Feeding your baby with a bottle

At the beginning and skin to skin….

Babies and their mothers are normally offered the chance to be in close, skin to skin contact straight after the birth, and maternity units should have this as policy unless there is some strong medical reason against it. You and your baby can enjoy this contact at any time, of course, but it’s especially valuable in the early minutes and hours. Babies come into the world ready to build on their relationship with you, and their senses are often very sharp at this time.

For many babies, there’s a period of alertness straight after birth, which allows you and your baby a great chance to start really getting to know each other, as you welcome her to the world.

Skin to skin contact (meaning with no clothing separating your skin from your baby’s) gives you and your baby a wonderful opportunity to see, taste, touch, hear and smell. Your partner can also hold your baby skin to skin, and if you need some form of medical care after the birth, he can step in and ensure your baby does not miss out.

If you are planning to bottle feed, you can also offer your baby a feed during this time. However, if you are unsure what you want to do or you are thinking about breastfeeding, then you can offer your baby the breast so that they can have some colostrum. This does not commit you longer-term; you will produce colostrum in any case. Some babies virtually attach themselves to the breast anyway – ask the midwife if you need help to be comfortable, as it’s not always easy to shift your position straight after birth.

Later bottle feeds can be given skin to skin as well – snuggle your baby next to you when you give the bottle, any time you want to.

How to offer the bottle

Hold your baby in your arms, across your body, and close to you, well supported. Babies shouldn’t be flat on their backs to feed, so support her so she is gently raised, and able to look at you.

Gently place the bottle teat against her lower lip, pointing upwards – she’ll probably open her mouth and you can then place the tear inside, following this sign that she’s ready. Tip up the bottle at an angle so the teat fills with milk, and watch your baby’s reactions. She should be able to suck and swallow, without spluttering, and without pushing the teat out with her tongue. The bottle teat needs to be full of milk during the feed, so that your baby doesn’t swallow too much air.

When your baby slows her sucking and swallowing, you can help ‘pace’ the feed by partially moving the teat out and then letting her draw it in once again. This mimics the natural stop-start of breastfeeding, and helps you avoid over-feeding your baby. If your baby gets upset at having the teat removed, tip the bottle downwards while it remains in her mouth, which will stop or slow down the flow.

Who should feed the baby?

Try to keep the majority of bottle feeds for you and perhaps one other trusted person in the early weeks and months. Babies build up trust and confidence during feeding, gradually coming to know what to expect. This is part of the development of healthy attachment, in the emotional and social sense.  So it's not good for your baby to be bottle fed by whoever happens to have a pair of hands free at the time (though this may happen occasionally when you really need the help, of course).

How much to give?

You can usually trust your baby to feed according to appetite and needs so be guided by her. Try to respond to her needs by not encouraging her to have more than she seems to want (unless you have been advised to give more by your healthcare professional).

Don’t worry if your baby seems to ask for more milk than you’d expect, either. Some babies have larger appetites; some babies go through periods when they need a lot more and then less. Your health visitor can help you assess if all is well.

When to give bottles?

In the early weeks, you’ll almost certainly find your baby is unpredictable, and her needs may change day by day. Your baby will show by her behaviour – increasing alertness, head movements, mouth movements, hand waving – that she needs milk, and you’ll find that feeding is calmer and easier if you respond before she gets upset. Most babies space their formula feeds further apart as they get older, and you can expect a regular period when they stay asleep without needing a feed for a longer time.

I your baby fights the bottle and is hard to feed after the first 20 or 30 mls or so then perhaps your baby needs a break at this point. You could try changing his position, putting him over your shoulder to see if he has any burps to bring up, then offering him the bottle again. If he’s not interested, perhaps he needs to feed little and often – this is perfectly normal for some babies. If this does not help, ask your health visitor to watch you feed him, and she may have ideas to help, and suggestions on holding him differently.

If your baby always brings back her milk this can cause her to be hungry sooner. Some babies are like this, and you have probably already worked out that feeding her means swathing her in a muslin cloth or towel to protect her clothes. You can try holding her more upright when you feed, or experimenting with a different teat – bigger or smaller holed.

Some women switch to formula milk when their babies seem unhappy with breastfeeding. However, sometimes the baby might suffer from discomfort as a result of the formula. If your baby is crying for long periods and nothing you do seems to comfort him, he may have colic. If he is unsettled, one option might be to restart breastfeeding – a breastfeeding counsellor can help you with this, and explore with you why your baby was not happy with breastfeeding. You could also check with your health visitor about his discomfort – some babies do have sensitivities to formula and a few are allergic. There may be alternative formulas she can suggest.

Sources of support:

NCT supports all parents, whatever their decisions about breast or formula feeding. Information and support is available from breastfeeding counsellors on the NCT Breastfeeding Line, 8am–10pm every day, phone 0300 330 0771. There may also be breastfeeding counsellors who are available locally.

NHS Choices also have information on this topic:
www.nhs.uk/Planners/birthtofive/Pages/bottle-feeding.aspx