Feeding your baby, a basic necessity and one that can be easy as pie or fraught and stressful, most usually a bit of both. Whether you are offering the breast or bottle, feeding is a moving experience for your baby and when you understand what is happening from this perspective it can help enormously to optimize the experience both for your baby and for you.
One of the most common questions I have heard is … “when should I introduce a bottle to my breastfed baby?” Or rather “...so and so said I have to wait x weeks… but someone else told me that if I wait that long my baby might not take the bottle… which person do I listen to?” There are no hard and fast rules, we are all individuals but understanding some of the principles at play here can help you make a good decision.
The first bit of information you need is that there is an important difference in how your baby needs to suck to get milk from a bottle or milk from a breast. When breastfeeding, the nipple is pressed right onto the soft palette and the baby will create a vacuum around it by pressing it into the roof of her mouth with her tongue (try sucking your own thumb pressing it into the beginning of the soft palette just behind your top front teeth, feel how strong the vacuum becomes and how your tongue shapes around the thumb). The top jaw will arch forward and down with each suck so that your baby is activating the vertebra and gently rolling through the whole spine. Breast-feeding is hard work, there is a lot of movement and the rhythm of breast feeding – sucking and then resting while the milk squirts in is something the baby couldn’t experience in the womb and needs to get used to. Sucking from the bottle is different, despite the various silicone nipples it is a much smaller movement with the bottom jaw doing most of the moving to suck in the milk (suck a drink through a straw and notice the difference), it requires less physical effort and does not engage the whole of the spine in the same way. The flow is different too, when you suck it flows, when you stop it stops and the milk is all the same, no watery fore milk and thicker hind milk, a constant even consistency and flow rate that the baby itself controls.
When one sees how very different both these experiences are it is clear that combining the two might be a bit difficult- if you introduce a bottle before breastfeeding is well established then the baby might just find it easier to bottle feed and reject the breast, if you wait too long they might find it hard to accept the bottle. So the advice to wait x weeks is based on someone else’s judgment on whether breastfeeding is well established for you and your baby. You can work that out yourself, if they are latching on and feeding easily and putting on weight (apart from the first week of course), if your nipples and breasts are comfortable, then it is safe to say feeding is established. Then you can try introducing the bottle but stay alert to any confusion in the way they suck. So make sure you can recognize the top jaw motion of up, over and down and then once your baby has tried and accepted the bottle, just be aware when you next breastfeed and check if she manages to get into her stride again, if it seems to be proving a bit difficult, give the bottle a rest and try again a couple of weeks later.
Of course your baby may reject a bottle for other reasons, feeding isn’t just about physical nourishment it is a time for close contact and bonding which makes it a great activity for your partner to get involved in. Sometimes a baby will reject a bottle from his mother but not from dad, so always worth a try!
For both bottle and breastfed babies start the feed by engaging the rooting reflex, i.e.: stroking the side of his mouth nearest to your body with the teat or nipple first. If your baby is hungry and wants to feed he will start to turn his head towards the finger reaching and opening with his mouth. If your baby fails to turn his head toward you (although called a reflex a baby can refuse it), it is an indication that he is not hungry and might be a helpful clue at those times when you are trying to work out what the crying is about.
Once your baby is rooting let him find the nipple or teat independently, he is learning about distance and focus by doing so and you can turn your attention to rolling his body towards you too so you are belly to belly- much nicer than having to turn your head while eating. If breastfeeding make sure you are not holding the back of his head, remember the motion of the upper jaw and how their head moves. Incidentally in BMC® we consider this rocking motion to release any tension held in the spine as a result of the birth. If you have a particularly ‘sucky’ baby, this might be something to consider. And finally make sure you are comfortable and supported- in the early weeks sorting out a particular feeding chair with lots of cushions, water or thermos of tea nearby so that you can relax as you feed is a great idea.
When exclusively bottle-feeding your baby there are some important movement based principles to remember that will support your baby’s development. In the first few weeks especially try and hold your baby as if you were breastfeeding turned belly to belly, with the bottle near your breast/chest so that the baby has the same visual distance to your face as if he were breastfeeding. Also make sure that you alternate sides throughout the day, holding your baby in your right arm for one feed, the left arm for the next. It is important to establish that your baby will happily turn his head to both sides and the initial rooting reflex, establishes the initiation of the roll, an activity that will start to interest your baby in the future.
If your baby is born prematurely, her sucking and rooting reflexes may not be developed. Often your baby will be fed through a tube at first because of this. Along with as much time as possible skin to skin with your baby, you can help the rooting reflex develop by gently stroking the sides of the mouth as you hold her, stimulating the cells to develop their sensory functions. If you would like to breastfeed your baby it can be done, contact a breastfeeding advisor and get some professional support as soon as you are able to.