The Bottle Conundrum

Certified lactation consultant Freda Rosenfeld debunks the age-old myth of nipple confusion.

For most new moms, the question of breast or bottle seems black and white…at least before the baby arrives. In reality, the feeding frenzy is a murky shade of gray, and most moms end up with a combination of nursing and bottle-feeding, whether by choice or necessity. For a nursing mom, introducing a bottle to a suckling newborn can be a tricky prospect, fraught with the fear of “nipple confusion.” Fear not, says certified lactation consultant Freda Rosenfeld. “For the most part nipple confusion is really nipple preference,” says Rosenfeld, who’s been coined the “Breast Whisperer” in many NYC social circles. “It’s not confusion, it’s hunger.”

Rosenfeld likens nursing vs. bottle feeding to cooking vs. eating out. Either your baby is a Julia Child baby, and cooking (i.e. nursing) comes easily, or your baby is not a great chef (i.e. not a strong sucker) and a restaurant is preferable. “If your baby is a ‘Julia Child’ sucker, breast or bottle shouldn’t matter. But if your baby isn’t a good sucker, it might prefer a bottle to the breast. Your baby wants whatever is easier and whatever feeds faster.”

With the right tactics, Rosenfeld says, a new mom can find a happy medium between the breast and the bottle. Here she gives us some tips.

What are some instances that could require a woman to have to introduce a bottle?
There are a lot of reasons a nursing mom might need to start bottle-feeding. For one, there’s the mom’s health or the baby’s health; if a baby is not gaining weight, we need to deliver food. There could be an emergency where the mom needs to go out and someone else has to feed the baby, or a mom eventually needs to go back to work.

What are your strategies for introducing a bottle that will enable continued success in nursing?
When you start bottle-feeding, I encourage the mom not to be the one who gives the bottle, and let someone else do it. That way the baby doesn’t see the mom and associate nursing. I also recommend making sure that the flow of the bottle is consistent with the flow of the mother. If mom is a steady-flow milk producer, the bottle should be steady flow. If it flows too fast, the baby will always want to eat that way and feel frustrated by the slower pace of nursing. The shape of the nipple on the bottle should also be similar to the mother’s nipple.

Is there a right amount of time to wait before introducing a bottle? Is it possible for bottle-feeding and breast-feeding to co-exist from day one?
If everything is going well with nursing, I encourage moms to wait two weeks before introducing a bottle so that your baby nurses as much as possible during that time to allow you to make as much milk as you can. But everyone has different needs. If supplementing with a bottle makes a woman enjoy her nursing and having a better experience, that mom should be able to use a bottle. If a mom wants to nurse for a year or more, and go straight from breast to cup, that’s also acceptable. As long as your baby is thriving, that’s the most important thing.

Some moms report that their baby has difficulty taking a bottle after nursing. What advice would you give to make the transition more successful?
If you know you’re going back to work, start introducing a bottle sooner rather than later. I recommend introducing a bottle by six weeks. If your child is having trouble taking the bottle, you can use certain feeding cues. Like start playing music when you’re nursing, then use that same piece of music when you use a bottle. In 22 years, I have only seen two babies that wouldn’t take a bottle. Some of them have taken two weeks or a month to take it, but virtually everyone takes the bottle.

How do you feel about pacifiers?
I love pacifiers. So far, there is no scientific evidence that pacifier use affects nursing. And babies that use pacifiers have reduced rates of SIDS, strengthened digestive systems and more. Pacifier use can be positive, and a pacifier can be very relaxing. Babies are suckers — that’s how they relax their spinal column and strengthen their gut. If the baby hasn’t eaten for awhile, he or she should nurse before being offered the pacifier, but if it’s been less then an hour since eating, it’s fine to try it. Mom should use a pacifier around the shape of her nipple. And when it comes to pacifiers, use it and don’t abuse it.


Jessica Pallay

Jessica Pallay

JESSICA PALLAY is Co-Founder and Editor of Well Rounded NY. She is a Brooklyn mama to Libby and Elsie, and writes about all things pregnancy and new motherhood.

Comments {2}

  1. I love the Julia Child analogy. Thanks for the information in this article.

  2. Pingback: Bottle Breastfeeding Nipple Confusion: This Post Could Change Your Life Forever

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