Tami's Opinion Piece On Bottles For The Breastfed Baby
The choice to use a bottle with your breastfed baby in the early days (first 4 weeks) is one that needs to be
undertaken with great thought and consideration. It's not something to just walk into lightly, as for some babies, it can
have very damaging and difficult repercussions, such as breast refusal, and nipple flow preference).
Sometimes, the choice to use a bottle is not left up to you. Sometimes, a bottle is given in the hospital because
baby or mother are ill and breastfeeding is not possible. Sometimes, baby is given a bottle in the hospital without the knowledge
or consent of the parents. Sometimes, a bottle is given by a well meaning family member while mom is resting, to allow her
a longer nap. Sometimes, a baby cannot latch on due to a facial anomaly, or a mismatch between the babies mouth and the mother's
nipple size. There are many reasons a bottle is given in those early days.
Are all bottles bad? Well, no, not all are BAD per say, in regards to their effect on breastfeeding, but some
definitely get a much lower acceptability score than others. Here is my little list, least to most preferred. I want to state
clearly, this is my OPINION, based on what I have seen with clients. Other Lactation Professionals might disagree with my
findings completely, and have their own preferences.
WORST BY FAR: The little Volumfeed bottles that they give you and use at all of the local hospitals, both versions,
preemie and full term baby styles.
Now, it is not the BOTTLE per say, it is the NIPPLE. It flows very, very fast, and babies often feel as if they
are going to choke from the speed at which the milk is delivered. In the preemie version, the nipple is TINY, and when baby
goes to breast with that teeny tiny pursed mouth, well, getting enough areola and nipple is a huge challenge! These bottles
should be avoided at every possible opportunity. You are not always offered a choice, but if you can avoid them, DO, and definitely
do NOT take them home with you to use at home. Leave those little freebies at the hospital. They are the derailer of MANY
a breastfeeding relationship, and many more to come unfortunately.
2nd Worst: Dr. Browns (Both standard and wide mouth) and Avent bottles (Yes, I said Avent)
Again, the issue here is speed of milk delivery as it affects the breastfed baby. A breastfed baby, generally
speaking needs to be patient at the breast, to allow his mother's milk a chance to flow in the first moments after latch on.
If a bottle is used that instantly begins to drip into the babies mouth, and requires very little suckle to get it to work,
well, that bottle will adversely affect breastfeeding, by causing the baby to be far less patient at the breast, resulting
in fussiness, arching of the babies back, and head shaking side to side when put to breast. Parents needs to be very careful
if they choose to use either of these brands if they wish to be successful with breastfeeding. An older baby might be able
to use these bottles just fine if mom goes back to work after 8 weeks or more, without adverse effects, but in the first 4
weeks, it is my opinion that they are a bad idea. Neither is a choice I would make for my own child.
Somewhat Preferred: Gerber Comfort Latch and Gerber Gentle Flow bottles.
(NOT GERBER STANDARD SLENDER RUBBER NIPPLES)
These bottles allow a more open latch for the baby and baby does get more nipple into her mouth, which is good.
They do still flow too fast for my preference, and therefore, get a somewhat preferred rating.
Secondary Most Preferred: The First Years Breast Flow Bottle
This odd looking bottle with it's double "nipple inside a nipple" concept is in very new testing by me with clients.
So far, so good. This bottle requires a good open latch, and a rhythmic suckle to deliver milk into the baby's mouth. It usually
does NOT drip milk without a suckle. The only real drawback to this nipple is that low weight or preemie babies might not
yet have the suckle strength to really feed well on this nipple before wearing out their energy store and falling asleep mid-feed.
Most Preferred-Most Often Suggested: Playtex Natural Latch Bottle, Slow Flow, Brown Latex Nipple
(DRAWBACK: Nipple is made from latex. Use the alternate silicone version if your family is sensitive
This nipple seemingly has it all. A nice consistent slow delivery, requires a good suckle, molds
to the baby's mouth, allows for a nice wide latch on. It also is for use with a bottle that takes bottle liners, which diminishes
the amount of air delivered to the baby during the feeding, because the bags collapse during feeds. IF A BOTTLE HAS TO BE
USED, this is the one I suggest most often.
The best time to introduce a bottle of expressed breastmilk or formula to a breastfed baby seems to be around
the 4th-5th weeks of life, to get baby ready for mother to go back to work. This should always be done by someone OTHER THAN
THE MOTHER if at all possible. We want to send a clear signal to baby that when mommy is here, I breastfeed. When mommy is
gone, I have a bottle if I need one. The first bottle attempt should NOT be done with mommy in the room, but with mommy in
another part of the home, or gone on an errand perhaps, and be given by daddy, or grandma, or care provider or friend. It
is confusing for a baby to be given a bottle when their beloved breast is right there, snuggled up against them. Also, mid-day
is a better time, not bedtime or nap-time, as far as a first introduction. Also, it is uaually very, very hard for a breastfeeding
mother, who has worked so hard to make breastfeeding work, see her baby being fed a bottle. Most mothers will cry if they
watch. It is a very emotional thing. It is just best all around for mommy to NOT be in the room. USE EXPRESSED BREASTMILK
Be patient with baby, wait for a wide mouth just like when breastfeeding, tickle the baby on her top lip to achieve
a wide mouth gape, and expect baby to latch on WIDE, not with little pursed lips to the end of the nipple. Baby's time with
bottle needs to be as close to breastfeeding as possible. Wide latch, flanged open lips, strong suckles. Pursed kissy lips
will only lead to pain at the breast for mommy later. Make sure baby latches WIDE, even to a bottle. If you need help understanding
how to best offer a bottle to a breastfeeding baby, please do not hesitate to call, we are here to help.
There is NO bottle that beats the breast. There is no bottle nipple that works as well as the breast, or feels
as wonderful to the baby as mothers nipple and breast. If at all possible, all feedings should happen at mother's breast.
Bottles are the LAST resort, not the first answer. Please work with a Lactation Consultant before choosing to go to the bottle
because "breastfeeding isn't working out". Get help to save your breastfeeding relationship, it's too important to lose!