Baby-Led Bottle Feeding: Paced Bottle Feeding Techniques with Amy Peterson, IBCLC

Katie Ferraro (0s):

Are you about to start solid foods but you don't know where to start? Or maybe you started with some purees and now you want to make a switch? The best place to get started learning about starting solid foods safely is my one hour online video workshop called Baby-Led Weaning for Beginners. I just rerecorded this free training and it's packed with videos and visuals on how to safely prep Baby-Led Weaning foods, what it looks like for the first few days, how to reduce choking risk and what to do if your baby has an allergic reaction to food. Everybody on this free training gets a copy of my original 100 First Foods list so you'll never run out of ideas about what to feed your baby. Next, you can get signed up for this video workshop at babyledweaning.co.

Katie Ferraro (41s):

If you have one hour to dedicate to learning about Baby-Led Weaning, come take this free online video training and grab your copy of that original a 100 First Foods list. While you're there, again, head to babyledweaning.co to get signed up and I hope to see you there.

Amy Peterson (1m 0s):

The interesting thing, Katie, is that most term healthy babies, usually after even three bottle feedings, they pace themselves. So pacing is definitely something we impose while they're learning, mostly because we don't know If the flow is gonna be right for the baby and we need to be able to really control that flow without overwhelming the baby So they don't have an aversion If the flow is right, if the shape is right and you have a term healthy baby, usually only pace them for maybe two or three bottle feeds and then they'll paste themselves. You can really just offer the bottle, tip it up and they'll go to town and spit it out when they're done.

Katie Ferraro (1m 42s):

Hey there, I'm Katie Ferraro, registered dietitian, college nutrition professor and mom of seven specializing in Baby-Led Weaning. Here on the Baby-Led Weaning with Katie Ferraro podcast. I help you strip out all of the noise and nonsense about feeding, giving you the confidence and knowledge you need to give your baby a safe start to solid foods using Baby-Led Weaning. Is it possible that you've been bottle feeding your baby wrong all this time? I am not here to shame the any decision you make about Feeding Your Baby, but when I first learned about Amy Peterson's work, she's an IBCLC and the author of Balancing Breast and Bottle Feeding Your Baby.

Katie Ferraro (2m 23s):

I read her entire book cover to cover. So I'm working on my IBCLC lactation credential. I just finished a big course with a bunch of required reading. Her book was suggested reading, but that was the one that I wanted to read first because we learned about how she teaches Baby-Led Bottle Feeding a paste bottle feeding techniques, And I was like, this stuff is so simple yet it's so important for moms who are going back to work or who are bottle feeding in addition to breastfeeding or even if you've totally ditched breastfeeding, letting your baby lead the way is important in bottle feeding just as much maybe if not more than it is when you're starting solid foods. So Amy Peterson is an IBCLC.

Katie Ferraro (3m 3s):

She's been one for nearly 30 years at this point. She's a very renowned author. She's based in southern Idaho and she told me an interesting story. She had her first baby when her husband was in the military and they lived like five minutes from where I lived in Southern California at that time. She said her first baby cried for world record for her 11 hours with no stopping and she talks about how important breastfeeding support was to her. She was a big advocate and still is of La Leche League and she became a leader. She went on to get her IBCLC and then she started working with the speech language pathologist to really support moms who are breastfeeding but who may also be using bottles. Okay. And that was like kind of anathema like back in the day If you were a IBCLC or breastfeeding person and you even talked about bottles, it was Like, what are you doing that's anti breastfeeding?

Katie Ferraro (3m 49s):

She really helped shape a lot of the way we'd look at the combination of utilizing breastfeeding, bottle feeding, pumping even formula. And so I think you're really, really going to enjoy Amy's outtake. She's going to teach you how to do paste bottle feeding. So even if you've been Feeding Your Baby with a bottle already or you got someone helping you might be like kind of forcing the baby to finish the bottle, she's gonna teach us what little tweaks we can make in order to promote Baby-Led Bottle Feeding or paste bottle feeding. I really do hope you'll check out her book Balancing Breast and Bottle Feeding Your Baby. And with no further ado, here's Amy Peterson to talk about paste bottle feeding techniques and Baby-Led Bottle Feeding.

Amy Peterson (4m 33s):

Many of the families I work with want to use a bottle in a way that doesn't mess up breastfeeding. A lot of the books they've read or things they've seen online make bottles seem very scary, like they're gonna sabotage breastfeeding, but it can be done in a way that doesn't and they can feel confident. So a lot of the families I work with are, are wanting to do that. This one particular family wanted to work together to choose a bottle and we found a bottle that worked well for the baby and when I see babies in person, I'll usually try three or four bottles with a baby to to check mouth placement. The baby sucks while a breather them just to make sure it's a good fit and everyone's on board and and we're comfortable and we found a great bottle for this little baby.

Amy Peterson (5m 16s):

And then the family went home and they, they decided they'd wait a few days and then bring the bottle back 'cause it was a early breastfeeding and they weren't going to work it anyway and that's fine. They, they had time. So when they began to introduce the bottle again, what they found was every time they put the bottle in the baby's mouth, the baby would gag. It didn't matter what time of day it was that the baby would either gag or cry or turn away and just seemed overwhelmed with the bottle. But we knew the baby could bottle feed well with this bottle when I was with them. So we, we hopped on a zoom call to figure out what was happening And I watched them feed the baby and then it was obvious right away.

Amy Peterson (6m 0s):

But if you're a new mom, it's probably not real obvious anytime you introduce a bottle to a baby, most of the time bottle nipples drip and when babies feel the drip coming out as it enters their mouth, their reflex is to put their tongue up and block it. So either that presents as the bottle can't even enter the mouth or the milk starts coming out or the baby turns their head and, and they're sad because they want to eat, but all of a sudden their mouth is full of milk. What that is is the air pressure equalizing with the inside the bottle with the air pressure in the room and most nipples will drip for maybe the first three seconds or so and babies don't like it.

Amy Peterson (6m 45s):

A very easy way to help the baby overcome that is you simply offer the bottle into the baby's mouth with the milk held to the bottom of the bottle. So the baby kind of needs to be upright. And then when you place the nipple in the baby's mouth, they begin sucking on an empty nipple. And once the baby's sucking and comfortable and gets a little rhythm going, parents simply tip the bottle up and then milk begins flowing and the nipples already in the mouth and the proper place where it will just be an easy suck, swallow, breathe.

Katie Ferraro (7m 17s):

That makes so much sense. But where does the idea come from though that we need to tip the bottle up? 'cause like I'm just thinking as you're talking, I'm like nodding my head because historically we always think, oh, starting solid foods, you need to shove a spoon of white rice cereal in a baby's mouth in order to get them to eat. If you're bottle feeding, you need to get that thing full of milk and shove it in their mouth. Where did this idea originate from because what you're describing makes so much more sense as far as mimicking breastfeeding and the letdown reflex and there's not immediate gratification like there is with the bottle, so you're kind of delaying it, but like not, I mean, how, why do we do it the old fashioned way instead of the way you're describing?

Amy Peterson (7m 53s):

I think it's just from what we see on tv. If you look at old shows, you know, babies are held in a cradle position and the bottle just naturally fits poking down into their mouth. So it, it is just a seamless process, insert A into B. But what I think of even more than delaying the milk flow is I think of, think of babies, newborns when they're learning to latch, particularly if mom is doing a laid back position where the baby's on top, the baby has a lot of time to figure out 'cause they can bob the little head and use their arms to figure out how to get the breast in the mouth so it feels just right.

Amy Peterson (8m 34s):

And in fact that's why a lot of moms experience a little pinching when the baby first latches is because the nipples not in the right spot in the mouth first. A lot of times if moms will shape their breast and do the asymmetric latch, when the baby latches, it actually places the breast in the right spot. We need to do the same with a bottle. If the nipples right in the front of the mouth, it doesn't feel right. They need the opportunity to adjust their little latch till it feels right and then milk can flow without overwhelming the baby.

Katie Ferraro (9m 5s):

Hey, we're gonna take a quick break, but I'll be right back.

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Katie Ferraro (10m 50s):

So I was introduced to your book Balancing Breast and Bottle. It was part of the recommended reading in a class that I recently took as part of the IBCLC work that I'm, I'm working towards that credential as well. And the instructors mentioned that you teach about Baby-Led Bottle Feeding, talked about your work in paste bottle feeding techniques. I was like, I need to get this book went on, Amazon ordered it, read your book straight through, start to finish in one setting. It was so straightforward, so helpful. I am so excited I get to connect with you here on the podcast to help our audience and me learn more about this. But before we dive in, could you talk a little bit about your background? How did you get into breastfeeding? What sort of work do you do? And then why did you decide to write this book with your co-author who is an SLPA speech language pathologist?

Amy Peterson (11m 34s):

I went to school to become an early childhood educator and surprisingly a lot of our required reading were books that were also required reading with Luchi League. If any moms are familiar with a very old support group for moms, I had my first baby and she was a horrible baby. I love her, but she was horrible And I needed a lot of support. We didn't live near any family And I needed someone to walk me through the journey till it was going well and then eventually it did go well, but I couldn't do it by myself. So I hooked up with Che Lee through March childbirth educator and it really saved our relationship.

Amy Peterson (12m 14s):

It, it made me the mom I am today after being in a left league for a little while, became a leader because I really wanted to be able to help other moms with the help I received. And then after about five years, I decided I would like to go beyond helping as a volunteer And I wanted to be able to help moms advocate within the medical field. And I knew to do that at the time I really needed to become an IBCLC. So I did, after becoming an IBCLC, I, I kind of got my foot in the door at the hospital, worked with lots of moms. I also was able to teach the baby friendly hospital initiative to the doctors and the nurses at our local hospital.

Amy Peterson (12m 55s):

I was doing lactation rounds there, moving from there, still running a private practice. I also was able to work with the infant toddler program, which is the early in intervention program that every state has for babies through five. And it was great to get in the door right away and start seeing babies. So I've been exposed to a lot of different scenarios. A lot of the babies I see are medically fragile or come from a medically fragile background where they've been in the hospital, they have been receiving bottles or they, they need an alternate way. They can't just breastfeed, they usually need to do both. And I've been able to walk through families of how to achieve that, how to get their milk supply up, how to transition hopefully if, if it's their goal to exclusive breastfeeding when possible.

Amy Peterson (13m 43s):

And then there was one baby I saw that I could not figure out what it was. You know, we all were always learning, but this was a baby, I was just stumped And I didn't have any idea of how to help her. So I ended up sending her to her family's speech language pathologist because all of the other children were in speech. And this baby went and saw the SLP and by golly, that baby went on to exclusively breastfeed and the SLP And I exchanged notes And I ended up taking her to lunch and picked her brain and we decided we wanted to work together because we both approach the mouth. She does pediatric, but a lot of, a lot of specializing in infants.

Amy Peterson (14m 25s):

So we approached the mouth very differently but so complimentary. It's like we filled in each other's knowledge gaps. So we wanted to start working together and we did. And after about three years of working together and seeing some very challenging cases, we also got the reputation that we could help families breast and bottle feed. Because in our practice since we were seeing medically fragile babies, we did a lot of supplementing and we used a lot of tools to train the mouth to learn to suck properly so they could breastfeed. So we decided we would write a book and our first book was called Balancing Breast and Bottle Reaching Your Breastfeeding Goal.

Amy Peterson (15m 7s):

And that was published back in 2010. At the time the reasoning for writing the book to have it accepted professionally was so many moms were returning to the workplace and all the breastfeeding books said don't use a bottle. It'll ruin things, have them finger feed your baby, I mean all sorts of other things. And just scared moms into using a bottle. So we wrote it with the point of view that if moms need to do it, they need to know how. 10 years later we came out with a second edition. It's called Balancing Breast and Bottle. Feeding Your Baby. Feeding Your Baby encompasses not just bottles but sometimes it includes formula.

Amy Peterson (15m 50s):

And we really wanted moms to have their questions answered. So it's change to Feeding Your Baby. It still begins with birth and breastfeeding and all the troubleshooting and how to get, I guess the first section is breastfeeding, but then we go through bottles pacifiers formula 'cause some moms need formula. We go through bottle strikes or bottle battles when babies won't take a bottle. How you can get through that. And then it ends with, I hope you liked the footnote, the the ending was my little pep talk to moms Feeding is one tiny portion of parenting and it goes on for a long time and this truly is one tiny slice and it's important that moms enjoy it.

Amy Peterson (16m 37s):

And that was our goal in writing. It was to be helpful and encouraging, give them enough information so moms would feel confident and happy with what they're choosing. So that hopefully we came across with that idea.

Katie Ferraro (16m 50s):

I loved it. It is so approachable and as a mom who wanted to exclusively breastfeed, but my first baby had nerve damage from birth. She latched perfectly transferred zero milk. I tried the SNS, I tried everything. I got to a point where we had to use a bottle. I remember it was the middle of the night and my husband was helping me put the SNS in, which is like, If you ever done that, like you need four hands to do this. The baby's screaming her head off and he like looks at me, he's like, how is this any different than bottle feeding at this point? Like at that point. And that was fine. Then I had a set of quadruplets, I had a set of twins after that I had to use bottles. And I love that. I feel fortunate that I came into new motherhood in an era where IBCLC such as yourself, it kind of paved the way where it's okay to talk about bottles because I know in a previous era you got chastised as an IBCLC for even mentioning bottles.

Katie Ferraro (17m 37s):

And I don't know how comfortable you are talking about that, but I love that the second version of your book is like, listen, I am a breastfeeding expert and of course we promote breastfeeding, but in real life moms have to go back to work and bottles are involved and sometimes formula's involved and there is a way we can do bottle feeding in a way that mimics breastfeeding, that doesn't promote overeating. And that's what like resonated with me about your book because I realize I look back, I was not doing paste or bite Baby-Led Bottle Feeding. And so I wanna transition into that part of the interview. Can you explain what paste bottle feeding is and how does it align with the concept of baby lead and Baby-Led weaning when it comes to starting solid foods?

Amy Peterson (18m 19s):

Great topic. So think of breastfeeding a baby. When you have your own little baby and you go to latch them on, it takes them a minute to get them breast in the right place. And then they start little tiny sex like flutter sucking, which triggers the mom's letdown and then milk begins to flow at that point, babies starts swallowing and they'll usually swallow at the beginning of a feed. Every baby's different, but the average baby probably swallows 20 times, 25 times in a row. And you can hear them swallow, breathe, swallow, breathe. Or you might hear, suck, suck, swallow, breathe, suck, suck, swallow, breathe. But every baby has a rhythm and the baby will go through a series of swallowing and that actually matches the mom's first letdown.

Amy Peterson (19m 9s):

And when the letdown subsides, the baby stops sucking and they do some catchup breathing and then baby starts sucking again when the breast lets down milk again. And this was Gettys did some ultrasound studies where they showed that the suck cycle burst coincided with a series of letdowns that moms were having. And most moms have, we don't feel them, but most moms have at least five letdowns and they get shorter as the feed progresses. So If you just think of how a baby breastfeeds, they do quite a bit of sucking and swallowing in the beginning and then they rest a little. Let's do some more, maybe not quite as many swallows rest a little, a few more swallows, rest a little. And what does a baby do when they're finished breastfeeding?

Amy Peterson (19m 53s):

They unlatch. We don't watch the clock. It's best if we don't watch the clock. Babies know if a baby's feeding well, they know when they're finished, they know when their tummy's full. And you can offer the other side and they might choose to have a little bit of milk or they might choose to have nothing at all. And we don't force it, we just trust the process. The other thing with that is every feed is different. I mean every day is different. Some babies, my third baby ate two hours around the clock, just 24 hours a day every two hours that child nursed for a year. But some babies will take long stretches and then little short stretches between feeds because we trust the process, we can't see what's going in.

Amy Peterson (20m 36s):

We just trust that they will ask when they're ready. That's the same premise with paste bottle feeding. We let the baby suck on the nipple to get it in their mouth in the right way before there's any milk coming out. When they start sucking in a rhythm, we tip the bottle up so they can swallow milk and then we listen and we should have a series of comfortable swallows. And with babies, if it's just a mom watching a baby, you really are gonna need to look at the baby's body language in their facial expressions. The baby should look comfortable. They should be making eye contact with mom or the feeder if they're looking away or their eyebrows are bunched up or they're looking worried, the flow's wrong.

Amy Peterson (21m 21s):

And that would be a time that you might need to choose a different bottle. And it's, it's hard to tell If you don't know everything about a bottle, which is why I love bottle consoles because I, I know how fast they flow and that helps me when I'm helping a baby. But, but anyone can figure this out by watching their baby. It just might take you a couple more tries. If the baby is swallowing comfortably the first time you offer a bottle, usually you'll aim for the same number of swallows that your baby generally has during a letdown. And again, that's different for every mom. I usually shoot for 12 to 20. I just look at the baby's behavior and let them swallow that many times and and they're gonna swallow in rapid succession.

Amy Peterson (22m 3s):

That's okay. They do that at the breast too. Once that 12 to 20 swallows is up, I give them a break, which would be pacing like how mom's breast stops flowing. We're going to make the bottle stop flowing just by tipping the bottle down a little bit. So the milk is no longer in the nipple and at this point the baby's gonna do some ketchup breathing like they do with the breast, waiting for the next letdown. And then when the baby starts sucking again, we follow their cue, we tip the bottle back up so milk is flowing and we repeat this process until the baby's finished. Now sometimes a baby will finish all of the milk that was offered to them and they'll still act hungry.

Amy Peterson (22m 44s):

Just like with a breast, if your baby was still acting hungry, you'd offer the other side. Sometimes babies need a little more and it can take a bit to figure out how much your baby needs, but in the same way we make an estimated guess and we don't make them finish it. So if they're, if we're doing paste bottle feeding with them and let's say they're still half an ounce in the bottle and they definitely do not wanna suck again, they unlatch or turn their head away, we can respect that they're finished and maybe they'll ask for a little bit more in 10 minutes, maybe they won't. Maybe that was the end of the feeding. But the important part, particularly in controlling obesity is to respect the baby's feeding cues and trust the process.

Katie Ferraro (23m 27s):

Hey, we're gonna take a quick break, but I'll be right back.

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Katie Ferraro (25m 13s):

Can you explain how the position of the baby and the position of the bottle differs in conventional adult Led Bottle Feeding compared to a baby-led or paste bottle feeding? Like what do we need to tweak in order to move from the old school, what we see on tv, shove it in their mouth and make 'em eat till they're done to the baby-led responsive paste approach?

Amy Peterson (25m 37s):

This is a little different, the breastfeeding because we're dealing with gravity and, and there is gonna be some milk coming out. So we wanna be able to control the angle of the bottle. In order to be able to do that, we need to control the angle of the baby. So I tell moms that your hand, and this is just while they're learning, eventually they'll be able to cradle their baby in their arm like a normal feed. But when the baby's learning your hand is like their exoskeleton, you get to be their backbone, probably put a thumb and a finger under their little armpits and support their shoulder blades so they can sit up enough comfortably without rolling into a little ball. If you want 'em to be able to sit up and lean back a little bit.

Amy Peterson (26m 19s):

And then with the bottle we can take it to the baby's lips and hold it at an angle where the milk is tipped down and the nipples empty. And that's possible because the baby is more upright. Baby doesn't have to be completely upright and like I said, a new baby's gonna roll into a little ball, it won't work at all. You, you have to get 'em at just the right angle and you can see that when you become the backbone for your baby, hold the baby up, introduce the bottle so the milk is tipped down and then the bottle never leaves the baby's mouth unless the baby chooses it to. Just like at the breast. So years ago when we first were riding Pastd, bottle feeding was taught.

Amy Peterson (26m 60s):

Literally I have handouts from different organizations. Let the baby suck five times. Take the bottle out of the mouth, let the baby suck five times, take the bottle outta the mouth. That's not how the baby feeds the breast. They just pause and feed and pause and feed and pause and feed and unlatch. So that's what we teach is the ideal way to do paste bottle feeding. So let it enter the baby's mouth, let them start sucking comfortably, tip it up so milk flows. And then if the baby is continuing to swallow, we impose a break. But The interesting thing, Katie, is that most term healthy babies, usually after even three bottle feedings, they pace themselves.

Amy Peterson (27m 43s):

So pacing is definitely something we impose while they're learning, mostly because we don't know If the flow is gonna be right for the baby and we need to be able to really control that flow without overwhelming the baby. So they don't have an aversion. But once the if, If the flow is right, if the shape is right and you have a term healthy baby, usually only pace 'em for maybe two or three bottle feeds and then they'll pace themselves. You can really just offer the bottle, tip it up and they'll go to town and spit it out when they're done.

Katie Ferraro (28m 13s):

Amy, can I ask a question regarding the nipple being empty? Like I distinctly remember my grandmother saying don't let the baby suck air in. If there's no milk in there, it's gonna make the baby belch. Is that true?

Amy Peterson (28m 26s):

I don't think it's been studied so I can't say definitively, but you can hear the baby exhale. So when the baby's sucking on a nipple, they're also exhaling through their nose, inhaling and exhaling through their nose. I've never had a baby have an issue with that.

Katie Ferraro (28m 44s):

So sucking air is fine. Like the fact, I think beards worry, oh my gosh, I gotta have the milk in there right away. And you're saying no, the nipple should be empty and what they're sucking is essentially air, but that's not gonna cause any damage.

Amy Peterson (28m 56s):

No, they're probably exhaling it anyway. They're also helping the bottle equalize and pressure faster with the outside air pressure, which is gonna make the bottle flow slower. I mean it's a win-win.

Katie Ferraro (29m 6s):

Now I know you said Amy, that after just even a few bottle feeds you see that babies actually start to self-pace but before that period so that mom can be, you know, hyper aware without stressing out. But Like what are the key signs that a baby is ready for a pause or to stop during a bottle feed and how do you help parents learn to recognize and respect those cues? Since every baby's different? And it might be hard to tell that If you're a new parent.

Amy Peterson (29m 31s):

One thing I forgot to mention that I'll put in now, when a baby is taking a bottle and when a baby's at breast, normal baby positioning is to have their arms midline. Same with the bottle. And that that's important because one of the things I look for is the arms start going out, their little hands start splaying fingers, their arms might go out. Like think of leaning back and pushing your arms out saying whoa, that's essentially what the baby's doing. They're starting to get overwhelmed and you'll feel very subtly the baby's leaning back, their eyes get bigger, their hands go out, they're, they're basically saying, whoa. And that's when I tip, I actually, I try to tip the bottle down before that happens.

Amy Peterson (30m 16s):

But you, you can feel that in your baby that or they'll look away or their breathing doesn't seem right. You, you can tell they're not breathing as they should. And those are all times to stop, let the baby catch up and then then see if it's still gonna work or not.

Katie Ferraro (30m 35s):

For breastfeeding parents who are also using bottles, Amy, how can pace bottle feeding help protect their breastfeeding relationship?

Amy Peterson (30m 44s):

The big problem I see doesn't necessarily come from parents. Usually the, the parents who have the information are really prepared. The problem is when they send them to daycare and maybe the daycare workers aren't prepared on how to do the same. So for this reason it is great for the parents to find the right bottle, make sure it's working so that baby will hopefully learn to self-pace before it happens. Because in daycare or grandma if grandma's visiting, the rule of thumb is they look to see if they finish the bottle and it's paced. Bottle feeding is not about finishing the bottle. Now that's important for a medically fragile baby, but that's a different topic for a a healthy baby that is having a supplement in a bottle, we're not looking at the ounces for each feed, we're looking at the ounces over 24 hours.

Amy Peterson (31m 38s):

So if a baby takes one ounce less during one feed, guess what? They're probably gonna take half an ounce more at a couple other feeds later and that's okay 'cause we're looking at the big picture. So part of it I think would be for parents to be comfortable knowing that it's no longer about the volume at each feed and to make sure the daycare worker knows the same

Katie Ferraro (32m 0s):

Amy besides pressuring the baby to finish the bottle with, you know, X number of ounces. What are some other common mistakes that you see parents or caregivers make when they're offering bottles? And then how does switching to a paste bottle feeding model help correct those?

Amy Peterson (32m 15s):

So the first would be offering a baby who hasn't had a bottle, the bottle with milk flowing immediately. That throws a lot of babies for a loop. The second would be not paying attention to the baby during the feed. A lot of times, I mean think of breastfeeding when we're feeding a baby, we can scroll on the phone, we can play with our toddler. We're doing many things because the body's kind of taking care of itself. It's a little different with a bottle. Sometimes babies are getting overwhelmed or whatever and our, our eyes might be somewhere else, but really the baby needs to be looking at you and you need to know how that swallowing pattern is going to make sure the baby's not overwhelmed. And I do think some babies become overwhelmed.

Amy Peterson (32m 59s):

Sometimes they even unlatch to a bottle, yet the bottle's still being held there and no one knows that the baby's not even drinking. So the, it takes a measure of paying attention just because, and then yes, having the baby finish the bottle I think is a big problem. The other question that we get very often is, well, can I put it in the fridge? Can I warm it up again? What do you do with the milk that's leftover? Because when you're figuring out how much your baby eats and the just the quantity and as it changes and, and depending on how many times a day they're eating, it feels like there's a lot of waste sometimes while you're figuring it out.

Amy Peterson (33m 40s):

So it makes sense to put some milk in the bottle and have other milk to add if the baby needs more. So you don't feel like you're wasting. But there are some rules of thumb for the leftover milk. Leftover milk can be given to the baby again within an hour of the baby stopping feeding. So if the baby starts sucking on the bottle at eight in the morning and doesn't finish, you have an hour for that baby to offer it to see if they'd like a little more. And then you're not wasting it. So If you, If you are respecting the baby's cues, let them feed, they leave half an ounce and it's like, oh my gosh, I'm gonna have to throw this out in 10 minutes. Maybe they'll take a little snack and then you don't feel like you're wasting any.

Amy Peterson (34m 24s):

So an hour is the rule for formula or formula mixed with breast milk. If it's a breast milk only bottle, then you have two hours the time extends. But if there's any formula added to the bottle, then you have to revert to the formula instructions which are one hour, not two. It is not recommended to refrigerate. You can, I think refrigeration we, we know from research it will inhibit some bacteria growth, which is fine If you wanna do that. But know that you can't heat the milk again, you only get to heat it once If you heat it at all. So you can heat it and then either leave it out at room temperature and let the baby have it again within the timeframe or put it in the fridge if you'd rather, but then they're gonna need to drink the milk cold because you don't wanna heat it again 'cause it's gonna proliferate bacteria growth.

Katie Ferraro (35m 15s):

Okay Amy, what if you've been bottle feeding but it hasn't been exactly a paste approach or baby lead. Is it hard to make a switch and is it even worth it to make a switch if the quote unquote old way is working? And if so, why?

Amy Peterson (35m 29s):

Let's say the mom is breast and bottle feeding. If the baby's doing fine and isn't having any resistance to the breast, let it be. You're fine. If you are newer using a bottle and your baby like let's say the first three, three or four weeks of returning to work where there's bottle introduction and breastfeeding, if there is any hesitation in the baby latching onto the breast, that would raise a red flag for me that we need to look at nipple shape and nipple flow. Because just like human nature, babies are gonna pick the easiest way to feed. And a lot of times that will be with the bottle, particularly if it's a shape that's easier for them to suck on, like maybe like a straw or something that they just have a preference for.

Amy Peterson (36m 19s):

And sucking at the breast is a little more challenging and takes more work. Those babies may come to prefer the bottle. But If you have been bottle feeding and things are going well, you know, you're three months in, I just do what you're doing.

Katie Ferraro (36m 33s):

So what practical tips do you have for parents if they have other caregivers, grandparents or people who help or even their partner or daycare providers, how do you suggest they broach this topic and then do they show that person how to do the pace bottle feeding? Like what do you recommend so that everyone gets on the same page here so the baby's not getting one approach at home and want a daycare or one when they're with grandma?

Amy Peterson (36m 57s):

Ideally a baby can learn how to, to latch onto the bottle easily get it in the right mouth position every time they latch, before they ever go to a subsequent caregiver. So if that can be done under the parents, to me that's ideal because a baby will will already know how to do it when they're with a caregiver if it's a younger baby. I think the important things are, are really simple. First and foremost, it's this is, these are important things for this baby. If a caregiver, a daycare worker thinks they're trying to change how they do all of the babies in their daycare, you're gonna need a lot of resistance.

Amy Peterson (37m 39s):

You just want them to do this for your baby. So make sure they know these, these are important things for our baby baby, please. And then show them what a good latch looks like. For example, if the nipple tip is just in the mouth versus wedging the bottle in more deeply so the mouth is open wider, that would be preferred because it's more like the breast. So it's just quickly showing 'em this isn't in far enough, this isn't far enough. If your baby still needs pacing, you could review that. But really, if you've been working with your baby, you probably aren't gonna need to teach pacing to someone else. You will need to teach them, this is how I know my baby's finished.

Amy Peterson (38m 21s):

My baby will turn their head, my baby will push the bottle away with their hand or just close their mouth, whatever it is. So they know it's okay to waste milk because they don't wanna waste your milk and they, they usually keep a log of how much the baby eats. So If you are sending four ounces just to be sure there's enough, you're doing a disservice because they're probably gonna feel like they need to feed your baby that much. So you just need open communication on quantities.

Katie Ferraro (38m 48s):

Hey, we're gonna take a quick break, but I'll be right back.

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Katie Ferraro (39m 15s):

Well Amy, thank you so much. This has been so informative. I can see a lot of moms out there, myself included being like, oh my gosh, I wish I knew this a while ago, but it's not too late to make the switch. Tell our audience please, where can they go to learn more about your work and to support your business?

Amy Peterson (39m 29s):

Oh, thanks. Our handles are all the same. Our website is breast and bottle feeding.com. Our Facebook is breast and bottle feeding. Our Instagram is at breast and bottle feeding. Our books are on Amazon and also through our website. And then we also have a series of tear off sheets such as Preparing Formula and which even includes considerations about water used for preparing formula and all of that's in the book. But we do have some different things available on our website for moms as you do bigger babies too. We have a great tear off on taking care of your baby's teeth, which was written on the back of my own little children after having dental issues and arguing with the dentist and then finding a better dentist who wrote a, a great handout with me.

Katie Ferraro (40m 18s):

A lot of the dentist, they're all about Baby-Led Weaning now. 'cause you're, they're using those jaws to eat real food and it really helps expand the oral cavity and helps prevent a lot of expensive braces down the road. So the, the dental community is slowly but surely coming around to this baby-led approach. So Amy, thank you so much. It was a pleasure getting to chat with you.

Amy Peterson (40m 37s):

Thanks Katie.

Katie Ferraro (40m 37s):

I am just like smiling ear to ear from that interview. Amy's amazing. She's so joyful, so bubbly, such a great way of educating in a non-judgmental fashion. Her book again, it's called Balancing Breast and Bottle Feeding Your Baby. Make sure you're reading the second edition. She co-wrote it with an SLP. I'm not lying when I said I read it straight through, start to finish in one sitting And I know you're probably already bottle feeding If you are, you're like, I know how to do this. Her tips are, they're just so minute but little tweaks that I think will really improve your own ability to continue breastfeeding even after your baby starts solid foods. I'm gonna put all of the resources that Amy shared and we're gonna be doing a lot of videos on social media about Baby-Led Bottle Feeding that Amy's gonna be teaching.

Katie Ferraro (41m 20s):

So be sure to check that out. Again, her handles are all breast and bottle feeding. The show notes for this episode are at blwpodcast.com/34. A special thank you to our partners at AirWave Media. If You guys like podcasts that feature food and science and using your brain, check out some of the podcasts from AirWave or online at blwpodcast.com. Take care. Good luck with the past or Baby-Led Bottle Feeding. Try out some of those techniques. I hope it helps protect and encourage and expand and improve your breastfeeding journey even as your baby starts solid foods.

Katie Ferraro (42m 3s):

Thanks for listening and I'll see you next time. Bye.

Dressed: The History of Fashion (42m 4s):

Hello, I'm Cassidy. And I'm April. And together we are fashion historians, friends and co-hosts of Dressed the History of Fashion, a podcast about why the clothes we wear matter throughout history and around the world From the cultural and societal to the personal and often political. With each episode, we explore the multitude of meanings, quite literally sewn into the clothes we wear. Please join us and unraveling the hidden histories reside in your closet over the course of our newly launched eighth season. You episodes are available on Wednesdays and Fridays, on Apple Podcast, Spotify, or wherever else you listen to your favorite shows.