Introducing Bottles and Pacifiers to a Breastfed Baby

If you are bottle-feeding a newborn, I recommend a slow-flow orthodontic nipple. Medela sells an excellent bottle-feeding set that includes slow flow silicone nipples, bottles, caps, etc. My second choice is the NUK or Avent newborn nipples. If you are offering the bottle to an older baby, I don't think the type of nipple is really important. A baby older than a few weeks is very unlikely to forget how to nurse just because you give him an artificial nipple. The exception to this rule is the nubby Playtex nipple -- you know, the one that is kind of square and supposedly looks just like a human nipple. Yes, it does look sort of like a human nipple, but it doesn't look anything at all like a nipple that is stretched out in a baby's mouth and pressed against his palate. That's where they got the idea for the orthodontic nipple, which looks a lot more like a human nipple in a baby's mouth. Babies who use a regular Playtex nipple often "bite" at their mother's nipple when they go back to the breast. Playtex nurser systems are very popular, and older babies tend to do fine with any type of nipple. However, if you are bottle-feeding a newborn, try to avoid the regular Playtex nipple.

Try offering the bottle when your baby isn't starving. This may seem illogical, but when a baby is frantically hungry, he is going to be in no mood to try something new. He just wants to nurse.

Try having someone else offer the bottle at first. Your baby associates your smell and touch with nursing, and may insist on the real thing if you try to give him a bottle. You may have to leave the room entirely in order for the effort to be successful. Let Dad try, and if that doesn't work, let an experienced bottle feeder try. You'd be amazed at how many babies refuse to take bottles at home, but will take them willingly at day care where the provider approaches the process matter-of-factly. Encourage the caregiver to cuddle the baby while offering the bottle, but usually it is better to avoid the cradle position.

Many babies associate the cradle hold, where they are cuddled against the breast, with nursing, and will refuse to accept the bottle as a substitute. This is especially true of newborns. Have you ever seen someone hold a hungry nursing infant in the nursing position? It doesn't matter if they are male or female, preschool or geriatric, the baby will turn his head, root, and try to nurse. Although some babies will accept a bottle more readily in the nursing hold, most will do better if you prop them up on your knees or in an infant seat, and make eye contact while feeding them.

Offer a small amount at first. If he takes it readily, you can always offer more. If he doesn't take it, you won't have wasted much. Even taking a few sips is a step toward accepting the bottle.

You don't have to substitute a bottle-feeding for an entire nursing. In the beginning, have dad try giving an ounce or two in the evening while your supply is lowest and you are the most in need of a break. Leave the room. Take a hot bath. Hope that it works.

Some babies will take the bottle more readily if you move rhythmically while walking, swaying, rocking, and/or talking to them to distract them.

If your baby is resistant to taking the bottle (this is seldom a problem in babies less than one month old), try:

• Feeding him when he is half asleep.

• Different nipples. Some babies prefer a slow flow nipple, some a faster flow. In general, orthodontic nipples tend to have a slower flow, which may be an advantage in a newborn, but a disadvantage in an older, more impatient baby.

• Make sure the nipple isn't cold when you offer it. Many babies couldn't care less if the milk you give them is cold (and it doesn't cause digestive problems -- that's an old wive's tale) but they don't like the feel of a cold rubber nipple in their mouth. Run it under warm water before you offer it. Newborns especially don't like cold nipples. Sometimes older, teething babies like having a cold nipple to bite down on, so once again, you'll just have to experiment and see what works for your baby.