Ep. 136 – How to Introduce a Bottle of Breastmilk

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*We apologize for any typos, misspellings or incorrect grammar. Our transcript is auto-generated by software that’s trying its best, just like all of us.*

This is Maureen Farrell and Heather ONeal and this is The Milk Minute. We’re midwives and lactation professionals bringing you the most up-to-date evidence for all things lactation. So you can feel more confident about feeding your baby, body positivity, relationships, and mental health. Plus, we laugh a little or a lot along the way. So join us for another episode.

Don’t you hate it when you go to pull up your sleeve and you slip and punch yourself in the tit ? I do do that. That is the worst way to start your morning, you know? But a good way to start this episode, . Yeah. I just had the, I was thinking about that the other day because I did it and then I was like, God, I’m so glad there’s no more milk in my boobs.

Cuz when you do that, when you, there’s milk in there, you’re just like, oh dude, the tip punch full of milk. Mm-hmm, could you imagine if men were accidentally bag tagging themselves each morning. They’d never go to work. No. They would just go back to bed six days . They’d be like, I’m a fragile male and I have to crawl back under the sheets, have accidentally bag tagged that self.

Oh my goodness. And then also, I was gonna say, have you seen the new Eliza Lysinger? Netflix comedy special? No. Oh my gosh. She is hilarious. She does like 15 minutes on bras and like her relationship with her old ugly bra. Sure. It’s, oh my God. I’ll have to go watch it. Yeah. It just like you’re she’s like the ugly bra only comes in one color, which is basically a gray beige

Yeah. And she’s like, any, and she gets mad at like any more than three claps on the back is no longer a bra. It is an ADT security system. And how I think the funniest one was where she’s like, Out at a restaurant. She’s like, you know when you’re eating a delicious meal and you’re like, God, I look so cute tonight, and you accidentally eat one bite too much.

Mm-hmm, and then your bra doesn’t fit anymore. She’s like, I call it the thickening. I know. She’s like, once the thickening happens, you better just go home. Yeah. I was like, it’s bra. Take the bra off and eat more food. Yeah, exactly. Oh my. Anyway, everybody go watch her. She was so funny. And it will make your day good.

I’ll have to watch that when I get home. Well, I have a. I have some new additions to my farm that I thought I’d tell everybody about . Oh, I know you guys like occasionally get updates about like critters and, you know, wild animals in my bathroom and whatever. So a friend, a good friend of mine had to downsize her farm.

She had to get rid of some things and she got rid of a bunch of animals. And then she had like a couple like sentimental animals left. What is a sentimental animal? You know, just like things she cared about and she didn’t want somebody to just like go home and butcher when they bought from her. Oh my God.

I would be so upset if I was not on the sentimental animal list. So we have now adopted a Turkey named Juanita, a rooster named Petunia. His hen named Silky. They’re, they’re silky chickens, so they have these like very. Like swab, feathers. Are they the ones with the tiny brown eggs? I don’t, that are brown.

I don’t know. I’ve never had them before, so I guess we’ll find out. Keep me posted. And then two geese who are very attached to each other and they’re very friendly. Cuz I’ve have had geese before and they were not friendly. These, we call them the honkeys , and they just walk around the yard going, ha ha ha ha.

Like, like chattering to themselves. . Mm-hmm. That’s, anyway, now we have yard geese. Let’s see. I think that’s all she brought. And then coincidentally but unrelated, we have a new dog hanging around. So we have like most of our open parts of our farm fenced in and, you know, we fence with the intention of like livestock and large dogs.

Mm. This is like a Chihuahua mix, so he’s just helping himself to any area on the farm that he wants , and he is in love with my great ponies, who is 90 pounds. . And he is about probably 12 pounds, you know. That’s so cute. Soaking wet . And he got, he ca he was like visiting for like an hour at a time last week, and now he’s like staying overnight.

Mm-hmm. , they’re snuggling in bed. It’s very cute. Does he have a name? I call him Tiny Dog because I am not creative about that, apparently Tiny Dog. And I’m also afraid that like, we’re gonna find his owner and then I’ll have to give him back and I’ll be really sad. Wait, that’s from the movie, that’s from one of those recent pet movies.

Oh yeah. TD Tiny Dog. Td. It’s the voice of Kevin Hart, right? Yeah. It’s what it’s what? The insane Rabbit calls. Oh yeah. The dog. Anyway. Yeah. , but he is really sweet and doesn’t look well taken care of, but also isn’t starving. So like I can’t, might have a home maybe, or might be like fed by someone and I haven’t found yet, and I don’t know.

So how did she transport them? Where they, she just like strapped them in the back of a minivan. She fed them in cardboard boxes in her trunk. Why so many foul? Because they’re, I don’t know, they’re cheap and easy. And she’s moving on with her life. Well, just for now, they just got kind of overwhelmed with the farm and need to reprioritize some stuff and Gotcha.

I was like, whatever. I already have like 50 birds anyway, so you just drop them off. You have 50 birds. What’s happening down there in Elkins? or over there? Well, we have like 25 chickens or something. Some of which will be eaten. And we have about 15 ducks, but many of which will be eaten as well this fall.

Whoa, you’re so cool. I mean, not to one up you, but I washed my washing machine yesterday. Oh, I wish I had time for that. . Yeah, I made time. It was one of those like psychotic mom moments where you have way too much other stuff to that, a front load. It’s a top loader. Oh yeah. It’s a top, an agitator. So you got like inside your washing machine?

Oh yeah. Your feet in the air close. Yeah. I didn’t wanna throw off the balance too much, but I ran one of those refreshers through it. Mm. And then I cleaned it literally inside and outside with a wipe. And then I ran a second time bleached through the bleach hole. Mm-hmm. . Then it was only then that I realized there’s a hole in the agitator that says fill line.

And I was like, wait, is this where the soaps been supposed to be all along? Cuz I’ve been, I think so I put it in the bin, like in the tub. I mean, I think that’s okay too. I mean, it’s been working so far, but really the only thing in the agitator hole was some gems from Heidi , some Bobby pins, some seriously disgusting linty pieces.

So I got all those out with tweezers. Mm-hmm. . It was a whole situation, but it smells a lot better. Now, does your washer have that weird filter like on the bottom? That you like pull out and there’s like a little weird like round screw thing and you empty the water and. Probably, and I forgot about that.

So now thanks. Good luck. Next year it’s gonna, I’m gonna have to uncheck it off the list and then go home and figure it out. Thanks a lot. I’m sorry, . But yeah, I did that and then I talked about it so much that my husband kept saying like, Thank you for all that you do. And I knew that I was being psychotic at that point cuz he’s like, thank you for everything that you do for your family looking, you dead in the eye.

I appreciate . I’m like, yeah, do you go down there and stick your head in it? Stick your head in it and smell it? He’s like, okay Heather, I to do that. Like I have days like that when I do something like scrub the stove top or something. I’m like, have you seen it? Have you seen, how do you, it should be shiny like that every day, every freaking day.

So yeah. That’s where I’m. But today, Today, where are we at? What are we doing? I’ll tell you, here’s what I’ll tell you. We are gonna talk about one of the most stressful things to new parents, which is how to introduce a bottle of breast milk. Let’s start out by saying there is no right way to do this, or better yet, there are 10 right ways.

To do it. However, we’re gonna give some basic concepts to follow and lots of troubleshooting ideas for when these things get super tough. And we also wanted to give a shout out to our good friend Lisa Meyers, founder and creator of Series Chill, who officially has her patent for the series Chiller. Yay.

Yes. She also has five more patents pending and. , it is incredibly difficult to get a patent, you guys. Yeah. It’s very expensive and time consuming and completely worth it because it protects your intellectual property and protects the product that you’re making to make sure it’s the best quality for all of you.

Mm-hmm. . And we are gonna link our episode with Lisa and the show notes in case you don’t know who or what we’re talking about. And Lisa, we are so happy for you and so proud of your contributions to the world of lactation. You have truly made a difference to all of our lactating parents, especially the ones that go to work and have to deal with all the disgusting employee refrigerators and like lack of time pumping and milk storage drama.

And you are the. , thank you. You’ve made a difference in my life. I still use the chillers even though I’m not pumping anymore now. They’re just my water bottles. wine bottles. Yeah, whatever they need to be used for that day. . I thought about putting coffee in one this morning and I was like; I don’t need 20 ounces of coffee.

Don’t do this to yourself, . I will not be able to sit in a room for eight hours and record. Oh goodness. Anyway so thank you, Lisa. and quick reminder, up top everybody that we both offer private consultation, virtual and in person. Links are always in the show notes. So don’t struggle at home when we could be helping you and we would absolutely love to help you.

And we’re gonna read an Apple review at the end of the pod. So if you haven’t written us an Apple review and we’ve made a difference in your life, we’d appreciate it. Makes our project really sustainable and we love you guys so much and we read them all and we love it. Thank you. Okay. Okay, oh, I wanna thank some patrons.

Yes, let’s do it. Oh my goodness. Okay. So thank you so much to Elisa from Sunnyvale, California and Christina P from Preston County, West Virginia. Yay. That’s right around the corner. , she probably has geese and. She might, maybe that’s, she might, people out there have those things. I wonder if she lives on the cheat.

I don’t know. We could find out cuz she’s a patron and we can message her anytime we want . Okay. Anyway, thank you so much guys. And we just deeply appreciate all of our patrons for contributing to the podcast. It costs money to make these things and they make it possible. So if you guys want to join our Paton community, you know where to find it.

Links are all in the show notes. Let’s take a minute to thank one of our sponsors, and when we come back, we’ll answer a question about volume of milk in a bottle. For a two week old,

you guys breastfeeding for busy moms? My little breastfeeding clinic isn’t so little. I’m so excited that not only can people book with you in person here or virtually, but they can book with the other i b CLCs in your clinic. We also do accept some insurance directly. A lot of insurance will actually pre-approve you for a certain amount of visits, even prenatally.

So please head on over to breastfeeding for busy moms.com and check out the services tab to see if your insurance is approved. Book with me or one of my IBCLCs, and we would love to work with you. You can do prenatal consults. What else can they do, Heather? Well, I often work with people who have supply issues.

We’ve got pumping, troubleshooting. We’ve got preparing to go back to work, weaning, starting solids. We really cover the entire journey. So if you’re struggling, stop struggling and just schedule with me or somebody on my team at breastfeeding for busy moms.com. dot com.

All right. Welcome back everybody. Today’s question is from Alyssa Sizemore from our Facebook group, and Alyssa says, how many ounces of milk does a breasted two week old eat during a feed? Her dad wants to feed her, so I have to introduce a bottle here soon, but I’m not sure how much she should get in a bottle for our feeding, especially because she’s sort of cluster feeding right now.

Hmm. That is really tough, especially if it’s like your first time and you’re like, I don’t know. They eat a poop full. Mm-hmm. , what is a poop full to a. Well, let me tell you, part of the problem with introducing a bottle early on is because you will end up wasting milk because technically we’re supposed to bottle feed on demand just like we breastfeed on demand.

I also like to remind people that if you are bottle feeding at this point in the game, you have to also be pumping to replace that feeding. Right. Unless it’s like one day a week or something, you know? But if it’s a consistent time, you probably do wanna be pumping. In this particular situation, it sounds like they do wanna be more consistent about it.

Which is fine. Yeah. There are risks to early pumping. The biggest risk of all I would say is that baby has bottle preference because at that age, they’re very neuroplastic and their brains naturally gravitate towards the path of least resistance, which is a bottle. because gravity, you tip it and it just flows in the mouth and they’re like, that is the easiest way to receive milk.

I shall do that now. And then they don’t wanna work at the breast anymore. So make sure you’re using a size zero or one at most nipple or slow. It should have an S on it. And really try to pace feed. And if you, if you do a whole feeding you, I would probably say offer three. I would say two ounces at the most.

Well, I don’t know. On demand. Every baby’s a little different. Yeah. You know, so if you offer three and they take two, then you’re done. Yeah. And then that milk has to be used within two hours, or most likely in this scenario would probably be chucked. Yeah. I mean, what, what I usually do or tell folks to do in this early situation is like if you have.

Thaw milk or like fresh milk in the fridge that you can heat up in like two minutes under the tap. Offer a smaller amount in the bottle. If they finish it, toss another ounce in, heat it up quick and offer that. It’s a much longer process than you’re think most people at this point, I’m just gonna say Alyssa, I just wanna say this.

You think it’s gonna be easier? Yeah. People want to help you. It ends up being much more complicated in time consuming than you think at this point in the breastfeeding. Sometimes. Sometimes, yeah. And you know, if, if you guys do give a bottle and you’re like, oh my God, that was so nice. Awesome. I don’t know how you are getting milk right now, but I usually recommend you try to replace that milk in the same day that you’ve used.

You don’t have to pump at the same time they’re getting the bottle. Maybe you use a haka and you get enough. You know, it’s, it’s kind of individual, but like if you’re, as long as you’re kind of keeping the in and out milk flowing on an equilibrium, it usually works out and, and really use it. Like if you’re gonna do it, do it.

Like let them bottle feed and then go get your hair done, sleep , or sleep or like do something. Don’t, please don’t sit on the couch. You know, just watching somebody feed your baby when you could do it. Mm-hmm. , it is not gonna. Like easy or that fun for you? Take a two hour shower. Yeah. Two hour shower, like whatever makes you feel human again.

Yes. Literally go do something for you if you’re gonna go to this. Okay. Thank you very much. Good luck with that. Good luck on that topic. We are talking about introducing a bottle today in this episode, and here is the thing, folks. There’s not like a plethora of research that tells us how or when to introduce a bottle for babies who are exclusively drinking human milk.

Now, I went through the trouble to look anyway and was of course, disappointed. You know, found a few things here and there that was like, well, maybe some data suggests blah, blah, blah. And it just wasn’t real definitive. And then I went and looked on a bunch of other people’s websites and they were like, this time, this time.

So I was like, all right, I’m just, I’m gonna, I’m gonna pull from expert opinion mostly here today and experience, and we’re gonna go with it. So I’ve split this into, like sections. I’m gonna go over basic concepts, stuff that I tell every person who’s introducing a bottle anytime. And then we’re gonna talk about troubleshooting.

What if that stuff, the basic stuff doesn’t work? What do we do then? Does that make sense, Heather? Yes. And I’m going to chime in as I do. Yeah, yeah. We’ll, we’ll get it. I, these are not in any particular order. , . I was like trying to make them like chronologically what you have to think about. Now let’s start with the most controversial one, shall we?

Can I pick? Yes. How? . What is a breastfeeding friendly bottle? , which one should we pick? Please don’t buy 40 bottles. Yeah. Step number one, take all of the nipple sizes that are above a one. Yes. And put them in a box and put them away. You’re not gonna need them for a very long time if you need them at all, and it’ll complicate your kitchen to have them around.

Choose small volume bottles, four ounces or less. Guys, you don’t need the ounce bottles. It’s hard to find a for. They make fives, whatever they are around that size. But you don’t need the eight 12. I mean like some of those are crazy and a lot of the marketing for those is hilarious cuz it’ll show them with like juice in them.

And I’m like, wait a minute. What child needs 12 ounces of juice. And also, we’re not supposed to put juice in bottles, right? If your kid is drinking juice, they can probably have a sippy anyway, so pet peeve with marketing and bottles. So get yourself a five ounce bottle. Yeah. Here’s the other reason why if you send your kid to daycare, with an eight ounce bottle that has four ounces in it.

The daycare provider looks at it like it’s half empty and they say, oh my goodness. Why is this mom starving this baby? Yeah. But if you put four ounces in a five ounce bottle, it looks like a nice full bottle. Looks full bottle, and it’s a mental game. Yeah. Now the nipple shape is really the controversial thing about the quote, breastfeeding friendly bottle as far as.

Scant research, an expert opinion tells us the best nipple shape for a bottle is one that tapers gently from tip to bottle mouth and kind of would look like a triangle with like equal sides, you know? Now that being said does that bottle shape work for every baby? No. Does it matter particularly, maybe not as much as people make it out to.

The problem with some nipples that are too skinny is that we have too shallow of a latch. And then the problem with some nipples that are those big flat ones with like just the little tip poking out are they also have a shallow latch for babies. So you kind of want the in between. You know what I want?

I want one that has the least amount of parts possible to wash. For real. Here’s my dream bottle. Can I talk to you about my dream bottle? Please? I’d love to hear your dreams. Okay. My dream bottle is a glass bottle that is five ounces in volume that can be thrown in the dishwasher and sanitized. So all I have to wash is the rim.

And the nipple. The nipple is no bigger than a size one. The mouth of it, like the squishy boob part, is a little smaller than a Commo tomo, but bigger than a Browns. Than a bigger than a Dr. Brown, somewhere in the middle. And I think the part that the event I have a problem with a lot of the time is, The like the shape of the tip of the nipple will be great and the shape of the base will be great, but it tapers too quickly.

Mm-hmm. in the middle when it should look more like a triangle and not like an hourglass shape. Mm-hmm. . Cause like I used the parent’s choice glass bottles and they were pretty good, but I was still like, Ooh, the narrow mouth ones are just a little too narrow and the wide mouth ones just aren’t quite the right shape.

And it was fine. It didn’t affect our breastfeeding at all, but, I just haven’t found the perfect one. Well, I say that because when I see the ones that are too angular mm-hmm. , and this is not research based. This is my experience with helping people. It seems like if you have a baby that has a really good suck, those nipples collapse.

Yes. And so those are the nipples that I’ve had to go above a size one on. So the only time I go up is if your baby is literally collapsing the nipple and having to work doubly as hard to. Milk out of it. So if your nipple is literally collapsing and every once in a while you have to pull it out to like reinflate it, then you need to just go up a size or figure out a different bottle.

Yeah, but I’m sorry, that was like unclear advice to begin with. But really what I tell people is pick one. Just pick one and try it. Pick one. Keep only that one in your kitchen. Don’t try a new one. Every feed, right? No. You have to introduce it to a kid multiple times and you know, before you call it quits and just keep all the rest of the bottles in a box.

I’m telling you. Don’t even keep ’em in the room. Keep ’em in a box in a different place. Absolutely. Now you know, most people will buy all these prenatally. They’ve got it sitting around. Great. When do you start using. When should we introduce it? There is no right answer. Four to six weeks is the most popular time.

My best advice is that you don’t wait till the last minute. Hi Heather. I need to interject. So, I have found in my clinic experience that the babies that are most at risk for refusing a bottle are babies that refuse a pacifier. Mm-hmm. . So if I see a kiddo that is refusing a pacifier completely at like three weeks, I’m eyeballing that kid and I’m like, Maybe we should either switch pacifiers or really, really work on a pacifier or go ahead and attempt a bottle.

Mm-hmm. just like an ounce to see and like start introducing once every 24 hours. Kids, that’ll suck on any pacifier no matter what. They’re usually. Because they’re used to having something plastic in their mouth that they’re sucking on and they’re not even getting rewarded for it. Yeah. So if you put a plastic nipple in their mouth and they get milk out of it, well, Yippy, Skippy, you know yeah, the kids that are like not accepting any plastic, anything in their mouth, they might need a little bit more time to adjust. And those are the kids that you might need to start with something like spoon feeding, cup feeding, syringe feeding where they don’t have to really work to get the milk, but they’re.

Introduced to the concept that milk can come from other places than mom, and it’s really important that the caregivers who are caring for your baby, who maybe doesn’t have the hang of bottles yet, understands how to use those tools. Can I tell you a quick story? Mm-hmm. , just as something to be aware of.

Okay. Because everyone always blames themselves first, and then they blame their baby. Sometimes you need to blame the bottle, so, I had a patient who is a nurse practitioner, by the way, who does work with children, and she tells me her baby is taking an hour, hour and a half to finish three ounces of milk.

And I’m like, what? And I’m watching this baby and healthy term fine baby, and continuously just like really struggling on this nipple. And I was like, are all of those from the same? And she said, yeah. And I was like, can we just try literally any other bottle you have, you could see the relief on that baby’s face.

There was a defect in the nipple. And so like every single nip, was it not letting air back in? No. Or something. It was like the hole was too small. Yeah. And it, and I don’t know, like it just could not transfer any milk. Yeah. It wasn’t pressurizing or something. I, it was a telehealth, so I can’t really say for sure.

But that baby was just like, oh, thank you, Jesus. And like drank a bottle in a normal 20 minute span and moved on with our life. That’s great. And she was like, oh my God, I thought it was me the whole time. And it’s like, if they’re all from the same set and you’re having problems, blame the manufacturer first.

Yeah. I’ve, I’ve. One time, you know, the nipples usually have a vent to let air back in. Mm-hmm. , I saw in one set somebody had that the vent wasn’t cut all the way through. Ooh. So like you could see it, but there was no air going through it. Oh. And so air was having to go back through the tip of the nipple.

Oh. Maybe that’s what was happening. And it was taking a long time. Baby was mad. Hmm. Yeah. Anyway, so don’t blame yourself first. Yeah. Okay. So. We want you to just start it when you have plenty of time because sometimes problems like that crop up and you need to troubleshoot. If you are not starting bottles until four months or later, I strongly urge you to consider sippy cups, straw cups, open cups, et cetera.

You might just be able to skip bottles entirely, and it is often easier for a baby of that age to learn something new like an open. And they usually like it better cuz it’s like interesting. Mm-hmm. . And then also you don’t have to worry about weeding them off a bottle at a year. , have you seen those honey bear sips?

Mm-hmm. or the straw? Sippy straw. Yeah. Yeah, those are interesting where they take like actual, those, those honey containers that look like bears. Yeah. And they just fashion a straw to it so you can actually squeeze it and it comes up through the straw and trains them to suck on a straw. Mm-hmm. . So it’s, it’s like straw training, which I thought is kind of.

Yeah, I like those. Okay, so. We’re gonna get small size nipples. We’re planning ahead. We’re gonna pick a bottle and stick with it for a while. And you know, I wanna encourage you to make sure that you are like paying attention to details in this. Prepare your bottles correctly. You know, pay attention to milk storage guidelines.

Warming the milk can be an interesting one. Little babies usually like warm milk. If it’s too cold, they might just reject it entirely and it might feel warm to you. You’re, it’s in your hand and you’re like, this feels warm. It might only be 85 degrees. Maybe it needs to be 98.6, right? I mean, my daughter was pretty adamant that it needed to be like 99, like a little bit hot, and that was fine, but it took some shooting to figure that out.

So I definitely encourage you with younger babies, warm that milk, make sure it is the right temperature, and take that extra time. Before you give them the bottle so that you’re not troubleshooting later, and you can always work them toward cold bottles. It gets much easier when they’re a couple months old, but for those little like first two months, just warm it and for their tummies too.

Yeah. It’s just kind of nice for their little guts to get the warm milk. Mm-hmm. . And then when we’re trying to get baby to latch onto that bottle nipple, don’t forget the basic principles for. Latching baby onto your boob, right? You want baby’s head to be flanged a little bit. You want to gently place the nipple at baby’s lips, you know, kind of getting them interested, not just shoving the whole thing in their mouth.

Yeah. And the reason for that is the same reason why like, Cats, like the big cats that are in the zoos. Mm-hmm. , they still make them hunt for their food. Yeah. Because they need to like still keep those skills and you still want your baby to be like hunting for the nipple in the wild, even though it’s a bottle.

So like letting them root around for it. Wait till their mouth is open and then putting the nipple in. Please do not jam it in like you need a shoehorn to get it in because that’s how we end up with like oral aversions. And if you know, sometimes I’ve seen this, you get the bottle in and they just kind of do nothing.

They don’t know what to do. If that’s the case, if you angle the bottle, so the tip of the nipple hits the roof of their mouth, that generally triggers their suck reflex, and then they’ll kind of get it. And also, what does your face look like when all of this is happening? Because your baby is always watching you as a gauge for how they should be reacting to what’s happening to.

I mean, everything is happening to them at this point in their life. Yes. So we’re gonna un knit our brows. Yes. And UNC unclench our jaw. We’re gonna have a gentle smile and we’re gonna be. What a good job you’ve done. My sweet baby. Even if they have knocked the bottle to the floor, . Yes. Because you want this whole scenario to just be happy, you know, you want them to see the bottle and be like, oh, yay, mommy’s gonna smile and laugh and I’m gonna get milk, and that’ll be so great.

Mm-hmm. , and usually this is all you need. You don’t need, you know, usually this works. It’s, it typically works to give a baby a bottle. It does. And may I recommend also the time of day , do not do this during the witching hour. Yeah. Okay. We need to be introducing a bottle. When it’s a good time to learn new skills for their little brain.

So when they first wake up from their morning nap is a quiet alert time. Yes. So like that beautiful nine 30 to 1130 time of day where you’re like, oh my God, my baby is the sweetest, smartest little chair there ever was. , not 7:00 PM to 10:00 PM for the first time. I mean, we’re talking first time. Everyone should be pretty in just the introduction.

And you know, I think a lot of people hear about bottle rejection over and over and over, and they get worried. So they’re almost afraid to start. And I can’t tell you how many consults I’ve done where I explain all of this, and then I’m like, have you tried? And they’re like, oh no, not yet. And I’m like, okay, try this bef, you know, and there’s always follow up of like, what if they don’t take it from me?

What if they don’t like the bottle and like, doesn’t. Save the what ifs for when it happens. Start simple. Call me tomorrow if it didn’t work. Just go home, make the bottle, be calm, be happy, and say, Hey baby, here’s a new toy that has milk in it. Let’s see what happens. Mm-hmm. , and usually they, you know, it might take them a couple tries of like weird licking and chomping and whatever, but honestly if they are pretty good at breastfeeding, they usually get the.

And then congratulations, you know, you’ve done it. You just wanna practice a little bit to make sure they’re good at it before you actually like have to leave them for 12 hours. Yeah. And I would start with just a small amount. Yeah. You know, no more than an ounce in the bottle the first time, you know, this is a new scale, so like mm-hmm.

it would actually be. A lot of pressure for a baby to be like, all right, you’ve never done this before. Three ounces in 20 minutes, go and you better not drool any of it out the sides, because I worked hard on it. And you can breastfeed right after. You can be like, here’s a snack. Oh, there’s a meal again.

Whatever. They don’t care. Yeah, they don’t care that much. I mean, most of them don’t care. I try to kind of separate it though a little bit. Mm-hmm. , like, if you can have somebody else do it, that is good. But if you can’t, it’s Yeah. Whatever. I’m gonna get into that a little bit later. Okay. After we take a quick break, we’re gonna talk about kind of more complicated scenarios with what happens if you tried these basic concepts and it didn’t work, and your baby’s being a, a bottle if they are being obstinate about bottle feeding.

Okay? All right. We’ll be our beck.

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and we’re back. Hey guys. Hello. Okay. Troubleshooting your baby’s being a butthole, not taking the bottle, and, and your butthole still hurts from birth. I get it , and something is happening here, like the clock is ticking. We have to go back to work. Stress is running high in the house. Possibly we have a partner that just really, really wants to be involved and can’t think of one other way that they could possibly help you out.

We do have an episode on that, by the way. You sound bitter about that. All Heather partner support is important. We’re gonna link that in the show notes. Yeah. We’ll give them other options to bond with your child. Absolutely. But you’ve tried offering baby a bottle in the simplest way and it didn’t work.

What now? My first piece of advice is just hand off the bottle and the baby to somebody else. Sometimes you need to try this when you’re not even home. You’re not even an option. You know, just like your children behave differently for other people when you leave them with babysitters. This happens with babies too.

Sometimes they can’t smell you, they can’t see you, they can’t hear you, and they’re like, fine, I will take replacement milk from whoever this is . And you might never be able to be the one who gives a bottle, but if the reason you’re doing it is because you have to be away from baby, that’s okay. I personally think that you could breastfeed first, and you might disagree with this, but breastfeeding first and then waiting like 30 minutes or so, and then offering it that way.

It’s not really about food, it’s about skill building. I do not disagree with that. Okay. I think that you should try. First when baby is like not stressed out about anything. But if that doesn’t work, try it when baby has just eaten. Try it when they’re a little bit hungry. Like give it a go. Be calm, but give it a go in those different situations to see.

What’s gonna motivate baby, right? Ideally, we’re gonna do it when they’re not super hungry, but they’re alert and they’re skill building. But maybe for your baby, it takes them being hungry to give a hard suck on the bottle, or to be motivated by the taste of milk on the nipple. You know? Yeah. Every kid is just a little bit different.

But also for me, this recommendation that I usually start with of breastfeeding first. Mm-hmm. is. Your brain as a parent is more calm. Yeah. If you don’t think your baby’s survival is, you know, hanging in the balance of whether or not this bottle goes well or not. Mm-hmm. . So if your baby’s already fed and you’re coming at it from a much lower pressure scenario, you’re gonna be calm and your baby’s gonna feel that energy and you’re gonna be much more easily happy in the face.

And your baby’s gonna be like, oh, okay. You know, of course if that doesn’t go. The way you think it’s gonna go, then you might need to have a hungry baby on board and just, or, or you might need a bait and switch. Or a bait and switch. I had to do that with Lira, where I would like give her some boob and hold her in the same position and then like nudge the nipple out of her mouth with the bottle.

Mm-hmm. . And then she would kind of do a few sucks without realizing it and then be like, wait a second. And then I put the boob back in. She was like, okay, , this is fine. And just did that for like longer and longer periods. Over the course of like a week or something, you know, just like a half ounce in the bottle.

And you know, let me also say that these scenarios. Although they do happen, I think are pretty rare. Yeah. So for the most part, babies take bottles, but when a baby doesn’t take a bottle mm-hmm. , it is so stressful that everybody shouts it from the rooftops cuz they need help like tomorrow. Yeah. For going back to work and then it becomes this thing that’s like, oh, should I be nervous about this?

Is this a thing? I don’t believe it’s that common. From what I’ve seen and I’ve seen, I’ve done. Almost 400 visits this year, and let me say, If your baby doesn’t take a bottle the first time, that’s not bottle refusal. Right. We need to try a couple of times and give them the opportunity to learn, because for the most part, if it’s past the first couple days of life, we’re not relying on reflexes so heavily anymore.

Mm-hmm. , and they have to learn. How to use new neural pathways for that. Yeah, it takes some time. Mm-hmm. , and it depends on the age of the baby. I would say the earlier you introduce it, the easier it is, but also the greater the risk that they prefer the bottle. Yep. So we, that’s why we say kind of like that four to six week mark is a good time to start practicing one bottle every 24 hours given by somebody else, preferably.

But, you know, there are some babies that are just like tough, you know, they love the boob. And honestly, like those are the babies where I’m like, try a spoon feed. Try a syringe. I love syringe feeding because you can basically just shoot a couple drops in and you know when they’re getting cranky, you’re like, here.

This is what’s going on. There’s nothing scary. It’s just milk. You know? And you can do that with, with the nipple tea, you can put a couple drops on the outside first. That doesn’t mean you’re syringe feeding three ounces. That’s just to like calm the baby’s brain out. Like five milliliters, . Yeah. Just to be like, relax, there is food here.

Yeah, everything’s fine. Go back to your happy place. Mm-hmm. , learn that skill, . And you know, if you absolutely had to syringe for a whole. It’s doable. It’s not ideal, but it’s doable. It could get you through like an unexpected surgery at the hospital or something, you know? It’s annoying, but not more annoying than trying to force feed a, a sobbing infant.

Exactly. You know, and cup and spoon feeding. These are all great skills to have and they’re good. Kind of like emergency feeding skills for infants too, if you do have an, oh shit, I never introduced a bottle and now we need it today. Yes, and side note with the syringe. Angle it down. Yeah. Towards the well of the cheek.

Never angle it up so it can actually hit the roof of their mouth and hurt them a little bit because it is hard. Yeah. And you don’t wanna create any accidental damage on the roof of their mouth. So the ideal way to syringe feed would be to put it in the well of their cheek, angled down and just do a couple drops at a time and, and then remove the syringe and let them kind of taste it a little bit and make sure they’re swallowing cuz sometimes.

They’re sneaky and they’ll hold it in their cheeks like chipmunks, and you just keep coordinated it in there and then all of a sudden they go and they spit it all out. It’s fun. It’s not fun at all. And if you’re gonna do it, tuck a bur cloth under their fat, roll under their chin so it doesn’t roll down into their chin fat.

Yeah. Since we were doing the Aviva with Lira, she got really good at this and I would like put the tip of it in her mouth and she would like curl her tongue under it and then just suck it and the whole syringe would go. Yep. See, that’s amazing. Yeah. But if your kid is not there yet, all of the, it took like a week of syringe of one syringe every day to get her to do it well, because if you put it down in the well of the cheek and they’re ready to do what Maureen just said, they will actually use their tongues, scoop the syringe, move it to the center of the mouth and suck it completely down.

And that is advanced and amazing to watch. Yeah, it’s pretty cool. Okay. Let’s see. So we could also put some milk on the outside of a bottle nipple or just like, Squeeze the nipple a little bit, like milk it a little bit when it’s at the tip of their tongue. You can make sure try a different temperature, milk, right?

Try fresh milk instead of frozen or thaw or vice versa, you know? Use breastfeeding positions, go to the breastfeeding chair and have somebody try that, like sit in the normal feeding place where baby is regulated and happy and they’re used to looking at the little twinkle stars on the wall. You know, take your shirt off.

Yeah. Skin to skin. Absolutely. And, and don’t be afraid to call for help too. This is like one of the number one things lactation professionals deal with is returning to work, adding a bottle in, navigating that whole thing. So we have lots and lots of experience with this. Yeah. And mostly just like moral support and buying you some time.

You know, sometimes we just need time. And I will say I have had some kids refuse for like a week. Yeah. And so this is where grandma is already watching the kid. Mom’s back to work and grandma is so desperate that they’re literally driving the baby to the place of work. So mom can breastfeed. Mm-hmm. . And I will tell you, if your baby is healthy and medically well and like term and chubby and like three to four months old, it’s always those like four month olds, they’re gonna make it.

Mm-hmm. . But you have to be consistent and you have to like do the syringes and I would. I’m gonna be the mean one and say, I would not recommend cracking and driving all the way to go see mom unless that’s a doable, long term thing, right? It’s really one of those situations where everyone has to get on the same page and bite the bullet because your baby will do it, but your baby, depending on their personality, like I’m pretty sure Maureen would’ve been this.

Type of baby is that they’re just like, unless you show me that this is my only option, I’m going to keep digging my tiny baby heels in and try to get what I want, which is a squishy nipple. So you really have to just show them and be patient and kind and just verbally explain things to them because.

They can understand a lot more than you think. So if you tell them in advance like, grandma’s gonna be here today and there’s not gonna be a boob. You’re gonna get a bottle, it’s gonna be fine. And mommy’s always come back and honestly just like talking in a soothing voice. Yeah. It like soothes you. It soothes the baby

It has this nice little like oxytocin thing going on, you know? Yeah, I told my, this person I’m specifically thinking of right now, I told her to tell her mom to take her shirt off to bottle feed, and she goes, oh my God. The baby would never recover. She’d be traumatized,

But it did. It took a week, and then the baby was finally like, all right, I’ll do it. Yeah, and they’re fine now. But God, there was tears. Absolutely. And, and it’s scary and you do wanna like pay attention to those situations. You don’t wanna just say, well Heather said it was fine, so it’s gonna be fine. We want you paying attention.

Yeah. And like, we just also want you to know it does usually resolve, unless you’re working a 24 hour shift mm-hmm. , your baby’s gonna be fine because. They’d be fine anyway. With a 24 hour shift, it would just be more annoying and you’d have to be a lot more diligent about making sure they got volume in.

But if you’re working an eight hour shift and you’re, you breastfed before you left and you’re gonna breastfeed as soon as you get home, your baby’s probably gonna cluster feed on night and you’re gonna be up on night. Yep. And that baby’s gonna be like, I am so glad that I did a hunger strike today so I could nurse all night with my favorite mom,

But it’s not fun for them to do that, you know? So eventually they’re gonna be like, no, thank you. Yeah. So being in there, you got. Okay, well we are excited to hear all of your bottle success and failure stories if you have any to share. So please send those over to, you know, milkman podcast gmail.com.

We’d love to share your story and we’d love to hear what worked for you if you tried something that we didn’t talk about in this episode. Okay. Let’s take another quick break to thank a sponsor, and when we get back, we’re going to give an award in the alcove.

I tell all my patients who are brand new parents to put a list of soothing techniques on the refrigerator so they can both remember what they’ve already tried for soothing baby. I like to put a happy tummy on that list. It’s a natural herbal wrap that soothes and relieves pain instantly ended so fuzzy.

It’s so great. It helps baby sleep at night, resolves collet gas or constipation and it’s great because it has. Cute animal on the front for when they’re doing tummy time, which provides gentle pressure to help them get their toots out. And you know what? They’re not just for babies. They have them for teens and adults too.

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Okay, everybody, we have a really fun award today. This award goes to Sarah k, and Sarah posted a very cute picture of her breastfeeding in the rain at a Philadelphia Phillies game under a, just take like 20 minutes to try and figure out what sports team it was. . Yeah. Maureen says, Heather, I don’t know anything about sports ball and we had to look up the logo , but.

Such a cool picture. We love it. You know how the Philly, Philadelphia people are about their, you know, sports ball? I don’t, I don’t know. , they’re big into it. They’re like, apparently very The dedication to take your baby to a game in the rain. It’s true, it’s true. I’m pretty sure the Philadelphia fans have some kind of reputation for being very intense and like die hard, so really?

Okay. Okay, so Sarah says, What a win. And our baby was there for her first game. By far, the most people I have fed her in front of it was pouring rain at that time. Hence, she is under my raincoat. Thank you to all the mamas that have posted their public feeding pics that built my confidence to sit unapologetically at a PAC Sporting event and feed my daughter.

Yay. We’re so proud of you. Yes, we are proud of you And the Phillies . Yeah. I mean, congrats to Phillies fans. I don’t really know what you say when a, the sports team. Let’s go Phillies, raw . Let’s go Phillies. Yeah, that’s probably it. Yeah, that’s probably it. That’s for sure what it is. Okay, let’s see. I don’t know that I’ve ever seen a picture of someone breastfeeding under a raincoat at a public stadium before to.

Okay, Sarah, we’re gonna give you the Raincoat Renegade Award for being someone that will breastfeed in all the weather in all the places. And we love that you did that and keep posting your public photos of breastfeeding or your pictures of you breastfeeding in public is what I meant to say, . It’s awesome.

The more we can normalize it, the better. Mm-hmm. , do you think maybe they’ll, like, if you do that in another game, they’ll put you on the big. , you know, they’d like. I hope so. That would be great. Hope I would clap for you. Hope. Thanks. That’d be so nice. . All right, Sarah. Well, we’re super proud of you and your, your team and your baby.

It’s all great. And thank you so much for listening. Oh, wait, we have a, we have an Apple review. Hold on. We do. Do you want me to, it’s on here. You want me to read it? Yeah, would you? Okay. Today’s review comes from Tay Colier and it’s titled Just The Best. Absolutely love this podcast as a breastfeeding mom and labor and delivery nurse.

I love everything about this podcast. I just want everyone to listen. I wanna share all of this knowledge I’m learning from with all my patients and mom. . Thanks Tay Colier. Yeah, we hope you do share it all. That’s off that. That’s a French ass name. Tay Colier. May, maybe we, if she’s from the south, maybe we say it.

Colier. Colier. It’s hard to say. I don’t know. I’m just thinking about that. Mad TV skit. Where he’s like, oh, what’s your name? And she’s like, Yvon. And he’s like, oh, Yvonne, that’s a French ass name. Yvonne. I about the skin. My little quel. . Well look at our little quel. Thank you very much. . Yeah, . And thank you all for putting up with us for another episode where we just say the most ridiculous things.

I swear we know what we’re talking about. If you found value in what we produce for you today, you can join us over on Patreon and. Some love with a small monetary donation for as little as 25 cents an episode. And it means the world to us and keeps this project going and make sure lactation education can be freely available to all people.

Yeah. Thanks guys. I think you said my part too. So See ya. See ya later.

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