When is the best time to offer a newborn a bottle?

We have a two week old breast fed baby and we have been given completely opposite advice about giving her a bottle. Her father wants to be able to help with the feedings, so we want her to take a bottle. One friend told us to give her a bottle right away, and the other said that if we give her a bottle she'll become confused and won't want to nurse.  Is there a right answer?

Both of your friends have good points!  What is most important is figuring out what is right for your family and your baby.

It's true that when babies are first learning how to breastfeed they may find it difficult to switch back and forth from a mother's nipple to an artificial nipple.  A baby uses a different mouth and tongue motion with each kind of nipple.  Since it can be easier for an inexperienced or sleepy newborn to get milk from a bottle than from the breast, it’s a good idea to avoid offering a bottle until  breastfeeding is well established. That means that your baby has developed a good pattern of sucking efficiently, latching on to your breast easily and beginning to suck and swallow right away.  If you have doubts about whether you or your baby have gotten to this stage, I’d suggest having someone with lots of experience with nursing mothers observe you feeding.

Once you are certain that your baby is satisfied with nursing and is clearly gaining weight on breast milk, it’s time to consider offering a bottle.  That time usually will be after she’s at least three to four weeks old.  Most Moms introduce a bottle because they want another person to be able to feed the baby while they are asleep or away, or because another person--like Dad--wants to have the ability to provide a feeding.  You don't have to offer your baby bottle at all, of course.  However, many mothers want to be able to leave the baby in someone else's care at some point, and if you wait until your breastfed baby is a few months old she may be much more reluctant to accept anything but the breast. 

When you offer a bottle, you don’t have to feed your baby very much.  The first step is to simply let your baby get comfortable having the artificial nipple in her mouth.  Don't worry if your baby doesn't want to suck on it for long in the beginning.  If you’ve been expressing milk, you can put that in the bottle, or you can offer plain water or water that is lightly sweetened with one teaspoon of sugar dissolved in four ounces of water. The sugar water is a little tastier than plain water but much less sweet than breast milk. Let your baby suck or mouth the artificial nipple for as long as she likes.  If you offer her an ounce or two of liquid in a bottle every day, she won't be put off by the feeling of the nipple and you will then find it easier to convince her to take a bottle of breastmilk (or formula, if you choose) at some future time.  

You can also choose to express milk regularly to feed your baby. If you know that you will at times have to be away from your baby for more than two hours, it’s a good idea to have some expressed milk stored up.  The health benefits of an exclusively breast milk diet are undisputed in the first few months of life, so if you can manage to express, you should.  Although it is sometimes hard to express very much milk when your body is just adapting to meeting a baby's newborn needs, with practice and regular pumping you'll get more and more milk.  Most Moms find that expressing milk gets easier over time.  A visit with a lactation specialist who can teach you to hand express as well as use an electric pump will make it much easier for you to learn how to get the maximum amount of milk in the minimum amount of time.

If you aren’t able to express milk regularly, you might not have an extra supply on hand. In that case, you may want to offer your baby infant formula.  Although many babies do just fine on a combination breast milk and formula diet, keep in mind that the formula will be digested at a different rate and pattern than breast milk.  Formula takes longer to digest than breast milk, so that your baby might not be hungry as soon.  That can seem like an advantage, but a mother's body is designed to make more milk to satisfy a hungry baby's needs.  If a baby isn't as hungry one day, then Mom will make less milk the next day.  Because it's much harder to predict and regulate feeding times when combining formula with breast milk, mothers who frequently give formula during the baby's first few months are more likely to give up breastfeeding altogether.  So don’t make the decision to combine types of feeding casually.

One more suggestion about Dads helping with feedings. It’s great when a Dad wants to be involved with your new baby’s care. That’s because babies who are the most successful in nursing almost always have a Mom who is being well cared for while she breastfeeds.  For that reason, the most important way for a Dad to help with feeding is not by offering the baby bottles but rather by helping the nursing Mom to take good care of herself while nursing.   A Dad can make a big difference by bringing Mom a glass of water or juice when she's breastfeeding, by making sure that she is eating well, and by bringing the baby to her during the night for nursing.  Dads can nurture their babies by comforting them, changing them, and playing with them after feedings.  In these ways, Dads will be adding to the care that babies are getting from their Moms, instead of simply substituting for Mom during a feeding!