Tuesday, July 17, 2012

How to have a bottle-refusing baby (and a life)

Before I had my baby 16 months ago, I was quite clear on one thing: if I breastfed her (and I wasn't yet sure which way I would swing), she was going to take a bottle. Oh yes, she would. I had no desire to join the dreaded ranks of the Mothers Whose Babies Will Not Take A Bottle. I'd read all the stories, you see--about how a bottle-refusing baby irrevocably ruined your entire life, chaining you to your infant night and day and ensuring that you never had a evening-out or date night ever again. I was horrified by such stories, but not terribly sympathetic. Really, these sad excuses for mothers had only themselves to blame for not introducing a bottle properly at the right time. Or maybe they did introduce a bottle in time, but then failed to follow up on it. Tut tut. Apart from anything else, how utterly irresponsible, I sniffed--what if they suddenly had to be hospitalized and the poor husband had no means of getting milk into the baby? I, by contrast, was going to do things properly.

And so I carefully introduced bottles--beautiful, carefully selected glass bottles--at five weeks, as per The Sleep Lady. Baby Seal took them like a dream and I congratulated myself on my superior mothering skills. I now had the ideal breastfeeding-yet-bottle-accepting baby who would allow me to leave her, when desired, with Dad or Grandma--though, if pressed, I would have been forced to admit that keeping my baby primed and ready for such occasions was actually a heck of a lot of work.

You see, the Sleep Lady stipulated a rule of "one bottle a day" to make sure that baby did not lose her bottle-latching skills. This meant that in addition to breastfeeding and babycare, I had to find time to sterilize the pump (carefully gripping each piece with tongs while pouring boiling water though it), set the pump up, mechanically wheeze the milk out drop by drop, store it, sterilize the bottle parts with more boiling water, screw the bottle together, fill it with milk and warm it. Then there was the business of trying to find a time-slot for fitting the bottle-feeding into the daily routine. As Baby Seal's bedtime became earlier, my husband was no longer home in time to give her an evening bottle, so I began to give it myself.

Perhaps that's where the trouble began. At any rate, at three months old, Baby Seal began to refuse her carefully prepared bottles. In horror, I posted on Facebook "She's stopped taking the bottle!!! HELP." Everyone weighed in with suggestions (from giving the bottle out of doors, to rolling the teat in icing sugar) all of which I duly followed--to no avail. My pliant little bottle-accepter was gone, and she never took one again... well, not until she was nine months old and bottles were no longer necessary anyway. Bit of a climbdown for me, as you can imagine.

And... it was okay. We managed--just about--without bottles. Not always very conveniently or efficiently, it's true (I moaned about the problems of my little bottle-refuser here). And yet, somehow, we got through it and came out the other side.

As it turns out, bottles are not absolutely indispensable for getting milk into a baby without a breast. Over the millennia, a variety of things from spoons to droppers to cups have been used for the purpose. So why the ubiquity of bottles? Well, the big advantage of bottles over other feeding methods is that they are a way of getting a lot of milk into a baby with relative speed and without wastage. If you are looking to get large quantities of milk into a baby sans breast, then a bottle is what you need. If speed/efficiency/quantity are less important--because you are, say, a stay-at-home/work-at-home mother or on mat leave and you only need to leave your baby for the odd evening out, the hairdresser's, doctor's appointments and so on, a bottle may not be essential and could even be more trouble than it's worth.
When it became clear that bottles were simply not going to work, I girded my loins and went to internet to learn about alternative feeding methods. Over the next few months our family ended up doing a mixture of dropperfeeding, cupfeeding and spoonfeeding (milk and cereal); no method was perfect, each method had its own advantages. On preparing to leave the house without the baby, I would basically defrost a container of breastmilk, sterilize a spoon, dropper, and cup, and say to Dad/Grandma, "Erm, your guess is as good as mine. Try lots of stuff and see what works." Here's my rundown.

  • Dropperfeeding
This method suggested itself from the dropper I'd used to give Baby Seal her Infacol. I know, I know--feeding milk in a dropper sounds like it is going to really, really, really slow. In fact, for this particular purpose, droppers should really be named "squirters" because you put the milk in one squirt at a time, not literally drop by drop. Slowish, but not nearly as bad as it sounds, and less messy than some other methods.

To give Baby Seal a dropper feed, we would put her in her bouncy chair facing us. It's a funny thing, but when breastfed babies are being fed milk from anything other than a breast--a dropper, spoon, cup or bottle--they tend to prefer the whole experience to be as different from nursing as possible; different posture, different part of the room, and often from someone who's not the mother. It's as if anything that reminds them of breastfeeding makes them furious--"Look, I know this isn't real breastfeeding... do you take me for a fool??" Anyway, we started off with a few drops at a time, then increased to half a dropperfull, then a full dropperfull. I found a video here, but honestly, there is no special technique to dropperfeeding--it's just insert and squirt. Any medicine dropper will do.

  • Cupfeeding
Baby Seal came to cupfeeding rather late--at four months, she grabbed the rice cooker measuring cup and put it to her mouth with a cheeky grin... and I had an "Aha!" moment. The best way to learn how to cupfeed is to see it in action--thank you, Youtube.
Shot glasses are the most popular cupfeeding option, but I used either the aforementioned rice cooker cup (which had a little "give" in it), or a tiny Japanese teacup. The trick with cupfeeding (and this flummoxed me for ages until I worked it out) is to get the baby's tongue inside the cup. You're not actually pouring the milk into her mouth, because if you do this, she will splutter and gag; you need the baby to use her tongue to sip or lap the milk from the cup.
I found cupfeeding faster than dropperfeeding, but at the expense of more wasted milk. When this is breastmilk you've spent forever carefully expressing and storing, that's hard (could this be the true origin of the old saying about crying over spilt milk?). After five months old when Baby Seal was having solids anyway, I made sure there was some ready-made formula knocking about in the house, which made it a bit psychologically easier to experiment with different ways of giving milk.

  • Spoonfeeding
Spoonfeeding breastmilk struck me as being the slowest and messiest method of the three mentioned thus far--Baby Seal always seemed to have a lot coming out of her mouth, perhaps due to the tongue-thrust reflex--yet my mother-in-law and mother seemed to prefer it to other methods. I guess it comes down to familiarity--grandmas are usually accustomed to spoonfeeding babies. Which leads me to....

  • Cereals
If a baby is at least four months old and you've been spoonfeeding breastmilk anyway, adding a little baby cereal like baby rice or oatmeal can be a nice, not-overthinking-it start to solid foods. It stabilizes the breastmilk and makes it less messy to feed, while also giving your baby a little extra iron... and there has recently been a swing back towards emphasising supplementary iron for breastfed babies. Now... I know I mentioned this in another post, but the funny thing about a lot of lactivists is that they think spoonfeeding breastmilk is great--like a kind of superior alternative to the evil bottle--but that spoonfeeding solid foods is a Bad Thing (forcefeeding, doesn't allow your child to control their food intake, blah blah). So according to this logic, the moment you add a little powdered rice to a spoonfull of breastmilk, your baby suddenly becomes incapable of controlling their intake of what's on the spoon, and you are essentially just waterboarding them with the contents. No, I'm not buying that bit of logic either. We did the cereal thing, and offered a couple of teaspoons of water as well, to counterbalance the solids that had been added.

  • Sippies
I had high hopes that Baby Seal might take to a sippy cup super-early; alas, she hated every sippy I tried on her for the longest time. She even hated the soft-spout type which are recommended for young babies. Still, it's worth giving them a try; I've heard of bottle-refusers taking a sippy as early as four months.

It doesn't last forever
So in the end, it was okay. I got out without the baby; somehow, with a bit of this and a bit of that, Baby Seal got enough milk inside her.
Now, I should stress, however, that I'm speaking from the privileged position of someone who was able to take six months' mat leave and then work from home while using in-house childcare. If a mother is going to work outside the home in the usual way, a bottle-refusing baby is far more of an issue, which is why (as discussed in a previous post) it drives me nuts when I see lactivists disingenuously advising planning-to-return-to-work mothers to wait for two or three months before introducing a bottle, or even not bother at all. With the best will in the word, babies are not going to get huge amounts of milk inside them with these methods, so if we are talking about a baby who is at a daycare nursery much of the day, suggesting to mothers that they don't bother with the bottle and instead just have their baby fed with an open cup or spoon is basically tantamount to telling mothers to encourage their babies to reverse cycle--a phenomenon which sometimes occurs with breastfed babies of working mothers, whereby the baby eats next-to-nothing all day and then makes up for it by clusterf*ck-feeding all night long. Which some mothers may be okay with, and others most definitely are not. That's even assuming you can get a daycare nursery to handle cupfeeding with a baby in the first place.

However, if you are, say, planning to leave your baby only for the odd evening out or whatever, having a bottle-refuser is a nuisance but not a disaster. Although I do generally rather hate the hoary platitude "This, too, shall pass," this is one of those instances where it does have the ring of truth. Most new mothers aren't doing much in the way of evenings-out for the first month or so after the birth anyway; and then at four to six months you start solids and the feeds start getting fewer and further apart; at seven or eight months baby may start taking a sippy cup, and so on, and the whole situation starts to look completely different. So in the great scheme of things, the time that having a bottle-refusing baby will inconvenience you is really, at most, only a few short months out of your entire life. And even during this period, honestly, you can go out without your baby when you want to--it's just a bit more fiddly and involves rather more spilt milk.

And there is a bright side to having a bottle refuser. At least you don't have to wean them off the wretched bottle if they never take to one in the first place (same with pacifiers). And to be honest, yes, going straight to an open cup probably is more hygienic, and better in terms of palate development and dental health.

In hindsight
Knowing what I do now... if I were to have another baby in similar circumstances, would I bother with the bottles this time? Well... I think would certainly introduce one like I did with Baby Seal--it's worth a try, at least. But I think that this time I wouldn't put myself through all that exhausting palaver of the daily bottle; it was just.so.much.work and I'm really not sure it was worth it. And if my hypothetical second child were to start refusing the bottle like Baby Seal, I 'm pretty sure that this time I wouldn't waste energy on fighting with her over the issue. I would just remind myself that the inconvenience of the bottle-refusing baby doesn't really last very long, and that in the meantime there is nothing more adorably precocious than the sight of a young baby drinking from a teeny little teacup.