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Q.    I have been breastfeeding my baby for the past 2 months.  I'm returning to work in 3 weeks' time.  One week ago, I started trying to give her a feed through the bottle, but she isn't taking it well.  She screams and cries and manages to drink only 10ml.  What can I do?

A.    Your baby sounds like a smart baby who know the difference between the warm breast, and a hard bottle!  Yours is a problem quite a few moms preparing to return to work ahve encountered.

My guess is that your baby probably did not have any feeds through the bottle for quite some time, before you tried offering her one.  She has grown very accustomed and attached to the breast, and is very reluctant to accept the substitute.

For moms like yourself, who plan to return to work after 2 or 3 months, but who still hope to breastfeed partially (when you are home), or fully (by expressing breastmilk to take home while at work), it is usually a good idea to prepare your baby for the transition so that the change from breast to some bottle feeds will not be too traumatic.

It is usually a good idea not to interfere with baby's direct feeding at the breast in the early weeks, so that she can learn to suckle well, and so that your milk supply can also be stimulated without interference of formula feeds.  Once you feel your baby has settled down to breastfeeding very well, I would suggest allowing her to take one feed a day from the bottle, this being your expressed milk, so that your supply will not be disturbed.  This can usually begin in the 4th week.  If you wait till the 6th week, baby may have developed her strong preference for the breast, making the switch more difficult.

About 2 weeks before you are due to return to work, you may substitute more direct feeds with milk through the bottle.  This may be your own milk, if you plan to fully breastfeed, or the formula of you choice, if you plan to partially breastfeed.   Substitute 1 feed at a time, skipping the same feed for 3 days before choosing another one to substitute.  Do not substitute adjacent feeds, or your breasts maybe very engorged.  Skip alternate feeds, so that your production has time to scale down gradually.

In your case, a late change to the bottle has made baby a little unwilling to accept the bottle.  I understand how heart-rending it must be to hear her cry.  Keep trying consistently.  It will help if you are not the one giving the bottle.  She can smell the milk on you and will look for the breast.  In fact, keep out of the way altogether - go and do your grocery shopping, or take your bath.

Other ways may be to try using orthodontic teats (eg. like the NUK teat) which is shaped more like mother's breast, or spoon feed the milk to her.  It is even possible to use a cup with a spout, which has very small holes.  Make sure she is held upright, and tilt the cup very gently for her.  Given time, I am sure she will come to accept her milk through one of these channels.

Should she persistently refuse, and the time has come for you to return to work, I just want to assure you that while she may choose to go "on strike" while you are away, she will certainly make it up by feeding very much on you when you return, and that she will be able to meet her own requirements this way.



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