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Many mothers use bottles to feed either expressed breast milk (EBM) or artificial breast milk substitute (ABM) to their babies. When a baby is not directly breastfeeding, usually the most often considered option is always a bottle. It is important to know that there are other alternatives available to feed the baby.

Risks of Bottle – Feeding:

Bottle feeding comes with its own risks like nipple confusion, bottle preference, overfeeding, less than optimal jaw development, dental issues, speech impairment etc to name a few. Weaning off bottles is another task in itself which has proven to be quite challenging for many mothers.

Alternatives:

There are many alternatives available through which a baby can be offered EBM/ABM. Let’s consider them individually.

  1. Open cups –

Babies can drink from small open cups. It takes a little bit of getting used to, but most feeding methods (including breastfeeding sometimes) takes a little bit of practice. The ideal size of the cup is small with a capacity of 1-2 oz (30-60 ml). Babies don’t drink from a cup like adults by gulping it down, They lap it up like kittens. Individual experiences of doctors and mothers show that even preterm babies born at 32 weeks gestational age can drink from a cup.

Steps to feed a baby from an open cup –

  • Have the baby in an upright position in your lap. A lot of mothers find it easier to keep the baby seated sideways in the lap. Baby’s neck should be well supported.
  • Bring the cup to the baby’s mouth, place the rim of the cup on the baby’s lower lip and tilt it a bit to let the milk (EBM/ABM) just touch the baby’s lips.
  • Wait for the baby to start lapping it up. Baby herself will decide the speed and rhythm that’s comfortable for her.
  • Never pour the milk into the baby’s mouth as it can be a choking hazard. Just ensure that the cup is tilted enough for the milk to just touch the baby’s lips.
  • When the baby pauses while drinking, patiently wait, without removing the cup from her lips.
  1. Paladai –

Paladai is a traditional indian cup with a spout which is a kind of stalwart cup. However, it’s different in the sense that it is low and the spout protrudes from the side in a triangular shape like Aladdin’s lamp. The design of a paladai makes it easier to be used as a feeding cup. It reduces the spillage of milk to a great extent and helps the baby drink a more amount in less time.

Steps to feed a baby from a paladai –

  • Keep the baby in an upright position. Sideways in the lap is most comfortable. Baby’s neck should be well supported.
  • Bring the paladai to the baby’s mouth and tilt the paladai enough for the milk to touch the baby’s lips.
  • Baby will slowly start pouting in order to accommodate the shape of paladai and will start drinking from it.
  • Do not insert the spout into the baby’s mouth and let the baby decide the speed of drinking.
  1. Spoon –

A small sized spoon with an elongated shape works well to help a baby drink milk from it. A cup of milk should be ready by the side in order to refill the spoon as soon as possible each time it’s finished by the baby, to not break the feeding flow.

Steps to feed a baby with a spoon –

  • Keep the baby in an upright position, sideways in the lap; supporting the baby’s neck with one palm.
  • Fill a spoon full of milk and bring it to the baby’s mouth and place the tip of the spoon on the baby’s lower lip.
  • Baby will start lapping it up and drinking at her own speed. Keep the spoon at the lower lip of the baby and keep tilting it so as to keep the milk in the spoon touching the baby’s lip.
  • Do not pour milk into the baby’s moth.
  • Fill the spoon immediately each time to try and not break the flow of feeding for the baby.
  1. Shot glasses –

These are just like open cups, only shaped differently. These are easier to hold for the feeder. The rest of the method is the same as feeding from a cup.

  1. Syringe –

Syringes can be used when above methods are difficult or when the baby needs to be fed the top milk only temporarily (for a few feeds) or occasionally.

Steps to feed a baby with a syringe –

  • Fill the syringe with milk.
  • Bring it to the baby’s mouth and insert just the tip in the baby’s mouth.
  • As the baby pouts to accommodate the tip of the syringe in her mouth, press the plunger to release the milk into the baby’s mouth. It should be done slowly.
  • Keep looking at the baby and respond to her cues. Pause when the baby pauses to swallow. Then release some milk again.
  1. Dropper –

Droppers can also be used similarly as syringes when the need to use them is limited. Droppers are very small, having the capacity of 1-2 ml. Therefore, they are good to give colostrum to newborns who are not directly breastfeeding or require top-up.

Steps to feed a baby with a dropper –

  • Fill the dropper with milk.
  • Insert the dropper into the baby’s mouth a bit.
  • When the baby is ready to drink, press the dropper to release the milk from it.
  • Since the dropper only holds about 1 ml of milk, sometimes, it can be inserted into the baby’s mouth and the milk can be released from it as the dropper touches the inner cheek wall.
  1. Supplemental Nursing System (SNS) –

SNS is a great system that helps a baby drink the top milk in one of the most ideal ways – with her suckling needs being met. In this method, a tube is attached or inserted into a container or a syringe. The other end of the tube goes in the baby’s mouth from where she drinks. However, instead of offering only the tube (like a straw), it is offered to the baby with something else.

  1. SNS at breast – here, the tube is taped onto the mother’s breast and it is inserted into the baby’s mouth at the nipple when the baby latches onto the breast. So, when the baby suckles, she is actually drinking the top milk coming to her from the tube. This method works wonders in cases where the mother is working on her supply as her breasts are getting stimulated as well.
  2. SNS with finger feeding – here, the tube is taped onto the caregiver’s clean finger. The finger is inserted into the baby’s mouth along with the tube. When the baby sucks, she gets the milk from the tube. This method is helpful for non-lactating single parents, transgender parents and/or other caregivers.

Advantages of using Alternatives to Bottles:

All the risks associated with bottle feeding are eliminated when alternatives are used to feed a baby.  Apart from that, the alternatives mentioned above like cups, shot glasses, spoons, paladai etc are much easier to clean and sterilise as compared to bottles. They are also more easily available in indian households. Using these alternatives make the transition to breast easier, simpler and faster.

References:

https://kellymom.com/ages/newborn/newborn-concerns/alternative-feeding/

https://www.askdrsears.com/topics/feeding-eating/breastfeeding/faqs/alternatives-bottles

https://www.llli.org/breastfeeding-info/bottles/

https://breastfeeding.support/cup-feeding-newborn/

https://www.laleche.org.uk/nursing-supplementers/