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How to Introduce a Baby Bottle

Jun07

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Hi Amy,

Advice Smackdown ArchivesYou may have covered this question already but frankly, I am way too tired and have way too much going on to even look or research myself.  So I will just hope you haven’t and get on with it!

I am currently breastfeeding my almost 4 week old son and I am very interested in getting him to take a bottle.  A side note–I have a 2 year old daughter who NEVER took a bottle.  I breastfed her for 13 months, exclusively.  It’s not that we didn’t try the bottle with her.  I think we started too late and she would have nothing to do with it.  At the time it wasn’t a big deal and I wasn’t that bothered by it.  But now…I need this little boy to take a bottle.  I need to be able to get away from the two of them for more than 1.5 hours (he is a voracious eater–seriously, every 1.5 hours for at least 20 min) and go to the gym or whatever without having to rush home, worrying he is freaking out because he’s hungry and my boobs aren’t there.  My question to you is…how do I introduce the bottle?  Even though he is my 2nd child, I am a total rookie when it comes to bottle feeding.  I need guidance!  When do I start?  What is a good method to employ to ensure he accepts a bottle of breast milk?  I have a pump and am very willing to use it.  How long can breast milk sit out at room temp?  What about after it has been in the refrigerator?  I am clueless to every detail involved in this.

I’m a SAHM so this is strictly for my own personal freedom and enjoyment.  In a bin I have a bunch of Born Free bottles and accessories that we bought for my daughter that were never used.  Is that a good brand of bottle?

Wow, this is frustrating!  I hope you can help me.  My sanity is at stake here.  Not that I don’t love my kids and love being with them but…you know.  Away time is awesome too and I am currently not getting any of it.

Thanks so much!
Liz

How to introduce a bottle:

1) Obtain a bottle.

2) Wash bottle.

3) Put breastmilk in bottle.

4) Offer baby the bottle.

5) PROFIT.

If, after these incredibly complicated steps, your baby rejects the bottle, or takes the bottle but develops gas, or wants so many bottles you need to build up a warchest of frozen breastmilk to keep up, things MAY get a little more complicated. But it’s really really really best not to overthink it all before you’ve even tried.

So right now, go grab one of those Born Free bottles. They are fine. Check the nipple for some kind of label about the flow — Level One (sometimes just labeled with the number 1) is what you want, although I also think the Preemie flow nipples are an EXCELLENT first nipple to try with a young breastfed baby — I used Preemie flow nipples for Ezra up until about 12 weeks. Put the bottle, nipple and ring into the dishwasher or sterilize it in hot water on the stove. Pump some milk — two ounces or so is probably enough for an introductory bottle, or you can use this handy dandy calculator from Kellymom to figure out how much milk your baby drinks per feeding. (And here’s a handy dandy chart for all your breastmilk storage questions, including how long the milk lasts at room temperature, in the fridge, in the freezer, etc.). Put the freshly-pumped milk in the bottle. Wait for a regular feeding time or signs of hunger.

Hold your son as upright as possible — the bottle doesn’t make him wait for the letdown so you don’t want him to choke or gag. Rub his mouth with the nipple and tap it gently against his top lip — sort of like you do when offering the breast. Let him open his mouth and accept the nipple, rather than forcing it in. Let him take a few swallows and pull the bottle back if he seems to be gulping or gasping at it. Burp frequently. Switch “sides” midway through to mimic a breastfeeding session.

We always had Daddy introduce the first bottle. Noah was absolutely fine taking a bottle from me, but Ezra definitely had opinions about Mommy and bottles. (Once he became a bit more aware, he’d reject a bottle if I was even in the room.) And I admit we completely ignored the “wait until six weeks” bit of breastfeeding advice. I’ve known way too many mothers who ended up with babies like your daughter who refused to ever take a bottle EVER, and like you, I was not going to have any of that. I love(d) breastfeeding. I also really freaking loved the freedom of an occasional bottle. Noah needed early supplementing, and since I planned to return to work I saw no reason to stop using the bottle once my supply was better. Ezra had a tongue-tie that took almost a full week to resolve and I was in pain and needed a break — just ONE LITTLE BREAK — and I again immediately remembered the wonderful freedom of…date night. A pedicure. Grocery shopping by myself. Not completely neglecting my older child by being tethered to the couch and Boppy every hour and a half.

So, at four weeks, if you’re reasonably sure that things are going well with breastfeeding — good supply, good latch, good weight gain and all that — I see no reason why you shouldn’t start pumping a little milk here and there and seeing if your son will accept it from a secondary source. And don’t get discouraged if he doesn’t take it right away. After your initial keep-it-simple attempt, you can play around with different nipple flows or bottle styles (a standard instead of a wide-neck, for example, or one of the eleventy million different options out there). Or even different milk temperatures! Kids are PICKY, even as newborns. I do think the longer you wait the more likely he’ll reject it, so what are you waiting for? Go! Go now!

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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26 Responses to “How to Introduce a Baby Bottle”

  1. Elizabeth Jun 07 at 12:08 pm Reply Reply

    OK, so not sure if this warrants a separate question for your queue or a comment will work: When you talk about supplementing with formula, how did you go about that? I think I need to do the same, but I’m not sure the protocol: Do I breast feed, then bottle feed? Skip a breastfeeding and do a formula bottle exclusively X times a day? I’ve tried Googling it and of course came up with a million answers. My baby’s 1-month appointment is next week, and I can try to wait, but I didn’t know if you might have an — even personal, anecdotal — answer for me. (note: my first was a preemie and tongue tied, and in the NICU for two weeks — I never got to breastfeed him, so I exclusively pumped for a few months until going to formula.)

    Thanks!
    Betsy

  2. Melissa Jun 07 at 12:26 pm Reply Reply

    Good advice! I had to return to work so I needed the baby to take a bottle. I found it easier to have my mom introduce the bottle. I would pump enough for a bottle and then leave the baby with her while I went to the movie or did some grocery shopping. I did that twice a week or so from about four weeks on until I went back to work. After the first couple feedings with a bottle my husband did a couple as well, but I couldn’t be in the room at all or the baby would refuse the bottle.

  3. Kim Jun 07 at 1:11 pm Reply Reply

    Both of my girls took bottles right from the get-go. One was 5 weeks early and in the NICU. The second was 4 weeks early and had a tiny little mouth, and OMG OUCH. I pumped and nursed and nippleshielded and eventually ended up at the occupational therapist, and we’re doing just fine now, thanks. Anecdotally, I know way more babies who don’t take bottles than nipple-confused ones. (Do I know any? Maybe one? There are so many factors that go into stopping bf’ing, it’s hard to tell.)
    @Elizabeth – I’d say how you supplement depends on your reasons for supplementing. If it’s a supply issue, you probably need to either nurse or pump when the baby takes a bottle. My LC had me feed first and then nurse – the OT had me nurse first and then feed. That last seemed to do the trick. However – I had successfully bfed my first, so I knew if I was patient and stuck it out, my second and I would work it out. It took a lot of time, help, and weird mouth exercises for her, but we did.

  4. Diana Jun 07 at 1:28 pm Reply Reply

    Not a big deal with my first, but my second would only take a bottle if it were warmed to slightly above room temp.

  5. Lori Jun 07 at 1:44 pm Reply Reply

    I had to find the right temperature for my second to take a bottle — she wanted the milk warmer than body temperature! Also, when I was trying desperately to get her to take the bottle (since I had to go to work!), the lactation consultant told me to try her in different positions — holding her, having her laying on a pillow watching her BFF the ceiling fan, etc…. and interestingly enough, she said that although it’s helpful to have my husband try to get her take the bottle, I needed to do it also ….

  6. the other Elizabeth Jun 07 at 2:00 pm Reply Reply

    I am 0 for 2 with babies taking bottles (they’d rather starve than compromise their stance on All Boobs, All the Time), so while I have a lot of tricks, I don’t know if they actually work.

    The temperature seems way more important than the bottle, and hotter was better. Some people think it’s a matter of finding the right bottle, I say stick with one and let your kid learn to do it (we “use” BreastFlow bottles, if using means for my son to reject them, and they are very boob-like; see also: Adiri). If you really have a hater, try bouncing on a big exercise ball. Something about that occasionally tricked my older son into letting a couple ounces in. And most importantly, be consistent. I thought we had #2 on the bottle, by doing one every day and starting at 5 days old, but we got lazy and he totally rejected it by 6 weeks.

  7. Heather Jun 07 at 2:01 pm Reply Reply

    My husband inroduced the bottle at 4 weeks during ‘night’ feedings. He was the one responsible for bottle feedings at night/early morning. I breastfed exclusively during the day. It worked. Good luck!

  8. Philip @ RAOP Jun 07 at 2:20 pm Reply Reply

    Excellent advice. It is when this doesn’t work it can be frustrating though. Our third child has thus far refused to take a bottle. She will have to learn some time as we will be away from her for an extended period of time for an adoption. We are hoping to change her mind of the subject before have to leave though.

  9. Cassie Jun 07 at 2:25 pm Reply Reply

    @Elizabeth I agree with Kim. It depends on your reasons. I needed to supplement for my son because I was returning to work AND because I had low supply issues and he was constantly at the breast and constantly hungry. (By 2.5 mos, I was breastfeeding every HOUR. It was ridiculous. I barely had time to pee or eat, never mind grocery shop or anything else.) So my pede suggested supplementing by switching out the noontime meal first, giving a bottle instead of the breast. Meanwhile, I would pump around that time too, to keep up my supply. Eventually we switched up other feedings too until he was strictly on formula from a bottle and not on the breast. Because we did it gradually (over a month and a half) he didn’t rebel TOO much, though it did take him about a week to get used to the taste of formula. Ask your doctor. They can definitely help with how to do it.

    By the way, we started with my husband offering the bottle, but soon learned that as long as I was cuddling my son like I was nursing, he was perfectly happy to take the bottle from me too. :)

  10. amber Jun 07 at 2:59 pm Reply Reply

    We have been having this problem with our now 4 month old son. After an emergency c-section, he was in the NICU and had to drink from a bottle because they wanted him to be eating a certain amount every day and my milk hadn’t come in yet. When we got home, we worked with our local LCs and was able to start breastfeeding without supplementing within a little over a week. No more bottles. BUT – now he doesn’t want to drink from a bottle. It is a struggle every time and even though he is eating a little more each time we attempt it, I am envious of people who don’t have this constant battle.

    Anyway – here’s what we’ve learned. Maybe it will help someone else who is in the same boat…

    1. Try the Nuk bottles. We have tried LITERALLY almost every bottle/ nipple type that’s out there. The Nuk is the only one that our son will even attempt to drink from. The nipple is a flat shape – maybe that’s it, who knows!

    2. You might have to be out of the house. If I’m at home, the bottle feeding is a no-go.

    3. Have whoever is feeding the baby use the same nursing pillow as you use. Familiarity seems to help. My husband says that our son will only eat while his head is turned, like he’s nursing.

    Good luck!

  11. natalieushka Jun 07 at 3:58 pm Reply Reply

    @Betsy/Elizabeth: Whatever you do, don’t skip a breastfeed to give the formula bottle if you are supplementing, unless you intend to eventually only formula feed. Breastfeeding works on supply and demand so if you skip feeds, you will decrease your milk supply.

    I strongly suggest you see a lactation consultant if you think you need to supplement.

    Good luck!!

  12. lizzie Jun 07 at 10:02 pm Reply Reply

    I second the NUK nipples. We started using bottles from 2 weeks on, and it has still been a struggle. First she got tempermental about temperature. Then she started refusing to drink from plastic bottles (obviously BPA free, no discernable smell I could detect…) so we switched to glass and that seemed to help. All along she has been super difficult taking a bottle from me, which has made “practicing” really tough. I went back to work last week and was so worried she would hunger strike! (which she has done before with my husband when I was gone part of the day!) She did pretty good, and supposedly (I was told) one thing that really helped was giving her a burp rag or her “lovey” to hold on to. Those are things that are often present when I breastfeed her, and I think the holding sort of mimics the holding onto my shirt she does when breastfeeding…? Anyway, whatever works! Good luck!

  13. Julie Jun 08 at 1:58 pm Reply Reply

    I second the recommendation to see a lactation consultant if you feel you need to supplement. You might find out that you really don’t need to. You might find out that there’s some underlying issue that can be corrected to up your supply. Supplementing with forumla has all sorts of pitfalls that can sabatoge breastfeeding, so I wouldn’t want to do it without expert guidance, unless you are planning to switch to formula for some reason.

    Also, I second the recommendation for the “Leave grandma and the baby and a bottle home alone for an hour or two” method of bottle introduction. That worked for us. Grandma has often done it before, while Daddy might not know what he’s doing, and the baby will pick up on that lack of confidence. And of course many babys will refuse bottle from Mom since the good stuff is RIGHT THERE! :) It took my husband a couple of tries to get the hang of bottle feeding our son. I was lucky that he would generally take one from me if needed, usually just if we were in the car, or if there was a little left in the bottle I’d left for Dad while I was out that I wanted to use up.

  14. Ashley Jun 09 at 12:49 am Reply Reply

    My first baby was 6 weeks early but was perfectly healthy, no time in the NICU, and although I was exclusively breastfeeding, I gave him a small bottle of pumped breastmilk starting at 6 days old, every other day, and he never experienced “nipple confusion.” My daughter on the other hand, was 1 week late, huge, exclusively breastfed, and would not take a bottle for the first 7 MONTHS OF HER LIFE. I tried every damn bottle made, from Adiri to Nuk, Dr. Brown to Soothie, even cheapie Gerbers, she just flat out refused. Finally I sucked it up (haha) and called my LC for advice. She told me to try a preemie flow nipple (on my 16 lb 7 month old!) because breastfed babies are used to sucking HARD from the breast to get their milk, and when they do this even on a slow flow nipple, they get too much and choke or get scared. I shit you not, I was still on the phone with my LC when I got into my car and hauled ass to my local Babies R Us to pick up a preemie nipple. Brought that SOB home and sterilized it, poured some pumped milk into a cheap medela bottle and my daughter sucked that bottle down like she’d been doing it her whole life. We still breastfeed, but she’s getting her fair share of bottles and I’m getting my fair share of pedicures and dinner dates :)

  15. Wallydraigle Jun 09 at 12:59 am Reply Reply

    Also! Make sure you keep giving him bottles regularly. Not all the time, but once a day or once every other day. Otherwise he may do what my kids do and suddenly decide that he is too good for the bottle and will accept only The Boobs. I thought I’d learned my lesson with my first. She took a bottle at first, albeit reluctantly. We kept it up for a while, and then, because I am lazy, I decided we could ease up and only give her one once a week or so because I so dislike pumping (it takes me FOREVER to pump a decent amount, even with my super awesome new pump). WELL. She decided she was not ever, no how, no way, not EVAR going to take a bottle again on the day that I went to a friend’s house an hour away for the afternoon. I came home to a near-sobbing husband and a baby passed out cold in the bouncy seat from hours of screaming.

    She did accept it again around 6 months, when she was able to hold it herself. That was the best day of my life.

    So with our second, we introduced the bottle at three weeks. She was the variety of child that does not care where she got her food, so long as she got it, and she got a lot of it (and it shows; she’s grown from 7lb14oz to 17lb1oz in less than 4 months). I kept it up for a lot longer with her, and she never fussed about it. I started slacking off and then stopped entirely. Yes, I do have “MORON” tattooed on my forehead, thanks.

    She has now declared her independence from the bottle and will only accept me for sustenance. It’s not a huge deal, since she goes to bed pretty early, and I’m pretty tied the house anyway with kids 16 months apart. But still. I would just like to know that I COULD go out if I wanted to. Sigh. Stupid, stupid me.

  16. lolismum Jun 09 at 12:38 pm Reply Reply

    WOHM here. Breastfed both kids until they were almost 2. First child was not happy about bottles, because stupidly, I tried to feed her. Second child, I started to work full time at 6 weeks. Breastfed the baby in the morning and left, for 9 hours. The babysitter warmed breastmilk and gave it to her. First couple of times she just chewed on the nipple, let it dribble down her cheek, but finally she was hungry enough to eat and she learned the new mechanics. I don’t agree with Amy suggestion to go with really low flow nipples. I always had to punch an extra hole in the nipples. Some kids like a more consistent flow. If they gag on it, it is obviously too fast. If on the other hand they are working really hard and the amount of milk in the bottle is not going down, move up a size in nipple hole. And yes, warm up the milk. Much more important than the type of bottle. Breast milk is body temperature, it’s a lovely look warm 95 degrees or so. Most breastfed babies do not like cold milk. Good luck.

  17. lolismum Jun 09 at 12:39 pm Reply Reply

    luke warm, not look warm. Writing on the blackberry is a pain.

  18. Katy Jun 09 at 3:44 pm Reply Reply

    Can’t remember much about how we got my first and second to take bottles, but both did at some point and fairly early on. With my third, I had intended to start a bottle for one feed per day around 4 weeks. We tried once and she took it, no-questions-asked. I had a hard time making time for pumping, especially since she nursed every 2-2.5 hrs so I didn’t feel I had much extra time (especially with the 2 and 4 year olds needing attention as well), so I basically forgot about the bottle for a while. At around 3 months old, we tried a bottle again and this time she refused it! One day I just offered the bottle through her tears to see how long she’d resist – after about 15 long minutes of crying, she gave up the fight, stopped crying, and tried to drink from the bottle, but really just played with the nipple and didn’t seem to know how to drink from it. That was with Avent, which my sons had both used. On recommendation from friends, I bought some cheapie ones (Gerber and Evenflo), which had fairly small nipples, and after a few attempts, she figured it out and has been using those very easily ever since.
    As far as formula, I never did manage to make enough time in my day to pump for bottles, so I finally decided to go ahead and use formula. But with my second, I had wanted to nurse for a year and had to stop around seven months, and I think it was because I was doing too many formula bottles at inconsistent times and it messed up my supply. This time, I decided to choose 2 feedings and do a bottle at those same two feedings every day, and otherwise try not to use bottles but just nurse. I chose late morning and bedtime (the two times I would most likely need to be away). I started with just the late morning feeding, doing a bottle of formula then and nursing all other times. After a few weeks I switched out the bedtime feeding as well. I figured this would be similar to how, with an older child, you might get to a point of doing only a few feedings per day and your body adjusts. So far it’s going well – she’s 6 months tomorrow. I have not introduced solids yet, but will soon. My only concern is that she recently dropped all middle-of-the-night feedings, which is great for sleep (yay!) but might not be so good for my supply. We’ll see.
    Sorry for rambling – hope this helps someone!

  19. Katy Jun 09 at 3:45 pm Reply Reply

    Meant to add – my daughter seems to take the bottle better when sitting, reclined, in her high chair or bouncy seat rather than being held.

  20. lawyerjen Jun 09 at 11:24 pm Reply Reply

    Great advice! I breastfed- took a relaxed attitude about the bottle (and let others feed my son his bottles) and we never had a problem. If was hungry he’d eat from the bottle. If he wasn’t he’d wait for me. We never tried different bottles (we started with Thinkbaby- loved them) but did learn he liked his milk warm. The only thing I would add to the mom asking for advice is don’t stress… it will work, babies know to eat no matter where its coming from!

  21. elizabeth Jun 10 at 8:35 am Reply Reply

    Thanks everyone for your advice/help!

  22. Amy Jun 14 at 5:18 pm Reply Reply

    We struggled with getting my daughter to take a bottle for months. It was awful. But of all the varied advice we got, the one consistent thing was to have the person who will be feeding her be the person who introduces the bottle. So my husband endured so many awful, failed attempts at it before someone told me that her twins would only take the bottle from her at first. So I sat down with my baby and gave her a bottle and she was fine. Turns out she must have wanted to get comfortable with the bottle with the only person who’s ever fed her before she’d let someone else do it. Then we gradually transitioned her to my husband and she was fine.

  23. Mary Jun 14 at 10:50 pm Reply Reply

    All you guys with older babies, I would totally skip the bottle and just do sippy cups.  I went back to work after 6 mo with both my kids and neither was too keen on bottles.  We stressed so much and endured countless episodes of crying with my first.  Around five months I started with a sippy cup and she was fine when I went back to work.  She nursed past 2 yo.  With the second, I did not stress out about bottles and just started with the cup when she was old enough.  She took a few bottles, but never well.  She’s still nursing at 15 months.

  24. stacy in europe Jun 23 at 2:51 pm Reply Reply

    I haven’t read through the comments…but

    I had some initial problems with latching, so before I could get the problem sorted out with a consultant, I was forced to introduce a bottle in week 1, when I had originally wanted to wait until week 4.

    And you know what? IT WAS FINE.

    All I read anywhere was Nipple Confusion! Aieeee! but it was all ok! We tried a couple bottles, admittedly — she didn’t much care for the rock hard squarish nipple of the Avent bottle that is ubiquitous here, and it actually seemed to make the latching thing worse… and we ended up with the soft flat nipple of the MAM bottle (ideally, it fits in the rings of the Avent bottles we already purchased!!)

    Anyway, Dad gave our little one her evening bottle everyday, and I breastfed her every 3 hours for 7 months….. so it didn’t seem to affect her adversely!

    She still takes her morning milk from the MAM nipple (fast flow) at 15 months… :-)

    best of luck to you!!

  25. Liz Jul 02 at 9:09 pm Reply Reply

    Amy, thank you for answering my question and thank you to all who commented! We’re working on it now and it’s going well so far!

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