Combining breastfeeding with a bottle – how to do it?

Okay, you have started breastfeeding (congratulations!) but you still want to sleep once in a while, have some flexibility, let your partner take responsibility, etc. Well, then! Easy as pie. Just throw out the spout sometimes and the bottle sometimes. Everyone happy and so easy. Or not.

It really can be easier said than done – combining breastfeeding with a bottle. For many, it seems more like a utopia – impossible to achieve. There are simply too many dimensions to get right. But at the same time, some people claim to have made it work, so we want to try to clarify as much as possible on the subject. Perhaps it will help you to find your best solution – or perhaps strengthen you to be forgiving of yourself if things don’t go your way.

“Boob confusion”
Some people call it bottle confusion, but we think boob confusion is a more fun word: It’s a risk for babies when they get a taste of the bottle. Perhaps it is easier to feed via the bottle and the baby then ‘loses interest’ in the breast. The confusion, according to this theory, is that the baby loses the skills it has practiced in sucking on the breast when the bottle is offered, which may involve a slightly different technique.

Pumpkin, pumpkin and pumpkin some more
The supply of breast milk is entirely dependent on demand. So, if you intend to breastfeed, production must be kept up, either by the baby eating from the breast or by pumping out the milk. If neither happens, milk production will soon come to a standstill. Similarly, if you pump out quantities between breastfeeding, for example, ‘too much’ will be produced. Finding balance in breastfeeding can take a while, even if you breastfeed fully. If you then add the parameter that the baby needs to be bottle-fed at certain meals, it can make it more difficult to find a balance in this range. In most cases, you need to pump (or breastfeed) a few times a day and night to maintain production.

Refusing the bottle
Some argue that the bottle must be introduced relatively early (but perhaps not too early to interfere with the establishment of breastfeeding?) in order for the baby to get used to it and then accept it. If you have tried and succeeded with a bottle a few times in the first few months, you may be shocked a few months later when your baby refuses the bottle. “It worked at 3 months, why wouldn’t it work now at 7 months?”. Yes, here some argue that bottle training needs to be done regularly for it to work. Others state that “some babies won’t take a bottle, period”.

Fear that my baby will prefer the bottle
Repeatedly, mothers mention that they have been told that introducing the bottle too early can make the child ‘lazy’ – that they will no longer be able to do the job of sucking on the breast once they have learned that there are easier ways to get food – through the bottle. “The breast requires more patience from the baby” say some, but on the other hand there are bottles that are supposed to mimic breastfeeding and flow slowly. For some, they seem to work just fine, and they say that babies do not prefer one over the other. For others, it doesn’t work. Remember that there is no right or wrong but that everyone’s situation is different; every mother is different, every baby is different, and the interactions between them are different.

Experiences from delamination
When we at UNA have asked about experiences with delamination, it can sound like this:

“The combination of breastfeeding and bottle has worked great for us! We only introduced the bottle when breastfeeding started properly and he bought it without any problems and has not stopped taking the breast. The hard part for me is that my breasts get so sore if I don’t breastfeed often enough, so I haven’t really gotten it to work as a relief at night, but during the day it’s worth its weight in gold to be able to go away for short periods of time and know that the father can feed at home!”

but also like this:

“We started introducing the bottle after one week in the NICU. I was exhausted from pumping and breastfeeding every three hours around the clock without any weight gain for our boy. As soon as he got my milk in a bottle, he started gaining weight. We breastfed and bottle fed every day. He never got “confused” by the combination, but as the weeks went by, it was like my body didn’t want to pump anymore. After three months, my breasts were not releasing a drop to the pump anymore. So there are such aspects to consider – it’s never quite what you expect.”

A warm reminder
It’s easy – if you think you’ve done something well – to make up your mind afterwards that it was because I did this or that. At Unna, we think it’s important to be humble about the fact that equations may not always be so simple when it comes to baby-making, and that things don’t have to be the result of something you control. If you look at the challenges of caring for a baby, you might also be more forgiving about things you think you ‘failed’ at. If you want advice, it is of course good to get advice, but general advice that is not based on you and your situation, and even worse, pointing fingers, does not create better parents.