Some mums may be using bottles as a top-up for newborns who are having difficulty achieving a full feed from the breast, while others may be going back to work and need to offer their baby expressed breastmilk or formula while they’re away. Then there are mums who’ve made the decision to fully wean from breastfeeding and are trying to graduate their littlie to a bottle full-time.
How much milk?
First things first. To work out how much expressed milk or formula you’ll need for a feed may take a little trial and error, but you can start by using a formula of 150 times your baby’s weight in kilos, divided by the number of feeds she normally has in a day. For example: (150 x 4kg) ÷ 8 feeds = 75ml. “This formula gives you an idea of millilitres required in each bottle, but babies can vary amounts from feed to feed,” says Jan Murray, PP’s child health consultant and author of parenting books Mum & Baby: Together We Learn and Taste It ($29.95 and $24.95 respectively, from www.settlepetal.com).
Babies are like adults in that they don’t want to eat a three-course meal at every sitting – sometimes they want a light lunch or a snack and that’s okay. “As long as your baby is gaining weight and content between feeds, the amount taken may vary to what is recommended on the formula tin,” Jan adds. It’s the same with expressed milk. Don’t stress if bub doesn’t want the whole lot, but to save precious breastmilk going down the sink, you may want to warm it up in small lots, say 30ml at a time, if you’re unsure if your baby will take it all.
Positioning your baby and the bottle
Like breastfeeding, you can have a nice snuggle while you’re bottle-feeding. To begin, change your baby’s nappy, wash your hands, then “cradle your baby in your arms close to your body and make eye contact,” suggests Jan. “Initiate feeding by rubbing the teat gently across her lower lip. When you can see her mouth is open, gently insert the bottle teat, aiming it towards the roof of her mouth over her tongue.” Ensure your bub’s lips are pursed open over the teat and not just sucking on the end. “This allows for a good suck reflex and creates a good seal,” says Jan.
You may also like to alternate offering feeds from your right arm and left arm. “This supports balanced muscle development,” explains Jan. Burp bub in the middle or at the end of the feed, or if she’s starting to fall asleep.
Types of teats
There are a huge variety of bottle teats available, but “it’s up to each individual mother and baby pair to use what they prefer,” says the Australian Breastfeeding Association’s (ABA) Renee Kam. You may need to try a couple of different types until you find one bub likes best.
When choosing a teat consider the flow, making sure it’s “not too fast and not too slow,” says Jan, who suggests tilting the bottle so milk is always covering the end of the teat while feeding, to lessen the likelihood of excess wind. If your littlie is sculling her bottle too quickly, “have a teat that requires bub to suck the milk out, such as Y-cut or peristaltic, and have your baby positioned in a semi-upright position, not lying flat,” Jan advises.
Weaning from breast to bottle
If you’ve decided to fully move from breastfeeding to bottle-feeding, it’s important to go slowly, replacing each breastfeed with a bottle one at a time. “In this way your breastmilk supply is allowed to gradually reduce and this helps prevent engorgement, blocked ducts or mastitis,” says Renee. “It also allows time for mother and baby to gradually adjust, emotionally, to the change.”
Jan suggests sitting in a different chair to the one you usually breastfeed in and making sure bub isn’t tired for the feeds. How gradually weaning occurs will depend on how frequently you were breastfeeding before deciding to stop. “Many mothers find it works well to drop one breastfeed and wait for their breasts to feel comfortable again before dropping another feed,” says Renee.
Coping with bottle refusal
You may have grand ideas of a shopping trip or dinner with friends, leaving a bottle with your baby while you’re out, but your little one may have other plans! It’s very common for breastfed babies to refuse bottles, because the rubbery silicone teat just doesn’t cut it when they’re expecting a fleshy boob, and their association with hunger doesn’t always equate with milk, but with Mummy.
To help your little one get used to bottles for these kinds of occasions, Renee says some mums find it helpful that, even if they’re available, a person other than themselves offers bub her formula or expressed milk. Another trick is to offer the bottle at certain times of the day. “It can be helpful to offer your baby a bottle as soon as she wakes up from a sleep, when she’s still a bit sleepy,” Renee says. If these tips don’t work, you can still get fluids into bub via a cup.
For more tips on coping with bottle refusal, see the ABA’s Caregiver’s Guide to the Breastfed Baby at the Australian Breastfeeding Association.
What about nipple confusion?
While some babies hate bottles, others love them and because of this, breastfeeding mums who’d like to offer an occasional bottle of expressed milk or formula often worry their baby will experience ‘nipple confusion’ and prefer the bottle to the breast. While this is a possibility, “many mothers introduce bottles to their breastfed baby without any problems,” Renee assures. “In the end, it’s all individual and up to each mother and baby pair to see how it works for them. If there any concerns, a mum can always contact the Breastfeeding Helpline on 1800 686 268 for individualised guidance.”
It’s difficult to predict how your baby will react to a bottle until you try one, so don’t be afraid to ask for help from the professionals if you need to. In the end, it will work out and you can relax into your new bottle-feeding regime. Remember, all babies are different!
When weaning or offering expressed breastmilk, some mums prefer to bypass bottles altogether and teach their child to drink out of a cup.
Babies often prefer this option, too. “Drinking from a cup is more similar to breastfeeding than drinking from a bottle,” says Renee. “Your baby needs to take an active role when drinking from a cup and her tongue is in a similar position to which it is in when breastfeeding.”
Babies of all ages (even very premature bubs) are able to drink from a cup with assistance. For newborns, a medicine cup may work well, or you can buy specific cup-feeders with a high lip, or feeders with a control valve and self-filling reservoir that the milk is squeezed onto. An older baby may be able to sip from a regular open cup with help, or a lidded cup with a spout or built-in straw by herself. Breastfed children over six months sometimes prefer straw cups, as they’re able to regulate the flow as they do from the breast. You may need to persist in showing your littlie how to sip it up the first time — one idea is to make it a fun bath game. The first sip may take her by surprise, but once she does it, she’ll remember how to do it again.