Listen, most mothers go back to work and so most babies need to have a bottle to get through the day while mom is away. Also, once breastfeeding is well established, I find that as long as parents bottle feed in a way that is like breastfeeding there isn’t a problem going back and forth between breast and bottle.
That is what I am talking about, bottle feeding in a way that helps sustain and promote breastfeeding. How many of us were given any instruction on bottle feeding? My poor son at 5 days of age was eating close to 40 oz of formula because no one taught me anything about how to bottle feed or how much food he might need to eat in 24 hours.
Because of the lack of information, I have found that most babies are overfed at child care while moms are at work. This can cause at least three problems.
One, this fast milk pouring down the baby’s throat from a bottle can make the baby confused once they get back to the breast. “Hey, where’s the easy milk?” I am not afraid of nipple confusion, I am afraid of flow preference. The younger the baby is, the more trouble we seem to have with flow preference.
Two, if a baby is eating like crazy while away from mom it is hard for her to pump all of that milk. Often during a working and breastfeeding consultation, I find the problem is not that mom isn’t making enough milk, it is that her baby has been overfed while away from mom.
Three, if a baby has had all of their calories while away from mom, they don’t need to breastfeed when they are with mom! These babies will often only nurse 2 times when home. Once in the AM before work and once in the PM before bed. This will lead to lower milk production from mother due to the lack of her milk being moved. Let’s say she pumps 3 times at work. Add that to her 2 breast feeds and that is only 5 milk movings in 24 hours! Most mothers need to move their milk at least 8 times a day or so.
Paced bottle feeding: A possible solution!
When you breastfeed your baby they get to control how much milk they get, and how fast they get it. Bottle feeding is very different. The milk flows fast! Sometimes babies choke. Sometimes they gulp quickly with wide eyes and a worried look. How can we help our babies cope with this quick flow, not over eat, and not develop a preference for that quick milk flow?
“Pacing (Kassing)” the bottle feed:
Helps babies feel safe and comfortable while they feed.
Helps keep flow more like breastfeeding.
Helps reduce overfeeding of babies with a bottle.
Helps protect the breastfeeding relationship.
How “pacing” the feed works:
- Have the baby sit very upright. You wouldn’t want to eat on your back, would you?
- Use a slow flow, stage 1, wide based bottle teat.
- Touch the baby’s chin or upper lip with the tip of the teat. When the baby cues for feeding by opening their mouth gently slide the teat in as deeply as the baby allows.
- Keep the bottle so the breastmilk just fills the teat. Don’t lift the bottle too high so that the weight of the milk makes it flow faster. We want the baby to have to sip the milk out of the bottle.
- Don’t worry about the baby swallowing air. You may need to burp more but this is a small price to pay compared to baby thinking that feeding is fast and easy. We want to teach babies that feeding takes time and effort, with the breast, and with the bottle.
- After 3 or so swallows, gently twist the teat so the nipple seal is broken and rest the teat against the baby’s chin, cheek, or upper lip. This allows the baby to catch their breath, realize feeding takes time, but not worry that the breastmilk and bottle is gone.
- Is the baby getting stressed? Are they frowning, wrinkling their forehead, widening their eyes, splaying their hands, making squeaking sounds, choking? If so, twist the teat out of their mouth, touch it to their face, and give them a break.
- When they cue again by opening their mouth allow wide, repeat the process.
- This process should take about 20 minutes. Babies need time to realize they are full just like grownups. It takes time but it is so worth it!
- Watch for satiation cues, getting sleepy, not cueing by opening mouth, turning away for the teat, becoming more interested in surrounding, let them decide they are done.
- If you feel the baby has had an appropriate amount of supplement, take a break, have a burp, change a diaper, shift position, and see if the baby cues again.
I think all babies should be feed in a respectful way, not just breastfeed babies! Give this a try and let me know what you think!