If you’re a breastfeeding parent heading back to work or on an extended trip, you likely have one big concern: How will my baby transition from breast to bottle?
It’s totally natural for nursing parents and their infant’s caregivers to have jitters going into a caregiving situation where the caregiver will have to take over feeding. Parents may be concerned their baby won’t take a bottle or that the caretaker may misunderstand the baby’s cues. Caregivers may worry about knowing how much to feed the baby, how to handle pumped milk and what to do if the baby won’t eat or seems hungry after eating.
At the end of the day, parents and caregivers have one common goal: keep baby fed and content while their parent is away. Don’t worry, it’s totally doable. Follow these tips for setting up a supportive breastfeeding partnership that goes smoothly from the start.
1. Discuss breastfeeding up front
When looking for a caregiver, parents should ask about a prospective candidate’s experience caring for breastfeeding infants. Past experience with breastfed children is not a must, of course, but it is important that the caregiver shows a willingness to learn everything they can to make it work.
In these early talks, parents may want to discuss:
- Why breastfeeding is important to them
- How breastfeeding differs from formula feeding
- Why they want to use breast milk exclusively (if that’s the goal)
- The ways they can work together with the caregiver to meet these goals
For caregivers who haven’t cared for a breastfed baby before, it’s normal to feel unsure about how best to feed the baby. But showing an openness to learning the nuts and bolts of breastfeeding might be all it takes to land the job.
2. Get to know the breastfeeding basics
Once parents hire a nanny or babysitter, it’s important everyone is as educated as they can be about breastfeeding. A little education can go a long way, even for new parents, who might not exactly feel like pros themselves.
Check out these reads that may help both both parents and caregivers:
- Be a caregiver who supports the breastfeeding mother, PennState Extension
- How to choose a breastfeeding-friendly child care provider, La Leche League USA
- For the caregiver of a breastfed baby, Lactation Consultant Nancy Mohrbacher
3. Set up a feeding plan meeting
Before the first official day of child care, set up a “feeding plan meeting” between parent and caregiver, recommends Liz Whalen, a mom from New York whose daughter was cared for by extended family while Whalen worked.
Think of the initial meeting this way: The caregiver has the awesome opportunity to support the parent’s breastfeeding journey, and the parent wants to find ways to help make that happen. Parents and caregivers should use this initial meeting to ask questions, communicate their needs, set expectations and discuss any concerns.
“A caretaker’s willingness to understand and be educated on breastfeeding is critical,” says Whalen.
At first, Whalen says, she was concerned about her baby losing interest in breastfeeding. She was also unsure if the caregiver would understand that a breastfed baby doesn’t necessarily need to eat a specific number of ounces per feeding and might not finish every bottle.
Whalen says that being honest about her needs from the start made all the difference.
“Open communication is very important,” says Whalen.
Even after the first “get to know you” meeting, continue to check in with each other. These are small gestures of support, but they can make a significant difference when it comes to establishing a trusting, long-lasting partnership between parents and a caregiver.
4. Agree on feeding schedules and amounts
In the beginning, many caregivers feel uncertain about how many ounces to feed baby or how often to feed them. Rachel O’Brien, a Massachusetts-based lactation consultant, and Leigh Anne O’Connor, a New York-based lactation consultant offer some easy-to-follow rules on the basics of breastfeeding and breast milk. Parents may even want to share this list with their nanny or sitter at their first meeting.
- Go with the “1.5 ounces per hour rule.” The baby may not consume exactly this much, says O’Brien, but parents can use this as a general estimate as they store their milk and as their caregiver feeds the baby.
- Don’t leave more than 3-4 ounces of milk in bottles or storage bags. Babies are unlikely to eat more than that per feeding, according to O’Brien.
- Feed the baby every two to three hours. Parents should nurse right before leaving, says O’Brien. The caregiver can feed the baby every two to three hours thereafter.
- Store breast milk properly. “Fresh breast milk is good at room temperature for up to four hours,” says O’Connor. “It is good in the refrigerator for up to four days, and it is good in the freezer for six months or more.”
- Decide on what to do with leftover breast milk. Most experts agree that leftover milk can be stored in the fridge and used for the next feeding, says O’Connor. However, there is a chance of bacterial contamination in milk that has been previously consumed, so it’s wise for parents to check with a lactation consultant or doctor for guidance. O’Connor says that in most cases, it makes sense to change the bottle nipple because this is where bacteria can build up. But tossing breast milk is almost never needed because it has natural antimicrobial qualities.
5. Discuss common concerns
Before the nanny or sitter starts, make sure you discuss the following concerns:
Concern #1: What if the baby won’t take a bottle?
If the baby refuses the bottle, remember there are other options for feeding. Whalen and Marna Mortimore, a mother of two from North Carolina, shares these tips for babies who are just not that into the bottle:
- Try spoon-feeding half-frozen breast milk “slushies” or even breast milk ice cubes in mesh feeders.
- Offer a sippy cup with breast milk to older babies.
- Keep trying different bottle nipple types until you find one that works.
Concern #2: What if the breast milk is gone but the baby is still hungry?
From time to time, a caregiver may feel the baby is “still hungry” and needs more milk than their parent has left or needs a supplement. Navigating these concerns can be tricky, says O’Connor, but she urges all parents to speak up.
- It may not be hunger. “I have parents tell caregivers that the baby may not be hungry, [but] rather the baby needs more attention,” says O’Connor.
- Look for hunger cues. Signs of hunger include rooting and hand/finger-sucking, says O’Brien. Crying is actually a late hunger sign, so try to feed the baby before this happens.
- Try alternatives. O’Connor recommends the caregiver offer holding, eye contact and — if parents have given permission beforehand — “nonnutritive” sucking options (pacifiers or empty bottle nipples). Formula supplementation should be a last resort and discussed with parents beforehand. Babies should not be given table food before six months (and at the direction of the parent), says O’Connor.
Concern #3: What if the baby starts to prefer the bottle over the breast?
“My biggest fear was that my child wouldn’t transition back to the breast after using bottles during the day,” Mortimore says.
Thankfully, while most parents share these fears, the majority do not end up having these issues.
Things parents can do to support the caregiver:
- Feed right before leaving home and right when you return home. “I made sure I gave my daughter a long nursing session before dropping her off and then nursed her right away when I picked her back up,” says Mortimore.
- Feed during dropoff or pickup. “I encourage parents to talk with the caregiver at pickup and dropoff while nursing the baby to keep up milk supply,” says O’Connor. “This gives the caregiver and parents time to share how the baby is doing.”
Things caregivers can do to support the breastfeeding parent:
- Utilize paced bottle feeding. O’Connor suggests a special feeding technique — often referred to as “paced bottle feeding” — as a way for a caregiver to support a breastfeeding parent and baby’s breastfeeding relationship. Through this technique, the caregiver can actually mimic what breastfeeding is like, and it’s also a great way for caregivers to bond with the baby. “The bottles should be fed lovingly, slowly and with the baby upright,” O’Connor says. “Babies will be happier if the caregiver watches for cues of satiety. If the baby is more upright they can handle the flow of the milk and digest easier.”
- Make sure they’re not overfull at the end of the day. O’Connor recommends that caregivers make sure babies are hungry and ready to breastfeed when their parent arrives home or to pick them up.