If you are a working mother, ideally, you will be planning to or have already started expressing your milk at around six weeks before going back to work.
This gives you time to develop mastery in expressing milk and build a stash in your freezer.
In most cases, mothers are advised to begin the process as soon as they give birth so as to have as much milk as possible.
But this often seems like the easy bit, compared to how you are going to introduce the baby to the expressed milk through the bottle.
For some babies, introducing a bottle past the age of 8-12 weeks can be quite difficult. At any given time, babies will prefer the nipples rather than the bottle.
But unfortunately, this is not always feasible, especially when mothers return to work.
For some mothers, they are lucky to pop into their houses and breastfeed their babies during their workday. But for other mothers, this is not possible.
Amanda* (not her real name) narrated to the Star how she was forced to spend over Sh10,000 to buy different feeding bottles after the baby refused to use the bottle to feed.
She made sure she purchased the best bottle in the market.
"Two weeks after putting the baby to bed, I bought Tommee Tipee, a bottle believed to give the baby the soothing effect of breast nipples," she said.
"The first week, it was a walk in the park, second week we did even better, and after one month, I was certain she was ready for bottle feeding and wouldn't stay hungry even if I was asked to report back to work before the end of the 90 days."
After one week of not giving her the bottle, Amanda says her baby Cynthia* began throwing tantrums when she resumed.
She tried bottles from different companies, from the most expensive one that cost Sh1,800 to the cheapest that cost Sh30. "...but my Toto refused. I even tried spoon-feeding, she refused. Forcing her would make her cry and even look like she was going to get sick. It broke my heart as each day it became tougher," she said.
"I now started trying different teats on the variety of bottles I had but unfortunately it didn't work. I wished she would speak but unfortunately, I just had to understand her, as that was my job as her mother."
FRUSTRATING EXPERIENCE
With only a week to go back to work, Amanda's frustrations and fear began to build up.
"She hit me with another surprise, puking or having the urge to puke when I gave her the expressed milk, whether fresh or stored. She completely refused it to go down her throat," she said.
As a norm, mothers are advised to leave the children with relatives so they can bottle-feed the babies.
"So I took my leave and Super Grandma started using her tricks. She tried all means and my daughter was so resistant that she would prefer sleeping hungry rather than taking anything else besides breast milk," Amanda said.
A visibly frustrated Amanda said they even tried to give the baby formula milk but Cynthia refused.
After a lot of cries from the baby, Amanda and the husband Peter rushed the baby to the hospital, thinking she was sick.
"The doctor checked for sores in her mouth but my little baby was just fine and healthy but could only allow one thing into her mouth, my breasts," she said.
"They were heaven to her and when I took her to breastfeed, she would latch and hold on so tightly."
Shedding tears, Amanda says her baby did not allow her to do exclusive breastfeeding.
Breastfeeding is one of the most effective ways of ensuring child health and survival. However, nearly two in three infants are not exclusively breastfed for the recommended six months — a rate that has not improved in two decades.
WHO notes that globally, only 40 per cent of infants under six months of age are exclusively breastfed.
It adds that if breastfeeding were scaled up to near-universal levels, about 820,000 child lives would be saved every year.
"I couldn't and so I had to start her on weaning porridge, which she quickly accepted, and pawpaw. Today, we still try bottle feeding, but she is still resistant and even after weeks of trying, she can't stand expressed milk, even if you put it in the porridge," Amanda said.
WHO recommends that infants start receiving complementary foods at six months of age in addition to breast milk, initially 2-3 times a day between 6-8 months, increasing to 3-4 times daily between 9-11 months and 12-24 months, with additional nutritious snacks offered 1-2 times per day, as desired.
"So I had to throw away all my expressed milk. For us now, it's one day at a time, although every chance I have with her, I breastfeed her a lot," she said.
Amanda said her milk supply has definitely gone down, but it's better now as compared to the first child.
"With my firstborn, my milk dried up after two months of returning to work, and I had to put her on NAN due to work stress, house help stress and other normal stresses. So I learned from that and now with the secondborn, we still have milk because I am also careful with what I eat to ensure the supply is enough for her."
EXPERT COMMENT
Nutritionist Henry Ng'ethe says when a baby refuses the bottle, there must be something that must have gone wrong.
"The baby might be identifying the expressed breast milk with something that he or she took. To the extent the baby refuses it, check again and see that it is not something serious," he said.
Maybe the mother gave the baby cold milk that made him or her to refuse the milk, he said.
"Did she check the temperature? When you give cold milk, it will shock the baby. Maybe the taste of the milk made the baby start rejecting anything that comes from the bottle," he said.
Ng'ethe said instead of weaning the baby on porridge, working mothers should try formula.
"Giving the baby porridge is worse than giving formula. It is shocking that a mother will give the baby porridge before six months," he said.
WHO notes that children given formula milk from birth were on average 25 per cent more likely to be obese than those nursed naturally for six months.
But in some countries, the risk of being chubby was up to 86 per cent higher.
Youngsters partially breastfed in the first six months had a 12 per cent higher chance of ending up obese, compared to those exclusively given their mum’s milk.
WAY FORWARD
Ng'ethe said working mothers should give feeds when everybody is having their dinner at home.
"Engage the infant while eating, so he or she doesn't feel restricted to eating alone," he said.
He noted that the baby should also be given small portions of food. Like 100 ml of milk every hour.
Other tips include:
Have someone else give the bottle (not you!). Your baby can smell you and even though they are so tiny, they know that with you around, they can have what they prefer: YOU.
Quiet, please. Before someone attempts to give your baby a bottle, have them go to this location for a few minutes and let them be rocked or swayed for a few minutes so they are nice and relaxed.
Find the magic “just hungry enough” window. It may make sense to try and give your baby a bottle when they are starving.
Common sense would lead us to believe that they are so desperate to eat at this point that surely, they’ll just give in and accept the bottle.
Use a pacifier. When your baby has a pacifier, it may help them get used to having something different being in their mouth.
Keep trying. Using the tips above consistently over time can make a difference in your baby eventually taking a bottle! If it's important for your baby to take a bottle, then try once a day!