It is most important to breastfeed only, in the first couple of weeks as you work on setting your milk supply, and to give your baby the opportunity to latch well from your breast. However, there are times when offering a supplement while breastfeeding is necessary. There are different methods of doing so, some more “breastfeeding friendly” than others. For example, you could use a cup, medicine dropper, syringe, teaspoon, or a medicine spoon. It is always a wonderful idea to supplement the baby directly at breast when possible. To do this, you could use a Supplemental Nursing System (a silicone tube attached to a reservoir of a supplement which is attached directly to the breast, so that the baby gets the supplement at the breast as he also draws out your milk). The reality of the situation is that sometimes parents just choose to give a bottle, and feel more comfortable doing so. If that’s the case, how can they do this in a breastfeeding friendly manner?
First, it is most important to choose a bottle that has a slow flow. This will help to pace your baby, and help them to regulate the flow a bit. Even a “so-called” slow flow nipple tends to flow quickly. Pick one with which you feel comfortable, and that your baby is able to easily handle.
Using a nipple that has a wider base that the baby’s mouth can accommodate is helpful. For example, the Medela nipples (not a personal endorsement) are designed in such a way that the baby’s lips can get all the way down to the base of the nipple- not on the nipple only. With whichever nipple you choose, try to get as much of the nipple in your baby’s mouth as possible without causing them to gag. This will reinforce the “widely flanged lips” that they need to have when on your breast. Use an upright feeding position. This will work with the flow of gravity to slow the flow of the fluid in the bottle.
When offering the bottle, stroke the tip of the bottle nipple against your baby’s top lip to get them to root and open wide. Wait until they do open, before advancing the bottle nipple into their mouth. They are not likely to open wide to accommodate your own nipple if it is not reinforced when offering them a bottle nipple. Once again, try to get as much of the bottle nipple in your baby’s mouth as possible without causing them to gag.
Lastly, try to pace their feeding. If the flow is too fast for your baby, and they are having difficulty controlling it, pull the tip of the bottle nipple out of their mouth a bit, but not entirely, still maintaining contact with the lip. Tip the bottle downward a bit to stop the flow, and then, when the baby is ready to resume, advance the nipple in their mouth again.