Bottle Feeding the Breastfed Baby: When and How?


As a self-employed International Board Certified Lactation Consultant (IBCLC), a very common question my clients ask is when they should introduce a bottle.

In the US, the majority of nursing parents are returning to work soon after baby is born. Understandably, early on these families are thinking about how their baby will take a bottle during that transition. For those breastfeeding parents who are not returning to work, often at some point they will be away from their babies as well. For nursing parents that never are separated from their babies, they can continue to breastfeed without ever using a bottle.

In most circumstances, I now often encourage families to practice with bottles around 3-4 weeks. This is a much earlier recommendation than I used to suggest. As I started to work with older babies who were struggling to take a bottle, I saw good results with starting earlier and regularly offering small bottles even if there was minimal separation early in baby’s life.

In a study from Kearney & Cronenwett (1991), they found that babies at 1 month generally took a bottle easily (around 70%), and only 4% refused. But by 2 months, 12% refused bottles and at 3-6 months 13% refused.  As you can see, many babies are just fine starting a bottle at older ages. But I have seen good results with babies starting younger, once nursing is established and consistently taking small amounts in bottles in order to hopefully avoid a higher chance of bottle refusal. Usually this means around 1/2 ounce or so about two times a week. Often this allows the nursing parent to not miss an entire feeding when practicing with the bottle, and pumping/self-expressing about 1 ounce a week is not typically too disruptive.

Waiting until 3-4 weeks allows for supply to be established, though some babies do need to take a bottle much earlier. Regardless of the time frame or reason, there are 3 important things to keep in mind while bottle feeding:

-Paced Bottle Feeding is essential for all babies who get a bottle — including an occasional bottle, exclusive bottles, and bottles with breastmilk or formula.

Kellymom has lots of information on Paced Bottle Feeding:

-The flow rate and shape of the nipple is important.

The book, Balancing Bottle and Breast is a great resource:

-If your baby will not take bottle, sometimes offering in a different way can help.

La Leche League has great tips on bottle refusal:

If your baby struggles with a bottle (for example: leaking, choking, not sucking well) or will not take a bottle, contact an IBCLC near you for support. IBCLCs are feeding specialists and often have experience with many parts of feeding besides nursing. I assist with bottle feeding babies of all ages in the Central New York area. For more information or support with bottle feeding your baby, visit my website at or follow me on Facebook at .

Jen has been a birth and postpartum doula (DTI) since 2013 and an International Board Certified Lactation Consultant (IBCLC) since 2014. After years of both doula and lactation work, she is exclusively transitioning full time into private practice in-home breastfeeding consults.
Jen brings years of experience and depth of knowledge on breastfeeding topics from prenatal preparation to extended nursing. She has seen a wide range of breastfeeding issues and is prepared to help you meet your goals. Contact her today to find out more about her in-home consults and classes.
Jen Deshaies (315) 263-7558 Email

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