You may wonder why I have written a post about bottle feeding. After all, I am a lactation consultant. My job as a lactation consultant is, first and foremost, to help mothers and babies breastfeed comfortably and enjoyably for as long as they both desire. One hundred percent breastfeeding is often the goal. The reality is, however, that most of my clients use bottles as well—either to supplement an inadequate milk supply or as an alternative means of feeding for times when mom is separated from baby. In addition, many babies I see have challenges that make breastfeeding next to impossible until the challenges are resolved. If a baby cannot get adequate nutrition at the breast, a bottle may be a temporary solution. Bottles are a fact of life in the western world.
It’s true that whether a mother is feeding her baby breast milk or formula, that baby will likely get a bottle at some point. It’s also true that most people do not know how to bottle feed a baby properly. That is why I’m compelled to discuss bottle feeding.
When a baby breastfeeds, he has some control over the amount of milk he swallows and the pace of the feeding. He will swallow rhythmically, then stop, take a few breaths and swallow again. If he feels overwhelmed by the flow of milk, he can release the breast and take a break. When he’s had enough, he can simply let go and close his mouth. Your milk ejection reflex comes in waves—milk flows quickly, then slows down, then flows quickly again. In this way he gets built-breaks. He also has control over whether he takes the breast to begin with. You have probably already learned that you can’t MAKE your baby latch on to your breast! It’s completely up to him.
What typically happens during bottle feeding? The baby is a passive recipient. The bottle is often placed in the baby’s mouth. The bottle is tipped up so the nipple is completely full of milk and the baby is laying face up on her back. The milk keeps flowing into the baby’s mouth whether she asks for it or not. She MUST keep swallowing because the milk keeps coming. The flow of milk is constant—unlike the breast which provides breaks in between milk ejection reflex cycles. When baby slows down or pulls away and there’s just a little milk left in the bottle, what usually happens? The bottle is placed in baby’s mouth again and encouraged to finish the last little bit. I’ve seen bottles twirled, shaken and tipped totally vertical to encourage the baby to drink more and faster. I’ve also seen caregivers literally chase a baby with a bottle when the baby turns away.
Whether you use pumped breast milk or formula, try to mimic how a baby eats normally. Remember that normal infant feeding is breastfeeding and try to replicate that experience as much as possible You can prepare the baby to take the bottle by touching the bottle nipple to the baby’s mouth. When baby is ready, he will latch on to the bottle nipple. Be sure to keep baby in a nearly upright position. The bottle should be nearly horizontal. In this position the baby will be able to take the milk at his own pace. Your baby should be able to suck swallow and breathe in an easy rhythm and also be able to pause frequently. The goal is not “gulp, gulp, gulp, gulp….” But rather “suck, gulp, suck, gulp, suck, gulp” with occasional pauses.
The nipple does not have to be completely filled with milk. As soon as your baby creates a vacuum on the nipple, it will pull milk in so she won’t be “sucking air.” If your baby shows signs of distress (waving arms, alarmed facial expression, squirming) remove the bottle from her mouth or change the angle of the bottle so that the flow will be slower. In this way you are helping the baby pace the feeding according to her needs. Give her frequent breaks—every ounce or so—so she can burp, cuddle and register that she has had enough.
When you help your baby bottle-feed in a way that is comfortable for her, you’ll also help avoid over- feeding, and possible tummy upsets. Whether feeding from the breast or the bottle, remember to pay close attention to your baby and you will both enjoy the experience.