When bottle feeding, you want to be sure to use paced bottle feeding techniques to avoid flow preference. This will better enable you to transition to breastfeeding.
Start when baby is hungry, but not ravenous. When baby is too hungry, all they will want to do is eat right then in whatever method is fastest and most familiar. Aim for about 15-30 minutes before you'd expect baby to want to eat. Get comfortable and hang out skin to skin and tummy to tummy. If possible, plan a nursing vacation. Pay attention to your baby's cues. When baby is ready to nurse, allow them to lead the way with a baby led latch. Here is a great article on awakening your baby's breastfeeding instincts via baby led latching. For visual learners or if you just want to see this in action, check, out this video: https://www.breastfeedinginc.ca/videos/baby-28-hrs-old-baby-led-mother-guided-latching/
Note the breastfeeding position with the baby in the video above. Recent research indicates that the tummy to tummy positioning is a far more natural feeding position and is far more conducive to a relaxed and successful breastfeeding session. Check out this article for more information http://www.mothering.com/articles/natural-breastfeeding/
I have transitioned both a 5 month old and a preemie starting at around 34 weeks (once the suck/swallow/breathe instinct kicks in). I found with the preemie that I fully experienced the newborn nursing period. The newborn feeding period, which goes up until they are 6 weeks adjusted can be super exhausting because it feels like all you do is feed them... for hours... just sit, and feed them... but that is totally normal... and it is all you are doing... it can make you crazy, but it is their instinct to build supply.
We were lucky with my micropreemie to be in a NICU that prioritized breastfeeding. The doctor's prioritized breastfeeding over bottling. The goal was to breastfeed for 10 minutes. This counted as a full feeding. The doctors gave us a couple of weeks breastfeeding 1-2 times per day with the other feedings by NG before adding bottles in. Generally speaking, they found this avoided nipple confusion. The nurses and anyone else who fed baby used baby led bottle feeding strategies and the breastfeeding mom was never the one to give the bottle.
With my older infant, I found that starting with a late night feed where he was mostly asleep gave me the best opportunity for introducing breastfeeding, he was snuggly, relaxed and sleepy and wanted to eat but was also comforted by sucking. For a few months, the only nursing session we had was at 3 am. The rest of the time was bottle. He gradually opened up and we added more nursing times. Our breastfeeding relationship continued until he was almost 3 years old. I'm still nursing my daughter as of this blog post. She's 15 months actual, 11 months adjusted.
Mothers, especially those of us who have been obsessed with supply and tracked every milliliter we've produced, find it hard to not be able to quantify consumption. The biggest thing to remember is if baby is latching and you see swallowing, you have to trust them and trust your body. As long as they gain weight, you are doing great. Check out this video (again from Jack Newman's breastfeeding clinic) that shows what swallowing looks like.
Jack Newman has a lot of great videos over on his website. You can check those out here I did e-mail him once in desperation while working to get my 5 month old to latch after his open heart surgery. He answered my questions completely and was very kind. He can be a great resource.
If, like me, you built a really GREAT supply over the months you were not able to directly breastfeed, you might run into another problem. Oversupply. What you once counted as a blessing can now work against you. Baby can be overwhelmed by the volume of milk and can have trouble drinking enough to get to the hind milk. I have talked with a number of moms who have had the experience of a baby nursing for a few minutes, then pulling off and screaming with rage. Some of them thought this was baby getting angry because they wanted milk faster, but in reality, they were experiencing oversupply issues and baby was angry there was TOO MUCH milk... Here is a great article from KellyMom on Overactive letdown/Oversupply and how to manage it. If you have an oversupply issue and try to decrease your supply to better match baby's needs, be sure to take lecithin and be careful with breast compression to mitigate your risk of blocked ducts. One risk for blocked ducts is an underwire bra. I'm a bigger girl and I have found the best, non-underwire supportive bra is this Goddess Women's Keira bra.
I hope these resources can help you as you begin your breastfeeding relationship. Good Luck!
Other posts in this series include:
- Initiating Milk Supply With A Pump
- Breastfeeding Primer
- Pumping to feed baby when you need to be away