How to introduce a bottle to a breastfed baby

Here is one approach to beginning pumping and introducing bottles that has worked well for many families as they prepared to return to work. As always, what works best for your family may vary from what is outlined below:

1. Once breastfeeding is well established – usually after about four weeks – begin pumping after one feeding a day where your breasts still feel a little full. Remember you are pumping “leftovers” and should only expect a small amount.
2. Chill that first pumping immediately. You can add more pumped milk to it after they have been cooled in the fridge.
3. Your healthcare provider may have given you a total number of ounces your baby may feed in a day or a range from the smallest probable amount to the largest, based on your baby’s weight. There are also online calculators that can be helpful.
   • If dealing with a total volume over a 24-hour period, divide that by the typical number of times your baby feeds for a target volume for the first bottle.
   • If dealing with a range, store volumes of the lower amount.
   • Store some extra small volumes (.5-2oz) in case baby is hungrier than expected.
   • When you have enough stored to equal the expected volume and a bit more, you can begin to plan a time to introduce a bottle.

Here is an example of what this might look like:

• • Your healthcare provider suggests that your baby probably takes about 24 ounces a day.
  • You know that your baby feeds between 8 and 12 times a day.
  • That means they could take anywhere from 2 to 3 ounces at a time.
  • You pump until you have a 2-ounce bottle and then have several 1/2 ounce bottles to equal at least three ounces or more saved.
  • Choose a day that your primary support person will be available and a feeding time where baby tends to be more pleasant and patient for feeding.
  • Baby may accept a bottle more easily from someone other than you. They know milk comes from you and may not understand why they are not going there instead of a bottle.
  • Thaw out the 2-ounce bottle in the refrigerator overnight.
  • When baby begins to stir, place the bottle from the refrigerator in a bowl of warm water, under warm running water, or a bottle warmer while the person offering the bottle goes to get baby changed and ready for the feeding.
  • Often it helps to run the bottle nipple under warm water, if it was also in the refrigerator, to make it more acceptable to the baby.
  • Baby should be held in an upright, almost sitting, position.
  • The warmed bottle should be held at an angle tilted just enough to fill the nipple to allow baby to keep control of when and how fast the milk comes.
  • Tickle the baby’s mouth to encourage an open mouth. Then, aim the nipple toward the top of the mouth for them to latch.
  • Some families have found that it can help to have an article of clothing you have worn, like a nightgown or t-shirt, to place on their arm, shoulder, or chest where the baby can smell your scent.
  • It is usually best if you are close but not present in the room during this first “experiment” with bottle feeding. Your baby is very wise and will wait for you to come feed them if they know you are nearby.

Once the feeding is completed, you will pump to create a bottle equal to what the baby consumed. Remember that a healthy baby is always more efficient than a pump! If you do not pump as much as the baby took, it is more likely a pump issue than an issue of not enough milk. Pump after another feeding and add that amount to what you pumped to get the amount baby took.

You can continue to pump until you have enough milk stored in your freezer to get you through a normal work day plus a few extra ounces for any hectic day at work where you may not have been able to pump as often. You can also plan to breastfeed at the breast for all feedings when not separated from your baby.

RESOURCES

Bottles and Paced Bottle Feeding, LLLI

Read more about returning to work on our Working and Breastfeeding page.

Read more about pumping on our Pumping Milk page.

Read more about how to store milk on our Storing Human Milk page.

IS YOUR CONCERN OR QUESTION NOT COVERED HERE?

Please contact a local LLL Leader with your specific questions.

Medical questions and legal questions should be directed to appropriate health care and legal professionals.

Page updated February 2020

Resource adapted from LLLI materials.