From the Guidelines
To introduce a bottle to a baby, it is crucial to ensure the infant has completed at least 2 successful feedings and can coordinate sucking, swallowing, and breathing while feeding, as documented in the medical record 1. When introducing a bottle, consider the baby's age and feeding schedule. According to pediatric health guidelines, newborns feed about every 2-3 hours, or 8-12 times every 24 hours, and by 2 months, infants feed about every 3-4 hours taking 3-4 oz per feed 1. Key strategies for introducing a bottle include:
- Starting when the baby is calm and slightly hungry, not starving
- Using a slow-flow nipple and warming the milk to body temperature
- Positioning the baby semi-upright and touching the nipple to their lips, allowing them to draw it in rather than forcing it
- Maintaining skin-to-skin contact during feeding to enhance bonding
- Being patient and consistent, offering a bottle once daily to establish familiarity
- If transitioning from breast to bottle, gradually replacing one feeding at a time over several weeks It is also essential to avoid bottle propping and only use breastmilk or formula in bottles, as recommended in the guidelines 1. By following these strategies and considering the baby's individual needs and schedule, parents can successfully introduce a bottle and ensure a smooth transition to bottle feeding.
From the Research
Introduction to Bottle Feeding
When introducing a bottle to a breastfed baby, it's essential to consider the potential for nipple confusion.
- Nipple confusion occurs when a baby has difficulty latching or prefers one feeding mechanism over another after exposure to artificial nipples 2, 3.
- To avoid nipple confusion, the World Health Organization (WHO) and UNICEF recommend avoiding formula supplementation and pacifier use, except when medically necessary 2.
- Cup feeding is encouraged as an alternative to bottle feeding to reduce the risk of nipple confusion 2.
Strategies for Introducing a Bottle
- Introduce the bottle at the right time: Wait until the baby is at least 3-4 weeks old and has established a good breastfeeding routine 3.
- Choose the right nipple: Select a bottle nipple that mimics the shape and feel of the breast to reduce confusion 3.
- Use expressed breast milk: Fill the bottle with expressed breast milk to maintain the baby's familiarity with the taste and smell of breast milk 4.
- Gradual introduction: Introduce the bottle gradually, starting with small amounts and gradually increasing the volume 4.
Supporting Breastfeeding
- Oral stimulation and supplemental nursing systems can help preterm infants transition to full breastfeeding 4.
- Lanolin and breast milk can be used to treat nipple trauma and support breastfeeding 5.
- Understanding the anatomy and physiology of the breast during pregnancy and lactation can help support breastfeeding 6.