Paced Bottle Feeding.
When a baby is not directly feeding at the breast, they can be fed expressed breastmilk, donor milk or infant formula. This can be given to them by cup feeding, using a spoon or syringe, via a Supplemental Nursing System or from a bottle.
Bottle feeding
The first thing to know about using a bottle and teat is that no design is anything like the human breast, no matter what marketing spin they put on it. And just as babies learn to breastfeed on their mother's unique breast and nipple design, they can feed from the most basic bottle and teat. Don't be misled by advertising which claims a product is better for helping breastfed babies switch easily between breast and bottle: silicone is nothing like any human breast.
Babies feeding at the breast control the flow of milk, which itself changes as a feed progresses. The “traditional” approach to bottle feeding has been to get the milk into the baby as quickly as possible. Babies can either swallow or gag on the stream of milk, so they keep swallowing. They can take a feed too quickly to recognise when hunger is satisfied.
Paced bottle feeding
Responsive feeding is about allowing the baby to take milk from a bottle more slowly, at a pace which is baby-led, not adult driven. Feeding can take twice as long and is closer to the time a baby would feed at the breast.
If you have chosen to use a bottle to give supplementary or replacement feeds, remember that feeding is an important time for babies to interact with their caregivers. Hold the baby and engage with them before, during and after giving a feed.
Support the baby so they are in a semi-upright, not reclined position, with their head higher than their stomach.
Hold the bottle in a horizontal position. Tilt it just enough for milk to flow into the teat. Imagine pivoting the bottle slightly to allow milk to to be taken by the baby.
Allow the baby to initiate feeding by holding the teat near their mouth and letting the natural rooting reflex be triggered by touch. Avoid pushing the teat into the baby’s mouth.
After the initial sucking, allow the baby to pause by gently drawing the teat from their mouth. Follow the baby’s lead as they either actively seek to continue feeding or they accept the pause you have offered. Keep the teat close so they can seek it again.
Follow this pattern until the baby shows signs they might need to burp, take a break or have taken enough milk. Don’t be tempted to get them to finish the milk to avoid waste.
Breastfed babies might take a rest between breasts or even a short sleep. Milk in a bottle, whether human milk or formula, should be discarded after 30 minutes. If your baby seems to prefer smaller feeds more often, divide the milk into separate containers in smaller quantities.
The volume of milk suggested for fully formula fed babies is a guideline and doesn’t reflect how much or how often a breastfed baby feeds. If you need to roughly calculate how much expressed breastmilk or donor milk to offer at a feed, we know that babies stomach capacity is around 80 - 150ml, however that is the maximum they can hold and they might be satisfied with a lower volume. Follow their feedback.
Breastfeeding is a relationship between a mother and her baby. Occasional or regular feeds from others due to paid work or study where mother and baby cannot be together at feed times are part of some families life circumstances. Some parents choose to use a bottle rather than cup feeding or using a Supplemental Nursing System while overcoming breastfeeding challenges.
