Feeding your baby expressed milk: Your questions answered
When can you start feeding your baby expressed breast milk? What’s the best way to do it? And should you be concerned about ‘nipple confusion’? We answer your questions about expressed milk feeding
When should I start giving my baby expressed milk?
If your baby is healthy and breastfeeding is going well, there’s no need to rush into giving her expressed milk. For the first four weeks, you’re working together to initiate and build your breast milk supply while she learns to breastfeed efficiently. While there is limited data,1 it is thought that unnecessarily introducing bottles during this crucial first month could interfere with these processes.
But if your newborn struggles to latch or suck for any reason, then start expressing milk as soon as possible after the birth. Read our articles on overcoming problems in the first week and feeding breast milk to your premature baby or infant with special needs for more advice, as well as getting support from your healthcare professionals.
How can I feed expressed milk to my baby?
There is a range of expertly designed feeding solutions that can help you give expressed milk to your baby, depending on your and her needs.
For example, Medela’s innovative Calma teat will only allow milk to flow when babies create a vacuum by sucking. This means they can feed from a bottle using the same technique, tongue motion and jaw movement they would at the breast.2,3 Developed with breastfeeding experts from the University of Western Australia, Calma allows your baby to suck, swallow, pause and breathe just as she does when breastfeeding.4 By maintaining babies’ natural sucking behaviour, Calma is designed to make it easy to switch from breast to bottle-feeding and back again.
Medela also makes conventional bottle teats in two flow versions. And all our teats can be attached directly to the bottles you express milk into, minimising the risk of spillages.
If your newborn needs expressed milk, but you don’t want to offer her a bottle until she’s become used to breastfeeding, you could use a baby cup designed for short-term feeding. This allows your baby to sip or lap your expressed milk – be careful to avoid spills! It’s advisable to have a healthcare professional on hand the first time you use the baby cup, to make sure you’re both getting the hang of it.
For babies who need expressed milk supplements in addition to regular breastfeeding, a supplemental nursing system (SNS) can be helpful. This has a thin, flexible feeding tube that can be fixed alongside your nipple to give your baby expressed milk while you’re breastfeeding her. This allows your baby to stay at your breast longer, which further stimulates your breasts to help maintain your milk supply, and also helps improve her breastfeeding skills. It can be useful for mums with low milk supply or with adopted or surrogate babies.
If your baby can’t create the suction needed to breastfeed – perhaps because of a disability, congenital condition or weakness – you could try a feeder designed for babies with special needs. These allow infants who can’t suck to feed using gentle compression instead.
What’s the best way to introduce a bottle?
If breastfeeding is going well and you’ve decided it’s the right time to give your baby a bottle of expressed milk, follow these tips:
Take your time
Don’t wait until your big night out or first day back at work to introduce your baby to the bottle. Start trying with a small amount of expressed milk, in a relaxed and unhurried way, a couple of weeks beforehand. Gradually build up to giving a full feed of expressed breast milk from a bottle.
Pick your moment
Ideally your breastfed baby should be alert, but not too hungry, the first time she has a bottle of expressed milk, so that she is as relaxed as possible.
Delegate feeding duties
Your baby may be confused or frustrated when you offer a bottle, as she’s used to your breast. It might be easier if someone else gives the first bottle, and you stay out of the room so your baby can’t see or smell you.
Not too hot, not too cold
Your baby may be more likely to take the expressed milk if it’s around body temperature, 37 °C (98.6 °F).
Dip and sip
Try dipping the bottle teat into some expressed milk before offering it, so it tastes and smells of your breast milk. Then gently stimulate your baby’s top lip with the teat to encourage her to open her mouth.
Positioning for bottle-feeding
Feed your baby on demand and cuddle her in a semi-upright position. Never bottle-feed her while she’s lying flat or prop her up with the bottle, in case of choking. Go at her pace, with as many pauses as she needs – you can even try switching sides during the feed.
Don’t worry if she doesn’t take to the bottle straight away – it may take several tries. If she pushes the bottle away or becomes upset, comfort her and wait a few minutes before trying again. If she still won’t drink from the bottle, wait a few more minutes and then breastfeed her as normal. Try again with the bottle at a different time of day.
How much expressed milk should I give my baby?
Every baby is different. Research shows that in babies aged one to six months, one baby may take as little as 50 ml during a feed while another may take as much as 230 ml. Start by preparing a bottle with around 60 ml, and see if your baby needs more or less. You'll soon learn how much she typically takes – but don’t ever pressure her to finish the bottle.
How can I ensure bottle-feeding is safe for my baby?
Always clean and sanitise your breast pump set and bottles according to the instructions, and wash your hands before pumping, handling milk or feeding your baby. Follow our guidelines for storing and thawing your expressed milk safely.
If warming your breast milk, place the milk bottle or bag into a bowl of warm water or a warmer, or run it under a warm tap (max 37 °C or 98.6 °F). Never warm breast milk in the microwave or on the stove top.
Will my baby cope with switching from breast to bottle?
Mums sometimes worry that if they introduce a bottle too soon, their baby will get accustomed to the artificial teat and struggle to return to breastfeeding. Others are concerned about the opposite problem – if they don’t get their baby used to a bottle early she may never accept one later. Both of these problems are commonly referred to as ‘nipple confusion’.
Experts disagree on whether nipple confusion is really an issue.1 Certainly sucking from a conventional bottle teat that doesn’t require a vacuum to be created is less effort for a baby than sucking from mum’s nipple, as the milk flows more freely and gravity lends a hand. And some babies do seem to have a preference for breast or bottle, and never take to the other. But many babies switch happily between the two.
If you’re still struggling to feed your baby expressed breast milk, speak to a lactation consultant or breastfeeding specialist.
1 Zimmerman E, Thompson K. Clarifying nipple confusion. J Perinatol. 2015;35(11):895-899.
2 Geddes DT et al. Tongue movement and intra-oral vacuum of term infants during breastfeeding and feeding from an experimental teat that released milk under vacuum only. Early Hum Dev. 2012;88(6):443-449.
3 Segami Y et al. Perioral movements and sucking pattern during bottle feeding with a novel, experimental teat are similar to breastfeeding. J Perinatol. 2013;33(4):319-323.
4 Sakalidis VS et al. Oxygen saturation and suck-swallow-breathe coordination of term infants during breastfeeding and feeding from a teat releasing milk only with vacuum. Int J Pediatr. 2012;2012:130769.