Formative Research to Revise Materials for Mothers and Child Care Providers of Infants (Individuals and Households)

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Attachment I – Research Stimuli for Parents – English
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You should practice bottle feeding before your
baby starts child care. Here are some tips that
have worked for other mothers:

Feeding Breastmilk
in a Bottle

Ask someone else to feed your baby the bottle.

If you are not going to breastfeed your baby
at the child care site during your breaks, you will
need to help your baby get used to a bottle.

Tip:
Introduce a bottle of your breastmilk
at least two to three weeks before
your baby starts child care.

Stay out of sight. If you are the one holding your
baby, he or she may search for your breast. If you
are nearby, the baby may resist the bottle. Be
patient. Remember, your breast is your baby’s first
choice. With time, he or she will accept the bottle.
Start small. When you first try using a bottle,
offer about ½ ounce of breastmilk an hour or two
after a regular breastfeeding session. This is
when your baby is alert and motivated but not so
hungry that he or she is upset. Once he or she
has accepted bottle feeding, you can increase
the amount offered.

How to Feed Your Baby with a Bottle
Bottle feeding should take about the same amount of time it takes to breastfeed. Hold the baby in the
cradle of your arm during the feeding, so that he or she is sitting almost upright. This makes the baby feel
secure and you can read his or her cues. It also helps to prevent choking during feeding. If a baby’s head
is tilted back or lying flat, the liquid could enter the baby’s windpipe and cause choking.

Try starting with a slow-flow
nipple. For breastfed babies,
it is best to choose a flow
that is like your milk flow. A
slow-flow nipple also requires
the baby to use the same
amount of effort to get
breastmilk from the bottle as
from your breast.

Make sure the end of the
bottle near the nipple is filled
with breastmilk. This will lower
the amount of air your baby
swallows.

Brush the nipple of the bottle
across the baby’s upper
lip. Wait for his or her mouth
to open.

Switch which arm you hold
the baby every so often when
feeding a bottle


Important

Make sure to look into your
baby’s eyes to build comfort
and trust.

Follow your baby’s lead and
burp your baby at natural
breaks during the feeding
or at the end of the feeding.
Burp by gently patting or
rubbing the baby’s back while
the baby is resting on your
shoulder or sitting on your lap.

Hold the bottle during feeding and do not prop it. Propping
means resting the bottle on something (like a burp cloth) instead
of holding it, and can:
• cause choking and suffocation.
• possibly cause ear infections and baby bottle tooth decay.
• deprive the baby of cuddling and human contact.

If the bottle is warmed under running water, gently swirl the milk and test a small
drop on your wrist before giving it to the baby. It should be warm but not hot.

Paced Bottle Feeding
Paced bottle feeding is a way of bottle feeding that allows your
baby to have control over how much milk he or she takes in.
• When you feed your baby with a bottle, try to
hold the bottle mostly sideways, not straight
up. Then the milk will flow into your baby’s
mouth at the right speed.
• Follow your baby’s lead. This gives your baby
a chance to show whether he or she is hungry
or full. If your baby opens his or her mouth
to accept more, then he or she is still hungry.

• If your baby turns his or her head, then it’s
time to end the feeding. Trust your baby to
know when he or she is hungry and when
he or she is full. Do not make your baby finish
a bottle.

How Can I Help My Child Care
Provider Care for My Breastfed Baby?
Talk to your child care provider about how you want your baby fed.

My Baby’s Usual Habits
Tell your child care provider the best way to
 

soothe your baby when upset. Let the child care
provider know if you want to use a pacifier, toy, or
something else to calm your baby.

Take time each day to talk with your child care
 

provider about how your baby is doing. Ask about
sleeping, eating, and bowel movements. Make
sure you read your baby’s daily activity chart if
they fill one out each day.

Tell your child care provider if and when you
 

plan to come to the child care site to breastfeed
your baby. This will help them plan bottle
feedings so your baby is ready to breastfeed
when you arrive.

Bottle Feeding My Breastfed Baby
Describe how to know when your baby is
 
hungry or full.

If possible, give your provider bottles with the
 

amount of breastmilk your baby drinks at each
feeding. That way they can spend more time caring
for your baby and less time preparing bottles.

Tell your child care provider not to heat your
 

breastmilk in a microwave. This can create hot
spots in the breastmilk and can burn your baby.
Heating breastmilk can also damage the important
nutrients your baby needs to stay healthy.

Tell your child care provider if you are using a
 
slow-flow bottle. Let your child care provider
know that it’s important not to make your baby
finish the bottle. Explain that each feeding may
take 15-20 minutes or longer.

Talk to your provider.

Dropping Off My Breastfed
Baby At Child Care
Fresh breastmilk is best. Frozen breastmilk
 

is good to have as back-up. Bring extra fresh
or frozen breastmilk in smaller amounts (1-2 fluid
ounces) in case your baby wants more milk.

Label all breastmilk bottles with your baby’s
 
name and the date the milk was pumped.

Give your provider enough of your breastmilk
 
to last the full day. How much your baby takes
changes as he or she grows.

How Do I Know if
My Baby is Hungry or Full?
How Do I Know When My Baby Is Hungry?
Look for these signs:

Tip:

• Rooting or turning his or
her head and opening
his or her mouth wide in
search of your breast

• Bobbing his or
her head or mouth
against your upper
body

• Bending his or
her arms and legs

• Smacking his
or her lips

• Sucking on his
or her hands
and other objects

• Making cooing-like
sounds such as “ah,
ah, ah” sounds

• Fussing or seeming like
he or she is about to cry

• Crying is a late
sign of hunger

Don’t wait until your baby is crying before feeding him or her. It may be harder to
get the baby to breastfeed once he or she is upset. It may be helpful to have your
baby sleep in a crib or bassinet next to your bed. That will allow you to breastfeed
when he or she shows the first signs of being hungry.

How Do I Know When My Baby Is Full?
Look for these signs:

• Stretches arms
and legs
• Slows or decreases
sucking

• Presses lips together

• Turns head away from
your breast
• Extends or relaxes
fingers

• Falls asleep

• Pushes or arches their
back away from you

You will normally see more than one of these signs
together. When you see more than one sign, it may be
time to stop the feeding.

When you get home
• Wait a few weeks after birth before giving your
baby a pacifier unless your doctor has told you
to use one for a medical reason. It is important
for you and your baby to feel comfortable with
breastfeeding before giving him or her a pacifier.
• Have your baby nurse at your breast often.
This is how your body knows how much milk to
make for your baby.

There may be days when you feel
like your baby wants to feed all the
time or can’t get enough breastmilk.
The reason may be that he or
she is having a growth spurt. Keep
breastfeeding when your baby
wants to eat. Most women’s bodies
will know to make more breastmilk.

How do I get my body
to continue making
breastmilk when my baby
is in child care?

Pumping Breastmilk

Learn how to express your breastmilk by hand
or by using a breast pump. That way you can
pump your breastmilk when you’re not with your
baby. Breastfeeding and pumping will allow you
to continue to make all the milk your baby needs.
You can pump and freeze small amounts to
build up a supply of breastmilk you can use later.
Having this supply will also make going back to
work or school easier.

Tip
Give your baby as much breastmilk as
you can. Try to breastfeed before
and after child care and on your days
off. Pump when possible. This will help
to keep your breastmilk supply up.

When you are away from your baby, it’s important
to pump breastmilk at the same time your baby
usually feeds. This helps maintain your breastmilk
supply. If you can’t go to the child care site
to breastfeed your baby, you can pump your
breastmilk. You can express by hand, use a
manual pump, or use an electric breast pump.
Electric pumps can have a single collection kit or
a double collection kit. A double collection kit lets
you pump both breasts at the same time. This
lets you pump breastmilk in half the time!

Some mothers have more breastmilk in the morning and find that it is easiest to express
breastmilk then. One way that works well for some mothers is:

opposite breast

Breastfeed your baby from
one breast after waking up in
the morning.

2

same breast

Put your baby down. Pump
breastmilk from the other
breast. Store the breastmilk in
the refrigerator or freezer.

Let your baby breastfeed on
the side that was just pumped.
Allow your baby to nurse as
long as he or she wants.

Pumping your breastmilk helps:

How often should I pump my breastmilk?

●● provide your breastmilk to your baby while in
child care.

Keep track of how often your baby eats during
the day for a few days before going back to
work or school. This will give you a good idea
about when you will need to plan to pump your
breastmilk while you are away from your baby.

●● keep up your breastmilk supply so you
can keep breastfeeding.
●● relieve pressure in your breasts so that you
can feel more comfortable.
●● prevent infections in your breasts.

●● reduce breastmilk leaking from your breasts.
If you are not breastfeeding or pumping and feed
your baby infant formula instead, your supply
of breastmilk will decrease and you may not be
able to breastfeed for as long as you and your
baby wish.
Contact your WIC clinic, breastfeeding specialist,
doctor, or health care provider if you’re worried
that you’re not making enough breastmilk.

Tip
How many times you pump breastmilk will
depend on how long you are away from
your baby. Pump your breastmilk as often
as you would breastfeed your baby to
maintain a good milk supply. In the first
few months, this may be 8 to 12 times or
more in a 24-hour period. So, it may be 2
to 3 times or more in an 8-hour work day.

Jose’s Story
Baby Jose is 3 months old and is breastfeeding. At home, his mom breastfeeds him
whenever he is hungry. The week before
mom returns to work, she writes down
when Jose breastfeeds and finds he eats
about every three hours. When she returns
to work, mom feeds Jose at the child care
center when she drops him off at 8:00 am.
In order to stay on the same schedule, she
pumps at work at 11:00 am, and 2:30 pm
which are the times when she would feed
Jose at home. This may change as Jose
gets older and his needs and eating habits
change. On some days Jose eats less
often at child care or doesn’t finish his
entire bottle – that’s okay! Sometimes baby
Jose just misses his mommy and breastfeeding directly so he decides to wait until
he can see her again to have a full meal.

3

Daily Breastfeeding & Bottle Feeding Schedule
How many times did my baby eat?

Sample
Day

Day 1

Day 2

Day 3

Day 4

Day 5

4

Morning

Afternoon

Evening

8:00 am

1:30 pm

5:30 pm

11:00 am

2:30 pm

8:00 pm

4:00 pm

10:30 pm

Food and Nutrition Service

Breastfed Babies
Welcome Here!
https://teamnutrition.usda.gov  FNS #XXXXXX  Publication date August 2018
USDA is an equal opportunity provider, employer, and lender.

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