Monday, November 5, 2012

5 tips for transitioning to bottle feedings

Some of you mamas out there might be lucky enough to never have to use a bottle (or maybe you'd consider yourselves unlucky?  But I would qualify it as lucky).  If you've got the opportunity to stay home with baby long enough to do 100% breast feeding (EBF or exclusively breastfed) until you're ready to move toward water in a cup, then this post probably doesn't apply to you.  But for moms in the world who need their kid to take a bottle, read on!

You mind find yourself wanting/needing to bottle feed your infant because you have to/want to go back to work.  Or maybe you want a date night with the hubby.  Or maybe you want daddy to feed baby while you sleep a little longer.  Whatever the reason, there's often a lot of anxiety around the transition.  Someone could (and people do!) write whole books about this process.  And I'm not gonna bother going into that much detail.  But here's my 5 quick tips... from the mouth of a feeding-therapist-turned-mommy... about bottle feeding.  Take it for what it's worth.

  1) Don't start too soon/too late - If your goal is to breast feed full time as much as possible, then in the first 2-3 weeks of life you really want the breast to be the only sucking experience baby has.  I don't believe in "nipple confusion" (the term often used to scare moms/dads into thinking that once baby does bottle, they'll be terrible at breastfeeding) in a typical, healthy infant.  But you do want to establish a good milk supply and a good comfort base with breast feeding before you add in other methods.  So if possible, breast feed only for the first several weeks.  If you find that being difficult, PLEASE consult a lactation specialist.  They're awesome.  And they'll help you figure out why it's hard.

On the other hand, if you know that returning to work is looming at 12 weeks, please don't wait until 11.5 weeks to try the first bottle!  In fact, if you wait too long, baby may be so used to breast feeding that you have a really tough time getting them to figure out or be happy with bottle feeding.  And then you have a whole different set of fights on your hands.  I'd say that ideally, you're doing at least 3-4 bottles spread out per week by 8-10 weeks old.  That way you know that baby will be able to take a bottle when/if you need him to when you return to work a few weeks later.

2) Don't do it just a few times and then stop if you need to continue at a later date- Sometimes I hear stories that people tried a bottle at 4 weeks old, it went well, so they didn't try it again until 11.5 weeks old... and the return to work was a nightmare!  All of a sudden, baby wouldn't take the bottle and we couldn't figure out why!!!  Your 4 week old infant is in one developmental stage and your 11 week old infant is in a different developmental stage.  So while it might have been easy at 4 weeks, please don't stop.  You don't have to do it every day, but you should keep going often enough that baby is gaining a skill set (and comfort level) with the bottle.  Again, 3-4 bottles a week (approx 1 every other day) worked nicely for us.

3) Don't stop pumping (yet...) - This will make more sense to current moms.  But if you're reading this pre-parenthood and thinking "oh yes, if the baby sitter can give a bottle, then I'll be FREE!!!  YAY!!!," sadly, you're wrong.  For each time your baby bottle feeds, you'll want to pump the same volume within a 24 hour period.  For example, little Ms. O takes 12 oz while she's at daycare, so I have to pump 12 oz while I'm at work.  If I'm short at work, then I need to pump extra when I get home.  The thing is, if you don't pump, then you're telling your body that your little one didn't need that extra 2 oz that day.  So the next day, your body produces 2 ounces less.  Please don't think that having a huge freezer stash gets you off the hook for feeding for a few days... you'll regret the changes to your milk supply when you try to go back to the previous volume you were doing.

(**CAVEAT** - I typed that last paragraph assuming that your goal is to keep your milk supply up.  Of course, if you've decided to replace breast milk with formula for any reason, then that might not apply to you.)

4) Have daddy (or another familiar caregiver) give the bottle - I heard this advice a lot before we started bottles.  And let me say, as a feeding therapist, it was hard.  I get so much benefit out of watching a baby feed WHILE i'm holding the baby.  I can feel how it's going.  I can see the swallows.  I can feel the way it feels as they breathe.  But I do think that for the average mom, choosing NOT to be the bottle feeder (if possible) reduces the pressure on you a little.  It also makes it a different task than nursing for baby-- they don't smell you or feel you while they're trying to bottle feed, so they won't be hunting around for the breast.  They can focus more on the bottle.  And no, it won't be perfect on the first try, but try not to tell dad it's his fault.  He's doing great-- he's on his first time too!

5) Brand is probably irrelevant - "What brand do you recommend???" is a question I hear a lot at work.  And let me tell you, for 99% of normally developing children, the brand of bottle/nipple is completely irrelevant, especially for the first bottle.  Yes, your baby will become accustom to one certain type of bottle and might, therefore, fuss with other types.  But a typically developing baby should be able to feed from any brand that you put in their mouth, given time to adjust to it.  So please don't spend a million dollars on the expensive one that "prevents colic."  And please don't spend a ton of time bringing home 20 different brands.  Just buy one.  One that you like the colors or shape of.  One that's priced right.  One that's BPA free or glass or made from recycled materials-- whatever works for you is great.  Heck, get used bottles from a friend and just buy new nipples!

What about you other moms... what tips would you add to my list?

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