This is an issue that really divides new mothers. I am equally likely to hear “This amazing midwife came and took my baby away for a bottle of formula so that I could sleep” versus “I can’t believe it! The midwife gave my baby formula without asking me! She has ruined my chances of breastfeeding because now my baby will be confused and I wanted to exclusively breastfeed!”
There are a few things to unpick here. First, nobody should give formula without your consent. This would be unethical and needs to be followed up with your healthcare provider. Most midwives know that a new baby generally does not need formula unless medically indicated. This could be, for example, when baby has low blood sugar (perhaps when mum has diabetes), baby is jaundiced, baby is clearly really hungry and the mother is too unwell to feed, when the mother does not have sufficient colostrum right now e.g. has lost more than average blood at birth or has retained placental fragments. In these situations it will be essential for the baby to have food. If no mother or donor milk is available, this has to be infant formula. In the vast majority of cases, it is absolutely the right thing to give baby formula from a bottle and then get back to part or exclusive breastfeeding when everything is alright again. In the meantime, if the mother is well enough, unrestricted skin to skin and breastfeeding or expressing will help to build the mother’s milk supply as much as possible. If the mother is too unwell to do this, then her recovery has priority while her baby is fed with formula.
Some mothers are worried about their baby becoming confused by an artificial teat rather than a nipple. I have looked at the latest research on this, and it is inconclusive. A new baby’s ability and willingness to suck on either a teat or a nipple is likely to be influenced by a huge range of factors, including but not limited to:
- Their maturity
- How they are feeling after the birth, and perhaps the medications used
- Whether they are excessively sleepy, as can happen with jaundice
- Mouth size and shape
- Ability to move their tongue effectively
- Sore or tight muscles from labour or birth, especially after instrumental birth
- Birth injury e.g. forceps bruises
- How fast the milk is flowing, and baby’s ability to tolerate it
- Nipple or teat size or shape relative to the above
Most of the time early feeding problems can be rectified with specialist help, perseverance and patience. Provided that the mum is able to protect her supply by expressing milk, I have seen babies get back to exclusive breastfeeding in a few hours, days or occasionally weeks. You might like to watch my video of techniques to help a sleepy or unsettled newborn to latch.
If a mother is really worried about giving a bottle, there are supplemental nursing systems such as thin flexible tubes from a bottle or syringe that are taped to the breast and provide additional milk as baby breastfeeds. Your midwife could also demonstrate how to feed baby from a cup. However, the majority of parents find that long-term a bottle and teat are more practical and easily cleaned than a nursing system and less messy than a cup. Given the lack of real evidence in this area, it is inappropriate for medical professionals or anyone else to blame or shame mothers for giving their babies bottles when babies need to be fed and breastfeeding is not possible. It is also not worth feeling guilty as a new parent in this situation. As ever, the key thing is to feed your baby, enjoy your baby, and try not to let one get in the way of the other.