With Amy Peterson, IBCLC
This post made possible by the support of EvenFlo Feeding
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Lots of breastfed babies will also use a bottle. Most of us have heard that introducing a bottle can potentially have a negative impact on the breastfeeding relationship. But thankfully, we can control these risks.
Lower risks
Latch: The way your baby latches on the breast needs to be similar to the bottle. Look at your baby while s/he is feeding at your breast. Notice how the bottom lip flares, and the top lip rests in a neutral position. Observe how the corners of the mouth seal on the breast, and how milk doesn’t leak from the lips while baby feeds. Pull down baby’s lip slightly and see the baby’s tongue cup or curves around your nipple. We look for these same characteristics when baby sucks on a bottle nipple.
Not a good latch: Averted gaze (no eye contact), top lip rolled in, leaking at corners, latched more toward the tip.
Decent Latch: Eye contact, flared lips, deep latch near collar of bottle, relaxed posture, no leaking at corners.
Flow preference: You want your baby to prefer the flow of your breast over the flow of a bottle. There is no standard flow rate for bottle nipples, so you might have to try more than one bottle to find a similar swallow pattern. Most babies will use a slow flow nipple, but slow flow isn’t best for every baby–match your own flow. For detailed information, Balancing Breast and Bottle lists bottle flow rates in Appendix C.
Milk supply: Anytime the baby takes 2 ounces from the bottle, ideally you will be able to pump this amount so your body knows how much your baby is taking and can maintain your supply. But don’t worry if you don’t pump exactly what your baby eats every time, baby is likely more effective at removing milk from your breast than a pump will be. Adding a pumping session may be necessary to ensure you’re producing the amount needed for your child’s bottle feed.
Good latch: Eye contact, flared top and bottom lips, no leaking, medium depth latch, relaxed posture.
Reduce risks by picking a nipple shape
One way to reduce bottle risks is in choosing the nipple shape we use to bottle-feed our baby.
Nipples have three general shapes: narrow, wide-abrupt, and wide-gradual.
Narrow neck nipples fit narrow neck bottles, and most have a gradual transition from nipple length to base where the baby’s lips can slide easily to latch deeply.
Wide neck nipples fit wide neck bottles. Wide, abrupt shapes have an abrupt transition (like a 90 degree angle) between the nipple length and nipple base. Make sure your baby is able to rest their lips opened widely on the nipple base, not suck on the nipple length like a straw. Also, make sure your baby is able to fully seal the lips without gaps in the corners of the mouth.
Wide, gradual shapes gradually blend from the nipple length to the base. This shape may help the baby’s lips to rest on a portion of the base, and help the lips to form a complete seal. Make sure your baby is able to keep the nipple inserted deeply during feeding, rather than sliding down to the tip of the nipple.
Best does not exist
Different bottle nipple shapes work for different babies. One bottle will not be best for all babies, but you can find which bottle is best for your baby. Therefore, beware of marketing and packaging claims. You’ve probably noticed many bottles claim to be best for breastfed babies, or to look just like the breast. But neither of these statements matters. How your baby latches onto the bottle nipple matters, not the packaging claims. You have found the right nipple when the nipple tip reaches deeply into the baby’s mouth; tongue cups the nipple; lips open widely and rest on a portion of the base; lips form a complete seal.
Additionally, now that you know that one bottle will not be best for every baby, don’t be swayed when you hear which bottle is “best” from other moms; what’s best for their baby might be terrible for your baby. You will need to look at your baby’s latch and then decide.
Buying bottles
If you are having trouble finding a bottle your baby accepts, make sure you have tried all three types: narrow, wide-abrupt, and wide-gradual. A lot of moms tend to buy various bottles marketed for breastfed babies, and then end up with a bunch of wide-abrupt shapes. Make sure you try the other shapes.
Chances are you will own more than one type of bottle, either bottles you have experimented with, or baby shower gifts that your baby can’t achieve a good latch with. Don’t despair. As your baby grows, the mouth grows as well. Nipples that do not work for young babies often work well when the baby’s mouth is bigger, say 4 months or so. Feel free to try the other nipples you have when your baby is older, and check the latch again.
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