Introducing Bottles and Pacifiers to a Breastfed Baby

A little piece of trivia here: did you know that in many countries, pacifiers are called "dummies?" Hmm. Makes you wonder. After all, all a pacifier really is just an imitation nipple, and as such it should be used in moderation and not as a frequent substitution for the real thing.

Back to bottles now: We've talked about the possibility of nipple confusion, and the advantages of waiting until your baby is a few weeks old before introducing bottles. But what if he needs to be supplemented during the early nursing period? This doesn't happen often, but it occurs often enough that you should be open to the possibility. Some mothers are so afraid of the dreaded "nipple confusion" that they refuse to give bottles, even though that might be the most efficient way to get milk into their baby. By the same token, some mothers feel that if they give formula supplements, they might as well give up and not nurse at all. Ideally, in the best of all possible worlds, all babies would nurse and no one would ever use bottles or formula. However, this is not a perfect world, and we are lucky to have options like bottles and formula when babies really need them. If you baby needs to be supplemented, look at it as a means to an end. Helping your baby gain weight rapidly, while working on increasing your milk supply and continuing to offer the breast, most often results in a baby who nurses stronger and more vigorously at the breast until there is no need for supplements.

If your newborn baby (less than two weeks old) needs to be supplemented, due to medical reasons such as jaundice, low weight gain, or severe nipple soreness, you should try to avoid artificial nipples if at all possible. There are many other options for feeding newborns, including cup feeding, tube feeding, spoon feeding, dropper feeding, or syringe feeding. If long term supplementation is necessary, Medela makes several products which may be helpful -- the SNS, the SoftCup Feeder, or the Hazelbaker Finger Feeder. See "Medela Products" for description and prices. I recommend the Hazelbaker Finger Feeder, as I have used it extensively and it is simple as well as effective. When cup, spoon, dropper, or syringe feeding, make sure the baby is awake and alert, hold him in an upright position (you may want to swaddle him if he tends to flail his arms around) and gently pour or squirt in a few drops of milk. He will get the hang of it quickly, and set his own feeding rhythm. Use a towel or cloth diaper to protect his and your clothing -- these feeding methods tend to be messy at first.

These types of supplementation work well for many mothers and babies -- and dad can help too. If you need to supplement for more than a few days, some alternate methods such as syringe or cup feeding tend to become rather overwhelming. In that case, I would suggest that you either purchase one of Medela's products to make feeding easier, or use a bottle. The most important thing is to get milk into your baby so he will grow and become stronger so he will be able to nurse more effectively. Remember that some babies never become nipple confused, and if this does occur, there are techniques you can use to get him back on the breast. Using a bottle to feed your baby is not the "kiss of death" for breastfeeding, and the most important thing is to lower your stress level and put weight on your baby as quickly as possible. When you are happily nursing six months or two years down the road, it won't matter one bit that your baby had some bottles in the beginning.

Let's assume that breastfeeding has gone along just beautifully for you and your baby. He is two weeks old, has regained his birth weight, and your nipple soreness and engorgement are things of the past. You now have a decision to make. If you plan to stay at home with your baby and take him with you wherever you go, and are comfortable nursing him in public places (see article on "Nursing Discreetly"), you may not care if he ever takes a bottle. In that case, you may not decide to introduce bottles at all. I tend to think that it is better to introduce him to bottles at some point, just in case you have to be separated at some time, or you become too ill temporarily to nurse, or you just want to have an occasional break or night out with your partner.