Review of "Top Tips for Bottle-feeding" by Clare Byam-Cook

Bottle-Feeding for Nannies and Au Pairs

When caring for newborns and infants, nannies and au pairs must know how to bottle-feed babies. Even when new mothers feed their infants breast milk exclusively, the in-home caregiver will need to bottle-feed the infant breast milk. And, despite all the values of breastfeeding we have all heard, some mothers must bottle-feed their infants formula and Clare Byam-Cook, author of Top Tips for Bottle-feeding explains how to properly bottle-feed infants and why bottle-feeding infants is fine.

Clare Byam-Cook is a retired midwife from London. She has spent the past 20-years helping thousands of women — including celebrities such as Kate Winslet and Helena Bonham Carter — to breastfeed. Although her book is written for mothers in the United Kingdom, her advice on how to bottle-feed is useful for mothers and caregivers world-wide.

Controversially, Ms. Byam-Cook believes it is okay to give breastfed babies a bottle when necessary — heresy in the breast-feeding world.

There is little doubt that breast milk is best. Typically breast milk gives babies all the nutrients they need for the first six-months of life and helps protect them from ear and gastro-intestinal infections, chest and urine infections, childhood diabetes, eczema, obesity, and asthma. It also helps protect the breastfeeding mother against ovarian and breast cancer, and weaker bones later in life.

“Most women have got the ‘breast is best’ essage,” says Byam-Cook. “But breastfeeding does not guarantee your baby won’t get these illnesses, it just means your baby is less likely to get them.”

She continues, “Yet because women are always being told how wonderful breastfeeding is, they assume that breastfeeding equals perfect health, while formula is liquid poison. So many women limp on miserably, still trying to breastfeed when it’s clearly not working.”

“Successful, happy breastfeeding, is based on the assumption that all babies feed perfectly and that all mothers have plenty of milk,” explains Byam-Cook.

Byam-Cook also disagrees with the theory that virtually all women are capable of breastfeeding. “This idea that every woman can breastfeed because she has a pair of breasts is ludicrous,” she argues. “It’s like saying no one should become diabetic because we all have a pancreas.”

No matter how they try, some women will never produce enough milk. Some babies have such a poor sucking reflex they will never manage to breastfeed successfully.

The author says, “Breastfeeding is a skill that needs to be taught well. Some midwives and counsellors are brilliant teachers. But other mums are let down by poor or conflicting advice.”

While Byam-Cook is not exclusively promoting bottle-feeding, she believes the use of a bottle should not be seen as some kind of heinous crime — and indeed, breastfeeding and bottle-feeding mothers should be taught how to give a baby a bottle properly.

“Focusing solely on breastfeeding and refusing to discuss bottle-feeding, which many antenatal classes now do, means that mothers no longer know how to properly make up, store and give bottles of milk — either of their own expressed milk or formula,” says the midwife and author.

“I have no qualms at all about advising a woman struggling to breastfeed to express her milk and give it via a bottle,” says Byam-Cook. “We can then try breastfeeding again when the mother is no longer tearful and in pain, and the baby is no longer screaming with hunger.”

She continues, “If a baby can’t or won’t get enough milk out of the breast to be satisfied, it’s better to give formula in a bottle than for the baby to end up dehydrated because of underfeeding.”

Just under half of all mothers who prepare powdered formula do so improperly. For instance, they use boiled water that has cooled for too long (raising the risk of bacteria).

“Without proper information, it’s not surprising that so many bottle-fed babies are more prone to problems like gastroenteritis,” says Byam-Cook.

Clare’s advice to expectant mothers is clear. Try to breastfeed. Every mother owes it to her baby to at least try. But have a sterilizer, breast pump, bottles, and formula — and access to effective help on standby just in case problems arise.

As nannies and au pairs we owe it to the mothers and their infants to encourage the mother and infant bond, whether the mother breastfeeds or uses formula. Ultimately, women need to accept that despite all their efforts they might not be successful at breast feeding. But, with a supportive caregiver and knowledge of proper bottle-feeding they will still have a healthy and happy baby.

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  1. I never thought of bottle feeding as a skill yet it seems obvious now that you mention it. It's a huge part of our jobs: the feeding, cleaning, sterlizing, organizing, storing, etc….Thanks again for another idea and great resource.

  2. Bottle feeding is a great topic for nanny training. Do any of the schools offer this book as a resource?

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