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Introducing the Bottle: How Early Is Too Early, How Late Is Too Late?

Jul18

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Dear Amy,

I’m expecting my first child is 4-6 weeks depending on how much little baby wants to get out of there. My plan is to breastfeed, and I would love to exclusively breastfeed for a year. I’m in Canada so I could take a year’s leave, but unfortunately due to financial reasons, I’m going back to work after 5-6 months and my husband will be staying home with baby. (We can’t live on a third of my salary and no benefits for a year ) I’m a teacher, so I can’t really do the whole pumping at work thing unless it was during lunch break, and that just seems like too much hassle with supervision and extra help at lunch etc. when I can barely find time to just go pee during the school day.

So, the current plan is to breastfeed until I have to go back to work and then mix breastfeeding when I’m at home, and formula while I’m at work. So really at that point, baby will only need 1-2 bottles of formula during the day on average.

That’s all fine and dandy… so when do I start introducing bottles? Do I introduce them with formula early on? Or just with breastmilk to start? I know some picky babies that refuse formula if they’ve only ever had breastmilk and that refuse bottles.

How do I ensure that this will work out 5-6 months down the road?

Thanks!
A confused first time mum.

The timing of bottle introduction is an easy question to get confused over, because holy crap, Internet, you sure are full of a million different and contradictory opinions and theories about it. MAKE UP YOUR MIND. Introduce too early and risk nipple confusion and bottle preference and screw up breastfeeding forever! Introduce too late and risk all-out full-on bottle rejection and screw up your work/daycare plans and any hope of a few hours’ escape! Heck, I’m pretty sure I’ve covered other versions of this question already, but the question keeps getting asked. So why not, let’s talk about it again.

We successfully switched back and forth between bottles and boob, and formula and breastmilk, with all three of our babies, and let me tell you: It was GREAT. Is it okay to admit that? Because I repeat: IT WAS GREAT. Best of all of the worlds, personally speaking.

Not that it technically happened by choice, mind you, and didn’t cause me all kinds of new-mom anxiety at the time. I had major supply issues with my first baby, and so a bottle of formula was introduced on day four or five when his weight loss officially dipped too far. (He also had a very weak suck, which compounded the supply problem, but we never experienced any nipple confusion or bottle preference, despite the bottle being “easier.” YMMV.) I probably supplemented at least once a day from then on until he weaned. My other two also had their first bottle of formula within their first few days because my milk took forever to come in and they were dehydrated. Once the bottle was introduced AND breastfeeding was going well, it just made sense for us to keep using the bottle every now and then. I’d pump milk to up my supply and we kept formula around too, so I had the freedom to like, go get my hair done or go out on a date night.

So much angst over that initial bottle, by the way! Every time, I felt disappointed that my perfect dreamy dream of true 100% exclusive breastfeeding was dashed so early on. Now I look back and think: Dude. Chill out. Breastfeeding is great. So are bottles. Let’s all just chill out together, yo.

Your baby and breastfeeding relationship will be your own, of course, and wholly unique. You might decide to supplement early on for a variety of reasons, or you might never need to. If you don’t, wait to fully establish a good latch and milk supply, and then think about trying out a small bottle of pumped milk or formula. My completely non-expert and unscientific opinion is that if you know for a fact that you NEED your baby to take a bottle later on, I wouldn’t wait too long before at least trying. A lot of sites recommend waiting six weeks (as that’s the average time it takes to establish your milk supply), while others say you can try earlier — just be sure to pump milk so the bottle doesn’t kill a regular feeding. Also, just because you try a bottle one time doesn’t mean it immediately needs to become a regular, daily thing. It can just be something you try every now and then, for your own peace of mind re: your back-to-work deadline. Trust your gut; you’ll probably know when the right time comes along.

Here’s what to do, for first bottle introduction: Buy a PREEMIE or LOW-FLOW nipple for the bottle. Let some milk dribble out onto the upper lip so the baby can smell it. Don’t ever just shove the nipple in his/her mouth — wait until his/her lips open. Some babies prefer the wideneck nipples/bottles; others prefer the standard. Some do better if it’s someone other than Mom who offers the bottle; others are the opposite. Some take a bottle just fine on their first try; others need a couple attempts before they get it. Same goes for what’s inside the bottle. Some are happier with breastmilk while others prefer that the bottle be something completely different. (Mine all seemed to like formula better than pumped breastmilk when it came to their bottles, and they liked their formula cold.) You can even go halfsies with both breastmilk and formula — just remember that any bottle with leftover formula will need to be discarded, rather than re-refrigerated. It all might click from the get-go, or it might take a little trial-and-error. That’s normal. DON’T PANIC.

And again: For every bottle you give the baby, give your boobs a session on the breastpump, so your milk supply won’t be affected. Save the pumped milk for the next bottle, or freeze it for when you go back to work.

This is a lot of words for something that hopefully won’t end up being a big deal for you at all. Instead, I hope breastfeeding winds up going spectacularly well for you and one day you can just be like, “Hey! Let’s try a bottle.” And your baby takes the bottle and then your baby goes back to the boob the next time and bam. Done. And the Internet tried to make it all complicated. Pffft.

 

 

About the author

Amalah

http://www.amalah.com
Amalah is a pseudonym of Amy Corbett Storch. She is the author of the Advice Smackdown and Bounce Back. You can follow Amy's daily mothering adventures at Amalah. Also, it's pronounced AIM-ah-lah.

If there is a question you would like answered on the Advice Smackdown, please submit it to amyadvice@gmail.com.

Amy also documented her second pregnancy (with Ezra) in our wildly popular Weekly Pregnancy Calendar, Zero to Forty.

Amy is mother to rising first-grader Noah, preschooler Ezra, and toddler Ike.


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23 Responses to “Introducing the Bottle: How Early Is Too Early, How Late Is Too Late?”

  1. Allison Jul 18 at 6:54 pm Reply Reply

    With my first i exclusively breast fed, and it was a fight to ever get him to take a bottle. it took weeks before he would eat nicely from a bottle. so with number 2 we introduced a bottle within the first week, and it was great!  it is so nice to be able to let someone else take a feeding. i think earlier rather than later with the bottles is a great way to go. 

  2. Cheri Jul 18 at 7:43 pm Reply Reply

    Also, keep in mind, it may take trying more than one kind of bottle/nipple  to get baby to switch. My second baby didn’t like the bottles I got for the first baby . Naturally.

  3. Karen Jul 18 at 7:49 pm Reply Reply

    I did early bottles with one, and with the other I waited until he started with his babysitter at 4.5 months and let them sort it out (it was fine). I much preferred the delayed start. My first took the bottle fine, but the routine of nursing/pumping/bottle was really hard on both of us.

    I recommend reading about paced bottle feeding. One reason that breastfeeding is beneficial for infants is because the suck-swallow mechanism protects their airway by preventing more milk from coming in their mouth while they swallow what’s already there. Bottle feeding a young infant should be done carefully otherwise they can choke or aspirate milk. This is a great resource on paced bottle feeding and I wish this kind of explanation was packaged in with all bottles: http://nurturedchild.ca/index.php/2010/12/10/baby-led-bottle-feeding/

  4. Brooke Jul 18 at 8:29 pm Reply Reply

    With my first, we went back and forth on bottles and breastfeeding because I wound up being hospitalized when he was less than a week old with post-natal preeclampsia (who knew that was a thing?). Anyhoo, he switched boob and bottle like a champ. When I was back home we went back to breastfeeding exclusively. Then, the week before I went back to work, I tried to give him a bottle and he downright refused. I spent the day in tears, convinced he was going to starve in daycare. Turns out all he needed was someone else to feed him, someone who wasn’t mom, and he took a bottle like it was no big deal. And both my kids were just fine with the nipples that came with the Gerber bottles (the ones that work with the Medela pumps). I definitely got lucky.

  5. Wade Jul 18 at 8:33 pm Reply Reply

    Also be aware that babies are tricky little buggers.  With my first, I was back at work when she was four months old.  She had been exclusively breastfed up to that point.  We’d tried a bottle of breastmilk, and she’d kind of mess with it but wouldn’t really drink it.  Then finally there was a day when I’d have to be gone 8 hours.  As new parents, we were really freaked out.  And sure enough, at 4 hours, she rejected the bottle.  At 5 hours, she messed around a little but rejected it.  At 6 hours, she looked at her Dad, sighed, and downed the whole thing.  Basically, she had to be convinced that I wasn’t just around the corner, but after that she did very well with the bottle.

  6. sassy Jul 18 at 9:04 pm Reply Reply

    I had to give my son a bottle in the hospital (I’m with Amy though – killed me at the time but now I wish I could go back and slap myself and tell me to cool the hell out lol). I will say that is the one and only time he ever took a bottle from me, although that was also his only formula ever. So I’d just be ready to have daddy have to introduce him to the bottle and if it has breast milk in it be ready to just go out for coffee or something.

    Also my son would take any bottle but he also was a happy spitter and we found that Dr Brown’s bottles with a low flow nipple worked best for him. And we only ever gave him 4 ounces at a time even as an older baby.

  7. Megan Jul 18 at 9:18 pm Reply Reply

    If you’re waiting till 6 months, I know it sounds crazy, but you might also consider a cup with a straw. We introduced our daughter to a cup with straw some time after she started solids, and it totally avoids the whole stress about bottles/nipple confusion. You should remember that a lot of the people who are preparing to go back to work with young babies have to go back as early as 6 weeks, 3 months tops. You’ve got a whole lot more options with a 6 month old!

    • A.L Jul 18 at 10:21 pm Reply Reply

      Definitely keep this idea as an option if your baby is picky about nipples. My son never really seemed to like bottles (though admittedly, I never really tried that hard– as a SAHM there wasn’t a lot of urgency so I didn’t really push it). But when he was around 5 months or so I noticed that he got a hold of one of his sister’s straw cups and he was actually sucking water out of it. So I tried it with some formula and he drank it! I never would have thought that a little baby could drink out of a straw, but it worked and was incredibly convenient for me.

  8. traci Jul 18 at 9:22 pm Reply Reply

    My plan was to exclusively breastfeed and to wait until my milk was established to occasionally pump so my husband could give him a bottle bc he really wanted to feed him too. Due to low blood sugar at birth he got a bottle within 20 minutes of birth (he breastfed first, but they were worried it wasn’t enough). Now at 3 months he mostly breastfeeds but has had a pumped bottle maybe 10 times. I do also keep some formula samples handy as an emergency back up if I go out and he gets too hungry while I’m gone. He’s had a few. I decided it was better to just take a whatever he needs approach instead of letting myself get upset if I’m not perfect with exclusively breast milk. He takes the breast milk just fine but goes super slow with formula, like he’s waiting for the right stuff.

    You should be able to pump at work if you want. My mil did it while teaching and if I hadn’t decided to stay home I would have. Don’t worry about inconveniencing anyone, it sounds like it would only be for 6 months anyway. They can find coverage for you. Again, if that is what you want, if not formula is fine too. I just know us teachers tend to put ourselves last, but this is one situation where you should feel no guilt for putting yourself first.

  9. Laura Jul 18 at 10:00 pm Reply Reply

    We did some early supplementing with formula/bottles while learning how to breastfeed. From 6 weeks to 5 months my son breastfed exclusively and then we were able to introduce a daily bottle fairly easily after we figured out he liked it warmed. Be prepared to experiment a bit and be patient with yourself and your baby and it will go fine.

  10. N Jul 18 at 10:38 pm Reply Reply

    FYI… remember that kids go through growth spurts. My 5 month old was downing 4 eight ounce bottles a day at *daycare alone* (I’m not even talking about his consumption when he was home with me) and he was not big by any standard (40th percentile for weight.) So you may want to reevaluate what might be needed in terms of food during the day.  But like others have said, don’t worry so much about the what… BM, formula, a mix of half and half… .it’s all good and will keep your baby fed, which is the important thing. :)

  11. Shannon Jul 18 at 11:04 pm Reply Reply

    The OP should be aware that her supply may dwindle if she does not pump at all while at work. It is recommended to pump roughly every 3-4 hours to maintain supply during the first 12 months if you want to continue breastfeeding for that whole year. After one year, many moms stop pumping & nurse when home because by that point baby is getting most of his/her nutrition from solids. Kellymom.com has solid research-based info on breastfeeding & pumping that may be helpful.

  12. Anna Jul 19 at 12:11 am Reply Reply

    Our lactation consultant has been working in the field for 30 years and has only seen a legitimate case of nipple confusion twice. This was comforting to hear when we were having issues in the early days. When our little guy was born with a sublingual cyst that made it difficult to latch properly, I had to pump and bottle feed from about day 4 until 2 weeks when his cyst was resolved. He had no trouble going back to the breast and if anything his time on the bottle helped him coordinate his latch/ suck-swallow rhythm. I would err on the side of introducing it earlier rather than later if I was in your position.

    • Anne Jul 21 at 6:39 pm Reply Reply

      My husband is a pediatric nurse who works mainly with infants, and many of his coworkers are our friends. None of them believe in nipple confusion, and they all introduce bottles as soon as mama can pump.

  13. Caroline Jul 19 at 1:24 pm Reply Reply

    I followed an old maternity nurse’s advice on this one and it’s worked for all of mine; introduce 1 bottle at or around 4-6 weeks. Literally, just one, ideally full of breastmilk (why waste money and you’re likely to have a good supply by that stage!). Thereafter, just as and when convenient, once or twice a week, depending on circumstances, but yes, do express as close to ”normal” feeding time as possible, just to stay with the flow! Only people I have ever heard of who have had an issue, are those who have flatly insisted on EBF and then tried to switch after months and months… and then it becomes a very upsetting pitched battle. Assuming you are breastfeeding relatively easily (and by 4-6 weeks in, that is likely), a bottle from time to time will do no harm at all, and it will allow dad and other family members to become involved… and… give you a real break!! When my babies got to about 8-10 weeks, I handed over the 10-11pm feed and expressed at around 9pm, a really good session, left a good bottle and WENT TO SLEEP AND STAYED ASLEEP till the 2-3 am pyjama parade… those hours of unbroken sleep were manna from heaven, let me tell you, and it meant my DH only went to bed a little later than normal, and shared in that tiring period, but without massive impact on him for the next day’s work. That first night when I was asleep – unconscious – from about 9.15 till 2.30 was bliss! I’ll never forget it :) Best of luck, don’t be put off by the nipple confusion brigade. They mean well but I genuinely have never heard of this being a problem!

  14. Ali Jul 19 at 3:49 pm Reply Reply

    We introduced a bottle around 2 weeks using milk I pumped. Our ped’s advice is that 2 weeks is a good time to start if breastfeeding is going well. We gave approx one bottle a week until 5 months , when baby boy started to absolutely refuse any and all bottles…and I tried every. Bottle. Ever . Created. He would seriously hold out for 8 hours and would still refuse, so I wound up having to head home over lunches to nurse. It was awful. No luck ever getting him to take a bottle again, but things finally got a bit easier when he started taking a straw (around 10 months). He still wouldn’t accept pumped milk with a straw, but I started giving him small amounts of cows milk that way (because mama needed a break). I’m currently expecting another baby and being chained to this little guy for a year simply isn’t an option . My plan this time is to introduce the bottle at 2 weeks or so , then give a bottle once a day to hopefully avoid bottle battles this time around . Fingers crossed you can avoid this scenario, but just wanted to throw out my experience and opinion as a result.

  15. Leslie Jul 19 at 4:59 pm Reply Reply

    Babies: PRONE TO WEIRD BEHAVIOR. I went back to work for short periods of time at two weeks, and I’d had such a miserable experience breastfeeding at that point that if anyone so much as mentioned a bottle or pacifier, they would immediately fall over courtesy of my death stare. However, the hubs at home was NOT happy with a hungry, grumpy baby going through a growth spurt so I used my sad little manual pump and we used the wacky $1.00 bottle that topped the diaper cake and IT. WAS. AMAZING. Baby was fine with it. Still nursed like normal. Manual pump continued to work like a champ in a way that the electric never could. Truly, Amy has given you great advice. You will find what works for you, and it might be very different from what works for other people (despite how hilarious, funny, down-to-earth, just like you they seem to be.) Sometimes it’s easy (especially when you don’t have a great support system or much knowledge of babies) to get hung up on a specific piece of internet advice that makes complete sense, even if it’s not maybe the best fit for you. Good luck, keep up your information gathering campaign, and only take advice like Amy’s to heart.

  16. Kim too Jul 19 at 9:10 pm Reply Reply

    It is purely anecdata, but I know so, so many more babies that refused bottles than had nipple confusion.  As in, after 2 children in a very, very bf-oriented community, and 5 years in a co-op preschool, I do not know one single baby that had nipple confusion, and more than I can count that gave their moms grief over taking a bottle.  Both my kids were preemies, and both got bottles and boobs from day 1 (one was in the NICU, one had latch issues.) I will say that my youngest did not get as many bottles as her sister, and so was more reluctant as she got older – by 9 months she was strictly a sippy cup girl.  
    I am going to add, because I do not see it talked about enough – my youngest’s latch issues were extremely difficult, and they were not solved until we saw an occupational therapist.  It took 1 visit to get us turned around, and only a few more until we were set (for the next 2 years.) I didn’t even know there was OT for nursing, but there is and it totally works.

  17. Kathleen Jul 20 at 9:39 pm Reply Reply

    Yes, former selves, chill out. We gave out first a bottle at four weeks and then a couple more (all breast milk) and it was fine. Then we went on a two week trip (why pump? I’m on vacation!) and he wouldn’t touch a bottle (so I do recommend keeping up the bottle every few days. Went to daycare at three months, didn’t drink all day, got all his food in the evening/morning (maybe 1 night feeding) and thrived. But damn, we stressed about it! Deeep breaths.

  18. SarahB Jul 21 at 10:38 am Reply Reply

    What great advice!

    My baby had to get a bottle in the hospital thanks to blood sugar issues and then my milk taking awhile to come in. It was a little crushing at at the time–though thanks to Amalah, I at least knew it could happen, for which my DH and I were/are very grateful–but it turned out to be a gift.

    It sort of broke the ice with formula and bottles for us. We ended up using about one bottle a week so I could go run out of the house and do something exciting by myself (like grocery shopping!) and DH could get some one-on-one time with the baby. It was also useful to be able to give the baby a bottle during growth spurts. If the baby’s been nursing from 4 to 7 pm straight and is still hungry, well, here’s the bottle!

    Good luck, however it all turns out!

  19. Jamie Jul 21 at 2:02 pm Reply Reply

    We introduced a bottle right away in the hospital with my first since I had a spinal headache and was put on painkillers and about 2 weeks in with my 2nd so he’d be ok with bottles once I went back to work.  Both worked, but I’d recommend a daily bottle once introduced.  A middle of the night bottle worked great for us, so the kids were getting a bottle, and I got some sleep.  I know a few people who introduced them but weren’t vigilant about giving one a day and their babies refused the bottles when mom went back since they were only getting maybe 1 per week.  

  20. Slydegirll Jul 21 at 2:43 pm Reply Reply

    I think the main thing I’ve learned, and realized my friends with tinies have also learned, is that you plan in advance when you want to introduce the bottle. Waiting until the Saturday before you go back to work is a bad idea, no matter when it is. We’ve waiting about two weeks after birth (because I go back to work at 8 weeks) and then made sure the baby had a bottle at least once/week until I went back to work. It always takes three or four tries until our little ones got the hang of it, but waiting until a few days before they actually NEED to use the bottle = no bueno. 

  21. tami Jul 21 at 6:03 pm Reply Reply

    My daughter was a stubborn one right from in utero and she refused to nurse – not that she couldn’t latch just refused to. so she had a bottle right from day 3 (in our hospital they would not give me a bottle to put my expressed colostrum in they gave me a syringe… :( but that’s a whole other story) and after 6 weeks of offering her the breast then when she screamed and refused feeding her a bottle of pumped milk she took to the boob and nursed and bottle fed seamlessly. Every baby is different – do what feels right :) good luck!

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