Does Bottle Feeding Affect Breastfeeding?
The decision to introduce a bottle and teat to the breastfeeding baby may be motivated by a number of factors.
- Concerns around weight gain or lack thereof.
- Pressure from healthcare professionals or family.
- A desire for the partner to help out with the overnight feeds.
- Returning to work
Whatever the reason, it's important to respect and support every woman in that choice.
However, there is little doubt that the introduction of an oral device, such as a bottle and teat has the potential to complicate breastfeeding.
Little ones become conditioned to the bottle quite quickly and this can create challenges transitioning back to the breast.
Here are a few reasons why this may be the case...
Conditioning
Babies quickly work out the differences they experience. They know the distinct difference between soft, pliable breast tissue that they can mould to fit their oral cavity between the upper surface of the tongue and the roof of the mouth.
They know that they have to continue to work to stimulate hormone production before the milk will flow through the ductal networks of the breasts and over the back of their tongue.
Oral Devices (Bottles and Teats)
The silicone teat is rigid.
The baby has to adapt the tongue and oral muscles to accommodate the fixed non-pliable teat. The teat can’t be drawn to the distance of the soft palatal cleft just at the junction of the hard and soft palate.
You can feel your own by running the tip of your tongue over the roof of the mouth until the soft spot is felt.
It’s a long way back, the distance is relative to the baby’s rapidly growing lower jaw and tongue and ours is relative to us, as adults.
If the silicone teat has a wide base (#3 pictured below right) with a wide neck bottle, then the baby can only use the tip of the tongue and uses gums at the base of the envisaged silicone nipple creating a chewing action.
The baby cannot seal adequately inside the mouth. Often you will hear the vacuum seal breaking and milk may leak from the corners of the mouth.
Sometimes there will be a 'clicking sound'.
What type of bottle and teat is best?
There's no perfect bottle and teat on the market.
There is no man made device or brand of oral device that perfectly matches the soft, pliable maternal breast tissue and nipple.
However, Dr Robyn Thompson, experienced Midwife and breastfeeding specialist offers some helpful suggestions to women who would like to combine breastfeeding with bottle feeding.
The top left image (#1) and bottom left image (#2) are the same longer teats attached to different bottles.
But #2 is not ideal as one third is placed over a disposable bottle that shortens the length of the teat available to the baby. Tongue function will be inadequate and the baby is likely to use only the tip of tongue and is also like to chew at the nipple.
The preferred teat in Dr Robyn's opinion is #1 as it is longer and has a narrower base. In short, a long narrow teat with a narrow bottle neck is preferable over short teats on a wide based bottle.
This provides further distance along the upper surface of the baby's tongue.
Certainly not like the breast, moulding to fit to the unique shape inside the baby's mouth.
The baby still has to adapt to the oral device, but the additional length means that more of the tongue muscle is working during drawing and swallowing episodes.
By all accounts in Dr Robyn's practice, it is easier to transition from bottle to breast, if the baby is not gravity feeding.
Simulation
Dr Robyn suggests that it's best to avoid gravity feeding your baby with a bottle and a teat.
It's a common oversight when bottle feeding the baby, as the focus is often on the quantity in the container, rather than observing the baby's cues of satisfaction.
Gravity feeding a baby with a bottle and teat increases the risk of gastrointestinal disturbances, often resulting in a crying and unsettled baby.
It also increases the risk of complications when transitioning between breast and bottle, as the baby quickly becomes accustomed to an easy flow of milk, without the need to stimulate hormone production, which is required for breastfeeding.
Dr Robyn shares a gentle process of 'Simulation' to mimic the behaviour of the breastfeeding baby while bottle feeding.
By simulating breastfeeding, it is easier for the baby to transition between breast and bottle, and reduces the risk of a crying unsettled baby, due to an overfull stomach.
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