Baby led Bottle feeding
Those of you that know me will be aware that I have very little first-hand experience of bottle feeding so you may be wondering what gives me the authority or why am I writing an article about bottle feeding?
I’m writing this article because of my experience supporting and listening to mothers, some who have come to me ridden with feelings of guilt and failure about not being able to breastfeed. No mother deserves to feel like this, we all know breastfeeding is ‘best’ I’m not going to pretend it isn’t, however, when it’s simply not possible we can find ways to meet your baby’s needs with a bottle.
Firstly, the word breastfeeding implies that it’s just about feeding, whereas the reality is there is so much more too it.
Babies suckle at the breast for many different reasons including
• To be in arms and close to their mother
So the question is how can this be replicated when using a bottle?
Skin to skin/in arms feeding
There is no such thing as too much skin to skin contact, it can help to regulate baby’s temperature and breathing, it also helps reduce fussing when baby is feeling overwhelmed or stressed.
Just as you would if you were feeding from the breast you may want to hold your baby for all or nearly all of the feeds or when baby is using a pacifier (you could always attach the pacifier to you instead of the baby).
One mum I spoke with told me:
‘I’m not comfortable with seeing other people feeding her. I didn’t realise how uncomfortable it would make me until I saw it happening. It doesn’t happen often, but if she’s being held by a relative and l notice that she’s starting to get hungry, they tend to assume that I will pass them the bottle rather than handing my daughter back to me once the bottle is ready. I think they’re trying to be helpful and don’t really think about why it might be an issue for me.’
This is normal, instinctive behaviour; Do not feel guilty, you are not being selfish, your baby may only want to be fed by you, particularly in the first few months. Only you know how you feel, listen to your instincts and if you feel able to, talk to your parenting partner about how you feel and ways in which they can support you.
Take your time! In the first six months babies have very few ‘needs’ other than to be fed and held. Treasure these moments, use them as an opportunity to put your feet up, snuggle up and rest with your baby. Despite what we are led to believe there is very little need for stimulation in the first few months, in fact overstimulation can be detrimental but that’s another story. The point is they don’t ask for much so try not to see feeding as a burden or a waste of time, enjoy the peace and definitely enjoy the time to sit down; Trust me, once they are crawling then walking and you are chasing them round you really will miss those hours where you got to sit, cuddling and feeding.
When ‘latching’ a baby to the breast the baby has to pull the nipple into their mouth then push their tongue underneath the nipple to stimulate and suckle the milk out of the breast. If baby is struggling to do this generally there is an underlying issue and often the reason why a baby may ‘prefer the bottle’.
Sadly very few midwifes, health visitors and even paediatricians receive the training required to conduct a full oral assessment to check for issues such as a high palette, lip tie or tongue tie (anterior and posterior). Even if you are going to bottle feed it is helpful to identify these issues early on as they can affect speech and dental hygiene in the future. A certified IBCLC (lactation consultant) can often help you to identify any issues and get the right treatment.
The teat on a bottle is more rigid than breast tissue therefore it requires less effort for baby to draw the milk out, however, the effort a baby makes when suckling on a breasts helps the jaw muscles to develop so mimicking breastfeeding by using a teat with the smallest feeding hole could help this.
Feeding cues, positioning and paced feeding
Hunger cues are a great way to help you know when baby is hungry, the earlier you respond, the less stressed they are likely to get and the easier it will be to feed them.
Remember we don’t eat and drink the same amount every time, sometimes baby may want more, sometimes less. If you make up smaller quantities you are less likely to waste unwanted milk.
Generally when we see babies being fed with a bottle they are in a horizontal position and the bottle is vertical. If you hold the baby in a more upright position and wait for them to open wide and draw the teat in rather than pushing it in their mouth, you are allowing the baby to initiate the feed when hungry and transfer the milk at their own pace. If baby start’s to push the teat out with their tongue, it is likely to be an indication they are full or want a few moments. When baby is allowed to pause it allows their stomach time to send signals to the brain to let them know when they are full, promoting self-regulation of food intake, this video demonstrates how.
Do you have to feed using a Schedule?
Bottle feeding is often associated with:
- Feeding at set times of the day or with set gaps between feeds
- Encouraging babies to finish every bottle
- Encouraging baby to consume ever increasing amounts of milk in order to stretch the time between feeds or in the hope baby will sleep longer
- Reducing the number of bottles from their schedule as they grow
It doesn’t have to be this way if you don’t want it too.
Can you image what it would be like as an adult to only be allowed to eat and drink at a set time every day and to only be allowed to eat or drink every 3-4 hours regardless of how much activity you have done and how you are feeling? I don’t know about you but I rarely sit down or go anywhere without a drink to hand, I would be surprised if I go much more than hour without a quick sip of water so why would babies, who have tiny stomachs be any different?
At birth, babies have tiny stomachs and human babies are biologically designed to be fed little and often. For the first six months of life babies only require milk to satisfy hunger and thirst. When babies go through developmental ‘leaps’, they typically start to ‘cluster feed’ this is your baby’s body telling you they need more milk. When they go through these stages they are likely to require more frequent feeding, this is often mistaken as a sign of readiness for the early introduction of solids.
‘Research shows babies can get all the nutrients they need from breast milk or infant formula until they are around six months old. Waiting till then gives their digestive system time to develop fully so it can cope with solid foods. This includes solid foods made into purées and cereals added to milk.’
Additional bottles of water (although sips are okay) are not required as it may interfere with the body’s ability to absorb nutrients in the milk. It may also cause the tummy to feel full and curbs the desire to feed.
Safe preparation guidelines
Quite often the reason mothers are encouraged to feed on a schedule is due to the attention and effort required to prepare a bottle safely. The advice on how to safely prepare formula is has remained unchanged since at least 2007, this is when the World Health Organisation issued worldwide safety guidelines. The World Health Organisation are the leading authority on health guidance, they use impartial and evidenced based information to prepare the guidelines.
Their studies found:
‘It is safest to prepare a fresh feed each time one is needed, and to consume immediately. This is because prepared feeds provide ideal conditions for bacteria to grow – especially when kept at room temperature. If you need to prepare feeds in advance for use later, they should be prepared in individual bottles, cooled quickly and placed in the refrigerator (no higher than 5ºC). Throw away any refrigerated feed that has not been used within 24 hours.’
For more information on safe preparation see:
For preparing feeds on the move or if you are considering using a formula preparation machine http://www.firststepsnutrition.org/pdfs/Statement_on_making_up_formula%20safely_Mar_2015_final.pdf is a helpful resource.
If you are struggling to come to terms with the circumstances you are facing please reach out for help, you can contact your midwife, health visitor, doctor or if you would like to access private support in the comfort of your own home I have a range of support packages available from just £99. Email firstname.lastname@example.org or see www.lucyedgehill.co.uk/parentingsupport for more details on how I can help.