Pumping and bottle-feeding guidance

Sometimes babies need a little extra help with feeding. Whether you're supplementing with formula or donor breast milk due to weight loss, engorgement or difficulty latching, we’re here to support you. Often this supplementation is only temporary. Here is what you need to know about pumping, bottle feeding and protecting your milk supply while you help your baby grow.

Maximize your milk supply

When you offer a bottle — especially in the first few days — your baby's feeding pattern changes. They tend to take larger amounts and go longer between feeds. If you don't take extra steps, your milk supply will drop.

Your body makes milk based on cues from your baby. More frequent feeding tells your body to make more milk. Fortunately, you can mimic a hungry baby by using a breast pump to stimulate your breasts. The bottom line is to not go more than four hours between a feeding or pumping session.

Methods of supplementing

You can give your baby extra milk or formula using a syringe, a bottle or a supplemental nursing system. We'll work with you to find the best choice for your family.

Syringe feeding

You can feed your baby by letting them suck on your clean finger while you slide a small syringe alongside it to deliver the milk. This works well in the first two days of life when your baby only needs tiny amounts. After that, your baby will need a more efficient way to eat.

Bottle feeding

Many parents worry that giving their baby a bottle will ruin breastfeeding. But babies generally prefer the breast! A bottle is just an efficient way to deliver extra milk. We recommend a paced feeding technique to slow the flow so your baby doesn't get accustomed to a fast feed and frustrated at the breast later.

Supplemental nursing system (SNS)

An SNS involves taping a small tube to your breast. Your baby latches onto both your breast and the tube to get extra milk while nursing. It takes a little practice to set up but it keeps your baby oriented toward the breast as the source of nutrition.

What is paced bottle feeding?

Paced feeding slows the flow of milk from the bottle. Start with the bottle tipped down so the nipple is empty for about 10 seconds. Since breasts don't flow constantly, you want to mimic that natural rhythm. Tip the bottle down again after a couple of minutes to give your baby a five-second pause. Repeat this so the feed takes about 20 minutes. Just don't pace it so much that your baby gets frustrated and falls asleep before they finish.

Another option to slow the flow of milk is bottle feeding with your baby in a sidelying position. In this position, milk flows only when your baby sucks, rather than with the help of gravity.

Avoiding nipple confusion

A good latch is key to successful breastfeeding. Certain bottle nipples and pacifiers can change how your baby sucks and make latching at the breast harder.

We recommend using a standard slow-flow nipple with a wide base. Avoid nipples that have a long, narrow shape on a flat base until breastfeeding is well established. You should also hold off on using a regular pacifier until nursing is going smoothly.

The feeding and pumping sequence

Developing an efficient routine helps both you and your baby get the rest you need. If you’re putting your baby to the breast, nurse on each side until the breast is drained — but no more than 10 to 15 minutes per side.

If you’re using an SNS, the supplement happens at the same time. If not, offer the pumped milk or formula right after nursing. If another caregiver can give the bottle, you should pump at the same time so the whole process takes less than 45 minutes.

Guidelines for storing pumped milk

Freshly expressed milk at room temperature:

• Up to four hours at 80°F
• Up to 10 hours at 70°F
• Up to 24 hours at 60°F (in a cooler with ice packs)

In the refrigerator:

• Five days at 40°F

In the freezer:

• Six months in a standard home freezer at 5°F to 15°F (store away from the door)
• 12 months in a deep freeze at -20°F to 0°F
• Two weeks in a small in-door freezer compartment

Tip: To make sure your milk stores well, defrost a bottle after a week to see if your baby accepts it.

Feeding your baby doesn't always go exactly as planned — and that is completely okay. Whether you’re exclusively pumping, supplementing with formula or using a mix of methods, you’re doing a great job nourishing your little one. If you’re struggling with your milk supply or need help finding the right feeding routine, reach out to a lactation consultant or your pediatrician. We’re here to help you find a feeding plan that works for your family.