Introducing the Bottle to a Breastfed Baby

Whether you're returning to work, want your partner to share feeds, or just need occasional flexibility, there comes a time when many breastfeeding families want to introduce a bottle. For some babies, this is seamless. For others, it's a battle of wills. Here's how to make the transition as smooth as possible.

When to Introduce a Bottle

Timing matters—there's a sweet spot: AAP

The general recommendation:

• Wait until breastfeeding is well established (usually 3-4 weeks)
• Introduce before 6-8 weeks to avoid strong preference
• The "window" is roughly 3-8 weeks

Why wait until 3-4 weeks:

• Nipple confusion is most likely early on
• Milk supply is still establishing
• Baby is learning to breastfeed efficiently
• Introducing too early can undermine breastfeeding

Why not wait too long:

• Older babies may refuse the bottle entirely
• Strong breast preference develops
• Harder to establish bottle-feeding skills

Exceptions:

• If baby isn't gaining weight and needs supplementation, bottles may be needed earlier
• Premature babies often have bottles in the NICU
• Medical situations require flexibility

Choosing a Bottle and Nipple

Not all bottles are created equal: AAP

Features to look for:

• Slow-flow nipple (especially important initially)
• Nipple shape that encourages wide latch
• Breast-like texture and feel
• Easy to clean
• Baby bottles labeled "newborn" or "slow flow"

About nipple flow:

Breast milk flow is controlled by baby's sucking; bottle flow is controlled by nipple speed. Fast-flow nipples can cause:

• Choking or gulping
• Preference for easier bottle flow
• Rejection of the breast later

Start with the slowest flow nipple and only increase if baby seems frustrated with flow speed.

Popular options for breastfed babies:

• Comotomo
• Dr. Brown's
• Lansinoh
• Philips Avent Natural
• Tommee Tippee

Every baby has preferences—you may need to try a few.

Paced Bottle Feeding

This technique mimics breastfeeding and prevents bottle preference: AAP

How to pace feed:
1. Hold baby semi-upright (not lying flat)
2. Hold bottle horizontally (not tipped up)
3. Let baby draw nipple into mouth (don't push it in)
4. Allow baby to suck a few times, then tip bottle down to pause flow
5. Re-present nipple when baby is ready
6. Let baby take breaks
7. Switch sides halfway through feed
8. Let baby decide when they're done

Why paced feeding matters:

• Baby works for milk like at the breast
• Prevents overeating
• Reduces preference for easy bottle flow
• Takes about the same time as breastfeeding

Getting Baby to Accept the Bottle

Here's where strategies matter: AAP

### Have Someone Else Offer It

The cardinal rule: Mom should not give the first bottles.

Baby smells you, expects the breast, and is confused about why you're offering this plastic thing. Have your partner, grandparent, or another caregiver offer the bottle while you're out of the room—or out of the house.

### Timing

Offer the bottle when baby is:

• Hungry but not starving (catching early hunger cues)
• Calm and alert
• In a good mood

Don't offer when:

• Baby is frantically hungry (too upset to try new things)
• Baby is tired or overstimulated
• Right after breastfeeding (too full to try)

### Create the Right Environment

Tips that help:

• Warm the milk to body temperature
• Warm the nipple under warm water
• Hold baby in a breastfeeding position
• Move and sway like during nursing
• Offer skin-to-skin with the person bottle-feeding
• Try in a different location than where you usually nurse

### Be Patient and Consistent

What to expect:

• Baby may refuse at first—this is normal
• May take 5-10 tries over several days
• Don't force it—end on a positive note
• Try again at the next feeding or the next day

If baby refuses:

• Try a different nipple or bottle
• Have someone else offer it
• Try during a calm, alert time
• Drip a little milk on the nipple so baby tastes it
• Let baby play with the empty bottle to get familiar

What to Put in the Bottle

For a breastfed baby: AAP

Breast milk is ideal:

• Pumped or expressed breast milk
• Can be fresh, refrigerated, or thawed
• Familiar taste helps acceptance

Formula if needed:

• Some babies accept formula more easily than pumped milk in a bottle (ironically)
• Useful for occasional supplementation
• Discuss with pediatrician if you're concerned about supply

How much to offer:

• Young babies: 2-4 oz per feeding
• Let baby control intake (paced feeding)
• Don't push baby to finish the bottle
• Breastfed babies typically take smaller, more frequent bottles

Troubleshooting Bottle Refusal

When the standard tips don't work: AAP

Try different approaches:

• Different bottles and nipple shapes
• Different people offering
• Different times of day
• Different positions (walking, bouncing)
• While baby is sleepy (drowsy feeds)
• In a warm bath
• Outside or with distracting scenery

Alternative feeding methods:

If bottles are completely refused, you can try:

• Cup feeding (even for young babies)
• Syringe or spoon feeding
• Supplemental nursing system

These are especially useful for babies who need supplementation but won't take a bottle.

When to seek help:

• Baby is losing weight due to bottle refusal
• You're returning to work soon and baby won't take any bottle
• Baby seems to have oral motor difficulties
• Feeding seems painful

A lactation consultant or feeding therapist can help troubleshoot.

Maintaining Breastfeeding

If you're introducing bottles while continuing to breastfeed: AAP

Protect your supply:

• Pump when baby takes a bottle (to maintain demand)
• Continue direct breastfeeding when possible
• Watch for signs of supply changes

Prevent breast preference reversal:

• Use paced bottle feeding
• Use slow-flow nipples
• Don't give bottles exclusively for extended periods
• Continue offering breast regularly

Watch for changes:

• Baby becoming frustrated at breast (expecting faster flow)
• Shallow latch after bottle use
• Decreased milk supply
• Baby preferring bottles

If you notice changes, try:

• Exclusively breastfeeding for a few days
• Slower nipple flow
• Paced feeding by all caregivers

When Baby Prefers the Bottle

Some babies start preferring the bottle—here's how to reverse it:

Strategies:

• Return to breast-only for a few days if possible
• Use slowest flow nipple
• Strict paced feeding
• Offer breast first, bottle as supplement
• Try different breastfeeding positions
• Skin-to-skin before feeds
• Nursing in motion (walking, swaying)

This usually resolves with consistency, but a lactation consultant can help if needed.

The Bottom Line

Introducing a bottle to a breastfed baby requires patience and the right approach. The ideal window is 3-8 weeks—after breastfeeding is established but before strong preferences develop. Have someone other than mom offer the first bottles, use paced feeding, and be prepared for some trial and error.

If baby refuses, don't panic. Many babies resist at first but eventually accept. Keep trying different approaches, stay calm, and know that this phase will pass.

Clara is here to help you troubleshoot bottle introduction or navigate feeding decisions.