“Keeping Up”: Some Facts About Bottle-feeding the Breastfed Baby

I got very involved with a facebook discussion from a stressed out mom whose caregiver has been telling her, daily, she’s not sending enough milk for her exclusively breastfed baby. This issue hits very close to home, because caregivers for my first son often said the same thing. I allowed them to let me think my milk supply was the problem, when I’ve since come to learn that breastfed babies drink milk from the bottle very differently from bottle-fed babies.bottle feeding baby

When breastfeeding moms go back to work, unless they are super-producers, they often experience a great deal of stress about the quantity of milk they are expressing for their baby, who is home facing hunger and discomfort if Mama does not leave enough milk. I found that I obsessed about the milk at home. I thought about it all day long when separated from my son and when I’d get a call at 11am saying he’d drunk all the milk I left to tide him over until 5pm, I spent the rest of the day in a panic.

Here’s what I’ve since learned that might have helped me both calm down and speak with my caregivers.

1. Breastfed babies drink less milk than formula-fed babies. A large study done in Belarus found that young breastfed babies drink about half the amount of milk their formula-fed companions need. By five months, the formula-fed babies are drinking SEVENTY PER CENT more milk. Breastfeeding USA has a fantastic article explaining the study and the differences in milk intake. Please give it a read if you’re concerned with the amount of milk you’re leaving behind with your breastfed baby.

2. Babies drink more and they drink faster from a bottle than from a breast. The Breastfeeding USA article suggests that if you offer a baby 6 ounces of milk in a bottle, the baby might drink 6 ounces whether she’s hungry or not. It flows out steadily through that nipple and baby doesn’t have to work too hard to get it. While it’s true you can’t overfeed a breastfed baby, you sure can overstress a pumping mom and easily feed a baby more breastmilk than he might require for that time period. If caregivers are offering baby 6 ounces of milk per feeding, three times per work shift, that’s putting a lot of stress on Mama to express milk.

(Tip: if your caregivers are feeding your baby too much per sitting, try sending in smaller, measured-out bottles [3 ounces] with instructions to pause in between bottles to see if baby is actually hungry for more milk)

3. Some babies reverse cycle and wind up digesting most of their calories right from Mama (when she’d prefer to be sleeping). If your baby is nursing all night long, he might not need to eat as much during the day while you’re at work. Keep an eye on your baby’s weight gain, and read the KellyMom milk calculator article for more insight.

4. Breastfed babies eat differently from bottle-fed babies. A technique called “Paced Bottle Feeding” can help caregivers to mimic the breastfeeding experience with a bottle. This means making eye contact with baby, allowing the baby to control the pace of the feeding and following baby’s cues while eating, among other strategies to slow the flow of milk.

(Tip: stick with the newborn flow nipple even if you have an older baby so the flow isn’t overwhelming)

Hopefully, some of this information can help mamas to feel a bit more confident about their milk supply and about the food they are leaving behind with their baby while they return to the workplace. Sometimes, caregivers used to feeding formula-fed babies can be very insistent and leave a new mom questioning herself! If you have concerns about your milk supply, speak with an LC and make a plan for while your baby is with the caregivers. In many cases, it’s the caregiver who needs to learn more and not a problem with your pumping stash!

Did you have a caregiver telling you there was not enough milk for your baby? Leave us a comment to share some tips for speaking with caregivers!

15 comments to “Keeping Up”: Some Facts About Bottle-feeding the Breastfed Baby

  • Great info! Just pinned this so I can keep coming back to it and sharing it with new moms.

  • This is so true, thank you for sharing your experience. As a lactation consultant I am always coaching my clients to work closely with their care providers. With so few women breastfeeding after returning to work, very few caregivers understand the difference between breast milk and artificial milk. Good job, thanks for helping all the hard working women out there!

  • Kathryn

    I had a problem with a caregiver who kept throwing out my expressed breast milk because she thought it had “gone bad.” No, what had ACTUALLY happened was my unpasteurized breast milk had separated and the cream had floated to the top — just like unpasteurized cows milk used to do back in the olden days. Happily, I was able to convince her it was not spoiled (it had been refrigerated constantly, was never more than a day old, smelled sweet, etc.) and she just needed to take shake it up before or after warming it.

  • lmilab

    I agree with most of the article however I have to point out that all babies are different. I have an experience with 2 very different styles. One took 1/2-1hr to feed, the other 5min to feed. Both are/were exclusively breastfed. “Paced Bottle Feeding” would have been fine for first baby and then he refused the bottle altogether. For second baby it makes him frustrated and more upset.

    I know some parents are adamant about “Paced Bottle Feeding” for children who feed fast this approach DOES NOT WORK, neither giving them newborn flow nipple.

  • Mae

    I wish I had read this 6 years ago when I went back to work and my husband was home with our daughter and feeding her the breast milk I left behind. I was soooo stressed out and thought my daughter was starving at home while I was at work. :( Not that my husband didn’t know “HOW” to feed a baby, he did fantastic with her, but neither one of us knew this information about breast fed babies.

  • Tiffany

    I have had a nightmare with my caregiver when I started going to work 3 months ago. I have had all the problems listed above and more. I wish I read this 3 months ago.

    To the commentor above, lmilab, I think the reason one baby would finish in 5 minutes is because each mother’s breasts are different and some babies are used to a faster flow which I believe is why the article said to use the slowest flow the baby will accept. They don’t want a baby whose mom has slow flowing breasts to get lazy about eating and start refusing the breast because he prefers the fast flowing bottle.

  • Lauren

    Kathryn – Please make sure that you and your caregivers are NOT shaking the bags of breast milk. Breastmilk should be swirled, never shaken. Shaking it kills the healthy enzymes.

  • Vicki

    I have been lucky enough to build up a large freezer stash with all 3 of my breastfed babies who all had different caregivers, some of whom caused me much frustration of this matter. My first was never away from me more than about 4 hours, and my care provider lived right upstairs and had a baby the same age. With my middle child she refused to take a bottle, I worked just a few blocks from her house so I would nurse her before dropping her off, go over and feed her at lunch time and nurse her as soon as I got off work. I would pump once in the morning and once in the afternoon and leave some of this milk with the sitter. There were several times when the sitter was practically force feeding it to my baby. I just really limited the amout of milk I left, and once she was older and would drink from a sippy and could control it on her own it was much better. My third child has an older grandmotherly sitter, who was really worried about it when I only brought about 10-12 ounces. However, I just talked to her and let her know that the Medela Calma bottle nipple he uses is one that he can control the flow and that he only eats 2-3 ounces at a time from the bottle when I feed him. After I explained this to her, there was usually a couple ounces left when I came to pick him up. The last couple months when I have started sending him some puréed foods he also has slowed down on the amount of milk he drinks and at times only drinks about half of it. I still mainly only nurse him at home, but it has helped calm her worries to know he isn’t starving….which he was 16lbs at 4 months, 20lbs at 6months and about 22 lbs now at 7 months, so she didn’t need to worry about it as he was growing excellently.

  • This is fantastic information! I was going to write a similar blog post… and now I don’t have to! :)

  • As a nanny/childcare worker for over 18 years, I’ve noticed that some moms have a decrease in milk supply(their words, not mine). This information is very helpful and I’m glad to know that I have been the kind of caregiver that, for the most part, uses the baby’s cues to know when he or she is really done and not always just feeding when the baby is crying. I think that is part of the issue as well, I’ve noticed a lot of places will just feed the baby when he or she is crying rather than trying to figure out what else the baby needs(sometimes they just want to be held or have someone near them and not all caregivers understand that or have too many kids to care for, if that makes sense).

  • Liz

    I agree. I’ve had to top my baby up with high calorie formula due to poor weight gain caused by a congenital heart condition. I never got her to take more than 2-3 oz at a time whether formula or expressed milk.

  • Katy Beale

    If shaking kills the enzymes (and I would like to see scientific evidence of this!) then presumably it doesn’t matter if you shake defrosted frozen milk, as the enzymes will have been killed off then anyway?

  • Jenny Emerson

    Katy Beale, enzymes are precisely folded protein structures, with water-liking bits on the outside protecting/hiding the water-hating (hydrophobic) bits in the centre. When you create bubbles by shaking there is no longer a complete layer of water surrounding the protein and it can unfold (denature). Because the enzymes work due to their precise shape, any unfolding will stop them working.
    Freezing reshapes and denatures proteins because of the formation of water crystals. However different enzymes will be more or less sensitive to different denaturing (reshaping) conditions. So shaking frozen milk might denture more of the enzymes. But do bear in mind that even pasteurised milk (with no stem cells / enzymes / immune components etc) is better than formula, so shaking milk isn’t the end of the world…

  • Sarah

    Shaking does not kill enzymes. High temperatures can denature enzymes, meaning they will no longer work, but shaking will not do that!

  • Sally

    It is standard recommendation to tell moms to swirl not shake breastmilk. I did find this article by Linda Smith, IBCLC. But she’s doesn’t list any references. Maybe there’s references somewhere on Kellymom?
    I do think it makes a difference if you are shaking it gently vs forcefully (like you need to do to mix power formula into water, which caregivers may be use to doing).
    Great article overall. I always tell my back to work moms that I most often find that moms CAN pump plenty, but that it’s easy to overfeed with bottles.

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