Bottle Feeding the Breastfed Baby FAQs

Did you know that lactation consultants not only help with breastfeeding, but can also help with bottle feeding?  It’s true! We are here to offer guidance with all aspects of feeding (introducing solids, as well!) and know a ton about bottles and how to balance them with breastfeeding.

Questions about bottle feeding come up in many of our private consults, as well as in our private Facebook Group (for those who purchased our online course: Breastfeeding for the Working Family.)  So, we figured we would write a blog article answering some of the most frequently asked questions. So, here you go…..

When is the best time to introduce a bottle?

Ideally, the best time to introduce a bottle is after your baby has mastered the art of breastfeeding.  There is a window of opportunity when your baby is between 3-6 weeks old where he/she still has an innate sucking reflex and is more willing to try a bottle.  Once babies reach 10-12 weeks, that innate sucking reflex goes away (or is integrated) which can make introducing a bottle more difficult at this time.  

Sometimes bottles are introduced earlier than 3 weeks, due to baby not breastfeeding well or baby not gaining weight well.  This DOES NOT mean your breastfeeding journey has been sabotaged! It might make breastfeeding a bit more challenging, as bottles are much easier to feed from than the breast, but you probably introduced the bottle earlier than 3 weeks BECAUSE you were having breastfeeding challenges, right?  So, definitely meet with an IBCLC to remedy those breastfeeding challenges, but please know that not all breastfeeding-hope is lost just because you offered a bottle to your infant before 3 weeks.

How should I choose a bottle and bottle nipple?

Many bottles out there say that they are ‘similar to the breast.’  Don’t be fooled by their marketing. Truthfully, there are no bottle that are similar to the breast.  If you haven’t noticed, our human nipples are all different shapes and sizes and no bottle nipple is stretchy like a woman’s areola and expands like a woman’s nipple when breastfeeding.  So start with choosing a bottle that helps your baby achieve a wide latch and choose the slow flow nipple of that brand.

Are all slow-flow nipples the same?

Nope!  Each bottle brand has its own slow flow nipple, but some ‘slow flow’ nipples flow really slow and some flow really fast.  You will want to see how your baby reacts to the flow to determine if it is the right flow for your baby. PS. Those bottle nipples given out in the NICU or postpartum floor ARE NOT slow flowing, even though they say they are.  They flow really fast, which is why your 3 day old is able to suck down 2oz in 5 minutes, which is way too much and way too fast.

How will I know if the bottle flow is too fast or too slow for my baby?

If the bottle flow is too fast for your baby, he/she will look panicked!  Eye bugging out. Hands splayed. He/she might choke or spill milk out of the sides of her/his mouth. He/she might be really gassy after finishing the bottle.  If this happens, you will definitely want to either try a slower flow nipple for that bottle brand or try a completely different bottle brand.

If the bottle nipple is too slow, your baby might get really frustrated when bottle feeding and it might take over 30 minutes to finish the bottle….way too long!

Bottle feeding should take about 15-20 minutes for the first few weeks to months.  Once breastfeeding is established and going well, then bottle feeding might speed up to faster than 15 minutes.

What is paced bottle feeding and why it is important?

Paced bottle feeding, or baby-led bottle feeding, is a feeding method that allows your baby to be in charge of his/her feeding.  This means, when your baby sucks, he/she gets food. When he/she pauses, no food is released from the bottle. Your baby is seated in an upright position and the bottle is held horizontally.  This is super important in those first few weeks of bottle feeding because we want the pace of the bottle to mimic the pace of milk at the breast. We don’t want bottle feeding to be so much easier than breastfeeding that your baby starts to prefer the bottle over your breast.  Also, baby-led bottle feeding also keeps your baby from overeating. This is important for all caregivers to know, which is why we created a YouTube video all about Paced (Baby-Led) Bottle feeding. Share with everyone who bottle feeds your baby!

If I am breastfeeding, am I able to offer a bottle, as well?

Yes!  If you have a partner or spouse who can offer the bottle while you pump, take advantage of this!  It’s just one less thing you have to do! But if you are in charge of all of your baby’s feeding sessions, then feel free to offer a bottle in place of a breastfeeding session to help him/her practice bottle feeding.

When do I need to change the bottle nipple to the next size up?

Probably never!  Really! Sure, you might want to replace the bottle nipple with a fresh, new one every few months, but as long as your baby is happy with the flow and taking the bottle in a normal amount of time (remember…. Somewhere between 10-20 minutes, depending on his/her age), then there is no reason to go up a level.  You could stick with the 0-3 month bottle nipple the entire first year. Essentially, if your baby is happy with the flow, stick with it!

How much milk should I put in each bottle?

One way to figure this out is to go to a breastfeeding support group and weigh your baby before and after a breastfeeding session.  That’s a great amount to leave in the bottle. Otherwise, most babies in the first 3-6 weeks take about 2-3oz per bottle. Babies above 10lbs need about an ounce an hour, in general.  This increases slightly as your baby continues to gain weight. Babies above 13lbs need about 30-32oz per 24 hours, so divide that by the number of feedings per day and there is your answer for how much your baby needs per bottle.

If I am returning to work, how often should I practice the bottle with my baby?

Ideally, you would introduce the bottle by the time your baby is 6 weeks old.  Then, offer the bottle a few times a week, just to keep practicing, so that when you return to work your baby is familiar with this additional way of getting food.  

What if my baby won’t take a bottle?

First, check out our article: Help!  My Baby Won’t Take a Bottle. Give these tricks about 1 week ONLY!  If your baby rejects the bottle for a full week, then is it time to meet with an IBCLC to figure out why your sweet babe is refusing the bottle.  Bottle refusal can happen for many reasons: baby doesn’t like a particular bottle, baby has a high palate, baby has a tongue tie, etc. Stop struggling and let us help you figure this out!

So what additional questions do you have about bottle feeding?  Share them here and we will add them to this article!