Most parents would like some flexibility in how they feed their baby. Being able to leave pumped milk or formula with another caregiver or co-parent so that they can leave without worrying about their baby’s nutrition is a necessary part of most women and lactating parents’ lives. But many parents are worried that their child will refuse to nurse after being introduced to a bottle.
“Nipple confusion” is actually a misleading term, but it’s widely used. Babies don’t get confused, but can develop a preference to the bottle.
The standard bottle as well as the way we are used to feeding babies on their backs create a strong flow of milk that does not resemble the flow experienced in breastfeeding. When babies nurse, they have to actively work for the milk to be let down. There can be lapses between each let down as well. The baby has more control over the experience, whereas the typical method of bottle feeding puts the baby in a passive position in which they do not have to work but do have to keep up with the milk flow an adult is administering.
Introducing a bottle between three to six weeks is wise, as your supply of milk has had a chance to establish and your baby has had the required time to learn to feed. There are exceptions to this rule, depending on how fast the baby is gaining weight and how efficiently they are feeding. When you do introduce a bottle, it’s helpful to mimic the experience of breastfeeding as much as possible.
First, hold the baby in an upright position as you feed them. When you offer the bottle, stimulate their latch reflex by brushing the nipple of the bottle down the tip of their nose. When they open wide, you can give them the bottle. It’s important to hold it horizontally rather than vertically so that they still have to suck to get their meal. They may start and stop throughout the feeding session, as they would while nursing. Every couple minutes, tilt the bottle so that less milk flows. This also mimics the dynamic they are used to while breastfeeding. Half way through, burp your baby and change sides. This technique is called paced feeding.
Contradictory to what is often assumed, using this method of feeding does not make the baby swallow more air or experience more gas. Actually, feeding the baby on his or her back with a constant fast flow of milk requires them to gulp vigorously to keep up, and swallow a fair amount of air in the process that can lead to gassiness. Making sure your bottle nipple is the correct size for your baby can also help to prevent gassiness, as well as using a nipple that is rounded at the base like a human breast. Certain bottles are designed to hold less air. When preparing your bottle, be it milk or formula, stir the milk rather than shaking it. Shaking makes air bubbles!
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