Many parents consider giving their baby a bottle of expressed breastmilk to allow someone else, usually baby’s father, the opportunity to feed the baby. Although this may seem an attractive idea especially if the mother imagines the bliss of sleeping through that feed time, it is not advisable for several reasons.
Introducing bottle feeds using a teat requires baby to suck very differently than how he does at the breast. The breastfeeding baby’s tongue massages the breast tissue and the nipple which fill baby’s mouth, working in union with the natural suck-swallow-breath rhythm that nature has designed to allow safe, comfortable feeding, and also to enhance the development of the baby’s mouth and facial anatomy as he grows. When a baby is given milk by a teat with holes in it the milk pours straight into the throat, and baby responds by swallowing the milk. The flow of milk dictates baby’s suck-swallow-breath action, and often forces baby to feed faster and take greater volumes than is comfortable for baby. The tongue is shaped to conform to the teat and works in a piston-like action using the tongue muscles differently to when breastfeeding. This can quickly confound baby’s natural and instinctive tongue action at the breast, and “derail” the baby from breastfeeding. Consequently it is not advisable to introduce a bottle and teat for feeds until baby is well established with breastfeeding (after about 6 weeks of age).
Another reason bottle feeds are not a good idea is the effect on the mother’s breasts. If the breasts are not drained regularly (for example, if a feed is missed) the breasts quickly become over-full and engorged, which can lead to problems such as blocked ducts and mastitis. If baby is given a bottle feed the mother actually needs to be expressing her breasts at the same time to avoid these problems. If the breasts are not drained well and frequently the breasts’ chemistry changes to down-regulate her milk production, which will reduce the mother’s milk supply. Breastfeeding the baby will probably take less time than expressing the breasts, and it is better for everyone if Dad helps by doing the nappy changes and settling so Mum can get some sleep.
Nevertheless, it is a fact of our modern lives that most babies will be fed by a bottle and teat at some time and breastfeeding mothers may decide to give some breastmilk by bottle once their supply is well established for a variety of reasons. They may be planning a night away from baby, or returning to work and needing to be able to leave the baby in someone else’s care for a period of time. It can be difficult to get a fully breastfed baby to accept a bottle and teat if it is not introduced by 3 or 4 months of age, so offering baby an occasional bottle feed after about 6 weeks of age can help baby adapt to this alternative feeding method more easily. It is important to understand that giving a breastfed baby frequent feeds by bottle and teat can ‘derail’ the baby from breastfeeding, and babies who are “mixed fed” breast and bottle can begin to prefer bottle feeds as the “easier option” as it requires less physical effort to bottle feed than to breastfeed.
There are numerous bottles and teats on the market which claim to provide a delivery system which is like breastfeeding, however in my experience most do not even come close! To maintain breastfeeding it is very important for those babies to be offered teats which closely simulate the way breast milk flows from the breast. In my opinion there are only one teat on the market which meet this criteria – The Pigeon Peristaltic Plus Wide-Neck Y Crosscut Y teat in sizes “M” and “L”. This teat, used with a Pigeon Peristaltic Plus Wide-Neck bottle does not have holes like every other teat, it has a cut which is “Y” shaped. Milk is only released from the teat when the baby applies pressure with the tongue and jaw as he sucks (similar to the action of breastfeeding), and when he pauses the milk flow pauses too. The baby can “pace” the rate which milk is taken with the crosscut teat which makes for more comfortable feeding, and the shape of the teat encourages baby to maintain widely flanged lips which also resemble a good breastfeeding latch. I have found the “M” Crosscut teat is well accepted by young babies even though the packaging indicates it is designed for babies over 3 months of age. All of the other wide-based bottles and teats are far too wide and baby’s mouth tends to slip to the tip of the teat, causing pursed lips and minimal jaw activity – like sucking a straw, which does not resemble the oral activity of breastfeeding.
When storing expressed breastmilk for later feeding by bottle it is helpful to mark the time it was expressed as well as the date, and efforts made to match the time the milk is given to a similar time it was expressed. This is because the constituents of the milk varies slightly throughout the day and can influence how satisfied baby feels after being given the milk by bottle. The rate the baby takes the expressed milk is also important, and “paced bottle feeding technique” is recommended for all bottle fed babies. Recent research has also indicated that some babies who are fed expressed breastmilk by bottle for every feed may be at increased risk of obesity, as they are unable to regulate the duration of feeds by feeling satisfied in the same way babies instinctively vary and regulate the frequency and duration of breastfeeds. Take-home-message: giving occasional bottle feeds to a breastfed baby is fine, but it is important to consider HOW the feed is given, when and why in order to maintain baby’s breastfeeding reflexes and the mother’s breastmilk supply. This is adapted from “New Baby 101 – A Midwife’s Guide for New Parents” and was published in part on April 2, 2016 on Mamamia http://www.mamamia.com.au/breastfeeding-tips/