Breast-Feeding: 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 some of the time. Women who are going to work outside the home want their babies to get used to bottle-feeding so other people can feed the baby during the workday. Mothers may choose to have their partners or other people feed the baby with a bottle of pumped breast milk. Rarely, mothers and babies need to be separated as a result of illness, and the baby needs to be fed with a bottle.

Some breast-fed babies readily accept a bottle, while others resist new methods of feeding. Many breast-feeding mothers get frustrated and discouraged when their baby refuses to drink from a bottle. Here are some ways to encourage breast-fed infants to accept a bottle.

• The most important thing is to stay calm when you offer a bottle to your baby. Your baby may resist a bit at first by turning away, making a face, or pushing the nipple away with her tongue. Don't force the bottle at any time. Stop at the first sign that your baby is unhappy with this lesson.
• Plan a time when you can spend 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 a little hungry. This helps motivate her to learn a new way to receive milk. On the other hand, don’t introduce a bottle when your baby is very hungry. An upset, very hungry baby will be in no mood to try something new.
• 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, it helps to have a familiar fluid to drink.
• No one 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 you switch to another. Trying a lot of different nipples will just confuse your baby more.
• Breast-fed babies may accept a bottle 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 accept the bottle better when they are in their own mother's arms and can hear her voice.
• Go slowly and gently. First touch the baby's lips with the nipple, and watch how she reacts. 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 calmly the whole time. Babies watch faces 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. Don’t let her get very upset and then take the nipple away. This will teach her that if she protests enough you will take out the nipple. It's better to take out the nipple before she gets upset or to try to calm her with your voice before you remove the nipple.
• If your baby is not upset by the bottle, move the nipple a little further into the baby's mouth and let her explore it. Keep smiling and talking in a soothing voice. Do not stick the bottle into your baby's mouth with too much force. This may cause the baby to gag.
• Don't spend more than 10 to 15 minutes trying the bottle. Stop sooner if your baby or you are getting frustrated. It's better to end the session on a positive note and try again tomorrow.