How to Bottle-feed as You’d Breastfeed

by Bettina Forbes, CLC | March 7, 2011 12:43 pm

Recently we provided a few bottle-feeding tips in our story about actress and breast cancer survivor Christina Applegate.  Not all moms can breastfeed, so it’s important to remember that lots of skin-to-skin contact, baby-wearing, feeding on cue, and the use of donor milk (if possible) can make for a healthier feeding experience.  We’re pleased to be able to give you further information on successful bottle-feeding, courtesy of Amy Peterson, BS, IBCLC and Mindy Harmer, MA CCC-SLP.   Amy and Mindy have co-authored Balancing Breast and Bottle: Reaching Your Breastfeeding Goals.  While written primarily for breastfeeding mothers, Balancing Breast and Bottle contains practical information to help all mothers—whether they feed breastmilk, donor milk or formula— select a bottle nipple or pacifier for their baby.  (For moms that are also breastfeeding, this information can help transition back and forth between breast and bottle, once breastfeeding has been successfully established, usually after 2-6 weeks.)  The authors developed an acronym called the SIMPLE Method that explains how to select an appropriate nipple according to a baby’s unique suck.  One chapter details common sucking difficulties with bottle nipples, and how to achieve better mouth placement and coordinated swallowing.  The book also contains an appendix which ranks common nipple brands from slowest to fastest slow-flow nipple, something that is sorely missing elsewhere!  To learn more, visit www.breastandbottlefeeding.com.  

Bottle-feed as You’d Breastfeed  

by Amy Peterson, BS, IBCLC, and Mindy Harmer, MA, CCC-SLP  

Feeding our babies is an important part of parenting.  We feed our babies many times each day.  Each feeding provides an opportunity for loving interaction.  Breastfeeding—literally feeding the baby at the breast—intimately connects a mother and baby, and also models natural feeding.  However, there may be times when a baby doesn’t feed at the breast.  In these situations, we can apply the elements of breastfeeding to bottle-feeding to ensure all feedings are nurturing and mimic “normal.”  

 Baby Milk  

First, carefully choose your baby’s milk.  At the breast, babies drink breastmilk.  Ideally, then, breastmilk will also be in the bottle for every feeding.  This usually requires a mother to pump her milk with a high quality breast pump and save it.  Provide your breastmilk exclusively for as long as possible.  

Sometimes a mother may not have enough breastmilk  saved to use in a bottle.[1]  “Sadly, some mothers give up breastfeeding at this point, thinking that the benefits of breastmilk are cancelled by adding formula.  But this is not true; breastfeeding need not be ‘all or none’” (Peterson & Harmer,  2009, p. 20).  Continuing to provide your breastmilk even when your baby also receives some formula is important for your baby.  There are different ways to combine baby milk.  It is safe to put breastmilk in a bottle and add formula to equal a full feeding.  A different way to combine baby milk is to use all breastmilk for some feedings, and formula for others.  These options may allow you to extend the length of time your baby receives your breastmilk.  

Mouth Placement  

In the early days of breastfeeding, mothers attend to their babies’ mouth placement for coordinated sucking and good milk transfer.   Likewise, mothers need to attend to their babies’ mouth placement and coordination on a bottle.  A bottle cannot and should not be chosen based simply on manufacturer’s claims.  Rather, a baby’s mouth placement on a bottle needs to mimic a similar placement as on the breast—whether or not the baby ever breastfeeds.   

Check your baby’s mouth placement on the nipple:  

Lips not on a portion of the base. From Peterson & Harmer, 2009, p. 66. Used with permission from Hale Publishing.

BEST: Lips on a portion of the base. From Peterson & Harmer, 2009, p. 58. Used with permission from Hale Publishing.

Swallowing 

Bottle nipples have various rates of flow.  The flow of a nipple will affect the coordination of a baby’s swallow.  Young babies need to start with a “slow” or “newborn” nipple, but even so, there is a wide range of how fast these slow nipples flow.  It is important to observe your baby’s behaviors when bottle-feeding to determine if the flow is hindering your baby’s swallowing. 

 Check your baby’s swallowing when using a bottle: 

 Improving the Bottle-Feeding Experience 

There are other elements of breastfeeding that can be applied to bottle-feeding: 

Peterson, A., & Harmer, M. (2009).  Balancing Breast & Bottle:  Reaching Your Breastfeeding Goals.  Amarillo, TX:  Hale Publishing.  



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