Cup feeding vs Bottle feeding

What's Covered

Feeding time is the bonding time as you connect with the baby physically and emotionally. It’s been decades to evolve and revolve the artificial feed methods. All we need to do is to choose the adapted way to feed your child. Cup feed or bottle feed the main word common here is the feed. The feed of your baby is a major concern, the rest are the accessories. So, make sure what is suitable, nutritious, and helps them grow. Choose the ways that make the bond between you and your child stronger and bring ease with peace to your lives.

Pros and Cons for Cup feeding or Bottle feeding

Cup feeding

When it comes to cup feeding sucking is an out of debate question mostly, the baby can just sip sap the milk in the lap. Cup feeding is a supplemental method to feed babies who are not in an urge to breastfeed or bottle-feed. It may seem like the toughest thing at first but by the time you realize it is an easy and ongoing process.

Bottle feeding

The tiny tot`s main work is to feed, nap and poop. Traditionally, bottles were used as an alternative so that babies can have the feed. Though it displays the negative slurping /sucking behavior and requires more vigorous strength.  In bottle feeding the baby is more in control in terms of the amount intake and meal duration. He can rest, refuse or intake the feed as per his ease of sucking capability.

ConcernsCup feedingBottle feeding
PricingAffordableBottles have to be sterilized and change after 3 – 6 months
Dental problemsChances for the dental misalignment of jaws and teeth lessensChances of dental misalignment of jaws and teeth are higher
Helping handAny other person can feed so mothers can get restAny other person can feed so mothers can get rest
Strength for feedA weak child can have the feed tooMore effort required for sucking
Pre- prepsNo pre-prep can be madeA pre-prep feed can be available for a child anytime.
Spills More spillageLess spillage
OverfedLow chances of overfeedinghigher chances of overfeeding
Nipple confusionFewer chances of nipple confusionNipple confusions are there
Colic babyLess gas/constipated babyChances of gas bubbles are higher
ChokingThe risk of choking/ aspiration is very highFewer chances of choking
HygieneBecause of open surface infections chances are rareGerms may trap in screws causing infections
The bondMuch time required but more time for bonding (eye contact)Less time required (less bodily contact)
Calculated feedExact feed calculations cannot be madeThe feed can be calculated
PreparationsPrep methods are easyPrep methods are time taking
Fussy babyWith tongue protrusions, the baby can easily have a feed.Nipples collapse and the vacuum created so more power for suctions makes the baby tiring and fussy

Nipple confusion in bottle-feeding

When a baby gets exposed to artificial nipples it prompts breastfeed problems. The confusions are real between the maternal nipple and the artificial nipple. Certainly, the present research shows that cup feeding is a trademark supplementary method for infant`s feed during their stay in hospitals. [1] The reason for nipple confusion is when the baby is being introduced to latch on a different method of feed as bottle-feed or breastfeed. [2]

Perks of bottle-feeding

The other person can feed your baby when you have some tasks to do. You can avoid public breastfeeding as some women are uncomfortable breastfeeding in public places. You can pre-prep the bottles before the baby demands feed. If you are on medications, you can still give your baby a supplemental feed. Most importantly the baby is nurtured. Sterilizations are the vital mechanism if you are picking the bottle feed.

Protrusions in cup feeding

The protrusions (tongue refluxes or sticking the tongue out) of the tongue, while the infant is trying to have milk from the cup, are similar to the breastfeeding tongue protrusion. It is a natural way the baby pursues incoming feed to his mouth. In comparison sipping triggers less breastfeeding mechanism than lapping as sipping is a mouth-centered action (involving lower lip more). However, cup feeding is a combination of suction and different oral mechanics which somehow mimics the breastfeeding mechanics.

Cup feeding as an alternative

Cup feeding is an ideal alternative as its indications and outcomes are similar to breastfeed babies. It may not be a substitute to breastfeed but it is the healthiest and finest way to deliver supplements in an infant’s body when circumstances don’t let them foster breastfeeding. Though positive sucking ability matures gradually as they learn to suckle and latch in earlier days of life since they are born. [3] In advanced cup feeding styles, the major objective is to avoid spillage and upsurges breastfeeding. [4] The major benefit of cup feeding is that the baby becomes physiologically stable, with proper oxygen saturations, and can avoid the nasogastric tubes or bottles which are prone to infections.

Cup feeding or Bottle feeding in premature babies.

Premature babies are the most delicate ones to handle. They are weak and seeking nourishment. So, things adopted for them should be as per their ability.

Pumping breastfeed in bottle-feeding

Ideal latching is not possible every time though the infant needs a supplemental feed. Mothers in some cases are not able to breastfeed at ease (especially when they are being operated on or faced C-sections). In such circumstances, the feed can be provided by varying methods to fulfill the needs of new life. Giving breastfeed via pump or any other means in the bottle feed can develop sufficient maturity and stability (physiologically) in the baby even if they are not directly on breastfeed. [5] you can even make pre-prep bottles too as this can be a time savior and mother`s feed can also be preserved. Indeed, a mother`s feed is precious so it is better to preserve it.

When to introduce cup feeding

When breastfeeding is not offered directly to an infant or preterm, it is time to opt for cup feeding with the number of ingestions, feed timings, the physiological stability of the preterm/infant allowing them the saturated oxygen intake. Cup feeding can be introduced even if a baby is normal and a mother seeks rest. When baby gets 3-6 months older you can offer him cup feeds too. In newborns, it is considered idyllic as it will nurture the probability of breastfeeding (without nipple confusion). It is an in-between method used before breastfeeding. [6] it is mainly acclaimed for infants in intensive care with low birth weight or preterm birth. The baby is kept in a vertical position or swathed in the lap. [7] the baby should be introduced after every 2-3 hours for cup feeding for probably 20 – 30 minutes to have a complete nurtured feed.  The amount should not be more than 2-3ounces per feed. Conversely, for breastfeeding, the feedings may increase with intervals.

Nifty Feeding Cup
Babies are fragile, when a baby is poured slightly and slowly the chances of choking, aspirations or coughing are less. This product is capable of giving your baby a moderate amount of milk by having a small reservoir. It is soft and also protects your baby from the effects of heat-based infection methods.

Baby`s aptitude to cup feeding

It is an alternative method for bottle feeding. The infants who are not adoptable to sucking (especially preterm) or if their mothers are seeking medical assistance or not available. Even in some critical situations, the cup feeding can be a redeemer.[8] Let the infant engulf the bolus of milk towards the oropharynx, allow him to be actively moving it posteriorly, this will initiate the swallowing. In sipping and lapping the positions to engulf may differ as in lapping the bolus will move directly to the oropharynx while in sipping a pressure has to be built in the oral cavity by the tongue. However, in both methods infant is allowed to breathe and maintaining oxygen saturation during the sipping or lapping breaks and surges. So, cup feeding is considered safe. [9] Assist the cup feeding cautiously if the baby is lacking sipping capability, as he may choke.

How to give feeds using Cup feeding or Bottle feeding?

While giving feeds the apparatus and the preparations for the feed should be keenly done from sterilization to execution.

Vessels in cup feeding

Some prime vessels used for cup feeding are extinct now. Some may use syringes as cup feeding. Syringes however will not help babies to realize where the feed is coming from however spoon is comparatively a slow process but spoons can also be used in place of a cup feeding strategy as they may mimic cup feeding. Better to put a bib and introduce spoon-feeding and allow the baby to take sips. Breastfeed can be easily introduced this way too.

How to cup feed?

Any clean and open surface can be used as cup feeding. Gather your accessories for cup feeding i.e. sterilize cup, bibs, towels, etc. Hold the baby in an upright position while he is fully awake. Swaddle them to avoid their hand`s interruption in between cup feedings or to avoid a sudden spillage. Place a cloth beneath the infant`s chin to avoid spillage is the supreme deed you can do. Don’t pour the milk. Introduce the sips by building the reflexes of the baby. Via touching the mouth using the cup feeding vessel you can allow the baby to feel the feed and initiate sips. Notice if the tongue is protruding. Feed-in lieu of intervals to allow the baby to breathe and burp. Pausing the feed also lets them breathe and lessens the choking hazards. Burp the baby after 15 – 20 minutes. It is better to lay down the baby once the burping is done. You can aid infants in burping by rubbing the back (in clockwise and anti-clockwise movements) slowly.

Nipples & Containers in bottle feeding

While choosing the nipples for bottles make sure they flow slowly and are made up of silicone as it is soft and non-porous. The wider the nipple is the more it imitates the breast nipples. The containers used for bottle-feeding must be of plastic that is BPA-free.  The smaller-sized bottle should be selected which can have 3-4 ounces. They should be sterilized. Don’t boil them but sterilized there is a thin line between boiling them and sterilizing them. Wash them after every feed with warm water. It is recommended to change the bottle after 4 months.

How to bottle feed?

The improper method can make infants aspirate. In bottle feeding be assured that the infant is in a position to have fed with proper closure and swallowing.[10] Make sure the child is in an upright position and the bottle is tilted to avoid bubbles (do not put the bottle straight as it will be causing gas or constipation to the baby). The ideal angle to hold the bottle is 45O to avoid the air intake in the baby`s stomach. Better to help them in burping around 3-5 minutes. Even if they are asleep try to help them burp by rubbing their back otherwise they will wake up in pain because of the air trapped in their belly.

Positions and timings in Cup feeding or Bottle-feeding

The vital thing is to introduce the feed slowly and make the baby upright. Other than that some major proactive measures are a plus in baby’s care.

Cup feeding positions and timings

It is better to half-filled the cup with a little warm milk (breastfeed or formula). Make sure the baby is not sleepy to avoid choking hazards. Wrap the baby`s hands (as you do in swaddling) so that the baby may not interfere in cup feeding by knocking hands. Put the baby is in an upright position holding from back and neck while you are aiming to lapping or sipping him. Make sure you are introducing the milk slowly to the baby, you don’t need to pour it let the baby take sips from the cup. Make a bonding and understand the gestures or signal he gave for pauses and swallows. When the baby is full he will close the mouth.

Medela SoftfeederTM Sterile
Spilling is a real mechanism to deal with in baby feeding. This product helps to maintain the right amount at the lip of the cup and softer and subtle for them to hold. The silicone compositions make it safer and healthier for baby`s use.

Bottle feeding positions & timings

It is better to put the child in an upright position for at least 15-20 minutes to help him burp smoothly. Avoid side-lying positions during or even after the feed as it may cause the exposure of milk to lungs or ears infections if a baby spills milk. Validate that the bottle feed is not so fast or neither slow. You can crosscheck it by pouring or dabbing it a little on your hand. The ideal time for a baby to have a bottle feed is 15-20minutes. While adding water (in case of formula feed in the bottle) be vigilant if it is boiled or not. Also, note that water should be boiled before the feed don’t give the boiled water or pour high-temperature water into the bottle directly. Babies who are given bottle feed by infant formulas are noticed to have fewer feedings as compared to breastfeeding in the bottle, so the frequency of feeding timings may differ in both cases.

Uncertainties & issues for Cup feeding or Bottle feeding

The major thing initiating uncertainties in both feeds is shaking. Avoid it as much as you can as this causes bubbles inside the feed which ends in making the gas in the baby`s tummy. Other than that some specific uncertainties are as under:

Uncertainties & issues for cup feeding

Babies may aspirate due to coughing, wheezing, breathing, or choking during this method if precautions are not made. If aspiration is not treated timely it may lead to complications or deficiencies in infants. Cup feeding is being revised as per needs and special care in infants. It is a simple, functioning, hands-on, and indeed an economical solution too. It is a slow process but increases bodily (eye) contact. [11] However, one can face spillage in cup feeding as compared to bottle feeding leading to wastage of milk. You might also get confused about calculating the amount of feed your baby gets. For the appropriate amount of feed, it is better to seek assistance from the pediatrician. In prolonging rare cases of cup feeding baby may lose interest in sucking breasts or may give preference to cup feeding on breastfeeding. As a new or being untrained person mothers cannot master the skill of feeding infants suddenly. The caretakers or nursing staff in hospitals can aid mothers to learn the skills of feeding or occupy the infant feed with a skillful hand to avoid any difficulties in initial feedings.

Uncertainties & issues for bottle-feeding

According to the present research, bottle feed is not recommended. The nipple collapse occurs mostly as the vacuum is created inside the bottle. In addition to that child needs to use more suction power which in turn results in a fussy screaming child.[12] The bottle caps and screwing tops are vulnerable to germs and may cause infections. While sterilizing, be sure it is not brought to the temperature where it can be susceptible to chemicals that are harmful to the baby. Allow the bottle to cool down and then let the baby have a feed.

Final thoughts

Indeed, nothing can compete with the heavenly equipped breast milk full of immunity and nutrients. But even then babies with formulized feed can survive and grow. So let us focus on quality feed with eminence methods. So, whatever the feed is given make sure the baby is getting enough of it. By the end no matter what way it is, the feed and the compassion you and your baby share are important.[13] The researches will continue to improve through interventions and so do the mothers.

[1] Collins, Carmel T., et al. “Effect of bottles, cups, and dummies on breast feeding in preterm infants: a randomised controlled trial.” Bmj 329.7459 (2004): 193-198.

[2] Abouelfettoh, Amel M., et al. “Cup versus bottle feeding for hospitalized late preterm infants in Egypt: a quasi-experimental study.” International breastfeeding journal 3.1 (2008): 1-11.

[3] Peng, Y. C., L. C. Lin, and S. C. Wang. “Is cup feeding better than bottle feeding on breastfeeding rates in preterm infants who are unable to fully breastfeed?.” International Journal of Evidence-Based Healthcare 10.3 (2012): 284.

[4] Bokhari, Khalid. “Is cup feeding preferable to bottle feeding?.” Pakistan Pediatric Journal (1997): 27-29.

[5] Carrascoza, Karina Camillo, et al. “Consequences of bottle-feeding to the oral facial development of initially breastfed children.” Jornal de pediatria (2015).

[6] Yilmaz, Gonca, et al. “Effect of cup feeding and bottle feeding on breastfeeding in late preterm infants: a randomized controlled study.” Journal of Human Lactation 30.2 (2014): 174-179.

[7] Gupta, Arun, Kuldeep Khanna, and Sanjay Chattree. “Brief report. Cup feeding: an alternative to bottle feeding in a neonatal intensive care unit.” Journal of Tropical Pediatrics 45.2 (1999): 108-110.

[8] Lang, Sandra, Clive J. Lawrence, and R. L. Orme. “Cup feeding: an alternative method of infant feeding.” Archives of disease in childhood 71.4 (1994): 365.

[9] Dowling, Donna A., et al. “Cup-feeding for preterm infants: mechanics and safety.” Journal of Human Lactation 18.1 (2002): 13-20.

[10] Thorley, Virginia. “Cup feeding: problems created by incorrect use.” Journal of Human Lactation 13.1 (1997): 54-55.

[11] Dowling, Donna A., and Warinee Thanattherakul. “Nipple confusion, alternative feeding methods, and breast-feeding supplementation: state of the science.” Newborn and infant nursing reviews 1.4 (2001): 217-223.

[12] Li, Ruowei, Sara B. Fein, and Laurence M. Grummer-Strawn. “Do infants fed from bottles lack self-regulation of milk intake compared with directly breastfed infants?.” Pediatrics 125.6 (2010): e1386-e1393.

[13] Greene, Vibert F. “Baby bottle feeding system.” U.S. Patent No. 4,463,859. 7 Aug. 1984.

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Tiffany Biondi

Tiffany Biondi

Mother of 4 kids, Tiffany is a certified childcarer and during her free time, she write posts in thebabychoice to share her hands on experience and knowledge.