The Delicate Dance Between a Breastfed Baby and the Bottle
Imagine you’ve spent the last 2-3 months chest or breastfeeding your baby, but now it’s time for a new plan.
Maybe you need to work from home and someone else will be helping care for your baby during certain hours of the day. You’d also like the flexibility of being on conference calls without a baby attached.
Or maybe you work in an office and your baby will be going to daycare every day of the week, and he absolutely has to be fed by someone other than you.
Or maybe the fog has just started to lift and you’re ready to take that yoga class at the gym. You’d also like to grab lunch afterwards and don’t want to have to run home to get your leaking breasts to your baby.
Or maybe you already had it all planned out. You knew you wanted to add bottles to your feeding plans and you made sure your baby could take a bottle from the start, and he did! But now that’s changed.
Now it’s all changed.
We are maternal and infant health occupational therapists and infant feeding specialists. Bottle strikes, bottles aversions or just plain out bottle confusions have kept our clients busy and often frustrated!
Generally when a client calls us for help, we hear something along these lines:
Help! My baby took a bottle right after she was born. We even kept it up for the first few weeks, and thought we were good. Now I need her to take a bottle and she absolutely hates it!
Help! I need to return to work next week. My job will not allow me to go to daycare every 3 hours to feed my baby. But when I give him the bottle, he won’t even suck on it.
Help! I want to be able to offer my baby a bottle occasionally. She seems really happy, but she seems not to know what to do with it. She just chews on the nipple and pushes it out of her mouth with her tongue.
Why is this happening?
Full term infants are born with reflexes that allow them to eat right out of the womb. If you put anything in a newborn baby’s mouth, they will suck. If you’ve ever had a baby suck on your nose, your shoulder, your arm etc., you may have figured out that a newborn baby might just suck on anything.
This reflex is a survival mechanism. Many parts of breastfeeding (or just feeding an infant in general) are not second nature, but the suck reflex is actually meant to be. At around 10 to 12 weeks of life, babies’ suck reflexes will begin to integrate. What that means is that they now have a choice about what they suck on and what they don’t. This transition is also purposeful and necessary for survival as it allows babies to begin to practice other oral motor skills that will lead to safe chewing and swallowing of solid foods in a few months’ time.
The unfortunate reality of being strongly encouraged to exclusively breastfeed, and also return to the workforce 3 months (or less) after establishing this, is that the integration of the suck reflex in babies developmentally coincides with the breastfeeding parents’ need (or desire) to no longer be the sole milk giver.
It means that exclusively breastfeeding parents are confronted with the timely need to offer a baby who has a strong preference for drinking from a breast – a bottle.
Sometimes if the sucking reflex is still there, or sometimes there (it comes back during sleep or drowsiness) the solution can be fairly simple. A few modifications can be made to make bottlefeeding enough like it is at the breast to be passable, and voila! We have a baby who takes a bottle.
But often, especially for families who come to use with babies who are 3 or 4+ months old, it is a delicate dance- a dance that must be initiated by the parent but led by the baby.
Babies are smart. Even very young ones. Getting buy-in from babies to participate in any task will be more successful if the baby is able to chose it. When we support families in this predicament, the first step is always to determine the underlying issue. This takes a lot of detective work and knowing when, where and how to look. In our experience, the underlying issues can be related to:
Function: Difficulty moving the body, controlling liquid, or with efficiency, can make it harder to drink from the bottle than from the breast. A thorough assessment from a provider trained in breastfeeding infants needs to be completed.
Aversion: Negative experiences around the bottle has taught the baby that this isn’t something she wants to participate in. Removing all possible negative associations and allowing the baby to re-familiarize themselves with the process in a positive and no pressure way needs to come first.
Inexperience: A baby who has gotten very good at and is familiar with breastfeeding may not know how to suck on a bottle nipple or know that it is a source of food. Breastfeeding and bottlefeeding require a different set of skills and coordination. The transition takes patience, the right environment, the right tool for the job and some creativity to teach a new skill.
Positioning: Babies who feed at the breast or chest get a lot of physical feedback and support to their bodies during feeds. This body contact is often not reproduced in the position they are put in to bottlefeed and they may just need more or different support.
Bottle system: Not all bottles or nipples are equal and marketing sure is not! Despite what the package says, no bottle is really like a breast. Finding the bottle system that best matches the nipple of the chest or breastfeeding parent is usually a good place to start.
And of course, all situations are unique and each solution is individualized. Our best advice for barriers to bottlefeeding is this: you are the expert in your baby and your baby is an expert in you. You may already have an idea of what might be in your way. Take a deep breath, have patience and see what your baby or the bottle might be telling you.
Do you want to learn more about babies and bottles? You’re in Luck! We will be holding our online class, Transitioning from Breast to Bottle (and Back), on Monday, April 29th at 5pm CT. Register for $30 per family below: