Re: Best time to introduce bottles?

[Guest guest]

I was asked by a rep the other day had I ever seen a reference aboutnot starting pumping and bottles in a breastfed infant until 6 weeks.I advise my clients to wait until breastfeeding is established- andthat means they when can feed easily , no pain, easy latch , goodestablished milk supply and weight gain. But definitely to wait for atleast 3 weeks...Is there any studies out there ? Is it written in black and whitesomewhere.

I think this is something that is bandied about and various times are suggested, but I don't think there is a definitive study on when is the best time. Just like everything else, I think it varies with the baby. For the most part, if baby is latching well and there is good milk flow (meaning AFTER lactogenesis II), mom's nipples aren't sore, past engorgement, and baby gaining -- there shouldn't be a problem with starting bottles. I'm sure there will always be a baby or two that will start bottles at 2 months and suddenly decide he likes them better -- but one wonders in those cases if the breastfeeding really was going as well as mom thought. There are lots of babies that get bottle after bottle in the hospital and go on to feed at breast really well. There are a few that will only go to where the milk is -- that is, instant milk flow, so that they won't breastfeed if there is low flow....

My recommendation is always to watch the baby, not the clock or the calendar.

(\__/)(='.'=)(")_(") Jan BargerLactation Education Consultants My Mother of the Bride Blog Torrey's Blog

[Guest guest]

If this was a formula or bottle company rep, you can bet your life if

there was a reference he would know about it! (and actually it's

probably unethical to do a study to find out!!)

I hear a lot of people say that you can't express or bottle feed for

6 weeks, I turn that around and say that you can express from day one

if you want, the problem is that if people express then they are more

likely to use the milk in a bottle and it was the bottle feeding this

early that was the problem. So I tell them to go ahead with express

if they want to especially important with engorgement and to stop FIL

taking over, but to freeze it for a few week time when they want a

night out!

As for using the bottle - I agree to not using one until

breastfeeding is well established, baby gaining weight well, mum

happy with supply etc. which in my opinion often take about 6 weeks

(sometimes it could be 4) so I encourage them NOT to use a bottle

till after 6 weeks for a couple of reasons, firstly obviously to

establish and make sure things are going well, secondly a growth

spurt is common at 6 weeks, so we don't want mum to be undermined

into thinking that she hasn't enough milk and reaches for the bottle,

and thirdly at about 6 weeks (co-incidentally with the growth spurt),

the prolactin levels start to drop and the supply then starts to be

controlled by the autocrine response instead of the endocrine one and

mums milk WILL drop (to what she needs rather than feeding the whole

street), so interferring with this natural timing of supply and

demand in my opinion 'could' be dangerous.

Sorry no refs though !

Pam Lacey IBCLC

UK

- In , " nicolaobyrne "

wrote:

>

> I was asked by a rep the other day had I ever seen a reference about

> not starting pumping and bottles in a breastfed infant until 6

weeks.

> I advise my clients to wait until breastfeeding is established- and

> that means they when can feed easily , no pain, easy latch , good

> established milk supply and weight gain. But definitely to wait for

at

> least 3 weeks...

> Is there any studies out there ? Is it written in black and white

> somewhere.

> Thanks

> Nicola O'Byrne

> IBCLC

> Dublin Ireland

>

[Guest guest]

I'm sure there will always be a baby or two that will start bottles at 2 months and suddenly decide he likes them better -- but one wonders in those cases if the breastfeeding really was going as well as mom thought. There are lots of babies that get bottle after bottle in the hospital and go on to feed at breast really well. There are a few that will only go to where the milk is -- that is, instant milk flow, so that they won't breastfeed if there is low flow....

My recommendation is always to watch the baby, not the clock or the calendar.

I so agree with you, Jan. Baby by baby. Human babies are not born in litters, so that the Mom can give the baby the focus and attention it requires.

In LLL, we have a phrase, "Many women have found..." And I think it applies here. Many women have found that after 6 weeks and your milk supply is well-established (meaning all the things that have been listed) that many babies can take a bottle with no impact on breastfeeding. However, many women have also found that introducing a bottle at that time can cause a drop in milk supply, babies beginning to prefer the bottle, sore nipples, etc."

Any time you change feeding methods there can be expected and unexpected results, at any age. I had a woman call me years ago, whose 6 month old had had one bottle the week before and one bottle several days before the phone call. This baby was now coming to the breast, flailing his head from side to side, pulling his head back trying to stretch the nipple, pulling off the breast and crying furiously at each feed for the last several days. Sounded like what we were calling then, "nipple confusion", gave the Mom the standard information. She called back several weeks later to say that the baby was back to his old breastfeeding patterns, comfortably and happily at breast but that it had been a rough week and a half to get there.

Could it have been b/c the baby was teething and the bottle offered more milk for less effort and discomfort?Could it have been that this baby was close to needing solid foods?

Could it have been that the bottle feeding was not paced, he could handle the faster flow and liked it?

We'll never know.

However, I do offer that situation as a cautionary tale, that there is a higher age level where problems can erupt unexpectedly. It is my understanding of informed consent. Mothers need to know all the information we have available in order to make the best decision for their babies.

Ann

North County Lactation Services

Poway, CA

[Guest guest]

I do not think we can state a specific time when it is safe to introduce a

bottle.All babies are different and we all know babies who can breastfeed

while taking a bottle once in a while, and we have seen those who cannot. I

know of a baby that was 4 months old when first got a bottle and the next

day he was not accepting the breast. Most babies can drink from a cup so I

guess, to stay at the safe side, it is better not to give a bottle at all.

(Am I being too idealistic? )

Ibolya Eva Rozsa, LLLL, IBCLC

Hungary

Best time to introduce bottles?

>I was asked by a rep the other day had I ever seen a reference about

> not starting pumping and bottles in a breastfed infant until 6 weeks.

> I advise my clients to wait until breastfeeding is established- and

> that means they when can feed easily , no pain, easy latch , good

> established milk supply and weight gain. But definitely to wait for at

> least 3 weeks...

> Is there any studies out there ? Is it written in black and white

> somewhere.

> Thanks

> Nicola O'Byrne

> IBCLC

> Dublin Ireland

>

>

>

>

>

>

>

>

[Guest guest]

As an LC, we must always be able to cite arecent reference of what we say. I found thisreference for those interested (wrote bf forbreastfeeding)"Suggest a mother wait to give a bottle until afterbaby has mastered bf.Introduce a bottle after baby has been bf well for 3to 4 weeks. According to research, most babies (about70%) take a bottle easily whether it is started at 1month, 2 months, or even 3 to 6 months. Some babies(26%) require patience and persistence. A few babies(about 4%) refuse a bottle no matter what, but babiesalso can be fed with cup or spoon"Breastfeeding Answer Book, Pocket Guide Edition,September 2005, page 60

While this is a good standard, Odile, unless there is a PRIMARY reference (that is, cited from some sort of study), it isn't worth much, just because it is printed in a book. I'm not refuting the reference -- just that "BF Answer Book, pg 60" doesn't mean anything unless it is citing a specific reference that is a valid study. In which case, cite the primary reference, not the secondary.I

That said, please keep in mind that much of what we do in lactation is NOT evidence based -- simply because we don't have the evidence. So, we may actually say things to mothers or HCPs -- "There is no specific reference on this condition/item/concern/whatever, but IBCLCs have found....or "I have found in my experience" or.... that "XYZ" is true.

I use this a LOT, especially when moms are asking me about storing breastmilk... I get every variation of question on the planet, so have to resort to the "there is no study that refers to your specific question,but...."

Warmly,

Jan Barger, RN, MA, IBCLC RLChttp://www.motherofbridebyjan.blogspot.com/Torrey's Blog

[Guest guest]

Bonjour everyone,

The obvious information is sometimes the hardest to

proove. As an LC, we must always be able to cite a

recent reference of what we say. I found this

reference for those interested (wrote bf for

breastfeeding)

" Suggest a mother wait to give a bottle until after

baby has mastered bf.

Introduce a bottle after baby has been bf well for 3

to 4 weeks. According to research, most babies (about

70%) take a bottle easily whether it is started at 1

month, 2 months, or even 3 to 6 months. Some babies

(26%) require patience and persistence. A few babies

(about 4%) refuse a bottle no matter what, but babies

also can be fed with cup or spoon "

Breastfeeding Answer Book, Pocket Guide Edition,

September 2005, page 60

Odile Lapointe, IBCLC

30 minutes north of Montreal

Canada

__________________________________________________________

Lèche-vitrine ou lèche-écran ?

magasinage.yahoo.ca

[Guest guest]

To go back to my original post , Thank you all so much for your

replies. Yes , it was a medela rep who asked me about this and the

reason was that I maybe running some classes for them - antenatal

breastfeeding - a new concept in Ireland - because all the mums would

have a very basic class as part of their antenatal but its not enough...

So the hospitals are not happy because they don't want me to be saying

things that might not be " hospital protocol " . I would give guidelines

to wait until bf established but not necessarily 6 weeks whereas its

a blanket statement in all the hospitals here no bottles or expressing

until 6 weeks. And all the mums have given up before then

Anyhow

Thanks again

Nicola O'Byrne

www.breastfeedingsupport.ie

[Guest guest]

I've been telling moms that they can introduce bottles when they no longer have to think about breastfeeding. It just happens.

Johanna Berger, MSW, IBCLCBala Cynwyd, PA

[Guest guest]

At 12:23 AM 8/4/2006 +0000, you wrote:

>I've been telling moms that they can introduce bottles when they no longer

>have to think about breastfeeding. It just happens.

This is a really good explanation, Johanna. Much better, to my mind, than

what I've been saying all along, the ol' " wait till breastfeeding is

well-established " which always gets the obvious next statement which is

" when will breastfeeding be well-established?? " You've got the answer

right here- " when you no longer have to think about it; it just happens! " :-)

Thanks- hope you don't mind that I start using your phrase giving credit to

a fellow-IBCLC!

~Dianne Oliver

Simi Valley, CA

>Johanna Berger, MSW, IBCLC

>Bala Cynwyd, PA

>

______________________

Holistic Lactation

www.holisticlactation.com