Spoon, Cup and Paced Bottle Feeding

Spoon, cup and paced bottle feeding 

Spoon feeding

Cup feeding

Paced Bottle Feeding

Supplemental Nursing System (SNS) and Nipple Shields

Some reasons for different feeding methods include: 

  • Baby or mother's health and medical condition 
  • Mother is not making enough milk for a number of reasons including breast injury, and surgery
  • Separation of mother and baby (for example, illness, surgery, or adoption)
  • Use of necessary medication that is not safe to take while breastfeeding/nursing.
How do I know if my baby is hungry?
Babies need to feed a lot in the early days. Your baby has many ways to tell you they are hungry.  These signs are called feeding cues. 

Your baby is hungry when you see these feeding cues: 

  • Rapid eye movements 
  • Stretching, moving arms and legs
  • Bringing hands to mouth
  • Sticking out tongue and licking lips
  • Sucking motions or sounds
  • Rooting (opening the mouth, searching to suck, and sucking on contact)
  • Turning head back and forth
  • Soft cooing or sighing sounds

Your baby is full when:

  • Your baby closes their mouth 
  • Your baby turns away from the bottle
  • Your baby spits out the nipple of the bottle
  • Your baby has milk dribbling out the side of their mouth
  • Your baby looks relaxed and calm

Following your baby's feeding cues will: 

  • Help feeding go well 
  • Help you get to know your baby
  • Allow your baby to build trust, and allow mom to gain confidence
  • Build a positive feeding relationship which supports child growth

Remember...

  • Your baby should feed at least 8 times or more in a 24 hour day, until about 6 weeks of life.
  • It is normal for some babies to have many feedings in a short period. They may sleep longer between feeds at other times. This is called cluster feeding. This is more common in the later afternoon or evening. 
  • Skin-to-skin contact lets mom learn baby's feeding cues. 
  • Crying is a late sign of hunger. A baby crying from hunger may be too upset to settle down to feed.  Get to know your baby's early feeding cues. 
  • Your baby will have growth spurts. These happen at around 2 to 3 weeks, 6 weeks, 3 months and 6 months. Growth spurts typically last 2 to 3 days. Your baby may feed more often at these times and your breast milk will increase to meet your baby's needs.
 Skin-to-Skin: Get to know your baby

What is Skin-to-Skin?

  • "Skin-to-skin" is when your naked baby (with or without a diaper) is placed tummy-down on your bare chest.
  • Your baby will smell, hear and feel you. This will help you get to know your baby, and your baby get to know you.

Skin-to-Skin Right after Birth

  • Hold your baby skin-to-skin right after birth, for at least 1 hour.
  • Skin-to-skin right after birth steadies your baby's temperature, breathing, heart rate and blood sugar. It will also help you heal from childbirth.
  • Skin-to-skin contact right after birth will help get breastfeeding off to a good start.
  • All mothers and babies can have skin-to-skin contact, even if you need stitches or have a caesarean birth. If you cannot hold your baby right after birth, your partner, or another person you are close to, can also do skin-to-skin. This will help them get to know and comfort your baby.
  • Premature babies also benefit from skin-to-skin. Many hospitals encourage this, and it is often called Kangaroo Care.
  • Let your health care provider know that you want to hold your baby skin-to-skin in the early time after birth.

Older Babies Enjoy Skin-to-Skin too

  • Hold your baby skin-to-skin even when you get home from the hospital. 
  • There are many benefits to holding your baby skin-to-skin in the months after birth:

    • Helps you learn your baby's feeding cues
    • Helps with feeding and helps with mom's milk supply
    • Calms your baby and reduces crying
    • Lowers stress in mom and your baby
    • Helps with bonding between family and your baby
    • Helps your baby grow and develop well
How do I know my baby is getting enough milk?

Most mothers will make as much milk as their baby wants. The amount of milk made depends on the amount of milk removed from the breast by feeding, pumping or expressing.

Is my baby getting enough milk?
 

In the first few months, a baby who is feeding well:

  • Is feeding at least 8 times in 24 hours. Feeding more often is normal and good. Listen for swallowing or quiet "caw" sounds.
  • At 1 day old has at least 1 wet diaper and
    at least 1 to 2 sticky, dark green-black, soft stools.
  • At 2 days old has at least 2 wet diapers and
    at least 1 to 2 sticky, dark green/black, soft stools.
  • At 3 days old has at least 3 heavy wet diapers. Occasional "red, brick-coloured" staining (uric acid crystals) is normal until day 3. At 3 days old has at least 3 brown/green/yellow, soft stools.
  • At 4 days old has at least 4 heavy wet diapers and
    at least 3 brown/green/yellow, soft stools.
  • At 5 days and older, baby has at least 6 heavy wet diapers and at least 3 large, soft, yellow, stools which may have small seeds in them.
  • Is back to his or her birth weight by about 2 weeks of age.

Get help if any of the above signs are not present or:

  • Your baby is very sleepy and hard to wake for feedings.
  • Your baby is crying and will not settle after feedings.

If you are breastfeeding or pumping and you have a fever, chills, flu symptoms or a red painful area on your breast:

  • Breastfeed/pump often
  • Put warm wet towels on your breasts
  • Get lots of rest
  • Call your health care provider if you do not feel better in 6 to 8 hours 
How long is a feeding?
 The length of time your baby feeds depends on your baby.
  • If your baby has a good latch and is actively sucking and swallowing they can feed for as long as they want.
  • When satisfied your baby may slow down or stop their sucking and swallowing or come off the bottle.
How often will my baby feed?
Feed your baby whenever they seem hungry. In the early weeks this is at least 8 times in 24hrs. Night feeds are important too. In the early days you may need to wake your baby up to feed.
  • At 6 to 12 weeks, babies will feed at least 6 times or more per 24hrs
  • At 3 to 6 months, babies will feed at least 5 times or more per 24hrs

Feeding cues are signs your baby uses to tell you they are hungry. They include:

  • Bringing hands to mouth
  • Sticking out tongue and licking lips
  • Sucking motions or sounds
  • Rooting (opening mouth and searching for the nipple)

Try to feed your baby before they are crying.  Crying is a late sign of hunger

Many babies have periods, especially in the evening, when they cluster feed. Cluster feeding is when babies have many short feedings over a few hours. It is normal and can occur at any time. Many mothers feel that babies are fussier and not satisfied but it does not mean that they are not getting enough milk.

During a growth spurt, babies grow quickly. These growth spurts commonly occur at 3 and 6 weeks, and at 3 and 6 months.  These periods of increased feedings will last from 24 to 72 hours.

How much weight will my baby gain?

Babies usually lose some weight during the first few days.
  • Early and frequent feedings will reduce the amount of weight your baby loses.
  • Most babies are back to their birth weight by 2 weeks of age.
  • In the first 4 months, babies gain about 170 to 240 grams (6 to 8.5 oz) per week. They usually double their birth weight by 3 to 6 months. 
  • From 4 to 6 months, babies gain about 95 to 140 grams (3.4 to 5 oz) per week.
  • From 6 to 12 months, babies gain about 55 to 90 grams (2 to 3.2 oz) per week.
  • Between 9 and 18 months, babies usually triple their birth weight.

Spoon feeding

You can give expressed breast milk to your baby using a spoon. This method works best if your baby leads it and controls the speed of the feeding . Spoon feeding your baby instead of using an artificial nipple can help to reduce the risk of nipple confusion.

  • Put a bib on your baby, because some breast milk may spill.
  • Sit your baby up on your lap using one hand to support your baby's upper back and neck.
  • Bring spoon to your baby's mouth and tip so that the breast milk just touches your baby's lips. It should NOT be poured into your baby's mouth.
  • Your baby will lap the breast milk up by moving his tongue forward.
  • Allow your baby time to swallow before refilling spoon and offering more breast milk. This will let your baby control the speed of the feeding.

Cup feeding

Babies of all ages are able to drink from a cup (even small premature babies). You can start giving expressed breast milk in a small plastic or glass cup such as a medicine cup .

  • Put a bib on your baby, because some breast milk may spill.
  • Sit your baby up on your lap using one hand to support your baby's upper back and neck.
  • Place edge of the cup gently against your baby's bottom lip and tip so that the breast milk just touches your baby's lips.  It should NOT be poured into your baby's mouth. Your baby will lap the breast milk up by moving his tongue forward.
  • Keep cup tipped during feeding so that the breast milk is always in contact with your baby's lips. This will let your baby control the speed of the feeding.

Paced Bottle Feeding

The way a baby sucks on a bottle nipple or pacifier is very different from how a baby sucks at the breast. For this reason it is best to not introduce any bottles until after breastfeeding is going well. This is usually about 4 to 6 weeks after your baby is born. Giving your baby a bottle before breastfeeding is going well can affect breastfeeding/nursing including building up your milk supply. 

Paced bottle feeding is when you control or pace the flow of milk to be like breastfeeding/nursing. It also helps your baby keep breastfeeding/nursing behaviours while they feed from the bottle. Here is how to pace feeds:

  • Hold your baby in an upright position, supporting their head and neck with your hand.
  • Feed your baby skin-to-skin if possible.
  • Use a wide-based, slow-flow nipple.
  • Touch your baby's upper lip with the bottle nipple until your baby opens their mouth wide.
  • Tip bottle horizontally. Let your baby pull the nipple into their mouth so their lips close on the wide base of the bottle nipple.
  • Keep nipple partially full as it will help your baby control flow better. Your baby will naturally swallow air during feeds.
  • If your baby gets tense or gulps, stop feed. Stop the feed by tilting bottle down to stop flow but keeping bottle nipple in contact with your baby's lower lip. This way your baby can pull the nipple back into their mouth.
  • Your baby will learn to take breaks and 3 to 5 second pauses on their own usually after the fourth or fifth suck and as needed.
  • When you think your baby is nearly full, twist and remove bottle keeping the nipple lying on your baby's lip as described above. If your baby takes bottle again, let your baby feed for a short period (for example, 5-10 swallows) and repeat process. When your baby has had enough to drink they will not open their mouth when you try to give them the bottle. This is 1 sign a baby uses to let you know they are full.
  • Throw away any breast milk left in the bottle after the feeding.

Supplemental Nursing System (SNS) and Nipple Shields

You should not start the use of these aids on your own. Talk to a Lactation Consultant or your health care provider about if you need to use them. To find a Lactation Consultant in your area, visit Ottawa Valley Lactation Consultants.

Do you have more questions about parenting?

  • Connect with a registered nurse from Health811 for free, secure, and confidential health advice. Service is available 24/7 in English and French, with translation support also offered in other languages. Call 8-1-1 or visit Health811.ontario.ca.
  • Connect with a Community Navigator from 2-1-1 for information about community programs and resources across Eastern Ontario. Helpline service is available 24/7 and in many different languages. Call 2-1-1 or visit 211ontario.ca.
  • Connect with other parents on the Parenting in Ottawa Facebook page.
  • There are a variety of services to make it easier for your child to grow up healthy in Ottawa.
  • You can update your child's immunization record using either the CANImmunize App or the Immunization Connect Ontario (ICON) Tool
  • If you have received a message from Ottawa Public Health such as a letter or a call regarding immunization, an infectious disease, or infection control lapse, please call 613-580-6744 and listen to the menu options carefully.
September 2019

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