Breastfed babies don't have to take a bottle

While occasional or regular bottle feeds of expressed breastmilk, donor breastmilk or infant formula are part of some breastfeeding experiences, not every baby needs to be able to drink milk from a bottle. Indeed, many babies refuse to have anything to do with the idea - leaving their parents wondering if they can never be separated from their breastfed baby.

Routine bottle feeding only really became a safe option with the discovery of germs and the invention of disinfection in the late 1800s. Once the idea of germs was established, ways of preventing their growth were developed. When this was successfully used in the cleaning and disinfection of infant feeding bottles and teats, infant deaths were reduced. Soon after, infant formula was developed and marketed so successfully that by the mid 20th century, formula feeding was widespread and images of babies and bottles cemented the association between the two.

However, when breastfeeding is going well and babies are getting all their needs met at the breast, bottles and teats are rarely needed unless extended periods of separation are required. This is most likely for babies whose mothers return to work before the end of their paid parental leave - in Australia this is now 20 weeks. Younger babies have high sucking needs and this might be met through using a bottle. However, feeding milk by other means and adding a dummy can be another option.

Most babies can be fed by alternatives from birth. These include:

• Cup feeding

• Spoon feeding

• Syringe feeding

Babies in the second six months are learning to self-feed family foods and can also learn to drink from a cup. After around 9-10 months, most babies are eating enough solids to spend time away from their mother with milk to drink from a cup. Sippy cups might seem convenient but open cups and straw cups are also options.

Babies who are not taking milk in any form when separated from their mother for a typical working day will often compensate with frequent breastfeeds when they are together: sometimes called “reverse cycling”. Breastsleeping continues to allow a baby to breastfeed as needed throughout the night while their mother dozes or sleeps. This can mean the baby meets their need for milk in the night and has food and water during the day.

Babies older than 12 months generally don't require additional milk during separation. They can eat foods containing calcium and other nutrients as part of their diet, have water to drink and breastfeed as usual when with their mother. The recommended age to cease bottles and infant formula is 12 months: toddler formula is a marketing tool and not recommended by health authorities.

Carers are often fearful of having a breastfed baby in their charge, especially if that baby does not use a bottle. However when we think about it, bottles are just one tool for giving babies liquids. Not a necessarymilestone.