by Angela Grant Cerasaro MS, CCC-SLP
If you are breastfeeding and want to bottle feed as well:
- Breastfed babies should be introduced to a bottle before 6 weeks of age, and should use the bottle regularly (ideally at least once a day or at least 3-4 times per week).
- Allow the baby to take in the nipple on his/her own, versus putting the nipple in their mouth
- Another caregiver other than mom may need to do the bottle feedings, and mom may even need to leave the room/house during the feeding session
- Switch sides as if you were breastfeeding to promote symmetrical head and neck control
- Experiment with different nipples and bottles. Sometimes a slower-flow nipple works better.
Sometimes breastfed babies will refuse a bottle even after repeated attempts, especially if the bottle is introduced later than 6 weeks. Breastfeeding and bottle feeding seem similar, but actually require different suck patterns, oral positioning and oral movements.
- Tongue, teeth and cheeks are “at rest” during breastfeeding
- Breast tissue forms to mouth, and the breast is pulled far back into the baby’s mouth
- Tongue movement mimics adult swallow (tongue moves from front to back in a wave-like motion)
- Bottle feeding:
- Bottle feeding drives the tongue back and up because of the position and shape of the nipple and because of the faster flow of the milk
- Baby often sucks with lips versus tongue
- Bottle feeding puts an upward force on palate (roof of mouth)
Bottles, pacifiers, and thumb sucking can create an open bite, high palate, and tongue thrust if continued beyond recommended ages or over-used. Using a pacifier or bottle for specific times during the day, such as nap and bed time, is not likely to cause a problem if continued even to age 2 or 2.5, but should not be used all day long.
Options other than breast or bottle for feeding include using spoon feeding, open (regular) cup feedings, sippy cups, and straws. All of these should be done in an upright position, such as in a highchair. 6-12 months is the ideal age to introduce open cups, sippy cups and even straws. Some children are ready to start even younger, around 4 months.
- Spoon feed milk/formula
- Cup feed milk/formula
- Tip the cup so that just the milk just touches the infant’s lower lip and allow them to lap up or sip the milk
- Do NOT pour liquid into the baby’s mouth
- You can use a small regular open cup
- Flexi-cut cups (available online at amazon.com or a variety of other websites)
- Foley cup feeder (www.foleycup.com)
- Sippy cup
- Around 4 months a baby can be taught to use transition sippy cups, such as the following:
- Munchkin Latch Transition Cup
- Playtex Soft Spout
- Tommee Tippee 4+ months
- If there is a valve, may need to remove it at least temporarily
- To introduce, use a regular straw and plug the end with finger and feed at an angle
- Once the baby can suck this way, introduce the straw in a cup with liquid
- Use valve-less straws (regular adult plastic straws)
- Take N Toss straw cup
- Litterless Juice box
- Other options for feeding infants 4-6 months and older:
- Mix milk/formula with baby food
- Make a smoothie with milk/formula
- Open cup and straw cup are best for baby’s oral development, but sippy cups are fine as a transitional cup until around 2 years of age.