Breastfeeding and Starting Bottles
When to Introduce a Bottle to the Nursing Baby
Deciding when to start a breastfeeding baby on bottles can be confusing for new parents. Understanding the consequences of bottle timing is important.
Before giving a bottle to their breastfed baby, parents should consider the implications concerned with the timing of bottles. If bottle introduction is done too soon or too late, it can affect the nursing relationship. Mothers should consider their lifestyle needs and the consequences of bottle introduction to determine the optimal timing.
Drawbacks to Introducing a Bottle Too Soon
- Nipple Confusion: Nipple confusion occurs when a breastfed baby cannot discern the difference between the suckling required of breastfeeding and that of bottlefeeding. This can result in fussiness and/or refusal of the breast. For more information see Nipple Confusion and Breastfeeding.
- Poor latch: A breastfed baby who is given a bottle too soon may have difficulties achieving an effective latch at breast. The baby becomes accustomed to the latch used during bottlefeeding and applies that same latch to breastfeeding.
- Reduced milk supply: The poor latch causes inefficient nursing and in turn reduces mother's milk supply. Breastmilk production is the law of supply and demand. If the baby is not stimulating the mother to produce more milk, her milk supply will drop.
- Sore nipples: This is also a result of ineffective latch. A poor latch will cause nipple trauma. For more information on treatment for sore nipples see Lanolin Treatment for Nipple Pain.
Drawbacks to Introducing a Bottle Too Late
Bottle refusal. Some babies may not accept a bottle after a certain point. They develop a preference for the breast and have a difficult time feeding from a bottle. It can be frustrating for the caregiver to get baby to accept a bottle.
Bottlefeeding Recommendations from Breastfeeding Professionals
Most lactation consultants agree that overcoming bottle refusal is much easier than overcoming the various problems that stem from introducing a bottle too soon. In light of that, if nursing is going well, there should be no reason to give a bottle in the early weeks. Lactation consultants suggest that a bottle should be introduced no sooner than three weeks of age. If supplementing is necessary, they strongly encourage alternative feeding methods to bottles to prevent nipple confusion.
Consider Mother's Lifestyle to Determine Optimal Timing
- Mothers who work outside the home should consider introducing a bottle between three to four weeks of age. If the mother is returning to work before baby is six weeks of age, she may want to consider introducing a bottle two weeks before she returns to work. This may give the pair enough time to work out any challenges to bottlefeeding before returning to work.
- Mothers who do not need childcare but still would like their baby to take an occasional bottle might consider waiting until baby is four to five weeks of age to introduce a bottle.
- Mothers who do not need childcare and are not overly concerned about offering a bottle may wish to wait longer. The longer the wait, the less likely baby will develop nipple confusion and supply problems.
When bottles are introduced, the mother should pay attention to signs of problems. Fussiness at the breast, sore nipples, and a reduced milk supply are all indicators that bottles may have been introduced too soon. It would be wise to wait a while longer to give bottles. With careful attention, mothers who wish to give bottles to their breastfed baby can do so without harming the breastfeeding relationship.
References:
Huggins, Kathleen, R.N. M.S., The Nursing Mother's Companion. The Harvard Common Press: Boston, MA, 1999.
Newman, Jack M.D., Pitman, Teresa. The Ultimate Breastfeeding Book of Answers. Three Rivers Press: New York, 2000.
Smith, Anne BA, IBCLC, of Breastfeeding Basics. Introducing Bottles and Pacifiers to a Breastfed Baby.
