Which Bottle Nipples are Best for Breastfeeding?

Recently a question came in from an expectant mama as to whether the Avent bottles were best for breastfeeding.      

In years past, I recommended Avent bottles more often than not.  Today, with design changes to Avent and other great choices on the market, I thought I would help this mother and others with information on choosing the right bottle for your baby with today's blog.

Nipple Confusion and Flow Preference

First, let me say that introducing a bottle before six weeks can be problematic.  It is essential that your baby learn to latch well and nurse from the breast frequently during not only the learning period but also during the three week and six week growth spurt phase so that mom's milk supply can be stimulated by the increased suckling during those time periods.  Infant's nurse differently from a bottle which is why the term nipple confusion is prevalent.  When nursing from the breast, the baby uses a wave motion to draw the nipple into the mouth, but when using a bottle the baby traps the bottle nipple in the roof of the mouth or thrusts the tonged toward the bottle nipple opening to control the overwhelming flow from the bottle. In addition, feeding from a bottle gives the infant immediate gratification whereas the infant must suck for approximately 30-60 seconds from the breast to achieve let-down. As human beings, we tend to prefer immediate gratification even thought this is not best for the infant.  Suckling at the breast aids in tooth and jaw development in addition to many other benefits. If there is a medical need to supplement prior to the six week mark, a feeding syringe is best to avoid preference of a faster flow.  See our blog post on syringe feeding.

Introducing a Bottle

Once the infant has passed the six week growth spurt and you are ready to introduce a bottle, the type of bottle nipple used can make for a smoother transition from breast to bottle and vice versa.  I always recommend silicone slow flow nipples with a large area for the baby to latch.  See image below for an example of this type of bottle nipple.  

Shallow or narrow nipples do not allow for the infant to flare out or rosebud their lips like they do on the breast. Or at least not onto a soft are but only only onto hard plastic.  This shallow nipple discourages infants to take enough of the nipple into their mouths.  This behavior can transfer to breastfeeding causing the infant to only take moms nipple and not at least the recommended inch of the areola into their mouth.  If this shallow latch happens on the breast, it causes nipple pain in mom and poor milk transfer for the infant.  The milk transfer is not well achieved unless the infant latches onto the areola where the breastmilk pools in the milk sinuses.  Pacifiers with this breast-like shape are also recommended such as the Ninni Co Pacifier.

Below are some links to bottles and nipples that meet the criteria for the infant to latch well onto the bottle and back onto the breast:

Spectra Bottles with Nipples

Motif Luna Bottles and Motif Luna Nipples

Many experts believe that in addition to a wider base, a graduated sloped shape is recommended such as the Evenflo Balance Nipples as optimal for infants.  

Nipple Flow

In addition, breast fed babies feed more efficiently due to their increase in jaw development so there is no need for a higher volume flow when purchasing nipples.  You only need to purchase slow flow or newborn nipples in most cases unless your baby has suck difficulty or tongue tie, etc.  Bottle companies often put an age range on nipples to encourage moms to purchase more from the company, but you only need to replace nipples when they yellow or if they drip too quickly. If you baby needs an even slower flow, the Pigeon Super Slow Flow can be very beneficial and it is compatible with Spectra, Motif and Lansinoh wide-mouth bottles as well as the Evenflo Balance + GLASS bottle.

Pigeon Nipples

Best wishes as you prepare for baby!

Tanya

Introducing a Bottle to the Breastfed Baby

When should I introduce a bottle to my breastfed baby?

     

Waiting to offer a bottle is essential for initiation of lactation.  Experts tell us that we should wait at least 3-4 weeks.  I believe it should be at least four weeks because even a bottle of breastmilk can interfere with stimulation during the three week growth spurt period. It can undermine moms confidence when baby gulps a bottle down during the hunger games of growth spurts.  When you offer a bottle of expressed milk, it is essential to pump to replace that feeding or it can interfere with milk supply or cause plugged milk ducts. 
     Most moms begin a bottle because they want the freedom of allowing someone else to feed or out of necessity because they are going back to work.  If you choose to nap and let Dad feed make sure to fully empty the breasts by nursing first.  If a bottle has been given while you were asleep or running errands, pump when you return even if you have nursed immediately when you came through the door.  Anytime a bottle was given, baby will not be as hungry and therefore not empty the breast as well and residual milk can cause clogs especially in the early weeks of breastfeeding.
     If you are not going back to work or want someone else to feed, a bottle is not an absolute.  You may wait longer if you wish, but some moms who wait longer than 8 weeks find it difficult to coax their baby into taking a bottle.  So if you are going back to work, the best window may be 4-8 weeks.  If you are not going back to work, but find yourself in an emergency situation that you have to be away from your baby, the baby will normally take a bottle from another person if you are gone very long.  If you are not gone more than 3-4 hours, the baby may also wait for you.  In any case, it is important to have stored up at least 24-48 hours worth of breastmilk in the freezer.   Here is a breast milk intake chart to help you determine how much you need based weight.

Store milk in 2-4 oz increments.  This makes it easy to defrost and access just the right amount without waste.  You may store breast milk in sealed bottles or breast milk bags.  Bags have been the preferred method for most moms due to the quicker defrost time and space saving size.  They are more costlly in the long run so bottles may be more cost effective and better for the environment, but today inexpensive biodegradable breast milk storage bags are available.

What to do if you baby refuses a bottle?

First of all, don't panic.  Almost all babies will eventually take the bottle.  Here are some tips to help you get things going:

1.  Start with a soothing environment such as in a favorite rocking chair and you could even put on some music or white noise.

2.  Use a silicone wide mouth nipple so that the nipple itself does not have a taste.

3.  Squeeze a few drops out of the bottle nipple so that the baby can smell and taste immediately.

3.  Let someone other than mom initiate bottle feeding.

5.  Place the baby in a breastfeeding position which is tummy to tummy with the caregiver and hold the base of the bottle close to your collar bone.

6.  If the baby just takes the tip of the nipple, gently screw it in like a lightbulb to get their lips flanged.

7.  Often the best time to try bottle feeding on a reluctant infant is when they are already falling asleep or not yet fully awake from a nap.

8.  If  you are still having trouble, try walking while feeding.

Happy Feeding!

Tanya