Feeding the baby

To become and be a parentRFSLPhoto: Rebecka Ekholm/RFSL

This is an introduction to nursing and bottle feeding for rainbow families. Here you’ll find links to more information and different kinds of support for people who have just started nursing or bottle feeding or soon will be.

Nursing and bottle-feeding – for new parents

Start by watching RFSL’s films Närhet, Amning, Flaskmatning at https://bliforalder.rfsl.se.

At rfsl.se you can also read more about:
Nursing and feeding for trans people, Guide to co-nursing and induced lactation, where you can read more about nursing with a supplemental feeding system.

Nursing support after your baby is born

  • 0-7 day old baby: BB (postnatal ward)
  • 7+ day old baby: BVC (child health care clinic)
  • Call 1177, they can refer you to a nursing center in your region
  • Amningshjälpen, a non-profit organisation, personal guidance and meetings, but also an online forum on Facebook.
  • Facebook group: Amningshjälpen’s closed group (advice and help about nursing from others who nurse and from qualified “HJÄLPMAMMOR” (Help mums) with experience in breastfeeding difficulties) https://www.facebook.com/groups/amningshjalpen/
  • Facebook group: LLL LGBTIQA+ Families: a safe space for families who identify somewhere across the sexuality and gender identity rainbow.

NURSING – general information

The links are selected because they contain relevant and correct information. However, their inclusiveness and norm consciousness varies.

  • Lin Dalén’s book from 2018: “Amning i nöd och lust. Skapa bra förutsättningar för amning och bli din egen amningsrådgivare”. In the book, there are chapters on nursing, partial nursing, co-nursing, bottle feeding etc.

BONDING, CLOSENESS AND SKIN-TO-SKIN – links to more information

Skin to skin contact: https://www.youtube.com/watch?v=2IYtFrgbDUo

Social and Emotional Intelligence of Infants: https://www.youtube.com/watch?v=51xmkaj8dOg

Bottle feeding and combining nursing with bottle feeding

Information about bottle feeding and formula

One way of giving your newborn baby food is through a feeding bottle. Some people give pumped milk and others formula in a feeding bottle. Some experience that it’s hard to get information about bottle feeding, partial nursing and combining nursing and bottle feeding. That is because WHO and Sweden are working to limit commercial businesses giving erroneous and biased information about formula to new parents. Many commercial businesses make multimillion figures from marketing and informing about formula and feeding bottles.  Nobody makes money on nursing. For many years, WHO has worked to protect, promote and support nursing worldwide. Sweden has legislation that forbids marketing of formula and feeding bottles. For example, you cannot advertise in midwifery clinics or baby boxes. Fewer and fewer children are breastfed, and more and more money is earned by businesses selling formula. Healthcare staff have therefore been given the task to talk about the advantages of breast milk and nursing. All parents have the right to this information to be able to make an informed choice about the feeding of their child. But nursing isn’t for everyone and doesn’t work for everyone, and in thoose cases bottle feeding is an adequate alternative. If you are to bottle feed you need information, advice and support, just like if you’re nursing. If you want to combine nursing with bottle feeding, something that is common in rainbow families with more than one parent, it’s important to get advice about how to preserve nursing when combining nursing with bottle feeding.

Combining nursing and bottle feeding

Children are different. Some can combine nursing and bottle feeding, and others can’t. Bottle feeding can disrupt nursing if the child develops a preference for the feeding bottle and doesn’t want to lie by the breast anymore. It can also disrupt nursing by decreasing the milk production, especially if formula is given in the feeding bottle. This leads to a downward spiral where the milk production decreases, the child becomes dissatisfied, the parent then giving it formula, which further decreases milk production.   Since milk is produced in the body, it’s easier to disrupt that process than with formula, that’s always on hand. But partial breastfeeding and combination feeding are nowadays common ways of nursing and feeding. Thus, it’s good to learn more and thereby finding ways to preserve nursing while combining bottle feeding and nursing. By being observant of how the child reacts and using advice on how to preserve nursing, you can, in many cases, make it work.

Advice about nursing in partial breastfeeding/combination feeding

  • aquire knowledge about how milk production works based on supply and demand
  • children’s growth periods and their need of cluster nursing (to nurse often and for a long time)
  • that evening restlessness and long periods by the breast is to be expected and is connected to a need for increased milk production
  • advice about how you bottle feed: to feed at the child’s pace, “paced bottle feeding”, and the importance of a slow flow with breaks, to mimic nursing
  • attentiveness to the child’s behaviour at the breast and feeding bottle, and hunger and satiety signals
  • be prepared to take away the feeding bottle and feed through a cup or supplemental feeding system if the baby prefers the bottle
  • methods of getting the child to take to the breast again
  • information about the advantage of giving breast milk in the bottle to uphold milk production (apart from the health benefits of breast milk)
  • pumping to uphold milk production if you introduce formula
  • tips for increasing milk production, such as power pumping and breast compressions during nursing and/or pumping

PARTIAL BREASTFEEDING & PARTICIPATION – links to more information

If you don’t want to, or can’t, nurse

Nursing is a personal choice. If you don’t want to, or can’t, nurse nobody should try to force you. If you’re ambivalent about breastfeeding, you should be able to get support in sorting out your thoughts and feelings during pregnancy. Sometimes, healthcare staff ask about nursing because they want to help you process things that may be in the way of you nursing. If you don’t want help, you can decline. Sometimes, healthcare staff ask about your thoughts regarding feeding to ascertain if you’ve made an informed decision or want more information. If you have decided and don’t want to talk about nursing it can be a good idea to be clear about that and ask someone to write it in your journal as it prevents staff from acting wrong and stressing you. Remember that you can be proud and satisfied as a parent no matter how your child is fed. 

Starting bottle feeding

If you chose to bottle feed your child, it’s good to get knowledge about how much a child needs to eat at different ages, even though feeding depends on the child’s hunger and satiety. It’s important to learn how your child signals that it’s hungry or wants to take a pause when fed, and when it’s full. There are many videos showing hunger signals, see suggestions below. It’s also important to read up on practical things, such as how you clean the bottles and make the formula correctly. There’s information on the websites of the manufacturers of feeding bottles and formula. Always read on the package when mixing formula, as the dosage may vary between different formulas. Always use the scoop in the box. Generally, you have to test the different formulas available, and if your child has a tummy ache it’s a good idea to consult the family’s paediatric nurse at BVC about changing formulas. Sometimes changing formula helps, but small children often have tummy aches and it can be caused by anything from immature intenstines, milk allergy or other medical conditions, so ask for support and advice from healthcare staff.

There’s an enormeous range of feeding bottles, and many manufacturers will advertise that theirs is the best. There are no recommendations from healthcare as to which bottle is best. It can be a good idea to choose a teat with a slower flow. Many recommend that you switch to a teat with bigger holes after a while. If you’re combining nursing with bottle feeding you can choose to keep a smaller teat with a slower flow to reduce the risk of bottle preference. You can also work on how you’re giving the food in the bottle. A good method (for all who bottle feed) is bottle feeding in the child’s pace, paced bottled feeding. This method slows feeding down and gives the child the opportunity to indicate when to pause, when it’s hungry or satiated if you as a parent are observant about the child’s signals and know how to feed in a way that resembles nursing. 

BOTTLE FEEDING -links to more information