The best time to offer your breastfed baby his first bottle is somewhere between the 4th and 6th week of life. Waiting until this time ensures that your milk supply is well-established and lessens the risk that your baby will become nipple confused. Waiting longer than this may result in a rough transition as your baby may have developed such a preference for the breast that he is more unwilling to accept an artificial nipple.

Once your baby has accepted a bottle nipple, take care not to bombard him with the bottles. Use them only when you must be physically separated, and when you are together only nurse. If you want to make sure that your baby will continue to accept a bottle, offering one once or twice a week should help him "remember" well enough. There is no reason to offer bottles on a daily basis if you are not routinely separated from baby just so that he will continue to accept one. Doing so may also compromise your milk supply and make it more likely that your baby may begin to prefer the ease of the bottle.

The following tips should be helpful when offering those first few bottles:

• Use a silicone rather than a rubber nipple to avoid an unpleasant odor or taste.
• Warm the nipple under running water before offering the bottle to the baby.
• Make sure the milk is not too warm and not too cold. If when holding the bottle in your palm, it feels warm to the touch, it is most likely too warm. If it feels cool to the touch, it is most likely not warm enough. If you can feel no difference in the temperature of the bottle and your palm, the milk is probably at the right temperature.
• Most babies will accept expressed breastmilk more readily than formula.
• Offer the bottle while holding the baby with his back to your chest so that he is facing outward, rather than trying to cradle him.
• Move with the baby - rock, sway, bounce, walk, walk in circles, etc. as you offer the bottle.
• Place the baby in a swing, bouncy seat, infant/car seat, etc. and offer the bottle. Try to distract the baby with something else as you offer the bottle.
• Place an article of mother's clothing up near the baby while offering the bottle, or wrap the bottle with an article of mother's clothing.
• Lightly tickle the baby's lower lip with the nipple and allow him to pull it in his mouth rather than trying to force the nipple in.
• Offer the bottle when the baby is already sleepy or just waking up (but not fully awake) or once the baby is already asleep. Many babies will instinctively suckle at these times.

Most babies will accept a bottle with time and persistence. Try not to allow feeding time to become associated with unpleasantness. Offer the bottle for no more than 10 minutes at a time. If the baby is still refusing the bottle and becoming more upset, it's best to back off and try again later. Remember that if the baby will not take supplemental feedings in this way, an alternative device may also be used such as a cup, spoon, medicine or eye dropper, finger feeder, nursing supplementer attached to the finger, etc.

It may also be possible to time outings without baby around feedings. You may be able to nurse just before leaving and upon your return. Some babies will even reverse cycle somewhat, especially those of working mothers. This is when the baby will only take small amounts of milk while away from mom and then make up for it once she returns with more frequent nursing. This is perfectly fine for the baby as he will still take in the same number of calories in a 24-hour period.

Written by Becky Flora, BSed, IBCLC on February 6, 2000

Source: La Leche League's The Breastfeeding Answer Book (1997) by Nancy Mohrbacher, IBCLC and Julie Stock, BA, IBCLC