How to Introduce a Bottle to a Breastfed Baby

Even if exclusively breastfeeding, most parents will want to offer their baby a bottle at some point–especially if going back to work, but even just to allow for a night out or for traveling. Or, you may be supplementing your baby with a bottle for health reasons. After managing the often all-consuming experience of learning to breastfeed, it's normal to have lots of questions when you begin approaching the time for bottle introduction. So let's talk through some common questions around introducing a bottle to a breastfed baby!

When should I introduce a bottle?

Introduce a bottle around 2-6 weeks.

If you’re planning to introduce a bottle, it’s best to offer early and often. While breastfeeding may seem to come naturally to some, it is a learned skill in many ways for both you and your baby. If you’re having latch or supply issues, or you’re just generally struggling, it’s best to avoid adding in another variable by introducing a bottle until you feel like you’re getting the hang of it. The timing may look slightly different for each family, but you can introduce a bottle after breastfeeding is well established–typically around 2-6 weeks.

Introduce before their suckling reflex begins to integrate.

Babies are born with many instinctive reflexes, one of which is the sucking reflex, and it’s activated by stimulating the roof of baby’s mouth. This reflex begins to fade as baby approaches 2-3 months old, meaning sucking becomes a voluntary, purposeful action. By introducing a bottle before the sucking reflex goes away, you can use it to your advantage. Once the bottle is introduced successfully, frequent and regular exposure to the bottle can prevent bottle refusal and allow your baby to learn to seamlessly switch between bottle and breast.

What type of bottle should I choose?

Choose based on the bottle shape. 

Did you know that the nipple actually looks much different while baby is actively breastfeeding than it does at rest? Many companies will boast of a “breast-like” bottle or nipple shape, which can lead to confusion for parents. When latched and sucking, babies stretch the nipple far back into their mouth, creating a longer, more narrow shape.

Look for a gradual slope & long, narrow tip. 

When choosing a bottle, look for nipples that have a gradual change from base to tip with a long, narrow tip. This design helps encourage a deep, wide latch. A few that I recommend that fit these criteria are the Dr. Brown's Natural Flow, Lansinoh, and Evenflo Balance,

A wide base & short tip may cause a shallow latch.

Avoid bottle nipples with a drastic change from the base to the tip or bulb-shaped, orthodontic nipples. These types of nipples are more likely to result in a shallow latch, which can sometimes create bad habits that are then carried over to the latch while nursing at the breast. You can find all of my favorite bottles at the links below!👇🏽

If your little one is using a bottle that is not listed as a "recommended bottle" and it is working well for them and your family, you do not need to switch. If your baby is struggling with their breastfeeding latch or you have yet to introduce a bottle and would like to be preventative, I recommend using one of the "recommended bottles."

Shop for all my top recommended bottles here!

Which flow rate should I use?

Start slow. 

When first starting out, opt for the slowest flow rate that your bottle brand offers. If the milk starts flowing too fast, many young babies are unable to coordinate their “suck, swallow, breath” pattern and begin to get overwhelmed, leading to increased air intake, decreased milk intake, and potentially a refusal of the bottle in the future. When breastfeeding, your baby is able to regulate the flow, so a slow flow bottle nipple that allows your baby to control the flow rate easily is ideal. 

Changing the flow rate based on age is a marketing gimmick. 

You do not need to increase the flow rate simply based on age. Your baby can use a slow flow nipple until they wean from bottles around age 1 year old. If you find your baby's feedings are taking a very long time or they appear inefficient, it's okay to trial a faster flow, but it is not necessary. 

To find your bottle's flow rate, check the bottle nipple or nipple base. Some brands describe the flow rate with numbers and some with levels. Aim to use a "slow flow" or "level 1" nipple flow rate. 

How do I introduce the bottle?

Start small with no pressure.  

You’ll need to have some milk saved up, either from pumping, using a milk catcher, or from hand expression. Or, you can pump immediately before the feeding and use fresh breast milk. Babies usually accept bottles more easily from a caregiver other than mom, so choose a time that a partner or family member is available and your baby is relatively content. For a first attempt, avoid a super hungry and crabby baby as they’re more likely to get overwhelmed and frustrated. 

Use a sidelying or semi-upright position for optimal support. 

Hold baby in a semi-upright, sidelying position, similar to how they would lay while breastfeeding (pictured below). This position makes it easier for baby to breath and manage the flow of milk. The bottle should be held at a slight angle with the nipple aiming towards the roof of the mouth. Gently stroke the baby’s lips by placing the nipple on the upper lip and dragging it downwards over the lower lip, waiting until baby opens their mouth and then letting them take the nipple. Allow the nipple to fill with milk just enough for baby to drink while still maintaining control of the flow. 

To reduce choking, use paced-bottle feeding. 

Watch for signs of stress or overwhelm, such as gulping, leaking, alarmed eyes, etc. and be sure to offer baby breaks or pacing as needed. To offer pacing, slowly tip the bottle down so the nipple is empty, and rest the empty nipple on baby's lips. Allow baby to breath and gain composure before filling the nipple and resuming the feeding. Offer pacing as frequently as needed. As your baby grows and develops coordination, their need for pacing will decrease. If you find your baby becoming frequently overwhelmed or stressed, consider transitioning to a slower flow nipple. 

At the end of the day, there is no one right time or way to introduce a bottle to your baby--it's ultimately what works best for you and your baby. If the timing of your bottle introduction or type of bottle looks different but it's working for your baby, don't feel like you need to switch gears! But if you've been feeling unsure of where to start, hopefully this gives you some direction!

If you have more questions or you're having other concerns with feeding your baby, my Bottle and Breastfeeding Course is right for you. Click the link below to find out more!

Access the Bottle & Breastfeeding Course Here!

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