Bottles and Teats for the Breastfed Baby

It is difficult for mum and baby when you have so much to do and return to work.

Little ones become conditioned to the bottle quite quickly and this can create challenges transitioning back to the breast. Here are a few reasons why this may be the case:

  • It is highly likely she knows that she has a bottle during the day but it also depends on the type of teat being used.

  • It may be how she is bottle fed by those looking after her during the day.

  • It may be related to a drop in your milk volume during the day and this would depend on how many times you can express your breasts at work and if the expressing times could be in sync with her at home bottle feed times (around about).

Let’s take one point at a time.

Conditioning: Babies quickly work out the differences they experience. They know the distinct difference between soft, pliable breast tissue that they can mould to fit their oral cavity between the upper surface of the tongue and the roof of the mouth. They know that they have to continue to work to stimulate hormone production before the milk will flow through the ductal networks of the breasts and over the back of their tongue.

Bottle/teat: The silicone teat is rigid. The baby has to adapt the tongue and oral muscles to accommodate the fixed non-pliable Teat. The teat can’t be drawn to the distance of the soft palatal cleft just at the junction of the hard and soft palate. You can feel your own by running the tip of your tongue over the roof of the mouth until the soft spot is felt. It’s a long way back, the distance is relative to the baby’s rapidly growing lower jaw and tongue and ours is relative to us, as adults.

If the silicone teat has a wide base (#3 pictured below right) with a wide neck bottle, then the baby can only use the tip of the tongue and uses gums at the base of the envisaged silicone nipple creating a chewing action. The baby cannot seal adequately inside the mouth. Often you will hear the vacuum seal breaking and milk may leak from the corners of the mouth. Sometimes there will be a clicking sound.

The top left image (#1) and bottom left image (#2) are the same longer teats attached to different bottles. But #2 is not good, one third is placed over a disposable bottle, that shortens the length of the teat. Tongue function will be inadequate, uses tip of tongue and chews at the nipple.

The preferred teat in my opinion is #1 as it is longer and has a narrower base. This provides further distance along the upper surface of the tongue, certainly not like the breast, moulding to fit to the unique shape inside the baby's mouth. Baby still has to adapt but the additional length means that more of the tongue muscle is working during drawing and swallowing episodes. By all accounts in my practice it is easier to transition from bottle to breasts if the baby is not gravity feeding.

Simulation: Avoid gravity feeding. Sit the baby up at right angles, tip of teat placed at lips bottle at right angle. Rest teat on tip of protruding tongue, no milk in the teat. Wait for inward drawing, assist gently if you have to, best not to put the teat in the mouth, baby draws it inward so that lips are at the plastic lid to achieve maximum length, almost to the soft palate in the young baby. When drawn right back the baby to completes several stop-start episodes of stimulating (this is to remember stimulating hormone release at the breast first) before the baby is tilted back gently, keep the same angle of teat in mouth, the both move together, the angle of the bottle is the same, milk comes into the teat, milk flow begins and the baby draw-swallows for a milk flow.

When a reasonable milk-flow is achieved, sit the baby up again to stimulate another episode of hormone release to achieve the next milk flow. Repeat this gently until the baby’s cues and body language tells you a level of stomach filling has reached satisfaction. Then sit the baby up again and let nurture for a short time. Rest and digest as for breastfeeding. Nappy change. Then offer the next part of the bottle in exactly the same manner, preferably sitting on the other side of your body to remind the baby about turning over for both breasts. Complete the remainder of the feed to simulate the second breast; hold upright and cuddle for rest and digest simulating the end of the second breast.

By simulating breastfeeding it is easier for the baby to transition to breast-bottle-breast.

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Dr Robyn Thompson

The Thompson Method
47/20 Masthead Drive, Cleveland, Queensland, Australia 4163

P: 0419 315 948


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