Pace Feeding and How to Get Your Breastfed Baby to Take a Bottle

Getting your breastfed baby to take a bottle can be tricky!  Maybe you are here after working so hard to make breastfeeding a success, but now have to be away from baby for an extended period of time and need them to take a bottle. Or maybe you just want your partner to be able to give you a break every once in a while. N fell into the camp of being stubborn when it came to bottle feeding.  If I was gone for only 2-3 hours she’d often choose to wait it out and then nurse like crazy upon my return.  Eventually though, with the right strategies in place my baby did take a bottle and yours will too!  Above all, remember that your baby, while stubborn and likely attached to the boob, will not let themselves starve.  Today we’re going to talk about pace feeding and how to introduce a bottle to your baby.  We will also learn the answer to the question, what is paced bottle feeding?

When to Introduce a Bottle

If at all possible, it is best to wait to introduce a bottle until 8 to 10 weeks postpartum in order to ensure breastfeeding and your milk supply is already sorted out and to avoid nipple confusion.  Of course, life happens, and it may be necessary for you to be away from baby before then. Above all else, the ability for your baby to thrive is of the upmost importance so it may be necessary to introduce a bottle sooner than later for medical reasons as well.

As long as baby is gaining weight well, and you don’t have to be away from baby, begin to introduce a bottle around 2-4 weeks before you are returning to work, or need to be away from baby.  In the end, if you are away from baby long enough they will take expressed milk from another source other than you (i.e. the bottle) so this timeframe is mostly for your confidence and peace of mind. However, I do recommend starting before the actual day because you don’t want to be worrying about baby taking a bottle on top of all of the other emotions you will feel when you are away from your baby for the first time.

I should warn you that N refused the bottle during every bottle “practice” session we did before I was away for an entire day.  But when that day came, my husband said that within 3 hours of me being gone she happily gulped down a bottle of expressed milk.  Your baby will not starve!

When to Practice Bottle Feeding

Some things that may help make the practice sessions go well is to try to pick a consistent time of day to give bottle to baby.  If morning is possible this is ideal because you will be able to pump during this missed feeding when your supply is the most ample.  If no one is available during this time, many families find a bottle of expressed milk before bed to be a nice way for their partner to bond with baby while trying to help get baby used to take a bottle.  I should note that before 8 to 10 weeks this is not advised because the before bed nursing is important to promote good sleep for a newborn.  Even beyond this point, it is beneficial for baby to be nursing at night because this is such a common time for cluster feeding, the milk is typically fattier in the evening, and baby continues to benefit from the sleep hormones that are present in the milk which is produced in the evening.

That being said, a bottle can still be used in addition to nursing in the evening.  Aim to nurse baby, then do a small bedtime routine and before putting them down offer a small bottle of expressed milk.  This will help tank up baby before bed in terms of fullness as well, which may help baby sleep for a longer stretch.

Remember that multiple exposures to the bottle may be beneficial and above all even if baby continually rejects, once baby is away from mom long enough, they will eat.  While you are going through this ‘practice’ time pick a bottle brand/type and stick with it!  Don’t fall into a consumerism trap of thinking that this bottle type is better than the next.  In general, baby is not particular to brands, just particular to wanting the breast.  So, consistency is important.  Constantly switching the bottle brand is going to add more confusion.  Just make sure that your bottles have a vented system to avoid excess air from getting trapped, which can cause an upset stomach for your baby.

Related Post: Pumping and Storing

Tips for Bottle Feeding

When you are working on getting your baby to take a bottle, remember that baby is unlikely to take a bottle from mom.  When your baby is with you they smell your milk and associate you not only with food but the comfort of nursing.  For this reason, if at all possible, have your partner or friend help during practice weeks.  If you are the only option for practice most days don’t fret, it can still work!  Some ideas are to give bottles in a place that you do not typically nurse, like the kitchen instead of their nursery.  You can also try walking around while getting baby interested in the bottle.  Another thing is to try going outside for feeding if the weather allows.  Sometimes a change of scenery and temperature can you enough to coax baby into drinking from a bottle.

Can you Bottle Feed and Breastfeed at the Same Time?

Introducing a bottle to your baby doesn’t have to be an all or nothing ordeal.  In fact, many mothers are able to successfully nurse their babies while together and have them happily take bottles while apart.  The keys to making sure you can continue to breastfeed as your time away from baby gets longer is to pump as often as your baby is taking a bottle.  This will help keep your supply up and matching baby’s needs.  The other key is to make sure you are utilizing the pace feeding method when bottle feeding your baby.

Related Article: Ensure Supply Isn’t an Issue, One Lesson in Milk Production

How Can I Introduce Bottle Feeding to My Baby?

If you are planning to have your breastfed baby regularly take bottles and still want to be mostly exclusively breastfeeding when you are with baby, it is essential that any and all of your childcare providers be familiar with the pace feeding technique. Talk to them about this and have them watch videos on YouTube to ensure that they will bottle feed this way.

What Is Paced Bottle Feeding? What is Responsive Bottle Feeding?

Paced bottle feeding is a way to bottle feed that mimics breastfeeding.  It is also known as responsive bottle feeding.  The same strategies are utilized.  Pace feeding will not only help baby adjust to the bottle faster, but will also prevent them from preferring a bottle, due to speed and efficiency, over the boob.

How do you Pace Feed a Baby?

If you are looking to implement pace feeding, I recommend watching a video to see it done in action, but here I will describe some of the key points.  Because you are mimicking breastfeeding as closely as possible you want to allow the feeding to be done over an extended period of time.  Aim for 20-30 minutes, which is likely about the length of a nursing session.  Throughout this feeding, switch the side that you have baby positioned in about half way through.  This is important because baby will not develop a side preference that may translate to nursing and cause challenges. Just like with nursing, pace feeding is all about watching baby’s cues.  You should use hunger cues to know when to give a bottle rather than watching the clock and you should allow baby to draw the bottle nipple into their mouth independently by resting it above their top lip instead of forcing it in.  This gives them control over when the feeding starts just like with breastfeeding and latching. You will also want to watch for cues when they are full and finished feeding.  While pace feeding, you should not encourage baby to finish the last sips or drops but instead refrigerate the remaining expressed milk to be used within 2 hours and then discarded.

Tips for Pace Feeding

Be sure to take pauses after every few swallows by dropping the bottle end down and allow baby to reengage with the nipple. This allows baby to check in with their own cues of fullness and prevents overfeeding.  Lastly, pace feeding is best done with a bottle that has a Level 1 nipple because the slow flow is most similar to the breast.  You may be able to continue pace feeding with a level 2 nipple if baby is over 3 months and clearly agitated by slow milk flow, or if you have a fast letdown.

How much milk should I leave for my baby? How much milk does baby drink each day?

These are stressful questions! I totally get it.  You want to make sure that there will be enough milk and that your baby is not hungry. But also, you don’t want to run the risk of wasting your precious pumped milk.  What is the balance?  Well, babies 1-6 months need on average 25 oz (between 19-30 oz) per day.  Research shows that during this time frame, the amount baby eats stays relatively constant and there is not a relation between baby’s size or weight with how much they eat on a given day.  After this point as solids are introduced, the amount of milk they need will slowly decrease.

How many ounces per feeding?

Basically, you want to take the number of ounces that they consume in a 24 hour period and divide that by the average number of times they feed per day.  If you are not already doing it, this may require the use of a tracker in order to familiarize yourself with any patterns and the amount baby typically nurses in a day.

Let’s take the average of 25 oz of milk per day and divide by average number of times they eat each day. Example: 25 oz/10 feedings per day = 2.5 oz/feeding

So, what does that mean for how much milk to leave?  Take the hours you are gone times the ounces per feeding. Example: 8 hours x 2.5 oz = 20oz needed

Remember this is an estimate. Always leave extra frozen milk in addition to what you thaw just in case. See safe storage and thawing guidelines.

In addition to these averages and calculations it is helpful to know that between the ages of 1-4 months babies take in between 2-4 oz of breastmilk per feeding and will very rarely take more than 4 oz per feeding.  See the sources at the bottom for more information about calculating how much breastmilk to leave.

Is it Okay to Bottle Feed and Breastfeed at the Same Time?

In short, yes!  For most mothers it is difficult to be with their baby all the time and not have a bottle available as an option.  But, in order to set yourself up for breastfeeding success it is best to hold off on introducing a bottle until around the 8-10-week mark, as I mentioned above.  Of course, the exception would be if your baby is having issues with weight gain or showing any signs of dehydration.  I want to encourage you to continue breastfeeding even if baby needs supplementation.  Any amount of breastmilk your baby receives is a benefit to them.  The comfort and closeness associated with nursing is also valuable and makes a great accompaniment to necessary bottle feeding.  Feeding your baby is never something you need to think of as black and white.  There is definitely space to maintain a breastfeeding relationship when bottles are also being used.

Bottle Alternative

If you are looking for a bottle alternative for medical reasons or because you are not having luck with a bottle, there are some alternatives to keep in mind.  You can try using a syringe if they are very young, particularly to calm baby and get a bit of milk into their bellies before attempting a latch.  Another idea is cup feeding which can be done with any age baby.  You can try spoon feeding expressed milk which is similar to cup feeding.  Lastly, frozen breastmilk “popsicles” can be effective, though are not practical for long-term feeding solutions.

Most of these are not permanent solutions and I do still recommend keeping with the bottle because your baby will take one eventually if they are hungry enough, or away from you long enough.

How to Avoid Nipple Confusion

So many aspects of breastfeeding are interrelated.  You can’t really talk about introducing a bottle to your breastfed baby without discussing the topic of nipple confusion.  Nipple confusion is when a baby becomes accustomed to the feel and process of extracting milk from an artificial nipple vs. your breast.  This article taught you how to pace feed when a bottle is needed in order to avoid this phenomenon for your baby.

The bottom line is that the longer you can wait to introduce a bottle the better off you will be in terms of establishing your own supply and ensuring breastfeeding success.  While there are some babies who can happily switch between the two feeding methods, many cannot.  Feeding from a bottle takes less effort and uses different muscles, so a preference can form quickly.  Of course, you need to do what is right for your family, your situation, and your baby’s health.  Fed is always best!

Is it OK to give a Newborn a Pacifier?

Pacifiers also fall under the category of artificial nipples.  Most experts advise against pacifier use in the early weeks to months because it can hide hunger cues.

You can read more about the vicious pacifier cycle and why it is best to avoid pacifier in my article: Avoid Nipple Confusion and Promote Exclusive Breastfeeding.

Always Remember

Your baby will not let themselves starve!  Stick to one bottle brand and keep at it.  Before you have to be away from baby for a length of time, try a day where you stay away from baby for 6-8 hours but are nearby should a true emergency arise.  Use this as a “me-day” before going back to work or going away.  It will also give you a chance to practice pumping and storing on the go and will be good for your mental health.

Next Steps

If you are looking to learn more about breastfeeding before baby arrives or as a new mother, check out our free 5-day breastfeeding course or learn about our handbook which is your complete guide to all things nursing!

If you are working on giving baby a bottle, my articles about pumping and storing as well as preparing to go back to work will be helpful for you as well.

To learn more about milk production and supply in general, Trina has a great resource in her article about breastmilk production.

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Sources:

https://www.newscientist.com/article/dn17908-evening-breast-milk-means-a-good-sleep/

https://kellymom.com/bf/pumpingmoms/pumping/milkcalc/