Bringing Baby Back to the Breast

Jacque Ordner BSN, RN, IBCLC 

There are scores of reasons why nursing at the breast may have gotten off to a rocky start or, perhaps, didn’t get off to a start at all.  Many mothers desire to bring their babies back to the breast after a period of bottle feeding.  While returning baby to the breast can be emotional, having the right tools, appropriate expectations, and the right support is essential for giving you and baby the best chance of achieving a successful latch. The following tips can help get you started. 

1. 1. Find a skilled International Board Certified Lactation Consultant.  An experienced IBCLC can help guide you and let you know what interventions to incorporate when.  Don’t be afraid to ask your potential IBCLC if they have experience with exclusive pumping and getting baby back to the breast.  It’s okay to be choosy when lining up your support team! This Find a Lactation Consultant directory can help put you in touch with IBCLCs in your area. 
   2. Consider the age of your baby and the potential reasons latching was difficult. Babies under 4 months of age tend to have a much easier time learning to nurse after a period of bottle feeding.  Older babies have been known to begin latching after having only bottles, but this is less common and often requires considerably more time. In many cases, the initial cause (or causes) of latching difficulty have been eliminated or reduced.  For example, moms and babies often pursue nursing after oral ties have been revised, low milk supply has been increased, baby has been discharged from the NICU, etc.
   3. Skin to skin is powerful! One of the first ways to help ease into latching is to soak up as much skin to skin time as possible.  Skin to skin helps engage baby’s inborn feeding behaviors and reflexes while contributing to a powerful hormone feedback system between mom and baby.  Skin to skin results in the release of Oxytocin, creating a bonded feeling and encouraging mom’s milk to let down.  Many moms and babies find latching success while taking a warm bath skin to skin.  Don’t underestimate the effects of skin to skin! 
   4. Paced Bottle Feeding is key. Many nursing relationships have been halted due to baby’s preference for the faster flow and ease of the bottle.  Paced Bottle Feeding is a technique that helps mimic the slower, less consistent flow of the breast while feeding from a bottle. Check out our blog post for Paced Bottle Feeding tips. Implementing Paced Bottle Feeding can help your baby transition to nursing at the breast by setting the expectation for a realistic flow rather than fast, immediate gratification.   
   5. Keep the experience positive.  Attempting to latch an already ravenous baby is not likely to go well.  In fact, doing so can lead to a negative association with the breast.  Choose a time to offer the breast when baby is calm and not excessively hungry.  Watching for early hunger cues like sucking on hands and fists, smacking lips, sticking out the tongue, rooting, and restlessness can help.  Many moms find great success in offering the breast while baby is sleepy.  If baby becomes upset, stop and comfort baby before attempting to offer the breast again.  It may also be helpful to allow for a small feeding from the bottle before finishing at the breast. This can “take the edge off” of baby’s hunger and help ease tensions.  Skin to skin before offering the breast is another great way to put baby in a calm state. 
   6. Make sure baby is well fed.  Intake from a nursing session can’t be precisely measured as intake from the bottle can.  For this reason, it is especially important to continue supplementing until you are confident baby is nursing successfully.  A well trained IBCLC can help assess baby’s nursing abilities and weight checks and diaper counts can help put mom’s mind at ease. 
   7. Consider the use of nursing tools. Many babies transition back to the breast by use of a nipple shield.  The texture of nipple shield feels similar to that of a bottle nipple, and many reluctant babies are much more likely to take a nipple with a shield over a bare nipple to start.  Squeezing a small amount of breastmilk onto the tip of the shield can also help entice baby to latch. Another tool that can be used with or without a nipple shield is a Supplemental Nursing System (SNS).  An SNS is a tool that helps deliver a supplement of breastmilk or formula via a thin tube placed alongside the nipple and connected to a bottle.  This is especially helpful for moms with low milk supply and for babies who struggle to transfer milk at the breast.Click here for a video demonstration of feeding with an SNS.  *We highly encourage working with and IBCLC if you plan to incorporate a nipple shield or SNS. 

Remember that nursing doesn’t have to be “all or nothing”.  Many moms and babies find feedings work best when they do a combination of nursing and bottle feeding.  Many bottle fed babies still like to nurse as much for comfort and closeness as they do for nutrition.  Breastfeeding looks different for different families, and PUMPING IS BREASTFEEDING!  We’re here to support you and offer any help we can as you navigate your breastfeeding journey.  Email us at ibclc@spectrababyusa.com or set up a free consultation with one of our IBCLCs at www.spectrababyusa.com/lactationservices.