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Here's Why New Mothers Should Avoid The Temptation To Bottle-Feed

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Here's Why New Mothers Should Avoid The Temptation To Bottle-Feed
Babies prefer to feed from the bottle than the breast and may refuse breastfeeding later. (Photo: Freepik)

It is crucial to avoid using a bottle for giving expressed breast milk to newborn babies, especially in the first month of life, as it may lead to 'nipple confusion', said a doctor.

Written by Prerna Mittra |Updated : December 4, 2023 2:05 PM IST

It has been established that mother's milk is immensely beneficial for the baby. If the baby is preterm -- born prematurely before 37 weeks of pregnancy -- it is all the more crucial to give them breast milk, which can boost their immunity and help them grow and develop faster. Dr Mahesh Hiranandani MD(PGI), senior consultant paediatrician and neonatologist at Cloudnine Group of Hospitals, Chandigarh says breast milk is easily digestible and contains all essential nutrients for optimum growth -- anti-infective substances (for protection against infection from birth), hormones, and growth factors (to regulate metabolism).

"For decades all scientific bodies, including the WHO have recommended the 'golden hour' advantage of providing mothers' milk to all babies of any size and any gestation, within the first hour of their birth," says Dr Hiranandani, adding that if the baby is "very small or premature", it may not be possible to provide breast milk directly by breastfeeding. "They require alternative feeding methods, both in the hospital and at home. Premature milk is higher in proteins, minerals and fats, which ensure optimum 'catch up' physical growth and brain development."

Breast milk expression

According to the doctor, breast milk expression should be initiated as soon as possible after birth to provide the preterm baby with colostrum that is enriched with live immune cells and antibodies. "Collecting milk for a preterm baby can be challenging. Premature babies are often separated from their mothers for a variable period, which makes feeding them with their mother's milk an unphysiological process. Most hospitals have a policy to encourage mothers to express milk manually or through a manual or electric breast pump. The milk is collected in a sterile cup for immediate use or in clean and closed stainless steel or glass containers for later use, and transported to the nursery in a cool box. It can be refrigerated to use within 24 hours and even frozen to use up to 6 months.

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"It is essential to express breast milk completely every 2 to 3 hours to provide an adequate milk supply and prevent breast engorgement," the doctor explains.

Avoid bottle feeds

Dr Hiranandani, however, adds that it is crucial to avoid using a bottle for giving expressed breast milk to newborn babies, especially in the first month of life as it may lead to 'nipple confusion'.

"The techniques of sucking at the breast and bottle are different, the latter being easier and quicker. Thus, the babies prefer to feed from the bottle than the breast and may refuse breastfeeding later. This leads to failure of breastfeeding, despite an adequate milk supply. The risk of getting diarrhoea and other infections is higher in infants who are bottle-fed," he warns.

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The expert concludes by saying that once breastfeeding is initiated, it may be attempted for short periods on an empty breast, before slowly graduating to feeding from a full breast.

"Allowing the baby to lick on milk applied to the nipple may aid in latching to the breast. Ensure that the nostrils are not obstructed by the breast during feeding, and experiment with different positions for nursing until it is comfortable for both the baby and the mother. Most preterm babies are fed every 2 to 3 hours till they reach a weight of 2.5 kgs when they can be shifted to demand feeding. It is important to ensure the baby is alert, awake, and calm while feeding."

Quick facts on the feeding process inside NICU

  • Premature babies can only handle small amounts of food at a time. They are initially given 1-2 ml of expressed breast milk per feed and this amount is gradually increased over 5 to 7 days to reach full feed.
  • Premature babies do not have any energy stores; they are given measured quantities of feed and intravenous fluids to maintain their sugars in normal ranges. Feed intolerance leading to vomiting and abdominal distension is common due to immaturity of the digestive system.
  • Once on full feeds, they are provided supplements (vitamin D, calcium, iron and vitamins) that kickstart the process of weight gain.
  • The process is slow. Transitioning from tube feed to spoon feeds, some babies may take longer to coordinate the suck-swallow reflex, which develops by 34 weeks.
  • At 34 weeks, babies may be allowed to feed on an empty breast (non-nutritive sucking) to check on their suck-swallow-breathe abilities and stimulate the process of milk let-down. Direct breastfeeding can be started only after the baby has developed a robust suck and swallow reflex and weighs more than 1700 grams.