From the Guidelines
It is generally not recommended to feed a newborn out of a cup or syringe to prevent nipple confusion if also breastfeeding, as the preferred method is to feed directly from the breast whenever possible. If supplemental feeding is necessary, using a bottle with a slow-flow nipple is typically the most practical and safe option [ 1 ]. Cup or syringe feeding can be challenging, messy, and potentially dangerous if not done correctly.
Key Considerations
- Nipple confusion is less common than once thought, and most babies can switch between breast and bottle without issues [ 1 ].
- The key is to establish breastfeeding first, usually within the first 2-4 weeks, before introducing bottles.
- If you must supplement, consider these tips:
- Use paced bottle feeding to mimic breastfeeding
- Choose a bottle nipple with a wide base and slow flow
- Hold the baby in an upright position similar to breastfeeding
- Switch sides halfway through the feeding
- These methods help maintain the baby's breastfeeding skills while ensuring they receive adequate nutrition [ 1 ].
- Remember, consistent and frequent breastfeeding is the best way to establish and maintain milk supply.
Breastfeeding Establishment
Early skin-to-skin contact and frequent feeding on demand can help decrease the risk of hypoglycemia and improve breastfeeding outcomes [ 1 ]. The American Academy of Pediatrics recommends exclusive breastfeeding for about 6 months, with complementary food introduction at about 6 months, and continued breastfeeding until 2 years or beyond [ 1 ].
From the Research
Feeding Methods for Newborns
- Cup feeding and syringe feeding are alternative methods to bottle feeding for newborns, especially for those who are having trouble latching or are being supplemented with formula [(2,3,4,5)].
- These methods can help prevent nipple confusion, which can occur when a baby is introduced to an artificial nipple and has difficulty latching onto the breast [(2,3,6)].
Cup Feeding
- Cup feeding has been shown to be a useful alternative to bottle feeding, allowing for successful breastfeeding without causing nipple confusion 2.
- Studies have found that cup feeding can result in higher breastfeeding rates at discharge and at 3 and 6 months post-discharge [(4,5)].
- Cup feeding has also been found to be safe and effective for preterm infants, with stable heart rate and oxygen saturation, and similar weight gain to bottle feeding 5.
Comparison to Bottle Feeding
- Research has compared cup feeding to bottle feeding, with some studies finding no significant difference in breastfeeding outcomes 4.
- However, other studies have found that cup feeding can result in higher breastfeeding rates and fewer instances of nipple confusion [(2,5)].
- The American Academy of Pediatrics and the World Health Organization have made recommendations regarding the use of artificial nipples, including pacifiers and bottles, and their potential impact on breastfeeding 6.
Recommendations
- The World Health Organization and UNICEF recommend avoiding formula supplementation and pacifier use, except when medically necessary, to promote successful breastfeeding 3.
- Cup feeding is recommended as an alternative to bottle feeding to help prevent nipple confusion and promote breastfeeding [(2,3,5)].