40: When Should I Introduce the Bottle?

Today I want to answer a question from Julie. Julie asks, “When should I introduce the bottle to my baby? I plan to breastfeed, but will need to go back to work at around 12 weeks. I’ve read that babies should not be given a bottle in the beginning to avoid nipple confusion.”

The first thing you need to know when determining when to introduce a bottle is what your general feeding plan is. Remember, it’s okay to pivot later, but if you know what you're aiming for it’s much easier to create a plan.

Julie wants to breastfeed. So I do recommend that, after her baby is born, she exclusively breastfeeds in the beginning. But not because of so called “nipple confusion”. I don’t believe babies are confused. I think they know the difference between your nipple and a bottle nipple. What I think is hard is learning too many skills at once. I mean, isn’t being born, adjusting to their new life outside the womb, and learning how to breastfeed enough all at once? Let’s not also add a constant change of what’s going into their mouth to the mix until they gain some confidence.

Another big reason to wait to introduce the bottle is that Julie doesn’t need to go back to work for 12 weeks. This means that she has some time before needing to add pumping and bottle dishes into the mix. I mean, isn’t giving birth, healing while sleep deprived, and learning to breastfeed enough all at once?

Physiologically, it also makes sense to wait on the bottle if breastfeeding is going well. Because cue based breastfeeding (that is, when you follow your babies communication on when they want to eat or drink) supports the establishment of your milk supply. 

This means that the first 2-3 weeks, Julie and her baby can just focus on practicing breastfeeding and get to a place where it is a comfortable, confident, routine. 

I also do not recommend waiting until right before returning to work. For one thing, this makes for a very stressful experience, given the nature of a tight window. And no one wants to learn something new and unfamiliar while hurried. 

But also, babies are born with helpful reflexes that support latching and sucking. As they age and gain skills, some of these reflexes will disappear as they are no longer needed. An example of this is the rooting reflex which may fade as early as 3 months. Babies will also have their own familiar feeding routine and skills they are used to as they practice feed after feed. Meaning, that by 3 months they may be like, “Nah I don’t want that bottle- where is my Mom?” and there’s no good way to make a baby eat what they don’t want. For any mom who will be relying on a bottle when she returns to work, do not wait until right before to practice…

So when should Julie introduce the bottle? Well, if she plans to be available and near her baby for breastfeeding throughout the first 12 weeks, then I recommend introducing a bottle by 4-6 weeks. This gives her wiggle room, plenty of time to establish breastfeeding skills, and time to take the new bottle slow and gradual.

If Julie plans to provide pumped breast milk in those bottles, it’s also a great time to start pumping practice. For some, pumping starts slow and takes practice to relax and let down for the pump. So if her baby is gaining and growing but very little amounts are pumped initially- that’s okay, pumping volume is not always an indication of supply. In fact, if her baby is growing well and happily breastfeeding but she is consistently only pumping a few drops even when full then I would chalk that up to a pumping issue not a supply issue.

On the other hand, if Julie plans to introduce formula, she may choose to offer small amounts in the bottle to see how her baby does with a new diet. One very important side note here: any time you feed your baby anything but your breastmilk- formula, donar milk, etc. That is less milk your body is currently making for your baby, and your body will adjust to that message. So when you introduce formula, and don’t pump, your body gets the message that it doesn’t not need to make as much milk and supply will go down. So just a little note to avoid accidental supply issues.

If you’re like Julie, want to start off breastfeeding but will need to be away during your baby’s feeds sooner than Julie does, then you may need to introduce the bottle practice a bit earlier. 

A general guideline is to take the time you’ll need to be away, and divide it by two to see around what week to start practicing. For example, if you go back to work in 8 weeks, start practice at 4 weeks. If you go back to work at 6 weeks, start practice at 3 weeks, etc. If however, you have 6  months of maternity leave, and plan to use a bottle, I still recommend introducing it around 4-6 weeks and not waiting too long.

Be sure to practice daily, or at least weekly to maintain the skill and familiarity. Many families have success with one bottle of pumped breast milk a day (ish) to keep the routine comfortable as they approach the time when they will be more reliant on the bottle. This routine allows pumping practice and bottle practice, but still prioritizes those breastfeeding benefits you’re after.

For those who know without a doubt they will not be separated during feeds until their baby is older and rocking a cup for all hydration needs, then you can decide if you need bottles at all.

I hope this helped clear up some common questions about when you might consider introducing the bottle. If you liked this episode, you may want to check out episode 36: From Day One- The Basics of Milk Supply to learn about how to establish and support your milk supply, or episode 17: How to Choose a Baby Bottle to learn more about bottle types and flow rates to better choose the right one for your baby.

If you want to learn more, and like video and print based learning, you may want to watch my Feeding Prep course. It’s free and is full of information on what to do to prepare for breastfeeding, how to choose a bottle, picking your pump, what you need to know about pacifiers, and even proper cleaning before your baby arrives. Shoot me an email at Barbara@FeedingByJanuary.com for free access to this resource.

And with that, I’ll see you next week!