Paced Bottle Feeding

‍If you use bottles at any point in your baby feeding journey, you’ll want to learn about paced bottle feeding. 

Paced bottle feeding has been shown to

• Decrease gas and stomach upset in babies
• Prevent overfeeding
• Prevent breast refusal in the breastfed baby
• Reduced reflux 
• Reduced risk of aspiration of milk
• Promotes responsive feeding in the infant, as they are more able to learn and pay attention to their hunger and fullness cues

Step By Step Guide to Paced Bottle Feeding

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• Watch for your baby to exhibit signs of hunger
• When your baby is ready to eat, position them by having them sit semi-upright, or side-lying. Learn more about side lying paced bottle feeding here.
• Start with the bottle parallel to the floor, and milk filling the nipple of the bottle halfway.
• Begin with the nipple of the bottle at the baby's nose
• Wait for your baby to open their mouth wide (do not force the bottle in), then gently insert the nipple of the bottle.
• Your baby will have a consistent pattern of sucks and swallows, and may take a few pauses. This is ok! Follow their lead.
• Watch your baby for signs of fullness - they may not finish the whole bottle.

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Which bottle should I use?

There are so many bottles out there that claim to be many things. It can be hard to know which one is best. Here are a few guidelines to use when looking for bottles.

Choose a bottle with a slow flow nipple or premie nipple -this will help slow down the flow of milk as well as help your baby practice their sucking skills.

Each company is different in how they categorize their slow flow products. Here are a few ways to a company may categorize their nipple sizes:

• By a numbers system (so their slow flow variation would be number 1),
• With a sizing system (such as S, M, or L, with S being the slowest flow size)
• With the words "slow flow" or "premie"

Look for bottles with a sloped nipple, so they continue to learn how to latch on to more than just a nipple (a correct latch at the breast includes mom's nipple and areola)

Here are some of my favorites:

• Dr Brown's Natural Flow
• Lansinoh Bottle for Breastfeeding Babies

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When do I introduce a bottle to my breastfed baby?

If you plan to use a bottle at any point in your breastfeeding journey, you can start to introduce a bottle between four to six weeks of age. By that point, breastfeeding is fairly well-established, and they are willing to learn a new skill.

Here are a few suggestions for how to introduce a bottle:

• To start, choose one of your feedings to be the one that you consistently practice at for a while. For example, if your baby usually feeds around 4PM, then express milk beforehand, and give that freshly expressed milk to your baby via the bottle. That will be their feeding for that time.
• If they finish the whole bottle and still seem hungry, finish at the breast.
• If they don't finish the whole bottle, you have two hours from the start to use the remaining milk, per CDC's guidelines.

Remember, this is a new skill for them! Just like it takes them a little while to learn how to feed at the breast, the same may be true for them as they learn how to feed from a bottle.

If you are struggling with bottle feeding or breastfeeding, reach out for help from a lactation provider in your area!

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Resources:

Li, R., Scanlon, K. S., May, A., Rose, C., & Birch, L. (2014). Bottle-feeding practices during early infancy and eating behaviors at 6 years of age. Pediatrics, 134 Suppl 1(Suppl 1), S70–S77. https://doi.org/10.1542/peds.2014-0646L

Ventura, A. K., & Drewelow, V. M. (2023). Knowledge and Use of Paced Bottle-Feeding Among Mothers of Young Infants. Journal of Nutrition Education and Behavior, 55(11), 796–802. https://doi.org/10.1016/j.jneb.2023.08.002.