breast to bottle

wandasmart

New member
I took my 2wk old daughter out to her pediatrician for a chk up, and also went for my follow up with the OBGyne. I had expressed some breastmilk and put it into a bottle in case she needed it during the wait. But when she did start crying for food, and I tried to feed her with the bottle, she wouldn't take it at all, and I had to ask for a room to feed her from my breast... any suggestions on how to get her used to the bottle so I can at least have some flexibility? I'd like to eventually get her on to 1 bottle feed a day so my hubby can get involved.

ps- she's also not taking a pacifier... and a mom in the waiting room said we should always have one.. but my little one snubbed it when we tried one at home.
 
hi,

agreed that you should try to get your daughter to take a bottle as breastfeeding is hugely demanding and exhausting and you do need a break once in a while. Some people advocate trying to get baby to take a bottle as soon as possible, some people advocate waiting until they are at least about 1 month old (so they don't get nipple confusion) but before they are 3 months old (too accustomed to direct feeds). Also pick a time when your baby is not overly hungry (ie screaming for a feed and unlikely to be cooperative) or overly tired and maybe some place familiar eg. at home. Also helps if you don't give her the bottle initially but rather someone else like your husband or helper. If baby's not cooperating, give it a few days and try again. Once baby starts taking the bottle, give it regularly eg. once a day or once every other day (depending on how often you plan to give baby the bottle).

As for pacifiers, it's a very personal decision - there is no "should" rule to it at all, worth exploring all the pros and cons before you embark your baby down that route. We never gave our son a pacifier in his early months and we noticed by about 2 months old, he would suck his thumb (for a very short period) when he was very distressed or tired or trying to put himself to sleep, hence learning how to self-soothe. Personally I think you learn to "read" your baby better (and anticipate their needs) without using a pacifier, although it can be heaps more stressful! Again, it's a personal decision and there is no right or wrong.

Best of luck!

Sumei
 
my boy, who is now 7 months old, very rarely takes a pacifier.. i think that he believes it's pointless, all this work and ....NO MILK!!!

as for trying a bottle, my boy has had both breast and bottle(formula) from the minute he was born without any problem...i don't believe all the stuff about nipple confusion(neither does the baby whisperer)...the other poster was right though, you will eventually need a break and i think that it's best to get her used to it sooner rather than later.

and lastly, you shouldn't feel like you need a separate room to breastfeed your child, ESPECIALLY at the doctor's office...it's something that you'll be doing for a long time and you should not feel ashamed to do it!

just my opinion though!

good luck with the feeding!
 
Generally the advice is not to give any bottles to a breastfed baby before about six weeks. This is for two reasons. The first is that until the baby is really accomplished at breastfeeding there is a danger than he will become confused and try to suck at the breast in the way he sucks at the bottle ? this can result in him not getting enough milk at the breast and/or sore nipples for the mother. Of course not all babies suffer from this but one estimate is that 95% of newborns under three weeks do.

The second reason is during the first six weeks your milk supply is establishing and the introduction of bottles can interfere with the supply. The biggest danger is when you leave milk in your breasts for a long time ? so although you earlier expressed milk to give the baby ? it isn?t wise to skip the feed from the mother?s body point of view. Likewise a pacifier before six weeks is also not recommended.

Here are some tips that can be used if baby is reluctant to take the bottle:

? Try offering the bottle before the baby is likely to be too hungry,

? Wrap the baby in a piece of the mother?s clothing (blouse or nightgown, for example) while offering the bottle,

? Instead of pushing the bottle nipple into the baby?s mouth, try laying it near his mouth and allowing him to pull it in himself,

? Try running warm water over the bottle nipple to bring it up to body temperature,

? Try different types of bottle nipples to find a shape, a substance (rubber or silicone), and a hole size the baby will accept,

? Try different feeding positions. Some babies like to sit propped against the caregiver?s raised legs; others prefer not to look at the caregiver and will take a bottle better if they are held facing out, with their back against the caregiver?s chest,

? Try to feed the baby while moving rhythmically ? rocking, walking or swaying from side to side ? because this may be calming to him,

? Insert the bottle nipple into the baby?s mouth when he?s sleeping,

? Keep trying, but remember that the baby can be fed the mother?s milk with a cup, spoon or eyedropper if the baby continues to refuse the bottle.

Best wishes,
Barb
 
thank you all for such great advice.. i think i will try to introduce bottle feeding nearer to 4 weeks just to make sure my supply continues to be adequate, and to lessen the risk of confusion for my little girl. I feel like i'm going to go insane if I don't have a little more time to myself and 1 bottle feed every other day may give me that extra couple hours sleep or time to dash out for a walk.

any more comments are greatly appreciated... can only learn from other people's advice and hopefully not many of my own mistakes as well!!

THANKS!!


Barb - how difficult is using a feeding cup or syringe? surely for the syringe, it doesn't contain the amount of milk that she normally takes from my breasts at each feed? can you add any comments on how i use them, as at the hospital i never actually watched them using a cup or syringe so a bit worried i'll end up with my breastmilk all over the baby's chin or clothing and none in her belly! thanks ahead of time
 
A two week old breastfed baby has a stomach which is between 45 ml and 60 ml. So in fact your baby won?t be drinking that much at each feed. Please do not compare the amounts it says on the side of formula tins because they are hugely over estimated.

Generally if a baby will latch on it is recommended that you supplement him at the breast. There are instructions for this at http://www.breastfeedingonline.com/5.html
And a video clip at http://www.breastfeedingonline.com/newman.shtml
Scroll down the page until you come to Lactation Aid. (Everything is in alphabetical order.)

If the baby is having problems latching on then finger feeding is suggested as this can help to train the baby to take the breast.
There are instructions for this at http://www.breastfeedingonline.com/8.html

There is another article, What to Feed the Baby When the Mother is Working Outside the Home at http://www.breastfeedingonline.com/17.html which you might be interested in.

This web site belongs to Dr. Jack Newman. He is very pro breastfeeding and has a very direct way of speaking about it. The information he has on this site is very useful when mothers run into problems.

Best wishes,
Barb
 
Looking after a new baby can be very overwhelming and exhausting. This is one of the reasons that La Leche League has meetings - so that new mothers who are breastfeeding can get the support and encouragement they need to continue.

Dear Mammalicious, and anyone else who might be interested, you are most welcome to join our meeting tomorrow afternoon:

Title: What's so great about breast milk?
Date: Tuesday September 13, 2005
Time: 2:00 pm - 4:00 pm
Address: Flat 2, 2nd Floor, Tower A, Villa Lotto, 18 Broadwood Road, Happy Valley, Hong Kong
Tel: 2817-7475

All our meetings are free and it is not necessary to be a member to join our meetings. Of course we do encourage membership as money from memberships and donations are our major sources of revenue. The format for all the meetings is similar. We spend the first part of the meeting discussing the meeting title topic and the second part of the meeting the topics which the mothers attending bring up. Thus every meeting is different depending on the needs of the mothers there.

The article Why La Leche League? http://www.wiessinger.baka.com/bfing/others/whylll.html
gives a nice description of why our meetings may be helpful to attend.

Best wishes,
SARAH
La Leche League Leader
 
Sarah

As my baby is still feeding on demand, is it okay if i bring my baby girl along and feed at the meeting should she require?

thanks!


many thanks also to Barb!! you'v been so helpful.. i will chk into the links you have sent.
 
Mamma,

We gave Dhruv his first bottle at 6 weeks too! I would express 2X a day - mornings and evenings. Would freeze the milk in 3-4oz storage bags.

Dad was responsible for giving Dhruv his first bottle, there was a bit of protest but he finally took it. I think we used a Nuk bottle. We then continued to give him 1 bottle of expressed milk a day, this was usually at his last feed at 10pm.
 
Babies and toddlers are always welcome at all La Leche League events. Most of the mothers feed their babies during the meetings ? after all two hours can be a long time when you?re only a few weeks old.

In fact the first place I breastfed in public was at an LLL meeting. And after the meeting I was so confident that I met my brother in a large din sum restaurant and fed in public for the second time!

I hope to see you there,
SARAH
 
hi Rani

How did your husband manage to get Druv to take the bottle.. i'm struggling... i expressed some milk after a feed... then my little one would not stop crying. After chking her diaper, cuddling her, we tried the bottle (this was only 40 minutes after the breastfeed) and she would not take the bottle. I had expressed only 1 hour before the breastfeed so we were concerned that perhaps my breast was not full or she felt there was no milk in there to drink.

she has been screaming so loud that she sounds like she's going to lose her voice.

i used an avent bottle with the newborn nipple. it seems harder then my nipple of course. but most of the advice i got was that avent nipples are the closest thing to breast nipples. but i'm not having any luck at all.
 
Dear Mammalicious,

You said,?I had expressed only 1 hour before the breastfeed so we were concerned that perhaps my breast was not full or she felt there was no milk in there to drink.?

The breast is not a bottle and breastfeeding doesn?t work like bottle feeding.

With bottle feeding we fill up a bottle all at once and when we give it to the bay it is full and after the baby has drunk it is empty until we fill it up again ? usually at the next feed.

The breast, however, is never empty and it can?t be filled up immediately. If everything is going well with breastfeeding then the breast will be part full the whole time. When the baby drinks and the amount of milk in the breast is reducing then the breast starts to make milk faster.

So if the breast is full and the baby takes ? oz the time to replace this milk is much longer than the time taken to replace ? oz when the breast is nearing empty.

So even if you could have taken all the milk out of your breast one hour before a feed impossibility) your breast would have made milk very fast and so there would be enough for the baby when she wanted to feed an hour later.

It is very normal for babies to ask for more breastfeeding only 40 minutes after the last feed ? this doesn?t mean she didn?t get milk at the previous feed. This might have happen for lots of reasons ? maybe she wanted an after dinner treat (I like chocolate cake after my dinner) or maybe she is having a growth spurt and needs to feed more often to get more milk to grow more.

And if you baby is upset it is NOT the time to introduce something new to her. Introduce bottle feeding when she isn?t tired, hungry or upset.

Best wishes,
Barb
 
Barb

thanks again for the info.. i also have a concern... i thought i had an adequate amount of milk supply.. or so the midwives told me at the matilda... also my baby has gained weight at her 2 week chk up. i'm only using the manual avent isis pump, which i thought was fine.. but i'm only able to express 1.5oz (40ml)after my feed... i don't pump until after a feed. i thought i had managed to express more with an electric pump. in any case... at 3 weeks now (baby's age) should i be able to express much more than that? i noticed some of the other ladies in this chat said they could express 3-4 oz!!

thanks

mamma
 
Barb

or anyone else who may be able to answer me or direct me to a link that may offer me some info... is there somewhere i can find out how much milk my baby will take at 3 weeks... 4 weeks etc etc so i know how much approximately to warm in a bottle (expressed breast milk) for each feed. you mentioned a 2 week old takes about 45-60ml per feed.. where do i find this info pls?

i assume formula cans offer info but as the content of formula differs and fills the baby's tummy longer, that i cannot follow that as a guideline?
 
Hi Mammalicious,

You have raised a number of issues. I will try to answer them.

First pumping is not the same as breastfeeding. The amount of milk you get from pumping is not the amount you have ? it is only the amount you managed to get out by pumping. Your baby will get a lot more milk when breastfeeding directly from you than you can pump out.

When a mother returns to work and pumps her milk at work her body is ready and expecting to give the milk to the baby (although some mothers still find this hard work). But when you are breastfeeding your baby AND asking your body to express more it is very hard work indeed.

Being able to express 1.5 oz is already very good. If you need more simply express on more occasions and add the milk together. In this respect expressing is like breastfeeding - the more you do it with more milk you will get. Thus if you express six times for 10 minutes you?ll get more milk than it you express once for an hour.

When you breastfeed directly three things are working together to help the milk leave your body and enter the baby?s body.
? Your hormone levels are raised, especially oxytocin. Oxytocin helps the milk ejection reflex ? this is the reflex that squeezes the milk out of the aveoli, the milk producing cells, and pushes it into the ducts which take the milk to your nipple. When you pump or hand express the levels of oxytocin are much lower.
? The baby uses suction to help the milk come out ? the pump tries to duplicate this but hand expression doesn?t.
? The baby?s mouth milks the breast with its tongue and jaw movements. Hand expression tries to duplicate this but the pump doesn?t.

On top of this many mothers have difficulty getting the let-down to work well when pumping. It works with no trouble when the baby is breastfeeding directly but doesn't seem to work at all when using the pump.

Many things that don?t matter when breastfeeding directly can affect the quantity when pumping. For example, how tried you feel and how much stress you are under.

You can also encourage the let-down reflex artificially, by looking at your baby, or by having a piece of his clothing next to you.
? Apply a warm wet cloth to your breasts.
? Massage the breasts in small circular motions around the perimeter of the breast.
? Gently stroke your breasts with your fingernails in a downward motion toward the nipple
? Lean forward and gently shake the breasts.
? Gently roll the nipple between your finger and thumb.

It may help to try a hand expression technique called the Marmet Technique, http://www.lactationinstitute.org/MANUALEX.html
This is useful because it helps the let-down and so you get more milk.

(Please note that the diagram of the breast anatomy is out of date. Recent research has discovered that the milk reservoirs under the areola (the dark coloured part of the breast near the nipple) do not exist. The method, however, still works.)

Some mothers have found that the pumps are not good at getting the let-down to happen and so they use hand expression until the let-down and then swap to pumping. You can also use the times at the end of the Marmet Technique, including the massage, stroke and shake but instead of doing the hand expression use the pump.

Different pumps work differently for different mothers. There is an article called, How Do I Choose a Breast Pump? http://www.lalecheleague.org/FAQ/pump.html which explains the differences.

A one month old full breastfed baby will drink about 750 ml a day. A six month old full breastfed baby will also drink about 750 ml a day. This is one of the big differences between a breastfed baby and an artificially fed baby. The amount of milk the baby drinks each day remains the same.

This is because breast milk changes. It changes from the beginning of the feed to the end of the feed. It changes from the beginning of the day to the end of the day. And it changes as the baby grows older.

In fact I?ve just been sent this link, http://www.nzherald.co.nz/section/story.cfm?c_id=5&ObjectID=10345723, which is an article in a New Zealand newspaper which tells that breast milk of older babies is higher in fat content than breast milk of younger babies.

Artificial milk does not do this. This milk is always the same no matter whether you make it in the morning or in the evening or whether you make it when the baby is one month old or six months old. Because of this the calorie content is always the same. This means that the only way to get more calories into the baby is to give more milk. Thus an artificially fed six month old baby drinks a lot more milk than an artificially fed one month old baby.

Your question, however, was how to tell how much a baby will want at a particular feed? This is a ?how long is a piece of string? question. It is too difficult to answer because each baby is different and each feed is different.

Generally the advice is to store the milk in small qualities. That way you can give the baby an ounce at a time until the baby doesn?t want any more. It is easy to add more milk if the baby is still hungry. But if you heat 6oz of milk for the baby and he only drinks 1 oz then you have just wasted 5 oz.

It you are dealing with fresh milk only using a bit at a time is easy. (And remember that breast milk can keep in the fridge for a long time ? up to 7 days.). One mother in our group who was freezing her milk for longer storage used an ice cube tray to freeze it in. Once frozen she kept them in a plastic bag ? this way she could easily get exactly the amount she wanted.

The article What are LLLI's guidelines for storing my pumped milk?, http://www.lalecheleague.org/FAQ/milkstorage.html, gives the LLLI guidelines for storing human milk.

Best wishes,
SARAH
La Leche League Leader
[email protected]
2548-7636
 
Hi Mammalicious

When my baby was 3 months old I had to go into hospital for a day for a small operation. Bubs was fully breastfed up until this point and being so young I thought she would just take a bottle, especially of EBM - WRONG. Poor little thing starved herself for the entire time I was in hospital (about 8 hours) then fed all night. She just screamed whenever my husband and helper tried to give her a bottle or feed her with a spoon. I never really had a much of a break from her until she self weaned at 11 months - maybe a few hours here and there. Next bub is having a bottle a day from birth!

To answer your question re amounts of expressed breast milk - I was told by a midwife, 150mls per kg per day. So, if your bub weighs 5kgs, that's 750mls. If your bub is taking, say, 5 feeds per day, that is 150mls per feed.

When I went into hospital, it took me 2 weeks beforehand to express enough milk to feed her. I just wasn't a good expresser. Sometimes I could only express 10mls at a time. I just added it to my meagre supply. I found the Avent hand pumps almost useless and quite painful. The Medela electric pumps were much gentler and more efficient.

I was assured that the baby is much more efficient at getting milk from you than an electric pump. As my bub was always putting on weight and generally quite a chubby bubby, I never worried.

Here is some information on expressing:

http://www.breastfeeding.asn.au/bfinfo/pumpsug.html

http://www.breastfeeding.asn.au/bfinfo/express.html

Hope that helps
 
for Sarah and also for Jane01

first - Jane --- I am using the Avent Isis manual pump and you'r right, i find that my nipples are getting a bit sore, although during my stay in hospital i used the big yellow medela one.. (not sure if its the symphony but that's wot it looked like just a big version of it) which also caused my some pain, though once i turned it down a bit it was better. do you suggest the lactina or the symphony model for medela?


Sarah - i have sent you an email to your hotmail address and would like to come to one of your meetings.. something i forgot to ask in the email is.. with storing breastmilk... i must chill the milk first in the fridge before freezing.. i didn't realise that and had been sticking my milk in the freezer straight from bagging it from the pump. will this be a problem for the bags i have frozen so far? do i need to throw them away? also, the link suggests that i thaw the EBM with warm running water. i have finally managed to have my baby successfully take 1 bottle of 1 oz ebm, but i thawed it by pouring boiled water into a bowl and then sticking my bag of EBM in there until thawed and then putting into a bottle. i guess i can't do anything about that now as it is in her tummy. but as i have still got 4 bags in the freezer stuck straight into there without chilling in the fridge. do i need to chuck them out and redo some EBM? I will await hopefully a reply from you to my email, also with your schedule for meetings.

Thanks so much! :cheers:
 
mammalicious said:
hi Rani

How did your husband manage to get Druv to take the bottle.. i'm struggling... i expressed some milk after a feed... then my little one would not stop crying. After chking her diaper, cuddling her, we tried the bottle (this was only 40 minutes after the breastfeed) .


We gave Dhruv the bottle when he was hungry, I think it was couple of hours after his last feed. He did resist and turned his head a few times, but he finally gave in and opened his mouth. I think the most difficult was weaning Dhruv from the teat to a sippy cup at 18mths! He cried so MUCH!
 
Dear Mammalicious,

Breast milk is fine going straight into the freeze ? there is no need to chill it first.

If, however, you are planning to add fresh milk to already frozen milk then it is recommended to chill it first. This is so that when the new milk is added it doesn?t defrost the original milk. Once milk has been defrosted it should not be refrozen and should be used within 24 hours.

But please remember that fresh milk is much better for your baby than frozen milk ? the freezing process kills off some of the beneficial properties of breast milk. So it is healthier if you can manage with milk keep in the fridge rather than freezer. But having said that even frozen milk is much better for your baby than the artificial milk available in the shops.

Best wishes,
SARAH
 
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