Transitioning from Bottle to Breast

Recently, we had a question from a mother whose baby was unable to nurse from the breast effectively because of a severe tongue tie.  From experience, we know she is not the only mom with questions about how to get a baby who has been bottle-fed for weeks back on the breast so our hope is that this blog post helps Bev and the other moms in her situation.

There are several things you can do to encourage an infant who is bottle feeding to take the breast.  One size never fits all in counseling nursing mothers, so we will outline a myriad of techniques so that you can find one the one that helps you the most.

Start by changing the way you supplement.  The best method is to go from a bottle to finger feeding with a syringe.  A 10cc syringe is 1/3 of an ounce.  This will help you determine how many times to fill the syringe for a feeding.  When finger feeding with a syringe, put your feet up on a stool and lay the baby on your lap facing you.  Then insert a clean finger, pad side up.  Once the baby begins suckling, place the syringe in the corner of their mouth and wait for 30-60 seconds before tapping the baby feeding syringe.  Syringe feeding will help the baby use his tongue properly instead of arching or thrusting his tongue as when bottle feeding.  This method also slows down the feeding unlike a dripping bottle so that there is not immediate gratification but instead proper suckling several times, then yields the result of you tapping the syringe and releasing the milk.  This is important because it takes 30-60 seconds for breast milk to be released.  

Change the way you bottle feed.  If syringe feeding is not feasible, especially if your infant is in child care while you work, you can change the way that bottle feeding is done so that it can help as well. Holding a bottle fed baby the same way as you would feed a nursing infant can help transition the baby from bottle to breast. This means the baby should be tummy to tummy with you while feeding from a bottle.  Hold the bottle close to your collar bone so that the infant is not on its back when feeding.  Make sure the infant has lips wide apart.  If clamping the tip of the bottle nipple, gently screw the bottle in like a lightbulb and it will help the infant rosebud their lips.  If an infant does not open wide on the bottle, they will not open wide at the breast and milk transfer will be inefficient.  The milk sinuses are located about an inch behind the nipple so a wide mouth is essential in breastfeeding effectively.

Take advantage of prime time opportunities.  There are several times when infants are more disposed to breastfeeding.  These are times when their natural instincts kick in.  These times include falling asleep, not yet fully awake and when mom and baby are in a warm bathtub together.  Have a syringe full of breastmilk available when taking advantage of these prime time opportunities and that way you can drip breast milk on your nipple (you can also hand express first instead).  Lay the sleepy or bathing infant at your breast with your nipple exposed and gently guide them to nurse.

Try a nipple shield.  A baby who is used to the feel of a silicone nipple in their mouth may not respond to a bare nipple.  A nipple shield is one way to transition.  Make sure that you change your bottle feeding position from baby on their back to tummy to tummy for at least 2-3 days prior to trying the nipple shield.  Wet the nipple shield to help it adhere.  Massage your breast so that milk begins to drip into the nipple shield before attempting to latch.  Please note that if you are using a nipple shield for more than a few days, you will need to use a breast pump 1-2 times per day since it is a physical barrier that can lower milk supply without the added stimulation of pumping.

If your milk supply is low, use a lactation aid feeding tube.  If you are getting your baby latched, but they keep disengaging because milk is not flowing, a lactation aid feeding tube which can draw from a syringe or a bottle for supplement can help keep the baby at the breast.

Remember, your baby prefers you!  It is often such a blow to our ego as a mom, when a baby refuses the breast.  Your thoughts are that the baby prefers the bottle.  Just know, this is not a personal rejection.  Your baby has just learned another habit of feeding.  The good news is that babies learn habits quickly, so they can also quickly change their habit. But even if your baby never learns to nurse from the breast, you are still their favorite! And any means that you can use to get breastmilk in your baby is a win!

Be patient.  Try these techniques, then try them again.  Use what works, and toss what doesn’t work for you and your baby.

Here is to a good latch!


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