Infant feeding can be one of the most significant challenges that new parents face. These challenges may be short lived or ongoing and are often the source of significant parental stress. A lot goes into decision making around infant feeding and it can be an intensely emotional experience when it doesn’t go as planned.
What happens when your goal is to breastfeed, and the baby isn’t latching? Or how about a baby who has breastfed exclusively for several months and now needs to transition to bottles because their mother is returning to work, but they’re refusing bottles? Is bottle feeding the only way to feed a baby when breast/chestfeeding isn’t an option? In a culture so focused on bottle feeding as the only alternative to bottle feeding, it is easy to forget, or to not even know that there are other ways to feed an infant. We will talk about them now.
Best used with newborns under one week old, syringe feeding is an excellent way to feed human milk or formula to a baby. This can be done as a supplement to completely replace a feeding or as a top up after breastfeeding to help increase calorie and fluid intake.
To syringe feed, use a small 1ml or 3ml syringe. Tickle the baby’s upper lip and wait until the baby opens their mouth. Once open, slide the syringe gently into the baby’s mouth and place it next to the baby’s cheek. Slowly push on the depressor and squirt 0.1-0.5mls of milk at a time, ensuring the baby swallows before giving them more. If the milk begins to dribble out of the baby’s mouth, stop and take a break before trying again.
Spoon feeding is an excellent way to provide expressed colostrum (the first milk) to a newborn as a way of waking them up with some sugar before latching, after nursing to provide a little more milk and calories (also gets in more breast stimulation and milk removal which will help boost milk production) or as a way to replace feedings if an infant is too sleepy or unable to latch and/or suckle enough to remove milk.
A tiny plastic spoon or a cutlery teaspoon are good utensils for spoon feedings. There are specialized spoons that are available specifically for spoon feeding infants that have an extra reservoir that the baby can drink from.
To spoon feed, it is best to have the infant swaddle, if they’re used to that, and positioned upright. The milk is touched to the infant’s upper lip. This should stimulate the baby to open their mouth and stick out their tongue, or open and close their mouth. The goal is to have the baby lap up the milk out of the spoon. Avoid pouring the milk into the baby’s mouth.
Cup feeding is a fantastic alternative to bottle feeding at any age. Newborn babies who are over one week old and need more milk at each feeding, and older babies who refuse to bottle feed can cup feed as a way of getting nutrient and fluid intake. Some cultures opt to cup feed when mother needs to be separated from baby rather than defaulting to bottle feeding.
The technique for bottle feeding is very similar to spoon feeding. The goal is to touch the liquid to the infant’s upper lip and have them lap it up out of the cup. Avoid pouring milk into the baby’s mouth. There may be spilled milk while this skill is still new. Once you and the baby get the hang of it, there will be less mess and more milk in baby’s tummy. This option may be chosen over spoon feeding if the volume of milk the baby needs at each feeding is over 30mls, as a cup can hold more volume than a spoon.
Lactation consultants often suggest tube feeding as an alternative to bottle feeding when there is interest in preserving the breastfeeding relationship, yet body feeding is not providing all the milk volume that a baby needs. Tube feeding at breast/chest can be done short term or for the duration of the lactation period.
Tube feeding can be done in 2 different ways:
- Tube finger feeding: This may be used if a baby is having difficulty latching and the short-term goal is to transition to breastfeeding.
- Tube feeding at breast: This is also referred to as a lactation aid or a supplemental nursing system. This is used when the baby can latch and needs supplemental milk on top of chest/breastfeeding. If a baby is partially breastfeeding first, the tube and supplement should be offered only after the baby has drunk everything they can from their lactating parent first.
Whichever method is being used, there are also 2 different ways of delivering the milk to baby through the tube.
- Actively pushing milk into the baby’s mouth through the tube that has a syringe attached to the end of it. In this case, the caregiver feeding the baby would push about 0.5mls at a time while the baby is sucking, stopping or slowing down if the baby shows signs of stress such as gulping, coughing, wide eyes, flared arms, dribbling milk out of their mouth or any signs of choking.
- Passive draw of milk by the baby’s sucking through the tube that is placed in a bottle of milk. Gravity can help increase or decrease flow when needed. Raising the bottle above the baby’s head will increase flow, which is useful to initiate flow at the beginning of the feeding. Bringing the bottle below the baby will decrease or stop flow. During the feeding while it is going well, keeping the bottle at the level of the baby’s head is best.
How to attach the tube for correct placement can be the trickiest piece of this feeding method. The tube can be taped on the side of a finger or at the breast so that when the baby is sucking, the tube will be at the corner of the baby’s mouth and sit along the side of the baby’s tongue. It should be taped so it does not extend past the tip of the finger or the nipple. When finger feeding, hands should be clean and fingers trimmed. The pad side of the finger should be up towards the roof of the baby’s mouth, with the fingernail on the baby’s tongue.
Additional Tips to Help With Feeding Your Baby
With any feeding method, it is important to remember that a baby’s mouth is a private and sensitive space. Be patient with your baby and recognize when your baby does not want anything in their mouth. Always tickle the baby’s upper lip area with a finger or nipple and wait for the baby to open wide before introducing finger, syringe, nipple into their mouth and allow your baby to draw it in as far as they would have it go. Some babies have more sensitive gag reflexes, and this is something to be aware of when offering any alternative feeding method, including bottles.
Why Choose an Alternative Feeding Method Over Bottle Feeding?
So, maybe you’ve read this far and you’re wondering, “what’s the point? Why would I want to choose an alternative feeding method over bottles”? Bottles are designed to be easy for babies to drink from, so the flow of milk is often much faster than from a human body. There is a TON of marketing that goes into selling bottles and several claim to have wonderful qualities that will make your baby think they are in fact drinking from a breast. No matter which bottle brand, shape, type, size you choose, a plastic bottle nipple is not flesh and the flow of milk from a bottle will never be the same as from a human body.
If your primary goal is to breastfeed or chestfeed, whether it will be exclusive chest/breastfeeding or bodyfeeding with occasional bottles or a half/half combo, it is better to focus on establishing a deep latch and good body feeding first before introducing bottles. Introducing bottles too soon may cause flow-related or nipple related preferences that can make body feeding more challenging. To learn moreabout the best way to bottle feed and when to introduce a bottle, read our blog, “How to Bottle Feed (the Better Way)”.
Need Some Support?
Need help or have questions about any of these feeding methods? Reach out to a lactation consultant today!