Last night, I had my last breastfeed ever.

As expected it was a huge emotional challenge for me. However I hadn’t acknowledged the logistical challenge that it would pose too, so I thought for those that may be having the same struggles I would share this post.

I consider myself one of the lucky ones. With my first two bubs, despite them being born prematurely and needing to exclusively pump for tube feeding followed by triple feeding, I was fortunate enough to be able to establish exclusive breastfeeding, which I was able to continue until a gradual natural wean suited us both.

However this time, due to medical reasons, I have had to wean my youngest and last bub rather quickly and well before either of us were ready.

When I come across this in my practice, when a Mum’s desired feeding journey doesn’t pan out the way they envisioned, I focus on the emotional support, giving them space to grieve, while ensuring they feel empowered with the knowledge that fed is best.

However, for the first time being in this situation myself, I have come across another stumbling block, one I knew less about overcoming… what if my baby doesn’t take a bottle?!

When it comes to introducing bottle feeding, some bubs have no qualms, while others (my daughter included!) can be a bit more discerning about how their milk is to be delivered.

Note – this advice is mainly from anecdotal evidence, so keep that in mind, and know that there is no right or wrong way to feed a baby, as long as they are happily fed then mission accomplished!

When to Introduce a Bottle?

Unless bub is to be exclusively formula fed, exclusive breastfeeding should be encouraged for the first 4-6 weeks to ensure the mum can establish optimal milk supply and breastfeeding technique.

However once supply is established you should then take the opportunity while your bub still has their suckling reflex to introduce the bottle. Also Continue to give a bottle at least a couple of times a week, to ensure they stay familiar/comfortable with it and keep up their bottle feeding skill.

How to avoid Nipple Confusion/Bottle Preference?

This is usually related to the flow of milk, and the ease at which milk is extracted.

To avoid this, ensure you feed to hunger cues and practice paced bottle feeding. (I’ll do a detailed post of this later but for now take a look at this article from the ABA and video from Possums practitioner Renee Keogh  https://www.breastfeeding.asn.au/resources/paced-bottle-feeding and https://possumsonline.com/video/about-paced-bottle-feeding-renee-keogh)

Bottle type

  • If bub will be mix fed, you want a teat that allows for a similar mouth position and tongue action to breastfeeding.
  • This way bub takes the bottle easily but also doesn’t develop an altered latch that can cause issues when back on the breast.
    • A short/medium length teat with a rounded tip and a medium-wide base is usually best.
  • Note- you don’t need to start with anything fancy, most babies will happily take a regular cost effective bottle as long as it has a suitable teat.

What Formula to Use?

All the formula sold in Australia is strictly regulated by the TGA to meet the nutritional needs of a baby and unless your baby has specific allergies/nutritional needs then the best formula is the one that is affordable and readily available to you.

Be wary of advertising/marketing – there is no evidence to support that more expensive formulas are better for your baby, and on this note despite there being follow on formulas don’t need to continue formula post 1 year old!

However for mixed fed babies or when transitioning to full formula, using a “sensitive” formula may help prevent adjustment issues when they are used to digesting breast milk.

Sorry last bit in next comment!… So much to cover!

What if you have an older bub who has never taken a bottle?

  • This is where things can often be a bit trickier but with calm persistence and a few of these tips and tricks, it is possible for most.
  • Start with play – let bub familiarise themselves with the teat or small empty bottle first.
  • If possible try with fresh EBM first so the only change is the delivery method.
  • Introduce when they are calm and not hungry (either around when regular feed might be due or after half a feed)
  • Try a narrow neck teat, as this may allow for similar older baby latch
  • Try different teat flows – sometimes older babies prefer the Y cut teat as they can control the flow.
  • Distraction can help – walking around, sitting outside, while watching other children.
  • If Mum is having no luck, try Dad or another carer/friend.
  • If bub becomes upset, abort and try again another day. It may take multiple attempts before they even allow the teat into their mouth, before they learn to suck on it, but you will likely have success with regular enjoyable exposure.
  • If all else fails and baby won’t take a bottle but you cant breastfeed – seek help early. As a stop gap you can try
  • Cup feeding you can try either an open cup or a cup with a spout /360 cup
  • Spoon feeding