Although you might think that drinking from a cup can appear to be an advanced skill beyond the capability of infants, babies of all ages, even preterm babies, have been successfully fed by cups throughout history. A 1994 study in England demonstrated that babies as young as thirty weeks’ gestation can feed well from a cup, sometimes before they can effectively breastfeed or bottle-feed. (1), (2) Some mothers choose to feed babies this way in order to avoid nipple confusion or flow preference. However, there can be significant spillage with cup-feeding,(3) which can be frustrating and expensive. Some lactation consultants believe that methods of bottle-feeding that closely resemble feeding at the breast do more to encourage appropriate feeding behaviors than cup-feeding does, though a recent study did show that while cup-fed premature babies stayed in the hospital longer, they were more likely to be discharged breastfeeding.(4)
Almost any clean small plastic or glass cup or bowl can be used to cup-feed. Small disposal “Dixie” type paper cups should not be used because they contain a plastic coating that may be toxic to infants. Many mothers find that a flexible plastic cup allows them more control over the flow of supplement. You may also prefer to feed your baby with a cup that is specially designed for feeding small babies. Medela markets two such cup-feeding products, the SoftFeeder™ and the Baby Cup Feeder™. Ameda also markets a cup, as does the Foley Company, and other companies. The Medela SoftFeeder and the Foley Cup Feeder work especially well because they feature a small self-filling reservoir that allows control over the amount of supplement offered at the babies’ lips.
How to Cup-Feed
Be sure your baby is awake and alert—do not attempt to feed him when he is sleepy. Swaddling may help keep baby’s hands from bumping the cup. You may also find it helpful to protect your and your baby’s clothing from spills with a towel or cloth.
Hold your baby in an upright position in your lap, either facing you or cradled against you, paying careful attention to supporting his head, neck, and shoulders. Fill the cup at least half full with the supplement. Bring it to your baby’s lips, gently tilting it so that when he opens his mouth the cup rests lightly on his lower lip.
Tip the cup slightly so that a few drops of milk flow onto the baby’s lips. Do not pour the milk into his mouth, as this can cause coughing and sputtering. Leave the cup in this position and let the baby set his own sipping rhythm. Pause when needed, and stop to burp the baby from time to time as necessary. End the feeding when he is satisfied.
Spoon-feeding is very similar to cup-feeding, except that it can take longer to give the same amount of supplement and the shape of a spoon does not give you as much control over the flow of the supplement into your baby’s mouth. The process of spoon-feeding differs from cup-feeding in that you will need to allow for periodic refilling of the spoon. While often used for short-term supplementation of newborns, spoon-feeding may be too cumbersome for long-term use.
(1) Lang, S., Lawrence, C, Orme, R. Cup feeding: an alternative method of infant feeding. Arch Dis Child 1994 Oct; 71(4):365-9.
(2) Howard, C., de Blieck, E., ten Hoopen, C., et al. Physiologic stability of newborns during cup- and bottle-feeding. Pediatrics Nov 1999; 104(5) Pt 2:1204-7.
(3) Malhotra, N., Vishwambaran, L., Sundaram, K., et al. A controlled trial of alternative methods of oral feeding in neonates. Early Hum Development 1999 Feb; 54(1):29-38.
(4) Collins, C., Ryan, P., Crowther, C., et al. Effect of bottles, cups, and dummies on breast feeding in preterm infants: a randomised controlled trial. BMJ 2004 Jul 24; 329(7459):193-8.