by Heidi Green
December 20, 2011
My baby is exclusively breastfed but I would like to start introducing one bottle a day since she’ll have to take breast milk from the bottle once I return to work. Is there a best time to introduce the bottle without creating nipple confusion?
The American Academy of Pediatrics (AAP) recommends exclusive breastfeeding for the first six months, and continued breastfeeding for at least a year. Since your milk supply is demand-dependent (i.e., your body produces more milk when your baby feeds more frequently, and less milk when she feeds less frequently) the best plan is to feed your baby at the breast for every feeding. But that’s not always possible.
Partial breastfeeding is most successful when bottles are offered on a limited basis. To maintain your milk supply and avoid unintended weaning, you’ll want to breastfeed when you and your baby are together and have bottles given by your partner or another caregiver when you and your baby are apart.
For the best results when combining breast- and bottle-feeding:
- Wait until breastfeeding is well-established. If your baby is feeding from a bottle, your breast is receiving fewer “demands” for milk. You won’t want this reduced demand to diminish your milk supply. Most mothers find that bottle-feedings can be added after six weeks of exclusive breastfeeding (when you feel you have enough milk and your baby seems satisfied and is gaining weight).
- Wait to avoid “nipple confusion.” Milk often flows faster from an artificial nipple compared to a breast. Plus, bottle-feeding and breastfeeding require different sucking movements. Waiting until your breastfeeding baby learns and perfects his breastfeeding skills makes it far less likely that your baby will reject your breast when bottles are introduced, or that he will become confused by the different sucking methods needed for real versus artificial nipples. Click here to learn more about nipple confusion.
- When possible, transition gradually. Many mothers who choose to introduce bottles do so because of a return to work or school. If you can, plan for this schedule shift in advance. Hand express or pump during one or two feedings each day and build a stockpile of milk in your freezer. Replace one breastfeeding with a bottle-feeding at a time. (You may need to have a substitute caregiver on-hand to offer the bottle, since babies rarely accept a “substitute” when the “real thing” is available!) Switching one feeding at a time will also reduce your risk of engorgement or mastitis due to a sudden shift in the number of breastfeedings.
- Breastfeed when you are together. Because breastfeeding is something only you can do for your baby, many busy mothers (especially those who work outside the home or attend school) find that breastfeeding makes it easier for them to reconnect with their babies at the end of the day.
If your baby resists artificial nipples at first (as many do), don’t despair. Some babies may be more receptive to cup-feeding than bottle-feeding, while others adjust to changes in their mother’s schedule by “reverse cycling”—sleeping more during the hours they are with their alternate caregiver and breastfeeding more often when mom is available (e.g., in the mornings, evenings, and at night).