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
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.
- 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.
- 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.
- 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
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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
- 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