Going Back to Work

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!


Help!  My baby won’t take a bottle!

Seen this face before?

Photo by  Brytny.com  on  Unsplash

Photo by Brytny.com on Unsplash

Good luck trying to get a bottle in this mouth!

So, breastfeeding has been going well!  Your little one feeds like a champ.  You have stored a bunch of breast milk in your freezer.  You have found a caregiver that will love your sweet, little muffin almost as much as you do.  Now, it is time to make sure your baby will be fed right while you are back at work and suddenly you run into a hiccup..... your adorable, lovely little one has decided that she is not interested in a bottle and downright refuses it!  

WHAT?  How can this happen?  

This is precious breast milk that you pumped with love!  How can she be that stubborn at such an early age? 

If it brings you any consolation, I see this all of the time at our breastfeeding center.  I have seen the stress in a parent's eyes when she has to return to work and her baby refuses everything, but the breast.  Well, I am here to alleviate that stress with a bunch of tricks to help your sweet, albeit opinionated, infant take a bottle before you return to work. 

List of Tricks to Help your Breastfed Baby Take a Bottle

  1. Have dad/partner try to give the bottle, not the breastfeeding mom. If he/she is not completely successful, have an experienced bottle feeder (grandma/grandpa, aunt/uncle, friend, nanny, daycare provider, etc.) give it a try. They may also not be as offended as dad/partner may be:)

  2. Patience is key! If your baby isn't interested, try at a different time of day. My kids were usually more calm in the morning than in the afternoon, so I would always try new things at the beginning of the day.

  3. Be playful! Rest the nipple on your baby's philtrum (the crease that connects her upper lip to her nose) and let her decide when she will take it in her mouth. This mimics what goes on during breastfeeding.

  4. Try different feeding techniques. Try feeding your baby with a bottle in a cradle hold. If that doesn't work, try feeding her facing you, either on your lap or in a bouncy chair. You can also try walking around.

  5. Some babies like to smell their moms while bottle feeding, so let her snuggle in one of mom's t-shirts or with her pillow case while bottle feeding.

  6. Choose a bottle nipple that looks most like your anatomy. Start with the slow-flow nipple. This will give your baby more sucking time, just like at breast. If your baby is a little older, or if you have a really fast-flow, your baby may prefer a faster flow nipple. Choose what most resembles you and your baby's breastfeeding experience.

  7. Use baby-led bottle feeding techniques to make bottle feeding more like breastfeeding. You can check out our YouTube channel for a video on how to do this!

  8. Experiment with different bottles and nipples. Babies have preferences, so give yours an opportunity to choose her bottle and nipple....without breaking the bank, of course!

  9. Warm the nipple under running water before offering it to your baby. She might have a temperature preference, too.

  10. You can always try a cup. Yes, even infants can drink from a cup. They usually lap it up rather than actually gulping. For more info on cup-feeding, check out Dr. Sear's article on alternatives to bottle feeding

  11. Try and try again! Something that didn't work the first time around may work on another day. It is like introducing avocado to your baby for the first time. Some babies love it. Others need to taste it over 10 times before they enjoy it.

If all else fails, call a lactation consultant!  We often can identify the root cause of why a baby isn’t taking a bottle and can offer suggestions for other bottles or other feeding methods.  At the San Diego Breastfeeding Center, we also have a variety of bottles to try in our office that we can try during a bottle-feeding consult!  You can make an appointment for one of those consultations HERE.

Hopefully this list has put your mind at ease and offered some advice to help you get through this challenge.  If the first trick doesn't work, just keep on going down the list.  If you have one that has worked for you, please add it to the comments.  Let's share our advice so that all parents can use this as a resource!

Our Biggest Announcement in Years!

When I think about my own Going Back to Work experience, as well as our lactation clients’ experiences, there are some common themes and emotions that come top of mind.

  • Feelings of overwhelm and stress while preparing for this transition. How can I get my baby, my baby’s caregiver, and my supervisor all on the same page?

  • Anxiety about our milk supplies decreasing. How is my pump going to keep up my milk supply?  How will I find time to pump?

  • Worry that our children are going to be overfed by their caregivers. How much milk should I leave for my baby and how can I convince our caregiver that this is the correct amount?

  • Concern about managing work life and family life (balance never really happens, right?) How will I be able to do it all?

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But, when I look even deeper into where those emotions are coming from, I believe that they are coming from this......


We just spent the past weeks and months tirelessly establishing and nurturing a breastfeeding relationship with our child that we now might lose control over!

And the fear that going back to work will sabotage our ability to reach our personal breastfeeding goals scares the hell out of us.  

We feel like we have lost control over our breastfeeding relationship.

This is the thing, though…. You have the ability to retain control.  It is all in how you prepare for this transition in your overall journey.

BIG ANNOUNCEMENT!

This is exactly why I created an easy-to-follow process to prepare yourself, your pump, your baby, your baby’s caregiver, and your supervisor for a smooth transition where you remain in control of your breastfeeding relationship!

We are so excited to announce SDBFC's first online course, Breastfeeding for the Working Family! This is the easiest, most comprehensive step-by-step course to prepare everyone for this transition back to work.

With the purchase of this online course, you will receive:

  • 14 short, info-loaded videos to watch at your leisure

  • 6 customizable handouts

  • Access to our exclusive private FB group, where you can share all of your thoughts and advice with other pumping working parents, watch extra video content, and get special deals from our favorite product partners!

  • Weekly Live Q&As on our Facebook group, with a lactation consultant, to answer your burning questions (This might be my favorite part of the whole course!)

I want you to imagine how amazing it will feel to meet your personal breastfeeding/pumping goals, despite going back to work.

Ready to make this happen?

For more information about the course, check out our online course page

How to purchase the course RIGHT NOW:

In honor of our online course launch, you may use this coupon code (COURSELAUNCH20) to receive $20 off your purchase! This deal lasts only until June 30, 2019.

I can’t wait to support you along this journey!




Breastfeeding Memoirs: Trusting my Body when Returning to Work

In honor of World Breastfeeding Week 2015, we are sharing inspirational stories from breastfeeding/working moms.  

Today’s story was written by Georgina.

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When I had to go back to work I knew I wanted to keep providing my son with the very best I could offer and one of them was his dear breastmilk.  I was very confused with the whole pumping at work idea. I had done some research at work before delivering as to where the lactation room was and what the process was to reserve the room.  I work at a hospital and I thought that just by going to the L&D department everyone would know where our lactation room was and it was going to be very easy to find.  Well to my surprise, no one knew exactly what I was referring to, all the nurses looked at me with puzzled faces and confused as to why an 8 month pregnant employee was asking about this room and they didn't even know where it was!  When I finally found it, it was a rather disappointing, sad room that looked like a utility closet, but at least it was clean and it had the necessities: a chair, a desk and a fridge.  

Breastfeeding Memoirs: Persevering when Returning to Work

In honor of World Breastfeeding Week 2015, we are sharing inspirational stories from breastfeeding/working moms.  

Today’s story was written by Maggie.

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I had a long, stressful delivery that resulted in an emergency c-section, a tongue tie revision on day 2, followed by 48 hours in NICU. I was given a nipple shield, instructed to supplement with formula through an SNS and sent on my way. Breastfeeding was painful and difficult even with the shield, I went to many support group meetings and did weighed feeds and was able to stop supplementing. We were also dealing with a "colicky" baby until about week 8 . Then at week 10, I was able to get off the nipple shield with the help of an LC at Mary Birch. I was supposed to go back to work after 12 weeks but I was so exhausted and we were finally starting to turn a corner where we could actually enjoy our time with baby, I thankfully was able to extend my maternity leave to 16 weeks.

This prelude is to say that with all the struggles we went through in the beginning, I was very anxious about going back to work, whether I would make enough milk, whether he would get nipple confusion or a bottle preference. I worked so hard and suffered through so much literal blood, sweat, and tears to make breastfeeding work I started to really resent the fact that I had to go to work and interrupt our breastfeeding relationship.

How Can I Pump Enough for my Baby When I’m at Work?

Written by Ashley Treadwell, IBCLC

Going back to work can be a very stressful time for many new moms.  It’s difficult to leave your baby for the first time.  You may feel nervous about returning to a job you’ve been away from for months.  Your schedule/routine may have changed due to child-care arrangements.  Plus, if you’re anything like me, none of your work pre-pregnancy work clothes fit yet!  A concern that often adds to this stress is the fear that you may not be able to pump enough for your baby’s bottles while you’re at work. Some moms find that they are constantly playing a game of catch-up, trying to keep up with their baby’s intake while with the caregiver.  Below are some things you can do to improve your ability to keep up with your baby’s needs.

Help a Mama Out: Tips for Talking with your Boss about Pumping

'Help a Mama Out' Topic of the Week:

Tips for Talking with Your Boss about Pumping

What's your best tip for discussing your pumping rights/schedule with your boss? 

Shelly Hovies Rogers: Be assertive with your rights, but be flexible and willing to work with your boss and coworkers.  I found my workplace to be quite accommodating to me when I nicely, but matter of fact, told them what I needed.  Also, although I didn’t have to quote the state law, I familiarized myself with it, just in case I needed to use it. 

Kelly Reyes: Before I left for maternity leave, I discussed my need to pump with my boss and then HR, just to make sure we were all on the same page.  When I had issues with the way the ‘wellness room’ schedule was being managed, my boss went to bat for me and fixed the problem that day! 

Marie Bishop: My best advice is to know the law and stand up for yourself and your baby.  In states, such as California, it is required by law that your employer provides a non-restroom space that is private for you to pump.

Meggin Dueckman: We just talked about it!  We’re all pretty close at work, so it was no problem.  I was the first of our staff to want/need to pump at work.  Mind you, here in Canada we get a year of maternity leave, so it’s not as common for people to want to pump as frequently when they return to work.  I only pumped 1 times a day at work, more for my own comfort!

Jamie Howell Swope: As a teacher at a school, it wasn’t an easy process, but I went in knowing the law and advised my principal ahead of time why I wanted to meet with her.  That way she had time to think about how to make it work, too.

Kat Picson Berling: I was really lucky in that 2 of my coworkers were pumping moms, so they had paved the way.  I told my boss that I was going to take 2 pumping breaks at x and y time and I will be in this office and it will take 15 minutes.  He was fine with it.  I’m not going to lie…. Because I had a cubicle at work, it was sometimes difficult to find a place to pump.  Even our HR coordinator wasn’t sympathetic for me.  Just make sure to know the law. 

Chantel McComber: My advice would be to put your fears aside.  Sometimes it’s hard as a working mom to ask for things because not everyone has them.  Remember that you are doing this for your health and your baby’s health and those are two things that should always come first.

Jennifer Haak: When I discussed my date of return, I told my boss that I needed a lock installed on my office door and I explained why.

Andrea Blanco: First, know your right.  Be sure that your company falls under those rights.  Then file that information away and try *not* to use it as it can be perceived as a threat (and no one likes to be threatened.)  Second, have a plan in place.  I find that if you’re willing to have the conversation in advance, go into it as sweet as possible, and have it all planned out as to how it will work for you (with consideration given to work environment/demands/pumping law.)  Then, it is much harder for your employer to say no. 

For the United States Lactation Accommodation laws, check out Break Time for Nursing Mothers

Help a Mama Out: Nurturing Your Breastfeeding Relationship when Back at Work

Help a Mama Out Topic of the Week: What are your favorite ways to nurture your breastfeeding relationship when you work outside the home?  

Sarah – When I was working out of the home, I pumped at the times my daughter would take a bottle.  Then, when I came home I would exclusively nurse her.  She was fine with 2 or 3 small breastmilk bottles a day, then nursed the rest of the time.  She always preferred the breast and when it came time to wean, I was nervous….but at 13 months she just did and that was that!

Alicia – Comfort nursing on the weekends and morning nursing cuddle time.  I always nurse as soon as we get home from work/daycare.

Alyssa – My favorite part of my working day (as a teacher) was when I sat down in the glider at daycare and nursed my son before taking him home for the night.  We were always so happy to see each other and it helped wipe away any headaches from the day.  Plus, I developed a friendship with his teacher and got to hear all about what he did that day, which was way better than just reading a quick note on a daily info sheet!

Jeanne – Co-sleeping helped us and a feed before I leave and ASAP when I get home.  I also pump 3-4 times at work and always demand feed when I’m home. 

Katie – We nurse in the evenings, when she wakes up in the middle of the night, and at least once more before I leave for work.  It’s funny, as soon as I pick her up after work, I think her mind lights up with ‘milk!’ because she immediately wants to nurse regardless of when her last feeding was.  I can tell that she misses that when we’re a part, as do I.

Janell – As soon as I get home, he’s on the boob.  The rest of the night, he is on the boob.  We spend all weekend with him on and off the boob.  Time consuming, but I love the connection time and it forces me to sit down and breathe with my son.

Rachel – I sit with my daughter every evening after work.  Even if she goes to sleep, we spend the entire evening and night together because we co-sleep.  I make a point to forget about all of the housework I have to do and just relax with her because I know that she won’t be little forever!

Rachelle – One of my favorite things is when I get home from work, I shower (I’m a paramedic).  After I shower, I fill the bath and my husband brings me the baby and we usually relax and nurse for 20-30 minutes.  It is my wind-down time and it is quiet with few distractions.  I love it! 

Sarah – If possible, try to arrange a mid-day nursing session.  I used a local daycare that I was able to visit at lunch and nurse, rather than pump.  It greatly helped my supply and we were able to EBF for 13 months without any supplementation.

Amanda – I asked out childcare provider not to feed our little one within 90 minutes of when I planned to pick up.  That way I could nurse as soon as I got there.

 

 

 

Breastfeeding and Going Back to Work: Roundup

With so many of my friends and breastfeeding support group mamas going back to work by the end of the year, I thought I would do a round-up of my favorite Going Back to Workarticles (written by me, as well as some of my colleagues.)

Here's what you'll find on the San Diego Breastfeeding Center website:

Hi ho, Hi ho, It's Off to Work We Go: Part 1 - Starting the pumping and bottle feeding routine.

Hi ho, Hi ho, It's Off to Work We Go: Part 2 - Making plans with your employer and your rights as a breastfeeding/pumping/working mom.

How Long Does my Breast Milk Stay Fresh? - Take the guesswork out of how long your pumped milk stays fresh.  Here are all of the answers you'll need.

Help!  I am Going Back to Work and My Baby Won't Take a Bottle! - Top 10 tricks to get your little one to take a bottle before you return to work.

So, You’re Going Back to Work - one of my favorite memoirs from a local breastfeeding, working mom!

Now that you've perused all of our articles (and I can guarantee there are more waiting to be written over the upcoming months), here are a few of my favorite resources beyond our web site:

United States Breastfeeding Committee - FAQ's: Break Time for Nursing Mothers

Kellymom - Links: Working and Pumping Tips

So, You're Going Back To Work?

A few months ago, this spunky, firecracker mama started attending our weekly breastfeeding support group and I knew from the start that she was amazing!  Over these past months, Jessica has warmed the hearts of all of the moms in the group, as well as lifted their spirits with her quick wit and sass.  Well, Miss Jessica landed this fabulous new job a few weeks ago and ended her maternity leave a little sooner than she had planned for.  I have missed her parenting insight, so I thought I would interview her about her return to work, as a breastfeeding and pumping mama.  Well, as you can see, her insight prevails!

Thanks, Jessica for your candor and advice for those breastfeeding mamas returning to work!

 

First day back at work

What did you do to prepare for going back to work?

Finding a good childcare provider was a huge part of overcoming my fear of returning. I don't have family here and my partner works full-time as well. I probably went to a dozen home daycares and a handful of corporate ones. You have to find someone who has a philosophy similar to your own and you feel comfortable with. As I went to providers, I discovered there were alarm bells for me: if the television was on the entire time I was there, if the provider interacted with a child in a way that I didn't like, if the terms of the contract were suspicious. I went with my gut. In the end, I found a nanny I could trust.

Breastfeeding was the surprise stressor. I was depressed I wouldn't get to breastfeed Ellie during the day and I was worried about pumping. To get used to pumping, I started pumping at home. It helped me stockpile a supply. Since I was starting a brand-new job, I made sure to thoroughly read their policies on pumping. Read the laws and understand your rights. You don't have to go in waving a boob flag or anything but you can gently inform and educate employers. Be ready to offer options like suggestions for places to pump. My employer did not know I was pumping when I was made the offer and I didn't ask any questions until I had accepted. After that, when I ran into a snag, I made sure to ask the HR rep.

 

What worked? Would you do anything differently?

Ask about your work schedule! The biggest surprise to me was that my employer let me have a flexible schedule. I found that getting to work by 6:30am worked very well for my family. My daughter wakes at 5AM, I nurse her and put her back down to sleep. Then I get ready and leave. My partner then takes over the morning routine until the nanny get there. My daughter doesn't have an emotional separation from me in the morning and neither do I! Then, I come home early so we can hang out most of the afternoon.

I also can't say enough about BabyConnect. It's an app on my smart phone. It tracks feeding, sleeping, diapers, medication, etc. I used it religiously before I went back to work and my nanny has the app on his smartphone as well. There is something very comforting about glancing at my phone and seeing that she went down for her nap. It tracks how much breast milk she's taking by bottle so I know if what I am pumping at work is on par with what she's eating.

 

What advice can you offer to a breastfeeding mom going back to work?

For breastfeeding moms, whether they plan to go back to work or not, I recommend finding a way to have a relationship with your pump. In the same vein, let your child take a bottle once in a while. You may want to leave the house one day. You might not think so in the beginning, but eventually, you will. And the more practice you and your baby have, the less stressed both of you will be.

I had a very negative relationship with the pump because of some difficulties when I first started breastfeeding but I had to get over it. I started by letting myself eat chocolate while pumping, then moved to trashy magazines. At work, I run through my to-do list for the week or look at pictures of my daughter. My point is the pump is a tool to help you continue breastfeeding.

Jessica Hilt is fiction writer that works in the technology field. In the BC era (Before Child), I hosted elaborate dinner parties, drank heavily, and stayed up late. Now I love my slow cooker, drink more water than a fish, and think 9PM is late. But it's all worth it when my seven-month-old Ellie gives me that big, gummy smile.

Also, check out Jessica's video about why she loves going to a breastfeeding support group!