As a certified breastfeeding counselor (CBC) you will be asked about many aspects of infant feeding. One thing parents often need to learn about is bottle feeding a breastfed baby.
Many infants have little difficulty switching between breast and bottle. However, there are some best practice tips to make the transition back and forth easier. Bottle feeding a breastfed baby is occasionally challenging for baby or the caregiver.
These few tips can make things a little easier:
Do Not Stress Over “Nipple Confusion” – Understand Preference
Once upon a time, many people worried about nipple confusion when combo feeding or using a pacifier. What we now know is that nipple confusion is not really a thing. Babies who are physically capable of latching can absolutely go back and forth between breast and artificial nipples.
That said, babies can absolutely develop preferences. Afterall, babies are humans and will have likes and dislikes. As a CBC you can help parents and caregivers understand preferences and how to work around them.
Generally, it is advised to wait a week from when baby has a good latch before introducing a bottle or pacifier. Of course, this does not work in every scenario. In some situations, a baby will need to be fed when they are unable to latch. When baby is unable to latch, it is important that they work with an IBCLC to problem solve and manage any underlying conditions.
Preference for a bottle can occur due to:
- Using a nipple with too fast of a flow
- Holding a bottle in a way which gravity causes a faster flow
- Low milk supply or slow letdown at breast
- Older infant who is on the go
Bottle refusal can sometimes occur due to:
- Too slow or too fast bottle nipple
- Not associating a bottle with feeding
- Difficulty pacing the milk flow
- Being overly hungry, missing their mom, and frustration
Be sure to read Breastfed Baby Refusing a Bottle to learn more.
Positioning Can Be Key When Bottle Feeding a Breastfed Baby
For some babies, being held in a different position while being offered a bottle can cause confusion. Positioning can also impact the flow of a bottle.
For breastfed babies, the following positions can be helpful:
- Baby side lying – especially for babies with reflux, difficulty pacing, and preemies
- Semi seated paced bottle-feeding position
- Cradled close belly to belly like when breastfeeding
Ensuring baby is not positioned mostly supine with the bottle mostly vertical can help with bottle refusal as well as bottle preference (due to fast flow without much work on baby’s end).
Paced bottle feeding, whether in a semi seated or side lying position, ensures the flow is controlled a bit by baby’s suck. This reduces overfeeding and prevents wasting expressed milk.
Patience Is Important
As mentioned, many breastfed babies happily switch between bottle and breast. However, for those who do not, patience is key. Babies are very intuitive and pick up on a caregiver’s impatience and stress.
It is important to remind clients that a healthy baby will not starve themselves during short separations. Some infants prefer to wait until their mother’s return in three or four hours and feed extra versus accepting a bottle. Unless a pediatrician has expressed concern over weight and hydration, the occasional spaced feed in an otherwise healthy baby is rarely concerning.
Being patient can help baby naturally come around to accepting the bottle if they go long without access to the breast.
Be Flexible When Bottle Feeding a Breastfed Baby
In some cases, even the most popular bottle will simply not be what a baby prefers. In some cases, trying different bottles can be the key to helping a baby easily switch from bottle to breast.