Bottles are designed to be easy for babies to drink from. They are a great way to feed a baby, especially premature babies or babies with low tone who need to drink milk easily. They help a baby practice their sucking reflex while also helping them consume critical nutrients and calories. While there is absolutely a time and a place for bottle-feeding, it’s important to note that the flow of milk from a bottle is very different from biological feeding and babies may get milk too quickly, which may lead to overfeeding. Research has shown that babies fed formula by bottle have an increased risk of being overweight and obese (see footnote1). The artificial nipple takes on a different shape in a baby’s mouth than a breast, forcing them to use different muscles to maintain suction. For a parent who wants to primarily breastfeed/chestfeed, introducing a bottle before breastfeeding is established may make it difficult for a baby to latch.
Responsive/paced bottle feeding
Responsive, or “paced” bottle feeding is a technique that can help reduce the risk of overfeeding and make it easier for a baby to transition between bottle and breast or chest.
Choosing the right flow rate and shape
Start with your selection of bottle and nipple flow rate and shape. You may need to experiment with different brands, shapes and flow rates. Generally, it is best to choose the slowest flow nipple that you can find, so that your baby has to work to get the milk, rather than chugging it. You can see how fast a nipple flows by filling it and turning it upside down to see how fast the liquid drips from it.
Tips for choosing the right flow rate and shape for a nipple
One strategy to ensure that the flow is slow enough would be to choose nipples with a flow rate that is one stage below your baby’s. For example, if you have a full-term healthy baby who is two weeks old, choose a preemie nipple and use that until the baby is about 3 months old, since most size 1 nipples are for 0-3 months. Always choose preemie nipples for premature babies. They may continue to need a preemie nipple beyond 3 months depending on growth and development.
The shape of the nipple you choose will be dependent on your baby’s oral structure and tone. Some babies prefer a narrow base nipple while others can open wide and have a good amount of lip tone to maintain suction on a wide base nipple. Some narrow base nipples may be too long for a baby with a sensitive gag reflex, and they may drink better from a wide base nipple. Buy several different sizes and shapes and try them out with your baby to determine which is best.
Choosing the right bottle
As for the bottle itself, the shape and material tend to have less of an effect on feeding success. The younger and smaller your baby, the less volume you will need and can choose a smaller bottle. As your baby grows, you can consider buying larger bottles. There are bottles that have an anti-colic mechanism. Usually pacing the flow of milk and burping frequently will help resolve increased air intake so anti-colic is optional, although they can be helpful if desired.
How to do Responsive Bottle Feeding with your baby
Responsive bottle feeding means paying close attention to your baby during a bottle feed and slowing or stopping the flow of milk if your baby is showing any signs of stress.
- Hold your baby upright and close to you so you can make eye contact with your baby.
- Start by tickling your baby’s upper lip with the nipple and wait for your baby to open their mouth wide before putting the nipple in their mouth.
- Aim the tip of the nipple toward the roof of your baby’s mouth.
- Allow your baby to suck the nipple into their mouth as far as they would have it go.
- When the baby is sucking, slowly lift the bottle so that it is parallel to the floor and the nipple is about half full of milk, just enough to have milk at the tip of the nipple.
- Watch your baby as they drink. Allow them to have pauses when they need it.
- Lower the bottle or remove the bottle from the baby’s mouth if they begin gulping, coughing, milk dribbling them their mouth, eyes are wide or frowning or your baby’s hands and arms begin to flail out.
- Pause at least once during the bottle feed to burp your baby. Babies who tend to be gassy may need to be burped more than once during the feeding.
- It should take about 10-15 minutes for your baby to finish the bottle and no longer than 45 minutes.
Maintain skin-to-skin contact whenever possible while bottle feeding your baby – this will help with bonding, and help keep you and your baby calm for a better feeding. It is recommended to hold your baby skin to skin as much as possible during the first several weeks of your baby’s life, including during feeding times.
Alternatives Feeding Methods
Infant feeding can be one of the most significant challenges that new parents face. In addition to bottle feeding, there are other alternative feeding methods which you can read about here.
Contact Our Team
At any point in your infant feeding journey if you have any questions or concerns, contact a trained professional / lactation consultant to support and guide you through your baby’s specific needs.
Footnotes 1 – References
Kramer, M.S., Guo, T., Platt, R.W., Vanilovich, I., Sevkovskaya, Z., Dzikovich, I., et al. (2004). Feeding effects on growth during infancy. Journal of Pediatrics, 145(5), 600-605.
Mohrbacher, N. (2010). Breastfeeding answers made simple: A guide for helping mothers, p. 810. Hale Publishing.
Ryan, C.A. (2013). Protection against chronic disease for the breastfed infant and lactating mother. In Mannel, R., Martens, P.J., & Walker, M. (Eds)., Core curriculum for lactation consultant practice, 3rd ed. (pp. 411-425)., Jones & Bartlett Learning.
References from the above text:
Burdett, H. L., Whitaker, R. C., Hall, W. C., & Daniels, S. R. (2006). Breastfeeding, introduction of complementary foods and adiposity at 5 years of age. American Journal of Clinical Nutrition, 83, 550-558.
Dubois, L, & Girard, M. (2006). Early determinants of overweight at 4.5 years in a population-based longitudinal study. International Journal of Obesity, 30, 610-617<
Koletzko, B., Broekaert, I., Demmelmair, H. Et al. (2005). Protein intake in the first year of life: A risk factor for later obesity? The E. U. Childhood Obesity Project. Advances in Experimental Medicine and Biology, 569, 60-70.
Kvaavik, E., Tell, G. S., & Klepp, K. I. (2005). Surveyr of Norwegian youth indicated that breastfeeding reduced subsequent risk of obesity. Journal of Clinical Epidemiology, 59, 849-855.
Owen, C. G., Martin, R. M., Whincup, P. H., et al. (2005). Effect of infant feeding on the risk of obesity across the life course: A quantitative review of published evidence. Pediatrics, 115, 1367-1377.
Stuebe, A. M. (2009). The risks of not breastfeeding for mothers and infants. Reviews in Obstetrics and Gynecology, 2(4), 222-231.
Tulldahl, J., Pettersson, K. Andersson, S. W., & Hulthen, L. (1999). Mode of infant feeding and achieved growth in adolescence: Early feeding patterns in relation to growth and body composition in adolescence. , 431-437.
Von Kries, R., Koletzko, B., Sauerwald, T., et al. (2000). Does breastfeeding protect against childhood obesity? Advances in Experimental Medicine and Biology, 478, 29-39.