10 Tips for Introducing Bottle-Feeding to Your Breastfeed Baby and The Alternatives

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Sometimes, a breastfeeding mother needs to leave her baby at home while doing some errands. It can be a short one such as doing grocery shopping, having a me-time with girlfriends, or regular separation such as going back to work or study.

If you do exclusive breastfeeding, that means to feed your baby with expressed breast milk when you are away.

How to do that?

You may say, just put the milk in the bottle and give to the baby.

Well, it can be true, but it can be more complex than what you think.

Here’s why..

Do you know that some lactation consultants recommend avoiding bottle-feeding for breastfed baby, especially in the early days?

Why is that so? Bottle feeding, if not done carefully, can lead to nipple confusion, where the baby thinks that the bottle nipple and breast nipple has the same way of drinking (which is incorrect), and thus the term ‘confusion’.

The issue here is that with typical bottle nipple, the baby does not need to suck extra hard to get the milk out from the bottle.

Whereas at the breast, first the baby needs to suck to stimulate let down reflex, and only after that the milk start flowing. So, some efforts need to be done first.

Now, let me ask you, which one do you think you would prefer, doing easier or harder job? Of course the easier one, right. That’s why some babies prefer bottles (due to less or no effort involved)  and refuse direct latch. Of course, you don’t want it to happen.

So, how to feed baby expressed breastmilk the better way?

This post will explain some tips on how to feed your baby with expressed breast milk, by bottle-feeding or its alternatives.

 

 

First, let me start by mentioning that there are alternatives to bottles, which can be a perfect solution when you only need to leave your baby occasionally for a short period of time. These alternatives are especially geared towards younger babies (less than 6 months old).

Here they are.

1. Spoon feeding

You can simply use a soft baby spoon (not a metal one please) to feed expressed milk.

Pour the milk to a cup (I use Avent VIA cup), then hold your baby on your lap (it is easier to use a sling if your baby is squirmy).

Take a spoon of milk and tease it to your baby by putting the spoon close to her lip. You’ll notice that you don’t actually need to shove the spoon inside her mouth because she will naturally suck the milk from the spoon.

Spoon feeding can be tricky if your baby is too hungry because, with a wailing and squirming baby, the milk can get spilled easily.

But with practice, it can actually get better. I happen to spoon-fed my baby until she was 5 months old (only once a day) because she happened to refuse bottle-feeding at first few attempts.

2. Cup feeding

Some working mothers swear by using Medela cup to feed their babies. And actually, they regularly use this approach until the baby transitions to a sippy cup at an older age.

PS: I found a new cup model that can be used to feed your baby expressed breast milk. It is called KindestCup. KindestCup is not only useful for cup-feeding your breastfed baby, but also catching milk drip and doing hand-expression. Check out the full review of KindestCup here.

3. Spout feeding

Have you ever seen a bottle that is connected to a spoon, but with a hard straw in between, like this? If you hate spoon-feeding due to repeat need to scoop the milk from the cup, you may love this little bottle.

I had one, and while I don’t use it to feed expressed milk, I used it to feed my baby plain water once she started solid. I totally love it. Just pay extra attention with the tilting angle do that you won’t flood your baby with too fast milk flow.

Another type of spout-feeding would be Medela soft feeder. It has a silicone spout connected to a small milk tube. The good thing about this product is it has a volume scale (so is easier for you to monitor how much milk your baby drinks). But I found the spout to be a little too big for my baby.

These alternatives, however, may not be practical for long-term and regular separation. Among the reasons are:

• The high learning curve for the caregiver, because s/he needs to divide the attention to deal with the hungry crying baby and not to spill the milk.
• Take a longer time to feed the baby. Problematic for impatient babies.
• Higher chance of spilled milk.

And that’s why a lot of mothers still prefer bottle feeding. It is easy!

But..,

How to safely use bottle-feeding to give expressed breast milk,

so that baby will not develop nipple confusion?

Let me share a few tips with you.

1. Use newborn flow teat as long as possible, and increase the nipple size gradually once the baby refuses the slowest flow. I found this method extremely useful in keeping the baby to be patient at the breast. Breast milk flow is not instant like bottle feeding, and that’s why you want your baby to work slightly harder in sucking the milk out of the bottle, just like how she works hard while nursing at the breast.
2. Use paced bottle feeding technique to avoid overfeeding. More and more lactation consultants recommend paced bottle feeding to feed a breastfed baby. This is simply to emulate how the baby usually nurses from the breast.
   • Sit the baby slightly upward, not lying down.
   • Position the bottle almost horizontal, about the right angle from the baby’s spline direction.
   • Aim the bottle to the baby’s nose and wait until the baby opens her mouth wide enough to insert the bottle nipple. Aims to insert as much as possible, reaching the nipple base. If your baby gags, perhaps you need a smaller nipple size.
   • A few times in the middle of feeding, taper off the bottle so that the milk flow stops for a while, then continue as usual

Here’s a video showing how paced-feeding looks like.

If you’d like to know more details about the benefit of paced-feeding, including 2 instructional videos on how to do it in an upright and side-lying position, Katie from Balanced Breastfeeding has an awesome post about it. Click here to read it.

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Now, having known how to safely bottle-feed your baby with expressed milk, there comes one big question.

What if the baby refuses to drink from the bottle and only wants to nurse directly?

Sigh, I experienced this before and it takes a while to solve the issue.

Here are what I have learned on how to dealing with baby refusing bottle:

3. Experiment with milk temperature. Is the milk too hot? Is the milk too cold? Direct breast milk is warm at body temperature, so it is best to mimic that temperature is possible. But, each baby can have her own preference. Some even take cold milk (without reheating), so follow your baby’s cue to know her preference.
4. Taste the milk, does it taste fresh? Some frozen milk tastes metallic/soapy (horrible taste and smell) after thawing due to the excess lipase problem. Read more about this here. If you suspect that you have excess lipase problem, try experimenting by giving the baby different milk: frozen milk, chilled milk, freshly pumped milk and see if your baby responses differently. See also: The Ultimate Guide on Building Breast Milk Stash Before Returning to Work
5. Don’t wait until your baby is really hungry to prepare the expressed milk. Warming a bottle of expressed milk can take time, and your baby may not be patient enough if he’s really starving. At the first sight of hunger cue, quickly prepare the milk and feed her while she’s still calm.
6. If you need to warm the expressed milk, one easy way is to use a bottle warmer. I’ve discussed the 5 most popular bottle warmer for breast milk in this post (including the pros and cons).
7.  Let other caregivers feed the baby. You should hide in the other room, or even go outside so that the baby feels she has no other option. The reason for this is because a baby can smell her mother’s scent within a close distance. When she is aware that mom is around but refuses to nurse her, she feels heart-broken. When I trained my baby to drink expressed milk, I would literally go outside my house (to check my mailbox, or just to take lift down), and say bye-bye to her. She will cry when I leave, of course. But then, once she knew that I’m not around, she would be more willing to take the expressed milk.
8. Use breastfeeding-friendly bottles and bottle nipples. Some babies can be very sensitive to the choice of bottle and bottle nipples. And therefore, I strongly recommend you to use breastfeeding-friendly bottles and bottle nipples.

With my second baby, I use a combination of Avent Natural Bottle and Pigeon Peristaltic Plus Nipple (newborn flow). The nipple is so soft (I think that’s why she liked it), and it has a wide base, just like breast nipple. I also heard a lot of recommendations regarding Dr.Brown’s nipple, while I never tried it by myself. If your baby still rejects these two, experiment with other bottles and nipple combinations. Perhaps your baby will prefer a skin-colored nipple which resembles real breast like this.

8. While you are in the stage of introducing the bottle, reheat the expressed milk little by little, say, heat 1 oz first and see if the baby will accept it. By doing this, in any case, that your baby refuses to drink your expressed milk and you need to throw it away, you won’t feel so bad because the amount is so little. You can check my guide on how to thaw and warm frozen breast milk here.
9. Be patient. Some babies are so persistent in refusing bottles until the last minute when the mom finally returned to work. This can be frustrating for moms, thinking how would the baby survive if she rejects the bottle altogether. But just like us, who are feeling overwhelmed leaving a baby under someone else’s care, I believe our baby has experienced his own stressful moment when he can’t get his usual milk right from mommy’s breast. But hey, babies are smart. They’ll learn that mommy is only gone temporarily and she’d back soon.
10. In the worst case that your baby keeps refusing bottle even after you’ve returned to work/school for sometimes, do know that babies won’t starve themselves. Some babies do reverse-cycling (i.e. taking very little milk when moms are away and nurse more often when moms are at home). You can learn more about reverse cycling in this article.

I hope these tips will help you while you figure out the best way to feed your baby expressed milk. Just remember that each baby is different, so what works for one baby may not work for the other.

Do you have other tips on how to feed expressed milk to your baby? Don’t shy and share with us here.

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