hungry so she will be motivated to learn a new way to receive milk. On the other hand, avoid offering a bottle when your baby is very hungry. An upset, frantically hungry baby will be in no mood to try something new.

  4. Offer milk that you have pumped from your breasts earlier in the day. Warm the milk first, taking care not to overheat the milk. Because the bottle nipple smells and tastes different from your breast nipple, having a familiar fluid to drink may encourage your baby to try the new feeding method.

  5. No particular bottle or nipple works best for every baby. If your baby uses a pacifier, she might prefer a nipple shaped like her pacifier nipple. Stick with one nipple for several days before switching to another. Trying a wide variety of nipples probably will just confuse your baby more.

  6. Breast-fed babies often accept a bottle more readily if it is offered by someone other than the mother. If the nursing mother tries to give the bottle, the baby may protest and turn toward the breast to nurse. On the other hand, some breast-fed babies actually accept the bottle better when they are in their own mother's arms and can hear her reassuring voice.

  7. Go slowly and gently, first touching the baby's lips with the nipple and watching her reaction. Don't force the nipple past her lips. Instead, let your baby draw the nipple into her mouth at her own pace.

  8. Express a little milk from the bottle nipple onto the baby's lips or tongue. Remove the nipple before your baby protests. Keep a smile on your face and keep talking in a reassuring tone the whole time. Babies notice their mothers' and caretakers' facial expressions and take their cues from you.

  9. If your baby starts to get upset, try to calm her down by talking in a reassuring tone. As soon as she starts to settle down, remove the nipple. Avoid letting her get very upset and then taking the nipple away. This will teach her that if she protests enough you will remove the nipple. It's better to remove the nipple before she becomes upset or to try to calm her with your voice before you remove the nipple.

  10. If your baby is tolerating the process and does not appear distressed, move the nipple a little further into the baby's mouth and let her explore it with her mouth. Keep smiling and offering encouraging words in a soothing voice.

  11. Don't spend more than about 10 minutes on this process. Stop sooner if you or your baby is getting frustrated. It's better to end the session on a positive note and try again tomorrow.

For more information, see:

The Storage and Handling of Breast Milk

Written by Marianne Neifert, M.D., and the clinical staff of The HealthONE Lactation Program, Rose Medical Center, Denver, CO. (303) 320-7081.
Copyright 1999 Clinical Reference Systems