Bottle Feeding

There are ways that you can help your baby to bottle feed effectively when your baby is unable to feed at your breast, or requires supplementation from a bottle.

  • Use a truly slow flow nipple. Not all nipples advertised as slow flow are slow. An ideal nipple requires a baby to suck to remove milk; this discourages a baby from “chomping” or “chewing” on the bottle nipple or at the breast. A slow flow nipple will also keep your baby from being overwhelmed with milk. Feeding should be a pleasant experience for your baby.
  • Fast flow nipples will cause some babies to protect themselves by lifting the back of their tongue to slow the flow down. If they do this while breastfeeding, they end up pushing the breast out of their mouth.
  • Avoid a short, stubby nipple with a very wide base. When babies breastfeed, they take a lot of breast in their mouth. A standard width nipple is preferable because most babies can get their mouth completely around the nipple. This makes them open wide. A wide mouth nipple, which may be advertised as “more like mother’s breast,” is often too large for a baby’s mouth. This causes a baby to latch only to the end of the nipple.
  • When holding your baby for a bottle feeding, think about how a baby is held at the breast. Babies generally are in a side lying position facing the breast, or upright with their head higher than their body. This allows them to control the flow and pool milk in the side of their mouth if the flow is too fast. Your baby’s head should be aligned with their upper body and should not be extended back or bent forwards.
  • You may find it helpful to start a bottle feeding by laying the bottle nipple over your baby’s lips, with the tip of the nipple pointing at his or her nose. When your baby opens wide, gently and slowly insert the nipple so that your baby’s lips flange out over the wider part of the nipple. Ideally, your baby’s mouth will cover the entire nipple and his or her lips should almost touch the ring that holds the nipple on the bottle. You should be able to see the pink of your baby’s lips. This is how your baby’s lips are positioned at the breast also.
  • If your baby is very sleepy and weight gain is important, you may find that your baby needs a lot of encouragement to bottle feed. You may try a faster flow nipple, but it is important that your baby is not overwhelmed by the flow, as evidenced by choking or spitting milk out while eating. Position the bottle so that the nipple is half full. It is normal for a bottle feeding to take 10-20 minutes with a young baby. If your baby is very sleepy, you may find it easier to finger feed your baby temporarily.
  • Every baby needs to get used to how milk flows from his or her mother’s breast. It may be different from a bottle. A mother may have a very quick, or a slower, let down. This means that a baby may get milk immediately at the breast, or may have to suckle for a couple minutes before there is milk. Some breasts let milk out slowly and evenly, and other breasts seem to be more forceful in letting milk out. Again, each baby needs to get used to his or her mother.
  • If a baby gets used to a very fast flow nipple and you are finding it difficult to transition to a slower flow at the breast, it may help to get your baby used to a slow flow nipple before returning to the breast. If your baby is used to an immediate reward with the bottle and your let down is slower, you may want to tip the bottle back so there is no milk in the bottle for at least 30 seconds. Then tip the bottle so the nipple fills only halfway. This will help your baby get used to a slower let down and slower flow.
  • To prevent overfeeding with a bottle, withdraw the nipple and take a short break after every ounce of milk. This break may help allow time for your baby to feel full on less milk.
  • As your baby gets older and is very accustomed to breastfeeding, it may be difficult to get your baby to accept a bottle. It may be easier for someone else to offer the bottle. A breastfeeding baby may resist and it may take much patience on the part of the person offering the bottle. Make sure they understand this is a new experience for your baby and it may take your baby a while to learn how to bottle feed and accept the bottle.
  • A baby who is older than 4 months may do better going straight to a cup with a soft spout, rather than trying to learn how to take a bottle.
  • Because the breast may be better for oral development of a baby’s mouth than a bottle, it is wise to limit bottles to when a baby cannot be fed at the breast. This may occur due to extreme prematurity, a physical anomaly, temporary mother-infant separation, or when a mother returns to work or school. Babies benefit from the process of being at the breast, just as they benefit from the nutrition and antibodies of human milk.