Your Most Common Questions, Answered

There are many reasons women choose to bottle feed, and like anything else, bottle feeding is a learned skill for you and your baby. To help you navigate the ins and outs of bottle feeding, here are answers to some common questions.

They say breastfeeding is best, but what if I can't breastfeed?

First, it’s important to know that you’re not alone. Many women aren’t able to breastfeed, and many others choose not to breastfeed because of medical, cultural, social and emotional reasons. Whatever the reason, it’s common to feel judged, disappointed or worried about giving formula to your baby.

You may worry about missing out on important bonding time, but any kind of feeding offers an opportunity to connect with your baby. Even when bottle feeding, you still can hold your baby close, make eye contact, and talk and engage with your baby.

If you choose to use baby formula, it’s important to use commercially prepared formula; do not make your own. You can purchase formula as powder, liquid concentrate or ready-to-feed liquid, and each option offers different levels of cost and convenience. Companies that produce formula invest a considerable amount of money in research to ensure their products have the proper balance of vitamins and nutrients. Talk to your pediatrician about choosing the one that’s best for your baby.

How do I introduce a bottle to my breastfed baby?

Once breastfeeding is established, you can introduce bottle feeding. This can be done as early as 10 to 14 days after birth or as many as six weeks later. If you wait too long, your baby may flatly refuse to bottle feed.

Try starting with one bottle per day with breastmilk, if possible. Choose a specific feeding to be the designated time for a bottle feeding, such as the mid-afternoon feeding, to help your baby learn the cues and know what to expect.

Some infants make the switch easily and seamlessly, while others will need more help. Breastfeeding and bottle feeding require differing skill sets for your baby, so be patient. The movement of the tongue, lip position and strength of suck differ from bottle to breast, so it may take some trial and error for your baby to adapt.

Which style or brand of bottle is best?

“The answer to this question varies, as there are a number of nipple and bottle combinations on the market, and what works great for your sister’s child may not work at all for yours,” says Jeff Loughead, MD, neonatologist, medical director of Ann & Robert Lurie Children’s at Northwestern Medicine Central DuPage Hospital.

You may have to try a variety to find the right combination. Work with your pediatrician on the type of formula or bottle.

Whatever product you choose, be sure to thoroughly clean bottles after every feeding, and get in all of the nooks with a bottle brush, too.

I’m returning to work and want to continue providing breast milk. What can I do?

Bottle feeding gives you some flexibility with involving other people in the feeding, and if you’re going back to work, this will be key.

If you want to continue providing breast milk, pumping regularly is important. During the work day, you’ll need to pump at least once or twice so your milk production stays strong. Be sure to pump in a place where your milk can stay sterile and avoid contamination, and where you’re able to properly store it in a refrigerated site.

A double, electric pump is the most efficient option for expressing milk. Check with your local hospital about renting a pump, as they can be rather expensive to buy. Schedule pumping times on your calendar to avoid conflicts with meetings. Keep extra supplies on hand, such as breast pads for those moments of “let down” when your milk leaks because you’ve waited too long to pump or your mind wandered to thoughts about your baby.

My baby was born early. Do I need to bottle feed?

Before about 34 weeks gestation, pre-term infants usually don’t have the stamina or the coordination to orally feed, explains Dr. Loughead. These infants usually receive feedings in the neonatal intensive care unit or special care nursery by gavage; this delivers milk through a tube placed through the nose or mouth into the stomach, and breastmilk based with a supplement fortifier is preferred.

As your baby develops, feedings will be increasingly offered by mouth. These can be accomplished by breast or bottle, or both. By about 36 to 37 weeks, your infant may be pretty skilled at orally feeding, but still may not have the stamina to breastfeed all the time. It is not uncommon for a pre-term infant to go home from the hospital on some bottle feedings.

The time spent in the hospital will allow the nursing and lactation staff to find just the right combination for your baby. The health and strength of your baby is most important.

I’m not producing enough milk. Should I switch to formula and bottle feed my baby?

Breastfeeding can be tough, especially in those first few days. Low milk production may be temporary, especially in the first week when production is not matching your baby’s needs.

“Breast feeding is a wonderful experience for some mothers, but not all. We aren’t entirely sure why some women make a ton of breastmilk, while others just do not. The important thing to remember is the goal to help your baby grow strong and healthy, whether that is from breastmilk or the next best alternative, which is formula,” says Anita Chandra-Puri, MD, pediatrician, Northwestern Medical Group.

If you want to breastfeed but are struggling with milk production, seek help from a qualified lactation consultant, who can work with you and provide helpful suggestions. Even if your volume isn’t sufficient, it’s important to continue to pump and breastfeed because your milk production depends on the stimulation from the feeding itself and having the breast fully emptied. Pumping may not fully empty your breast as well as your baby does.

“Any amount of breast milk is beneficial, so if you can nurse for a short time, or choose to pump, the quality of the breast milk is the same in the bottle as from the breast,” says Dr. Chandra-Puri.

If I bottle feed, will I know exactly how much my baby is getting at every feeding?

For some women, it reduces some stress, knowing exactly how much their baby is getting at every feeding, and bottle feeding provides for this, as well as bonding with your baby, according to Dr. Chandra-Puri.

Remember, appetites vary, even among babies, and his nutritional needs will change from day to day and with every passing month. Babies eat when they’re hungry and stop when they’re full. Consult your pediatrician for advice about the right amount, which can be determined based on where your baby falls on the growth chart.