With early and frequent opportunities, most mothers and babies can successfully establish breastfeeding. However, some infants may initially have difficulty latching or feeding effectively. If your newborn is not breastfeeding well, shows inadequate diaper output, experiences excessive weight loss, or other concerns, temporary supplementation may be necessary. When a supplement is medically indicated, mother’s own milk is preferred, followed by donor milk, and then formula.

This guide will help you navigate alternative feeding methods, ensuring your baby receives the nourishment they need while supporting your long-term breastfeeding goals.

Spoon

Why Avoid Bottles in the Beginning?

Although bottles can seem like the most practical way to offer extra milk, introducing artificial nipples too early can interfere with early breastfeeding. Research shows that babies who receive bottles before breastfeeding is well established are more likely to:

  • Refuse to breastfeed

  • Have difficulty latching

  • Wean earlier

  • Be less likely to transition to exclusive breastfeeding

Breastfeeding is considered well established when:

  • Milk supply is sufficient

  • Baby latches consistently, comfortably, and effectively

  • Baby demonstrates appropriate weight gain

The time it takes to establish breastfeeding varies for each mother and baby. Being patient and consistent in the early days can make a big difference in long-term breastfeeding success.

When Are Alternative Methods Helpful?

Providing any needed supplement through an alternative feeding method will ensure your little one is well fed, while giving you both time to work on improving breastfeeding. These methods also help prevent overfeeding and encourage self-regulation better than bottle feeding. Common situations where alternative methods may be helpful include:

  • Difficulty latching

  • Poor milk transfer

  • Excessive weight loss

  • Delayed onset of transitional milk

  • Late preterm infants

  • Low milk supply

  • Nursing strikes

  • Health reasons for mom or infant

  • Relactation and adoption

Spoon Feeding

Using a spoon to offer your newborn supplemental colostrum in the first few days is a low-tech intervention to ensure your little one is getting plenty of milk while you are both learning to breastfeed. If your newborn is having trouble latching or is extra sleepy, hand express your colostrum directly onto a spoon and offer it at the next feeding, while continuing to offer your breast frequently.

How to Spoon Feed  

  1. Hold your baby in an upright position.

  2. Fill the spoon with milk and bring it to your baby’s bottom lip.

  3. Allow your baby to instinctively lap up and swallow the milk.

  4. Let your baby set the pace and length of the feeding.

Cup Feeding

Research shows that premature infants benefit significantly from cup feeding compared to bottle feeding. When drinking from a small open cup—such as a medicine cup or shot glass—your baby uses the same muscles needed for breastfeeding. Cup feeding is a safe, effective short-term option that supports breastfeeding while ensuring your baby gets the nutrition they need.

How to Cup Feed

  1. Make sure your baby is awake and alert. Hold them in an upright position.

  2. Place a bib or towel under your baby’s chin. 

  3. Bring the cup to the baby’s mouth, grazing the bottom lip. Let them lap or slurp up the milk.

  4. Slowly lift the cup as they feed; do not pour directly into the mouth.

  5. Allow baby breaks and burp as needed. 

  6. Continue until feeding is complete. 

Syringe Feeding

An oral syringe can be used alongside breastfeeding to offer supplementation and may encourage more active and alert feeds. When your baby is latched to the breast, insert the tip of the syringe into the corner of their mouth and slowly press the syringe to provide additional milk. The syringe can also be used with the addition of small flexible tubing at the breast or with your finger.

How to Finger Feed 

  1. Wash hands or use a glove.

  2. Place your index finger (soft side up) in the baby’s mouth.

  3. Encourage the baby to suck on your finger.

  4. Insert the syringe or flexible tubing next to your finger.

  5. Slowly press the syringe to deliver milk while your baby suckles.

Supplemental Nursing System (SNS)

An SNS delivers a supplement while your baby breastfeeds, eliminating the need to offer a supplement after breastfeeding. A small tube enters the corner of the baby’s mouth and connects to a bottle or syringe containing milk. As your little one breastfeeds, they receive your breast milk directly from the breast plus more, from the added supplement. SNS can be used short or long-term.

Benefits of SNS

  • Encourages direct breastfeeding

  • Streamlines feedings by reducing supplemental bottles

  • Promotes more skin-to-skin time

  • Stimulates increased milk production 

Reasons for Using an SNS

  • Preterm infants

  • Poor milk transfer

  • Low milk supply

  • Breast surgery (e.g., reduction)

  • Induced lactation or relactation

Bottle Feeding

Bottle feeding is common, but not all bottle nipples labeled "breast-like" or “breastfeeding friendly” are suitable for breastfed infants. Many bottle nipples, even those labeled "slow flow" have a much faster flow than the breast.

What to Look When Bottle Feeding

  • Deep latch

  • Tongue extension

  • Tongue cupping around the nipple

  • Relaxed, outward-flanged lips

Paced Bottle Feeding

Pacing the flow of the supplement will make the transition from bottle to breast easier. Pacing feeds may also help prevent gas, reflux, overfeeding, and choking, and is especially important for preterm infants.

How to Pace a Bottle

  1. Hold your baby upright.

  2. Hold the bottle parallel to the floor.

  3. Let your baby suck for 15–30 seconds, then pause.

  4. Feedings should take 15–20 minutes; your baby should appear satisfied.

  5. Look for relaxed hands, face, and body to indicate fullness.

There are many factors to consider when choosing an alternative feeding method, such as ease of use, cost, convenience, and parent and baby preference. You don’t have to stick to just one method—many families find that using a combination works best. Each method has its pros and cons, so always discuss any questions or concerns with your baby’s healthcare provider and a lactation consultant.

Disclaimer: Our classes and accompanying materials are intended for general education purposes and should not replace medical advice. For personalized recommendations, please consult your healthcare provider and/or lactation consultant.