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Paced Bottle Feeding

Paced Bottle Feeding

by Wendy Wright

A year ago

Using a Bottle with Your Breastfed Baby




Perhaps you bought bottles “just in case” or maybe you’re having breastfeeding problems and need to use a bottle temporarily. Maybe you’re going back to work, or you need to be separated from your baby sometimes. Whatever the reason, you may have concerns about how to introduce a bottle, if your baby will get “nipple confusion” or if a bottle will hurt breastfeeding.

Why might a breastfeeding mom need to use bottles?

The number one rule is to make sure the baby is getting calories. And if there’s any issue with baby at the breast, then he may need a bottle to get what he needs while working on better breastfeeding.

When baby is having problems latching or when latching is painful for mom, a bottle may be needed just until mom and baby figure out the best way to feed. If baby is premature, or is sick at birth, a bottle may be needed (though prematurity doesn’t always mean baby can’t go to the breast). If mom’s milk supply is low, baby may need bottles until mom is producing more milk.

In addition, sometimes a mother chooses not to breastfeed but wants to provide her breastmilk by bottle. Or perhaps she’s uncomfortable nursing in public so wants an occasional bottle for outings.

How can I find the right bottle?

While many brands of bottle and teat make claims about being closest to breastfeeding, there’s no particular brand that is best. There may be some trial and error to see what you prefer, and what your baby likes. Breastfed babies may do better with a slow flow nipple.

Is there a way to go about feeding the breastfed baby with a bottle?

In a Journal of Human Lactation article, lactation consultant, Dee Kassing, describes a method of bottle feeding that closely mimics breastfeeding, and can be used when a baby goes back and forth between breast and bottle. To use this method, called “paced bottle feeding,”:

  • Just as you would with breastfeeding, bottle feed when your baby shows hunger cues (rather than feeding at set times).
  • Hold baby semi-sitting in your lap.
  • Hold the bottle fairly horizontal while keeping the nipple filled with milk.
  • Tickle baby’s lips, wait for a wide-open mouth, and let baby draw the nipple in, just like at the breast.
  • Allow pauses just like with breastfeeding
  • Follow baby’s cues for when he’s done, rather than forcing him to finish the whole bottle

What if my baby refuses the bottle?

Tricks for helping a breastfed baby accept a bottle include:

  • Have someone other than mom feed baby
  • Warm the nipple under running water before feeding
  • Try movement – stand, walk or rock while feeding
  • Avoid sitting where you usually do to nurse baby
  • Wrap the bottle in something that smells like mom (perhaps a t-shirt that mom has slept in)
  • Hold baby facing away from your body to make it less like breastfeeding
  • You don’t necessarily need to use a bottle - instead try a small flexible cup, a syringe, or a medicine spoon.

Will my baby become “nipple confused”?

The hard bottle nipple provides a super-stimulus for baby that immediately triggers sucking; whereas with mom’s nipple, baby has to work a little to form a teat and to milk the breast. Your baby’s not confused - he has just learned to prefer the feel of the bottle nipple and the flow from the bottle. Nipple preference can happen, but paced bottle feeding as outlined above can help to stem this behavior. Also, the number of bottles a baby gets compared to how often he nurses can also impact whether or not he decides he prefers the bottle nipple – the more bottle, the more likelihood of a preference.

Reference: Kassing, D. (2002). Bottle-feeding as a tool to reinforce breastfeeding. Journal of Human Lactation, 18(1), 56-60.


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