Alternative methods to bottle-feeding

Using an artificial teat to feed a baby milk can cause nipple confusion and flow preference. Some babies can go between breast and bottle with no issues, but for some, giving just a few bottles can cause issues with breastfeeding. There is also increasing evidence that bottle feeding can cause jaw development issues, which in turn, can cause issues with the airway and teeth later in life.

However, if a baby cannot transfer milk at the breast, they will need to be fed in some other way, either while the issue is sorted out or long term. Or there may be times when the mother needs to leave the baby with another caregiver.

Due to good marketing, most people think that bottles are the only alternative to direct breastfeeding.

But there are other options, especially if direct breastfeeding is the desired goal.

Supply line

This is where a very thin piece of tubing is placed into a container of milk and the other end is placed at the mother’s nipple. It can be taped on to ensure it doesn’t move or gently put into the baby’s mouth once they are latched. When the baby sucks at the breast they also get milk through this tubing.

Devices are available commercially for this sort of thing – such as the Medela Supplemental Nursing System or the ‘Lactaid’. Or you can buy just the tubing and make your own (often called a ‘homemade SNS’) – some bottles have a little valve on the side of the teat, which can be opened and the tubing placed through that, or you can make a slightly bigger hole in the teat and put the tubing through that. This helps keep the tubing in the bottle and prevents milk from going everywhere if the bottle is knocked over.

The benefit of this method is that the baby is still latched to the breast directly. So it can stimulate milk production and give the benefit of the baby being close to the mother and in the ‘natural’ feeding position. If attaching to the baby is painful, this might not beneficial and you should seek advice from an IBCLC if you have painful attachment.

The downside is that it can be quite ‘fiddly’ to get the baby to latch to the breast and get this tubing into their mouth. Also, if they are not very patient, they might not suck long enough to get the milk to flow. You can counter this by sucking on the tubing yourself and bring the milk right to the end of the tubing so that the baby gets an instant ‘reward’ for any sucks they do make. And once they get some milk they will usually continue to suck.

This is a picture of my daughter and I using a homemade SNS for her to be able to feed at the breast

Finger feeding

Instead of putting the tubing at the breast, you can use it on your finger. The finger is then gently placed into the baby’s mouth nail to the tongue (ideally when they open their mouth, indicating they are ready to feed), and as they suck, they take the milk through the tubing in the same way as above. Again, you can use either a regular bottle and teat to hold the tubing into the bottle or a device like the Medela SNS.

The plus to this is that anyone can do it – so this method can be used for a baby that is not latching to the breast (or who is causing damage) or when the mother and baby have to be separated.

Another plus is that you can control the flow of milk (this is also a benefit of the tubing at the breast) – you can kink off the tubing and get the baby to suck a few times with no milk flowing (mimicking how they would suck at the breast to initiate the letdown) and then open up the tubing and allow the milk to flow.

The main issue with bottle feeding is that milk usually flows regardless of how hard or not the baby is sucking, and it can be hard for them to rest – another plus of finger feeding is that they can usually take a pause in their sucking and the milk will stop flowing (you can help ensure this happens by having the bottle lower than the baby).

As far as I know, there is no downside to this method….in fact, this would be my preferred feeding method for any baby whose parents have the goal of long-term breastfeeding.

Finger feeding would be my preferred method of feeding for any baby needing supplementing

Cup feeding

I learned how to do this when working in NICU in the UK. Any baby whose mother/parents wanted to breastfeed was cup-fed instead of giving bottles.

This is where a small amount of milk – 20-40mls – is put into a small cup (like a medicine cup), and the baby ‘laps’ it with their tongue, which preserves the tongue motion needed for breastfeeding.

The main point is NOT to pour the milk into the baby, but rather tip the cup up just enough so that milk is at the rim and then the baby ‘laps’ it up. I would highly recommend finding a health professional who has experience with this feeding method to show you how to do this in person, as there can be a small risk of the baby aspirating the milk if it is done incorrectly. Alternatively here is a good fact sheet I have just found online - click here

If it is done correctly, it can prevent nipple confusion.

A variation on this is spoon-feeding – literally, put the milk on a spoon, put it to the baby’s mouth, and allow them to lap it up (again, DO NOT pour the milk into the baby’s mouth).

As always, if there are breastfeeding issues, please seek assistance/support from an IBCLC – their job description is purely ‘breastfeeding support’! If you are in Perth, please feel free to get in touch (Medicare rebates are available prior to 7 weeks post birth) – www.cherishedparenting.com.au/lactation-consultant-perth