Bottlefeeding Breastfed Baby

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  on  Unsplash

Photo by 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!

If I Give My Newborn Baby a Bottle, Will She Refuse the Breast?

The short answer is “we don’t know”.  There is so much information out there about nipple confusion.  Some will tell you that if anything other than a breast *touches* your baby’s mouth, he’ll never want to breastfeed again. Others will regale you with stories about how their exclusively breastfed baby had bottles! cups! pacifiers! in the first few hours of life and had no problem switching back to breast.  Each baby and situation is different.  It’s never a given that your baby will, or will not, develop nipple confusion if he/she has a bottle before breastfeeding has been successfully established.

Top 10 Ways to Stop Caregivers from Overfeeding Your Breastfed Baby

I hear it all the time. 

Mom and partner get home from a much-needed date night to find out that grandma gave their 4-month old two 6oz bottles in 4 hours.

Mom picks up her baby from daycare to find out that her 6-month old took three 5oz bottles, plus the backup 5oz bottle in the freezer, in 8 hours.  She pumped 12oz at work and thought that would be plenty for the next day. (which it is!)

Mom comes home from getting a haircut to find that her partner gave their 3-month old a 5oz bottle.  The baby only ate 3oz, so her partner threw the extra 2oz away.

Who ever said there’s no crying over spilled (or wasted) milk never pumped breastmilk for her baby!

It’s hard work to pump… who has extra time when taking care of a newborn to pop on some plastic milk-extracting contraption and just sit for 15 minutes?  Um… no one!  So when a caregiver over feeds a baby, or throws away breast milk that could have been used at another time, it can be very frustrating and defeating for a mom.  And as that extra freezer stash starts to dwindle because of misuse and over feeding, moms might feel their stress levels spike to an uncomfortable high.

So how can a mom ensure that her baby’s caregiver isn’t overfeeding, or unnecessarily throwing away, that precious liquid gold she spent time to pump out?