Please note: Breastfed babies often never need to take a bottle. While we support breastfeeding as the natural way to feed a baby and promote feeding from the breast where ever possible, many of our clients for a variety of reasons may need to have their baby eat from a bottle. Feeding from a bottle is not the only way to feed milk to a baby for alternatives see KellyMom's Tools for Feeding
The traditional way to bottle feed has been to hold the baby in fairly reclined position and tip the bottle into their mouth making sure there are no air bubbles in the nipple that will cause uncomfortable gas later. As you watch your baby gulp down the milk or formula you may feel that she must have been starving to be eating so eagerly and hungrily. Often times if you’re supplementing a breastfed baby this can lead to doubts of the strength of your milk supply, especially if you’ve just fed her. Unfortunately the gulping down of a bottle is not an indication of hunger but rather an instinctual need to prevent the food going into their lungs. When drinking from a bottle each suck creates a negative pressure that forces more milk to come out of the bottle. Your baby has to keep swallowing to avoid choking.
Signs that your baby may be in distress during a feed are:
- Milk running out of the corner of her mouth
- Splayed fingers or toes
- Stiffening of arms and legs
- Opening eyes widely
- Flaring nostrils
- Trying to turn her head away
- Pushing the bottle away
- Swallowing quickly without taking a breath after every 3-5 sucks
- Lips turning blue
If you look at breastfeeding as a model of how a baby should eat you will notice that:
- A feed takes, on average, anywhere from 20-40 minutes
- Babies will actively drink in spurts, taking rests and breaks between swallowing lots of milk
- The baby chooses when to latch and come off (have you ever tried to get an unwilling baby to latch!)
Thinking that a baby needs to eat a predetermined amount as quickly as possible can easily lead to overfeeding, spitting up (which can be normal but perhaps minimized when you feed your baby slowly), reflux, and difficulty breathing while eating. By following some simple steps you can help your baby have a relaxed and healthy feed, allowing her to recognize when she’s full, a skill that will follow her throughout her life.
Gentle Bottle Feeding
This paced bottle feeding video shows how to do this gentle feeding technique.
Gentle Bottle Feeding Tips
- When starting out, always choose a bottle nipple with the slowest flow so that your baby needs to suck to get milk. Even older babies may cope better with a slow flow nipple.
- Hold your baby in a more upright sitting position.
- Hold the bottle horizontally. The tip of the nipple can be filled with milk but not the whole nipple. This will allow her to control the flow of milk more easily so she can drink at her own pace. This will also avoid the possibility of choking or aspirating. Babies will take in air when they drink and it will come back out one of two ways!
- Your baby’s head should be straight in relation to the rest of her body. It’s difficult to swallow with their head sideways or tilted way back (try it yourself)
- Allow your baby to take the nipple into her mouth. You can start by placing the nipple on your baby’s top lip, much like how a breast is offered for breastfeeding. She will open and take in the nipple when she’s ready to start eating. Never force a bottle into a baby’s mouth.
- Burp her often. This will help give her breaks as well as prevent any uncomfortable gas.
- As a guideline, a bottle feed should last around 15-20 minutes. If your baby is finishing in less than half this time the flow is probably too fast. If the feed is longer than 30 minutes she may be ready to move to a faster flowing nipple. Taking this time also allows her to recognize when she’s full before she gets overfull.
- Watch your baby’s cues. Babies should be allowed to eat when hungry, not according to a schedule. Watch for cues of satiation as well, babies don’t necessarily eat the same amount at each feed. If you notice any signs of distress (as listed above) let her have a break. You can tip the bottle so the nipple is no longer filled with milk but is still in her mouth. When she’s ready to start eating again, she’ll start to suck. If she’s turning her head or pushing the bottle away odds are she’s full. If no longer sucking, letting go of the nipple or falling asleep, she’s done. Never force a baby to finish a bottle.
- To prevent overeating remove the nipple just before you believe she is full and rest it against her lips. If she opens her mouth to look for it let her suck for another 10 swallows or so and repeat. This lets your baby finish when she is full and will allow her to self-regulate as nature intended.
- Alternate sides during the feed. Again, this copies the switching of breasts as would happen during breastfeeding. It provides your baby with eye and body stimulation.
- Never prop a bottle up and leave your baby to drink alone. You must monitor your baby at all times when they are eating to detect choking. Remember, the time you spend feeding your baby is valuable bonding time and is important in establishing a loving relationship.
Here is a great tip sheet from MomLovesBest.com where you can find more feeding information
How To Bottle Feed Your Breastfed Baby (By Mom Loves Best)
Article by Andrea Strang and Erin Lalonde KinderSleep