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: BOTTLES :

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).

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!

BEST AND WORSE BOTTLES
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 to latex) 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.
2ND 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.
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.
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.
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.

Bottle Introduction:

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.

It is usually 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 WHENEVER POSSIBLE.

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 contact me for help immediately.

**Please note, this list states my OPINION, compiled from years of observation of babies and mothers. The opinions of other Lactation Consultants, Doctors, Nurses or Hospitals may vary, as might the opinion of your Primary Healthcare Provider. This list is to be considered no more than a statement of consumer opinion, a sharing of ideas. Not every observation is applicable to every baby, not every preferred bottle works for every baby. Of course, premature/sick/medically or congenitally affected babies often come with different needs, and this list should only be considered applicable to a healthy, full term newborn.**