when to introduce bottle

SophiaAlbert · March 2016

Fellow working moms,
When are you planning to get your baby used to the bottle? I'll be back at work 2 months after giving birth and am terrified baby won't accept anything but boob by then. Is it smart to practice from early on?hugs to you all :-)

swflJD · March 2016

I am a FTM, as well, so I can't speak from experience. However, when I was doing the tour at the daycare we ultimately chose, the director suggested introducing the baby to a bottle (regardless of whether you plan to feed with formula or breastmilk) at least a couple of weeks before you plan for him/her to start daycare. She also suggested sometimes having your SO or someone else feed the baby so he/she will be used to taking a bottle from someone else. I would be interested in hearing from some STMs on how they made the transition, though.

ETA: We plan to start introducing the bottle from the very beginning because I'm sure as hell not going to be the only one getting up in the middle of the night to feed this baby!

ayeshaohara · March 2016

FTM here and have 9 months at home but still planning to introduce bottles early. I hear so much conflicting evidence on this but I think at the end of the day it is very baby dependent as well. We're going to start introducing one bottle feed at night before bed from day 1. All our friends who have done this haven't had issues transitioning between boob and bottle and all their kids will take from either depending what is offered. The one friend who was anti bottle has had a nightmare of a time getting her baby to bottle feed, now 7 months later. Don't know if that's helpful but that's our plan...and we all know that plan may not go as well as expected!

yogahh · March 2016

ayeshaohara said:

FTM here and have 9 months at home but still planning to introduce bottles early. I hear so much conflicting evidence on this but I think at the end of the day it is very baby dependent as well. We're going to start introducing one bottle feed at night before bed from day 1. All our friends who have done this haven't had issues transitioning between boob and bottle and all their kids will take from either depending what is offered. The one friend who was anti bottle has had a nightmare of a time getting her baby to bottle feed, now 7 months later. Don't know if that's helpful but that's our plan...and we all know that plan may not go as well as expected!

Another FTM, so what do I know, but I think this is a great idea. Not only would it allow baby to transition to bottle, but I would like DH to also be involved in feeding. He will be with her (alone!) for about 3 weeks between when I start back at work and when she starts daycare, so getting into the groove for us is important.

The whole feeding/pumping thing is so overwhelming for me..
For those who have been through this, does pumping decrease your supply? I feel like I keep reading it does. So I do worry that pumping enough for one bottle feeding a day might screw things up?

scbonnell04 · March 2016

I plan to ebf for the first 3-4 weeks then start introducing a bottle on occasion. My other children never had any trouble with the bottle but I want to be sure that we're all comfortable with our options as we prepare for non-maternity leave life. The 3-4 weeks will give baby and I enough time to get in a sort of routine and develop a good latch and by then I think we'll all be ready for an occasional change of pace.

KelleAlward · March 2016

I pumped and had hubby or grandma give a bottle occasionally within the first few weeks. Just make sure you start with the slowest flow nipple so it doesn't make the bottle too easy. My daughter was happy to have the boob or the bottle.

lest12 · March 2016

@yogahh - It's OK. It's hard to EP (exclusively pump) because your supply is stimulated by the contact with your LO. That being said, pumping can also help boost your supply if you need to (power pumping) and for the most part, you shouldn't have a problem pumping to replace a nursing session once a day.

I could go on forever about nursing/pumping but haven't been around much to know what you guys have discussed, but my best advice is to try and make sure you pump to replace whatever it is you are bottle feeding the baby, as much as you possibly can, to keep your supply up.

valerie4786 · March 2016

ayeshaohara said:

FTM here and have 9 months at home but still planning to introduce bottles early. I hear so much conflicting evidence on this but I think at the end of the day it is very baby dependent as well. We're going to start introducing one bottle feed at night before bed from day 1. All our friends who have done this haven't had issues transitioning between boob and bottle and all their kids will take from either depending what is offered. The one friend who was anti bottle has had a nightmare of a time getting her baby to bottle feed, now 7 months later. Don't know if that's helpful but that's our plan...and we all know that plan may not go as well as expected!

I also think this is a great idea. As a FTM and hearing the struggles my sister and best friend have gone through recently trying to transition their child from boob to bottle, I've been terrified about how difficult the transition will be for us. I'll only have 8 weeks home with Harper before I go back to work, but my MIL will be with her for another month before she begins daycare in September. I'll still be breastfeeding/pumping, but obviously when I'm not around she'll need a bottle. I've heard about the importance of establishing a good latch before introducing bottles, but at the same time I've been struggling to see how I can establish a good latch/breastfeeding and transition to her taking a bottle all within 8 weeks. Thanks for this @ayeshaohara! I think this will be super helpful for us and it will be less stressful for me if I introduce a bottle a day from the beginning.

Lusitano8 · March 2016

FTM but I just met with a lactation consultant who was so helpful, here are the recommendations:

2 weeks before going back to work do one pumping session a day put 1 oz in a bottle and freeze the rest. This shouldn't impact your supply because you still have plenty of feedings with LO stimulating your hormones. And you will build a supply!
Feed LO 1 oz per day from the bottle to get him familiar with it, and have someone else feed if you want. If you feed him the bottle he might know you from your smell and want the boob, go out of the room and have you SO or other feed.
They might fuss when you go back to work and have the bottle but if they are hungry they will give in and eat.

AmmyBelle · March 2016

Hey! FTM as well, but I just did the Breastfeeding Class at my hospital and the Lactation Consultant there was great and answered a lot of these kinds of questions. The takeaway was: introduce the bottle after a few days (you may still be in the hospital for this, and should totally use the hospital pumps since you'll have nurses/LCs for help) but limit it initially to once per day and at least 3 times a week, so that the baby will get used to it by the time you go back to work.

Also, she told us to try and not introduce pacifiers for the first couple of weeks (if baby will not settle, then hell - give in! But if you don't have a generally fussy baby, don't try and pacifier-them before then)

Pumping correctly also keeps and sometimes increases your milk supply @yogahh - she recommended ensuring that the setting on a mechanical pump alternate between "slow pumping" (which stimulates the nodes in your breasts) and "suck pumping" or "fast pumping" which draws the milk out. This is what most closely imitates an actual baby - they go for bouts of not swallowing where they suck on the aerola (spelling?) that stimulates milk production, and only do the deep, swallow-type of sucking when milk comes out. If you have a manual pump, she suggested mimicking this by alternating how you pushed the lever - slowly and fast, obviously (though it looked hilarious when she did it)

Hope that helps!

laurenmdrn16 · March 2016

I will say that you do want to introduce the bottle fairly early, at least 2 weeks before you plan to go back to work. Again, like PP mentioned, use a slow flow nipple so baby still has to work at getting milk out so they don't get frustrated at the breast. And it is super important to have others involved in feeding. When I was working as a nanny, the mom was really reluctant to introduce the bottle, so the first time he had a bottle was with me! It was sooo difficult because no one else had ever fed him and I had to wear one of her shirts just so he would try to eat. I find that having the other person feed the baby in a completely different position than you BF is also helpful because when I would hold my charge up to my chest, he was just so determined to BF he would completely refuse the bottle. One day I actually did just BF him (after talking with the mom of course!) because my milk was still in and there was no way he was taking a bottle.

Pumping is a whole different story. As someone who EP'd for almost 4 months, it was quite hellish. My son had no ability to latch so we barely had a handful of successful nursing sessions, but I still went at it, pumping away until it became just too much. I agree with PP to make sure your pump alternates between fast and slow suck to really help with let-down and effective emptying. Also, I would have pictures or videos of my son on my phone to watch while pumping and I felt it helped get a more effective pump. Don't forget to really inspect and change pump parts as recommended too. There is this tiny rubber flap on the valves of the Medela pump that I never really paid attention to, but changed them on a whim and all of a sudden my pump was like super charged! I had no idea such a teeny thing could make a HUGE difference.

ayeshaohara · March 2016

Thank you for all of this information everyone. It's super super helpful!

finnybooboo · March 2016

STM - definitely recommend introducing by someone else then you, and you not being in the room either. If they see/smell you, they're more likely to put up a fight and want it right from the source. Also if they don't take right away try some different bottle/nipple types
but don't give up!

JessicaB0627 · March 2016

Have you guys seen the nipple that medela has now that's made for breastfeeding babies? Supposedly it's designed so that the baby completely controls the speed of flow. Sounds like a good idea but I'm not sure I want to invest the money in one if it won't be worth it.

kbrands7 · March 2016

I'm going to try to not repeat advice on here (sorry if I do, I read quickly!)

There's not really an exact time to introduce a bottle, but if you're looking to introduce one only for daycare and want to continue breastfeeding otherwise, aim to introduce it around 1 month and use paced-feedings. Earlier than that can be difficult for some babies (not all-- with DS we had him on a bottle at 1 week because I was pumping more than bf initially. We teaspoon fed before that to not interfere with teaching a latch and he bf like a champ eventually), later than around the 1 month mark and some babies will reject it at first.

Like @lest12 said, pumping can boost supply, or degrade it depending on the circumstance/technique. Some great tips have already been given by a few different people, but another thing to consider is that a baby is more efficient at emptying the breast than a pump is, so you'll often need to pump more minutes at a time to get the same amount of milk out than you would if your baby was breastfeeding-- and like @AmmyBelle said, being sure to use the letdown button or the speeds (if it's a smooth dial) to mimic a baby will give you the best output. Pumping out at least as much as your baby eats will maintain your supply.

@Jessicab0627 I tried the Medela nipple with DS when I went back to work and he absolutely hated it. He did well just sticking with a regular slow-flow wide base Medela nipple and paced feeding techniques-- plus we encouraged a habit of a wide latch on the nipple rather than just having him put his lips on the thin part. I've seen some great reviews though, so some babies must do well with it.

For anyone starting back to work later, if you're not planning to start a bottle until 8/9 months or so, I would probably just go straight to a sippy or something like the 360 cup (again, you can use some paced methods with this is you want to continue bf).

Lastly, I started my freezer stash just as DS was coming off of a growth spurt (they're pretty predictable...and you'll know it too because they will eat 24/7 for anywhere from a couple days to a week). It worked really well because my supply had already increased to meet his new demand, then when his demand eased up a bit, I just pumped the excess. We basically did the same thing for starting solids at 6 months-- we introduced solids just as the growth spurt kicked in so that solids took the place of some of his new food demand and we could maintain bf alongside of it.

lest12 · March 2016

@kbrands7 - I agree with the 1 month mark for bottle or pacifiers. That was the advice my LC gave at the hospital. It all went back to being able to establish a good supply before introducing any other factors.

One example is potential nipple confusion; another is that the baby might prefer the bottle (it's less work for them!), which could ultimately hurt your supply.

Just food for thought. I'm not sure if you need to get them used to the bottle right away. They will learn to take it when they need it because yes, they will be hungry. I think it's more important to make sure the baby is on your boob as much as possible.

AmmyBelle · March 2016

@JessicaB0627 - the lady that ran my BF class discussed it briefly and said it's a hit-and-miss. She recommended the Munchkin Latch nipples/bottles and the Dr. Brown bottles for babies that switch from breast to bottle.

JennyS86 · March 2016

Think of me when people tell you that you cannot establish/maintain a supply just by pumping. I pumped for my twins for 16months (mooo). There were a few months in there that I breastfed, but growth and feeding issues led us back to the pump. Pumping doesn't mean you skip skin-to-skin though!!
Hoping to nurse directly from the breast this time, but also looking to give a bottle of breastmilk now and then (Grandma loves to babysit!).

kwrightnb · March 2016

First time momma here also! Just came from a breastfeeding class tonight with some lactation consultants and we went over this topic!
Her advice was to wait until baby has established a good understand to your nipple (about 3-4 weeks). She said the motion they use on your nipple helps them gulp down quickly and and their tongue moves in a wave-like motion. Whereas with bottles/pacifiers there tongue moves up and down to stop the flow when they need to swallow.
They explained that when a baby is introduced to the bottle too early (not fully understanding how to suckle on the breast well first) makes then automatically use the up and down motion on your nipple: causing not only it to be extremely painful on your nipple, but also prolonging each feeding session because baby isn't getting the proper milk flow. And can ultimately make the switch between breast and bottle actually take longer and be more complicated then waiting until baby understands one, then learning the other later on.
BUT I have no experience, that is just what the taught us tonight

the nurses in labor and delivery can probably teach you lots on this after your delivery (or midwives/doula/etc in other birthing centres or at home) !

lbachran · March 2016

This particular topic causes me so much anxiety. DH really wants to participate in the feedings, particularly because I'm having a c-section and not sure how great I'm going to be feeling. The Breastfeeding Class at our hospital said no bottles or pacifiers for a minimum of 6 to 8 weeks. I nearly cried! I'm honestly not in love with the whole breastfeeding concept, in fact, I would be fine just being an exclusive pumper, but seriously? Two months of no one feeding him all day or all night besides me? There also appears to be no consensus on the best bottles for breastfeeding babies, which is frustrating. I saw Latch and Dr. Brown's mentioned above and our class exclusively pushed the newborn flow Avent bottles. So which one is it? Honestly, breastfeeding feels like the most stressful part of all this because everyone has different rules and advice.

st3lla · March 2016

kwrightnb said:

First time momma here also! Just came from a breastfeeding class tonight with some lactation consultants and we went over this topic!
Her advice was to wait until baby has established a good understand to your nipple (about 3-4 weeks). She said the motion they use on your nipple helps them gulp down quickly and and their tongue moves in a wave-like motion. Whereas with bottles/pacifiers there tongue moves up and down to stop the flow when they need to swallow.
They explained that when a baby is introduced to the bottle too early (not fully understanding how to suckle on the breast well first) makes then automatically use the up and down motion on your nipple: causing not only it to be extremely painful on your nipple, but also prolonging each feeding session because baby isn't getting the proper milk flow. And can ultimately make the switch between breast and bottle actually take longer and be more complicated then waiting until baby understands one, then learning the other later on.
BUT I have no experience, that is just what the taught us tonight the nurses in labor and delivery can probably teach you lots on this after your delivery (or midwives/doula/etc in other birthing centres or at home) !

I received very similar advice at the prenatal class I attended except the recommendation was to not introduce bottles or soothers until 6 weeks, if possible. The fear of my nipple being crushed makes me think I want to try and follow this advice...but I'm sure it's not an exact science and everyone has other factors to consider as well so will take it with a grain of salt and do what works for us at the time.

lest12 · March 2016

@jennys86 - that is amazing! Major kudos to you. I'm impressed!

Karenpreggo · March 2016

lbachran said:

This particular topic causes me so much anxiety. DH really wants to participate in the feedings, particularly because I'm having a c-section and not sure how great I'm going to be feeling. The Breastfeeding Class at our hospital said no bottles or pacifiers for a minimum of 6 to 8 weeks. I nearly cried! I'm honestly not in love with the whole breastfeeding concept, in fact, I would be fine just being an exclusive pumper, but seriously? Two months of no one feeding him all day or all night besides me? There also appears to be no consensus on the best bottles for breastfeeding babies, which is frustrating. I saw Latch and Dr. Brown's mentioned above and our class exclusively pushed the newborn flow Avent bottles. So which one is it? Honestly, breastfeeding feels like the most stressful part of all this because everyone has different rules and advice.

Nothing to add except this post is 100% me and where most of my stress and anxiety is coming from. Glad to see im not alone!

erikaja6 · March 2016

Just wanted to reiterate what other posters have said - it's not an exact science. Take everyone's advice with a grain of salt because your experience might be totally different.

My oldest son was a preemie and was in the NICU for 11 days. He started off with a bottle (my pumped milk). Both my husband and I fed him. I didn't start breastfeeding him until he was about a week old. I didn't have any problems. He didn't care where the milk came from - breast or bottle.

My youngest son was full term and I started breastfeeding him immediately (but also pumped so my husband could feed him too). Like my oldest son, my youngest didn't care where the milk came from as long as he was being fed.

I plan to do the same with baby girl when she arrives. However, I also know that every baby is different so I may not have the same luck and may have to adjust my plans.

Chappy_jr · March 2016

I remember being afraid of "latch confusion" that I read about on breastfeeding websites and in books but my DS didn't have an issue. He got his first bottle at about a week and a half when MIL babysat so DH and I could go out to dinner (for sushi and wine!!) and I probably used one bottle every few days so I could pump and get some milk saved up.

With this baby I would like to pump (as much as I hate the process) on a regular basis early so that DH can feed her with a bottle while I put DS to bed. I still want her to primarily nurse from the breast (because I loathe pumping) but my DS is so attached to me that I knew we need to do as much as possible to keep his routine the same.

Chappy_jr · March 2016

I second the last two points @laurenmdrn16 said, below. I had forgotten about the effect that looking at pictures of my DS on my phone would have when I pumped - especially when I first started having to pump multiple times a day. I even took one of his blankets with me to work the first few days to have his smell (but that didn't seem to release as much as seeing his sweet face).

This discussion is reminding me that I need to order new parts for my pump like new flanges, tubes, and nipples.

laurenmdrn16 said:

I will say that you do want to introduce the bottle fairly early, at least 2 weeks before you plan to go back to work. Again, like PP mentioned, use a slow flow nipple so baby still has to work at getting milk out so they don't get frustrated at the breast. And it is super important to have others involved in feeding. When I was working as a nanny, the mom was really reluctant to introduce the bottle, so the first time he had a bottle was with me! It was sooo difficult because no one else had ever fed him and I had to wear one of her shirts just so he would try to eat. I find that having the other person feed the baby in a completely different position than you BF is also helpful because when I would hold my charge up to my chest, he was just so determined to BF he would completely refuse the bottle. One day I actually did just BF him (after talking with the mom of course!) because my milk was still in and there was no way he was taking a bottle.

Pumping is a whole different story. As someone who EP'd for almost 4 months, it was quite hellish. My son had no ability to latch so we barely had a handful of successful nursing sessions, but I still went at it, pumping away until it became just too much. I agree with PP to make sure your pump alternates between fast and slow suck to really help with let-down and effective emptying. Also, I would have pictures or videos of my son on my phone to watch while pumping and I felt it helped get a more effective pump. Don't forget to really inspect and change pump parts as recommended too. There is this tiny rubber flap on the valves of the Medela pump that I never really paid attention to, but changed them on a whim and all of a sudden my pump was like super charged! I had no idea such a teeny thing could make a HUGE difference.

Vivian0809 · March 2016

Honestly, nipple confusion is made up. If baby is nursing fine and you aren't having any issues, introduce a bottle in the first week, and keep giving every other day or so to keep baby familiar.
i did this with both mine and it was perfect. I have a bunch of friends that waited weeks, and it was an absolute cluster. I wouldn't recommend waiting.

BlueJuice · March 2016

I don't think nipple confusion is made up, but certainly not every baby/mother is going to experience it. With my last I was very concerned about it and waited a conservative 6 weeks to introduce a bottle, however, which did not result in much success for us - in part this was because we were not very consistent about it because, as I was at home 24/7, there was no driving need to figure it out except for occasional outings. It would probably have progressed better if I had been returning to work and she had been forced to figure it out or be hungry.

This time around, my plan is twofold:

1. Start a little bit earlier - I'm still going to wait to help ensure good BF technique/latch, but probably more like 3-4 weeks, not 6.

2. When we do introduce a bottle, I'm going to insist/demand that my H do a bottle feeding once a day or at least every other day, so the baby can get practice and become accustomed to the alternate feeding style. It will be more work for both of us (me because I'll have to make sure to pump consistently and him because he'll have to commit to a regular feeding), but I'm hoping better flexibility with me being able to leave the baby for more than a couple hours will result from it.

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