Bottle Feeding A Breastfed Baby - Paced Bottle Feeding

Paced bottle feeding is a bottle feeding technique that mimics breastfeeding.  I first heard about this technique from an IBCLC (Internationally Board Certified Lactation Consultant) coleague of mine (Flossie) in the US.  It's a great tool to use when you are going back to work and you will be expressing your milk.  Many times women have spoken to me about going back to work and not being able to express enough milk to leave with the carer.  Often times carers are not used to caring for a breastfed baby and so these tips on bottle feeding like breastfeeding so that they can provide the level of care that is best for baby and your milk supply.

Breastfeeding and breastmilk are the normal ways to feed a baby and provide many benefits such as - 

• Baby can control the flow of milk and length of the feed.
• Baby can take pauses during a feed just as we do.
• Baby is held close.
• Baby switches sides which helps with eye development.

Paced bottle feeding is a technique that will help baby regulate their milk intake and give them time to listen to their bodies hunger signals.  It's also a very respectful way to feed any baby.

We've all seen bottle feeding in the movies and on tv or when we are out and about.  Usually baby is laying down with the bottle sticking upright out of their mouths.  Bottles are designed to drip milk whether they are being sucked or not, so if you hold a bottle upside down you'll see the milk drip out all by itself.  So, when a baby is being bottle fed as described above with an upright bottle they need to swallow the milk at all times and cannot take pauses.  Bottle fed babies are also encouraged to finish the bottle (it's expensive stuff!).  We can now see why a bottle fed baby will gain weight at a higher rate than a breastfed baby and possibly why studies have shown that formula fed babies have a higher risk of obesity in adolescence and adult life.

Paced Bottle Feeding

• A straight edged bottle is best for paced bottle feeding.  When you hold the bottle horizontally you do not want the milk to pool in hand grips and bulges and not be able to reach the nipple/teat.
• A breastfed baby takes about 2-3oz per feed, so start with small amounts.  If you freeze your milk in small amounts you will not waste as much.  If you give the carer a few 1oz portions for emergencies then they can be easily defrosted and if they are wasted then it's not a huge amount.
• Snuggle baby close to you sitting facing your right or left side (you might find it easier for someone else to bottle feed your baby as it will be a little confusing for baby if you are there but they can't have milk direct from the source).
• Invite baby to latch to the nipple/teat with a wide open mouth just as they would when breastfeeding.  This encourages a good latch at all times and is respectful of the baby.  Noone wants a bottle forced into their mouth.
• Hold the bottle horizontally so that the milk isn't using gravity to flow out of the bottle.
• Let baby feed.  Allow pauses and breaks just as baby would during breastfeeding.  These pauses allow baby to listen to signals from their body telling them if they are hungry or full.
• Switch sides each feed or halfway through a feed if you decide to burp baby.  This will help baby's eye development and reduce the possibility of side preference.

 A bottle should NEVER be propped.  A propped bottle can cause choking because an infant may not be able to push the bottle out of their mouth to prevent it, and propping the bottle may encourage you to believe that you can leave the baby unattended which should never happen when baby is being fed.

If you are going back to work soon and you are wondering what to dress your baby in for "school", then consider these adorable infant T-shirts with witty breastfeeding slogans from Lactivist.  They are available in sizes 3mo-18mo in 100% organic cotton from BoobieMilk.  Help promote breastfeeding initiation and duration in your own way with these adorable infant T-shirts at BoobieMilk for only £12 each.

 

Win Tickets to the Baby & Toddler Show at Glow, Bluewater!

I have exciting news!

BoobieMilk will be fitting and selling nursing bras at the Baby & Toddler Show supported by Emma's Diary at Glow Bluewater on October 5th-7th

 

This will be my first three day event and I've been busy busy deciding what to take and how to dress my stand.  Bluewater is a great location for a big baby show because it is very close to the M25 and there is tonnes of FREE parking.  You can also make a real day of it by eating at one of the great restaurants at the mall and popping in to catch a movie before going home.  I had some great soft tacos at a mexican place I'll have to look it up for you.  But be warned that the margharita's are tiny from an American point of view.  Wahaca!

If you have never been to a Baby Show before then let me tell you why you might want to come along.  It's a one stop shopping experience for everything you might need for your baby or toddler.  All those important items on that ever growing list of things to get before the baby arrives can all be done in one place.  If you've never shopped for a buggy before then this is the place for you, you can get up close and personal with every buggy you ever dreamed of and find out how difficult they are to open and close and feel how heavy they are.  We have the Inglesina Zippy by the way, it's small, easy to fold, light as a feather and has lasted through two kids, although I will tell you that I use a sling 90% of the time.

Here are some other great companies that will be there - 

Baby Sensory - Ellie loved all the bubbles and parachutes used during her classes in Sevenoaks.

Snugglebundl - Who can forget this fabulous idea for a blanket with handles for easy sleepy baby transfer.

Play Duvet - A great idea from some lovely people, a big play mat which you can all fit on.

Bibisili - Fun and Funky silicome bibs with crumb catchers that you can put in the dishwasher!

Tell all of your friends about The Baby and Toddler Show sponsored by Emma's Diary at Glow Bluewater they will have such a fab time.

Opening times -

Friday October 5th - 1:00pm - 8:00pm (late night opening!)
Saturday October 6th - 10:00am - 5:00pm
Sunday October 7th - 10:00am - 5:00pm

Full address for your satnav - DA9 9SG or check out their own directions and follow signs to GLOW

Come see BoobieMilk at stand J36 for your FREE fitting.  I'll have a selection of Emma-Jane, Carriwell and Hotmilk nursing bras and nursing vests for you to try on as well as some new products you haven't seen before and some fabulous items from Lactivist.  I will be holding a competition over the weekend for some fabulous breastfeeding goodies and if you enter the competition you not only get the chance to win, but you also receive 10% off your purchase.

I am taking advanced bookings for fittings so don't hesitate to reply to this email or send me a message to set up a time during the weekend for your very own FREE fitting and if you book ahead before the show, I'll give you 15% off your purchase.  Prices start at just £10.

I have 5 pairs of tickets for you to win so please use the rafflecopter to enter for your chance to come to the show for FREE.

a Rafflecopter giveaway

(Use code BT13 to pay £10/2 tickets if you're not feeling lucky) 

How To Start Pumping So That Dad Can Feed Baby

Following on from my last post about bonding without feeding I thought I'd share some tips on pumping so that Dad can feed the baby.  I am as ever a realist and even if I think it's not what I would do, I know that many women want the Dad to feed baby from early on.  You are probably going to need to express some milk at some point for a date night or returning to work or an emergency back-up.

I would suggest waiting until your milk supply is established before you start to express your milk for the following reasons - 

• It's important to establish a good supply in the first 4-6 weeks and the baby on-demand feeding at the breast is the best way to do this.
• Expressing very early on can make you doubt your supply because you are expressing such small amounts (which is normal), you are pumping only left-overs and it can take time for your body to react positively to expressing by hand or pump.
• Pumping is another chore, ask anyone that pumps.  It's not the most fun and it involves extra washing and sterilising not to mention equipment.
• Early supplementation with donor milk or formula can affect your supply by telling your body that you don't need as much milk.  Often it is the late night feed that is supplemented in the hopes that baby will sleep longer, but you should know that baby feeds often at night because your milk making hormones are at their highest after midnight and feeding through the night helps with your supply.

A milk supply is usually established in the first 4-6 weeks and baby does this best.  It's the time when the foundations for a good long term supply are set down.  If you have decided as a family that you need to give a bottle for whatever reason then here are some things for you to consider.

• To maintain your milk supply and exclusively breastfeed then you will need to express your milk.  If you decide to use donated breastmilk or formula for this feed then you need to understand that your body will react to one less feed at the breast by making less milk, which can in turn lead to a premature end to your breastfeeding relationship.
• Try to wait until your milk supply is established at 4-6 weeks.
• Work out the best way to express your milk (by hand, a manual pump, electric pump) and if needed buy an appropriate pump.
• Find a time once a day to express milk and try to express at the same time each day so that your body gets used to the "feed" and starts making an additional feed.
• Be patient, you will only be expressing leftovers at the beginning until your body adapts.
• Try to feed your baby with a bottle just like you would at the breast so that he/she is held close and has more control over the flow.

Introducing a bottle works for many families, and as you can imagine it also doesn't work for others.  Mum can often go to bed a little earlier and then Dad can do the last feed of the evening.  Keep in mind that you really should be expressing when baby receives the bottle as the best time, and that if you sleep through a feed you may become a little uncomfortable and engorged which may wake you up.  Lots of partners have also gone back to work and may want to get some much needed sleep too, so again it's all about your own family balance.  I have always found it so much easier and much less time consuming to feed directly from the source at night so that I can take advantage of those lovely hormones released that help me drift back to sleep.














If you are going back to work, pumping every day will help you build up a stash of milk for the baby's first day at nursery or Grandma's house.



I don't sell pumps and there are many choices out there.  When choosing a pump think about the effort that has gone into its production.  Does the company involved spend a lot of research on pump development?  Do they make a lot of money from selling bottles?  Do they follow the WHO code of marketing of breastmilk substitutes?  There is only one company in the UK that adheres to this code of marketing and that is ARDO.

How Can Dad Bond With Baby?

A common concern for many new parents how how can dad/partner/granny/grandad/brother/sister/uncle/postman bond with the baby.  It comes up A LOT so it must be on the minds of many new parents.

Apparently word has spread that the only way to bond with a baby is to feed them (I'm sure the formula industry spread this rumour, but that's just my guess).  Feeding is definitely a bonding experience, but then why are there so many products on the market that help babies to hold their own bottles.  I often see bottles propped with a towel and babies being bottlefed in buggies and bouncy seats.  If bottle feeding is such a bonding experience and so important for bonding then why are babies being taught to do it for themselves and left unattended while doing it (choking hazard!).  What I love about breastfeeding is that I have to be present.  I can't give it a miss today or go into another room while it's going on.  I admit it, I'm quite lazy.  I have a short attention span, I google while nursing but I am present, and we have some amazing "conversations" when breastfeeding (not real conversations, she has her mouth full and can't talk yet) we also have lots of snuggle time.

I think that feeding can get a little tiresome after a while (hence the propped bottles), but Dad gets to do all the fun things with baby while we wash laundry and cook dinner.  When my son turned two he forgot I even existed and became a real Daddies Boy.  Nursing became something we did just before bed/nap or during the day when Dad wasn't around.  When he falls over he doesn't ask for me.  When he wakes in the night he doesn't ask for me.  We do have our very own special bond, but I don't think that Daddy has missed out by not having bottlefed him as an infant.

Anyway, as you can tell I'm in the "Daddy doesn't have to feed baby to have a bond with baby" camp but here are some suggestions for Daddy/Baby bonding time - 

• Wear baby to help soothe and sleep
• Skin-to-skin contact in the hospital and at home
• Rock baby to sleep
• Bathe baby
• Sing to baby
• Play with baby
• Take baby to a baby class
• Take baby on a walk

and I'm sure you can think of a few more.  If nothing else, Mummy will love you for those few minutes she gets to herself to pee or eat.

As baby grows older you will both create such important but such different bonds with your baby/child that you will forget even worrying about it at the beginning.

I asked my husband if he minded that I did all the feeding after we had our second (Ellie).  We had no feeding problems with Ellie and his response was that he loved to boast to his friends that he was getting tonnes of sleep because he didn't have to get up in the night.  We bed-shared and I nursed lying down so Ellie nursed and slept without a sound all night long.  He never mentioned a problem with bonding, in fact they both light up when he enters the room each evening after work and there is no denying that they love each other to pieces.

I actually wonder whether it is the Mum who wants Dad to feed the baby because breastfeeding can seem overwhelming at first.  It is an enormous responsability for one person, and it can sometimes seem that it is all you do some days.  I remember those early days when I spent all day on the couch nursing and dozing (don't tell the health visitor) and watching Dexter on the laptop changing episodes with my big toe.  My husband would come through the door and I would throw William into his arms and run (more hobble) up the stairs to pee.

My words of wisdom - Your baby is only tiny for a very short amount of time and it will fly by.  Breastfeeding is really important and it will take time to master and it will be time consuming at first, but before you know it your baby will be feeding faster and sleeping longer and you'll wonder why you were even worried in the first place.  Take these first few precious months, take a seat and feed your baby.

The first few weeks are going to fly by and you are going to be busy feeding and healing and getting to know your baby (not to mention the dirty nappies that Dad will be changing).  It can be hard to get out of the house for errands that don't involve family, breastfeeding support groups or Doctor visits.  Invest a little money in some great value nursing bras that will help you through this transitional time from pregnancy, birth and breastfeeding.  Transitional nursing bras can accomodate small changes in cup size so that when your milk volume increases after birth you won't need to think about which nursing bra to wear.  They are also seamless and super comfy to sleep in and wear all day long.  Because they can accomodate small changes in size they only come in a few sizes and are easy to fit too from bands 32-44 and cups A-H.  Check out these Nursing Sleep Bras from BoobieMilk starting at just £10.

7 Ways To Encourage Infant Weight Gain To Make Your Health Visitor Happy

I've mentioned before that some health professionals may have higher expectations than you or me when it comes to weight gain.  They may not be using the most current growth charts or they may just not be used to seeing many exclusively breastfed babies at their clinic.  Some babies gain weight faster than their friends, and some gain weight slower.

Always look at your baby as a whole.  Is he/she content, alert, meeting developmental milestones, peeing, pooping and in general good health and born at term?  If your baby was born a little early then you can use the same growth charts, you just need to subtract the number of weeks they were born early to read the correct weight expectations.  An infant born 8 weeks early should be plotted accordingly and would reach 12 months of age on the chart 8 weeks after their birthday..

If all is OK, but the health visitor is still not happy with your baby's weight gain and you would like to please them (I don't think it's mandatory) here are some tips to encourage more weight gain.

• Offer feeds more often.
• Offer the second or third breast if not already doing so.
• Use breast compressions or do a little breast massage once you feel that feeding has slowed or baby is falling asleep.  (Hold down the breast for a number of seconds to provide a sudden gush of milk which may wake a sleepy baby and massage towards the nipple to help move the thicker, fatty milk towards the baby's mouth).
• Lots of skin-to-skin contact with baby is great for getting those lactation hormones going.  Take a few days and spend them in bed with baby just snuggling and feeding.
• Make sure you are drinking plenty of fluids and eating well, it can be easy to let things slide when you have a new baby to take care of.  Continuing to take a multi-vitamin can be beneficial too.
• If you have the time or inclination and are going back to work anyway you could consider pumping once a day at the same time to cheat your body into thinking you need an extra feed each day.
• Expect to cluster feed at some point during the day and go with it.  The more a baby feeds at the breast on-demand the better your supply will be.  If you are using a dummy, hide it for a few days so that baby is feeding at the breast at every opportunity.  If baby is able to get all of their sucking needs met at the breast then you'll have a good supply and benefit from not having a period or being fertile for longer (LAM - Lactational Amenorrhea)

Try some of these or all of them consitantly for a few days or weeks and may make your health visitor happier.  Of course, if she is expecting a 20oz weight gain in one week then she will always be disappointed.  Talk to your health professional about their expectations.  Have an open and honest discussion with each other.  A good health professional is one that listens and works with you not against you.

I have recently met a few new mums who have extremely sensitive nipples which causes pain for them usually between feeds and when they are in cold places such as the freezer aisle of the supermarket.  I too suffered in this way for a few months after my son was born.  My nipples were white when they came out of my sons mouth and I had pain between feeds.  If this has happened to you, make sure that you see a local breastfeeding specialist to make sure it does not need medical attention.

A company sent me a sample of their new breast warming pads and I shared them with one of these new mums to see if keeping her npples warm between feeds would help with the pain.  Her comments are here - 

 "I found Breast Aid very comfortable and definitely kept the breast warm so ideal for preventing nipple vasospasm associated with Raynaud's. If you position the pad exactly right the nipple isn't squashed and if worn under the Emma Jane bra (which does compress the nipples)  the pad helps to push it out again therefore minimising compression of the nipple so ideal for Raynaud's sufferers. I've also worn them outside when it's been really cold and they've really helped to protect the nipple from the cold."

You can find other testimonials at the company website here, note that I used my name instead of the clients to keep her anonymous.

I have these new breast warming pads in stock if you feel they could help your situation.  They are created using flectalon which reflects your own body warmth, keeping the nipples warm and helping milk flow.  They come in small and large in colours black and white.  Buy your own Breast Warming Pads for only £22.50 at BoobieMilk.

Baby Weight Gain Challenges

Baby weight gain discussions can become very heated.  In recent days past the growth charts were not the best guide for breastfed babies having been created using growth data from middle American formula fed caucasion babies.  I think even someone who doesn't have a scientific background could tell you that they wouldn't be the most accurate in the case of majority of babies.

"The WHO Multicentre Growth Reference Study (MGRS) was undertaken between 1997 and 2003 to generate new growth curves for assessing the growth and development of infants and young children around the world.
The MGRS collected primary growth data and related information from approximately 8500 children from widely different ethnic backgrounds and cultural settings (Brazil, Ghana, India, Norway, Oman and the USA).
The new growth curves are expected to provide a single international standard that represents the best description of physiological growth for all children from birth to five years of age and to establish the breastfed infant as the normative model for growth and development".

read more here

When comparing the American CDC growth charts and the WHO growth charts differences were found - 

" Overall, the CDC charts reflect a heavier, and somewhat shorter, sample than the WHO sample. This results in lower rates of undernutrition (except during the first 6 mo of life) and higher rates of overweight and obesity when based on the WHO standards. Healthy breast-fed infants track along the WHO standard's weight-for-age mean Z-score while appearing to falter on the CDC chart from 2 mo onwards".  taken from Comparison of the WHO Child Growth Standards and the CDC 2000 Growth Charts Mercedes de Onis, Cutberto Garza, Adelheid W. Onvango & Elaine Borghi J. Nutr. January 2007 vol. 137 no. 1 144-148


The resulting growth charts are now used for infant growth in the UK, USA and beyond.

Although the charts have been improved, you may still need to keep in mind that many health professionals were trained before the new growth charts were released.  You may also want to keep in mind that these same health professionals may not see a huge number of exclusively breastfed babies.  Only 3% of babies in the UK are still exclusively breastfed at 5 months old (UK National Statistics), so give them a little bit of a break for being shocked and for expsecting your baby to behave the same as a formula fed baby.

When looking at an infant for signs of good health the health professionals are probably going to be looking for the following - 

• Baby looks well, alert and happy
• Baby has gained back birth weight by 2 weeks of age
• Baby is peeing lots and pooping regularly (pooping can slow down after the first few weeks/months)
• Baby is content after a feed
• Baby is gaining about 1/2oz - 1oz per day in the first few months (3 1/2oz-7oz per week)  I think I remember that an ounce is about 28-30g from home economics class at secondary school

These are just guides, all babies are different.  Some will gain more and some will gain less.  Some will gain more one week than another so weighing too often can put you on high alert.  There should be an upward trend though, and after a few weights you should be able to see where on the growth chart your baby has decided to stick.  A rough guide in the first year would be a doubling of birth weight by six months and a trebling of birth weight by twelve months.

You have to look at the baby as a whole.  A quiet baby that never cries and sleeps a lot, although perfect in your eyes may be missing feeds and may in actual fact not be feeding well so you might not see lots of nappies and weight gain might be slow.  If you or your health professional are at all concerned about weight gain sit down and have a frank discussion about it.  Talk about all of these things and also talk about any expectations that either of you may have.  If either you or your health professional are expecting a weight gain of 20oz in one week then there is bound to be disappointment.

You may see babies in your group of friends with very different growth patterns.  There are no awards for having a baby in the 99th percentile for weight, it's not a competition.  What you ARE looking for is for YOUR baby to find his or her own percentile.  It may take a few weeks to find it, but once they do they usually settle into their curve and stick to it near enough.  A sudden deviation from a childs usual curve can be an indication of something not being quite right.

An average feed for a breastfed baby is about 2.5-3oz (references can be viewed here), so you can see why a formula fed baby might gain weight faster.  In nursery I was once chastised by a carer for only having 3-4oz in each bottle of expressed milk.  The other infants in the class had 6-9oz in their bottles of formula and she assumed that I should do the same.  In fact, I never needed to increase the amount above 4oz in the entire first year (he stopped having milk in a bottle at 12 months), and although I provided two additional 1oz bottles each day "just in case", they were never used but kept the carers happy.

William was born at 9lb and stayed in the 90th percentile.  He gained weight quickly and easily (my daughter was in the 9th).  I always knew that I was in the right when providing for William at nursery, and it was also obvious to me that my baby didn't need to eat something the same size as his arm at every feed (think about that for a minute!).

So, if you or anyone else has concerns about the weight gain of your little bundle of joy I ask you to do one thing - 

Think Logically

and don't just reach for the formula. 


If you are proud of the fact that you are doing an amazing job of breastfeeding your little cutie you may want to shout about it (in a quiet but obvious way) and Lactivist infant T-shirts with a witty breastfeeding slogan are a great way to do it.  With slogans such as - 

"I like milk from my mum, not just any old cow"

"Keep Britain Breastfeeding"

"I Love Mummy Milk"

"Care Instructions"

Each Infant T-shirt is available to purchase for only £12 and are made from 100% organic cotton in sizes 3-18 months from BoobieMIlk.

To Burp Or Not To Burp?

I hear some interesting things at support groups, but this is one that I thought a little funny until I heard if for the fifth time.  Honestly, there is someone telling new mums in my area that breastfed babies NEVER burp.  Maybe you have heard this too?  It's quite interesting to think that advice is being given as if all things "baby" are that black and white.  I, for instance don't burp very often, but I would be lieing if I said I never burp.  When looking at anything baby I think you have to apply the bell urve rule.  Just like the growth charts for weight, height and length, each baby has their place on the curve.  The majority of babies will sit somehwre near the middle of the curve, but there are still plenty of babies that are outliers.  It's not a competition, you don't win a prize for having the most burpy baby of the longest.  The charts are just a guide that shows you the vast range that exists if you randomly line up 100 babies born on the same day.

I'll share my personal experiences with you - William would probably fall into the 1st percentile on the chart for burping (if one existed).  You could probably count the number of times he burped as a baby on one hand.  He started nursery when he was a little over three months old and received expressed breastmilk in a bottle.  He was the only breastfed baby in his class when he started and as you can imagine not all of the carers had a lot of experience with breastmilk fed babies.

I visited William every day for lunch and would call ahead to make sure that he wasn't given a bottle right before I arrived.  At the end of his first week at nursery I arrived to find a really frustrated carer trying to burp William.  SHe told me she had been trying for some time and just couldn't get him to burp.  It had obviously never even occurred to her to stop.  By the time William turned 12 months they decided to stop trying, but you can tell that the idea of a baby not burping was alien to them and so unbelievable that they kept trying.

Ellie is my second cutie and when she arrived I could have assumed that she would be the same as William in every respect, but I had worked with many families and seen how different babies are.  Ellie wouldn't win any prizes for her burping efforts, but she did get fussy and refused to eat if she needed to burp.

The lesson in all of this - You cannot assume ANYTHING with babies, you just have to spend time getting to know your baby so that you can do what works for them.

I don't sell burp cloths or even any devices for patting babies on the back (don't exist I hope), but I do sell adorable breastfeeding slogan t-shirts for newborns - 18 month olds from the wonderful Lactivist that will put a smile on your face and also catch some of the spit-up.