Bottle Feeding

Bottle feeding is one of the most viable alternatives or supplements to breastfeeding. However, it has been getting so much negative publicity in the last few years that few mothers bottle feed their babies without wondering whether they are doing the right thing or not.

It has several undeniable advantages: bottle feeding is convenient, relatively infallible and a lot easier to schedule. For mothers who have to work outside their homes when their babies are young, the feeding bottle is a godsend. Also, other than expressed breast milk and formula, babies may be given other liquid foods like juice and soup through the bottle, which makes the transition from milk to other food much simpler at times.

Bottle feeding, however, also has several known disadvantages. It is less convenient compared to breastfeeding -- since a bottle feeding mother needs a fair amount of additional equipment while a breastfeeding mom is naturally equipped. Cost is considerable compared to breast feeding. Bottle feeders tend to swallow much more gas and air than breast feeders, which leads to more olic-related problems. Bottle fed babies are more prone to cavities than breast-fed babies. Further, some babies do not react well to formula, but none have been known to react badly to mothers’ milk.

However, most pediatricians agree that colic, cavities and other such problems associated with bottle feeding are often because mothers are ignorant about the correct technique of bottle feeding.

How to Introduce the Bottle to the Baby

Introducing a bottle can be a little tricky. Done too soon, and the baby might show signs of Nipple Confusion, for she needs to use different sucking techniques for the bottle and the breast. Introduced too late, the mom runs the risk of having the baby reject the bottle completely. The best time to introduce the bottle seems to be after the baby begins to feed well from the breast, roughly three to four weeks after birth.

There are two simple strategies moms use to ensure that the introduction is successful. First, offer the bottle before baby is mad with hunger. This is when she is likely to be willing to try something new and hungry enough to be interested, yet not so hungry that the bottle with its cold nipple frustrates her. You'll want her to be hungry and interested, but not so hungry that this cold nipple will frustrate her. Second, try getting another caregiver to offer the bottle. As long as she smells mother’s comforting smells, she is not going to want any other form of sustenance. Sometimes wrapping the bottle in a piece of mom's clothing helps.

How to place the nipple inside the baby’s mouth? Instead of forcing it in, place the nipple near her mouth and let her put it in herself. Some mothers report that warming the nipple a little helps the baby take to it better.

The Right way to Bottle feed

Bottle feeding should ideally be as nurturing an experience as breast feeding. So take it as an opportunity to hold your baby, with the head a little higher than the rest of the body. If this is not done, sometimes the milk reaches the inner ear causing an ear infection. Here are some other basic dos and don'ts to keep in mind while bottle feeding.

• Since nurturing is important and necessary for the baby, propping the feeding bottle is psychologically unwise and also potentially physically dangerous.
• Tilt the bottle till the milk fills the nipple. Hold the bottle so that it sticks straight out at a right angle to the baby's mouth. This ensures that the baby does not swallow air with the milk from the nipple.
• Check to see that the milk comes out of the nipple slowly (about one drop a second is fine). If you notice that the baby is drinking noisily or too fast, it could mean the hole in the nipple is enlarged or cracked.
• With regular glass or plastic bottles, look for air bubbles entering the bottle when the baby is drinking steadily. If you don’t see the bubbles, it means that milk has stopped flowing, either due to a clogged nipple or due to vacuum in the bottle.
• Never force the baby to finish a bottle. Look out for signs of fullness – she could stop sucking, lose interest, spit out the nipple or seal her lips.
• Alternate arms during feeding, to give the baby a different view and to allow her extra eye movement.
• Don’t forget to burp the baby! Put her on your shoulder and pat her back gently until she burps. If this does not work, try holding baby face down in your lap and pat her back.

Did You Know?

• One way to warm the bottle is to keep it in a pan of hot water or by running it under a hot water tap. There are many types of bottle warmers available in children’s stores as well.
• NEVER use a microwave oven to heat bottles. It causes the bottle to heat unevenly, creating pockets of heat that could cause burns. Also microwaves cause vital nutrients in food to break down. Even more worrying are reports that microwave heat causes the plastics or acrylics in feeding bottles to leach into the milk, or alters its components into harmful forms. According to a report in the December 9, 1989 issue of Lancet, Dr. Lita Lee of Hawaii reported -- Microwaving baby formulas converted certain trans-amino acids into their synthetic cis-isomers. Synthetic isomers, whether cis-amino acids or trans-fatty acids, are not biologically active. Further, one of the amino acids, L-proline, was converted to its d-isomer, which is known to be neurotoxic (poisonous to the nervous system) and nephrotoxic (poisonous to the kidneys).

Are Plastic Feeding Bottles Safe at all?

Plastic feeding bottles are made from one of two compounds: polyethylene (or EVA plastics) and polycarbonate. While both materials are considered generally safe, research has shown that polycarbonate is not very stable at higher temperatures. If milk is heated in polycarbonate bottles for 20 to 30 minutes at 100 degrees centigrade (212 degrees Fahrenheit), a chemical called bisphenol-A could contaminate it.

Baby bottle manufacturers argue that nobody should ever boil baby milk or formula in bottles, so this criticism is not valid. Both the U.S. Food and Drug Administration and the Juvenile Product Manufacturers' Association say that bottles warmed to room temperature are safe for your baby, just so long as they are not heated to high temperatures for long.

When to Change that Old Nipple or Bottle

Nipples or teats need to be checked carefully and periodically for signs of wear (look out for discoloration, thinning and cracks). Replace all worn ones, for they could break in the baby’s mouth and become a choking hazard.

Upturn the filled nipple to see how liquid flows out of it – if it drips steadily, the nipple is fine. However, it pours out in a stream, the hole is too big and the nipple should be replaced.

Plastic bottles are unbreakable but they do deteriorate, so you need to replace them regularly. Look out for signs of deterioration – when they begin to look less transparent, or change colour, they need to go. As a rule of the thumb, change all bottles being used regularly after two to three months. Glass bottles may do a better job of retaining the nutrients in formula — and they never need to be replaced as long as they don't break, chip, or crack.

Dos and Don'ts using Plastic Feeding Bottles

• Choose the right bottles. Today, you can choose between a right-angled bottle that lets in less air into the nipple, or a sreamlined bottle that baby can hold himself, and a variety of disposable bottles. You also can choose between plastic and glass. If you'd rather not use polycarbonate bottles, you could use disposable nursers with throwaway liners that contain no bisphenol-A.
• Never store breast milk or formula in plastic bottles. Pour it into the bottle just before your child drinks it and discard any left over.
• Always follow the FDA's advice and never overheat bottles with breast milk or formula in them.
• Don't feed formula left at room temperature either in a nursing bottle or open can for more than an hour.
• Don't leave a bottle containing formula or anything else with your baby to calm or help him or her sleep. Your baby's teeth are developing and milk, formula, juices or other liquids that remain in your baby's mouth can lead to cavities.

Nursing Problem Feeders

First, try and assess why your baby is not interested in the bottle. If she does not regularly wet her diapers or is not gaining weight satisfactorily, see your doctor. If everything else is all right, try some of these strategies.

• Change feeding positions. Some babies like different positions every time, others feel smothered if they are held too close. Some like to be propped up against the caregiver’s legs, others like being held facing out with baby's back against caregiver's chest.
• Try feeding baby while moving rhythmically: rocking, walking or swaying side to side. Some babies who refuse a bottle at other times will take one when riding in a car seat.
• Experiment with other nipple shapes and types, for different children have different preferences. Nipples could be made of latex, silicone, or rubber. Latex nipples are soft and more flexible, but short-lived. Silicone nipples are firmer but harder than the latex ones. Nipples also come in different shapes -- traditional, orthodontic, or flat-topped nipples. Orthodontic nipples, have a flattened bulb that rests on your child's tongue, and are designed for your child's palate and gums. The flat-topped nipples are shaped like mother's breasts.
• Try other methods of feeding like sippers, cups, spoon, milk-droppers.

Alternatives to Bottle feeding

These alternative methods may take a little bit longer than conventional bottle feeding, but none of these methods are difficult to use.

Cup Feeding – Even newborns can drink milk from a cup, lapping it up like kittens, or drinking it slowly, drop by drop. Cup drinkers are least likely to get nipple confused, and more likely to go on to successfully breastfeed. Many neonatologists prefer this method of feeding for premature babies, and have successfully used it to feed babies with gestational ages as young as thirty weeks. Research has shown that premature babies actually maintain a more stable blood-oxygen level during cup-feeding than during bottle-feeding.

Here's what to do: Ideally, use a small cup with a spout (a small milk jug will do well, or you could buy special cups available in the market that are meant for infant feeding). Fill half the cup with formula or expressed breast milk. Hold baby on your lap in an upright supported position, and tilt the cup so the milk just touches the baby’s lips. Allow baby to lap up the milk and swallow at her own pace. Don't pour the milk into baby's mouth; she may sputter and choke.

Spoon Feeding – this is a much more time-consuming alternative, but works just the same, especially with babies who have not learnt to suckle well. Support her upright on your lap as you would for cup-feeding and offer small spoonfuls of milk, placing the tip of the spoon on her lower lip. Allow her to swallow the milk at her own pace.

Eye Dropper or Feeding Syringe – You could use specialized droppers to drop milk into the baby’s mouth while holding her upright on your lap. A feeding syringe is similar to an eyedropper, but it holds more.

Nursing Supplementer (also known as supplemental nutrition system) – This allows baby to receive supplements while she is being breast fed. A container for the milk (either a bag or a plastic bottle) hangs from a cord around mother's neck. Narrow silicone tubing runs from the container to the tip of mother's nipple and is secured with tape near the nipple. So when the baby latches onto the breast, she gets the supplement along with breast milk. This technique is often used when the mother is not producing enough milk or the baby is not suckling properly. The sucking helps stimulate the mother's milk supply, and the supplement rewards the baby for sucking properly. It may also be used by mothers nursing adopted babies, or by those who want to re establish lactation after early weaning or an illness. For more, go to Nursing Supplementers.

Finger Feeding – this technique is used with babies who have not yet learned how to latch onto the breast. It involves using a nursing supplementer to provide milk while baby sucks on an adult finger. Instead of being taped to the breast, the supplementer’s tubing is taped to the adult finger, and the finger is gently inserted in the baby's mouth. An alternative to the suupplementer is the feeding syringe.

Other Feeding Devices – these are designed for special circumstances. For example, the Haberman Feeder, is used for infants with oral-facial abnormalities, such as cleft lip or palate, receding jaw, or babies who have a developmentally delayed suck. This bottle has a long nipple and a valve that regulates the flow of milk.

References

• Baby Center
• Alternative Feeding Methods
• Ask Dr Sears