How to bottle feed a breastfed baby – Paced bottle feeding

Lots of mums decide to use bottles to give milk to their breastfed babies at some point. This is often considered if mum and baby will be separated for a time, like when mum returns to work. Bottles are not always necessary and there are other options for feeding milk to your baby, such as cup feeding, that can be helpful in these situations. You can find more information on cup feeding here: Cup-feeding | Australian Breastfeeding Association and a great video here: Dr. Jack Newman – Cup Feeding – YouTube. If you’ve decided bottles are right for your situation, you might be wondering how to bottle feed your breastfed baby.

What is paced bottle feeding?

Paced bottle feeding is way of slowing down the flow of milk from the bottle so your baby isn’t overwhelmed by the fast flow. Slowing down the feed also helps parents (or whoever is caring for your baby) to be more responsive to your baby’s fullness cues. This technique is also great for bottle feeding formula fed babies.

Babies have some control over the flow of breastmilk when feeding directly at the breast, but bottle feeding is different. Because milk automatically starts to drip out of the bottle teat as soon as the bottle is tipped up, when baby sucks on the teat the milk comes out in a strong squirt and they aren’t able to have much control over the flow. Many parents notice that their baby seems to guzzle and gulp down the milk from a bottle which makes it seem like they were super hungry, but actually, they can’t help but gulp and swallow the fast flow to avoid choking.

Slowing down the bottle feed also helps your baby to realise when they’re full. This is important as you definitely can over-feed a breastfed baby when you’re using a bottle. Small pauses during the feed and watching your baby’s cues will give them the chance to feel their full signals and avoid upset and uncomfortable tummies. Following your baby’s cues in this way can also help to preserve your precious expressed breastmilk since you will only use the milk your baby needs.

Paced bottle feeding also helps to avoid bottle preference and breast refusal. Some babies come to prefer the fast flow of a bottle (that is not paced) since they don’t have to work so hard to get the milk. Pacing the feed and slowing the flow makes it less likely that this will happen.

How to pace bottle feeds

Use a narrow neck teat and bottle. These are longer teats and reach further back in your baby’s mouth than wide neck teats. When feeding at the breast, the nipple stretches far back into your baby’s mouth to where the hard palate (at the front of the mouth) meets the soft palate (at the back of the mouth). If you try and feel for this line in your own mouth, you will notice it’s quite far back.

Hold your baby in an upright position.

Rest the bottle teat on your baby’s lips and wait until they open their mouth wide to accept the teat.

Once the teat is in your baby’s mouth, hold bottle in a horizontal (flat) position instead of tipped up high, so that milk only just fills the teat. Most of the teat should be in baby’s mouth with their lips almost touching the collar of the bottle top.

After a few minutes, tip your baby forward slightly while keeping bottle in their mouth to let them rest (the milk will no longer be in the teat). Your baby will stop sucking when the milk is gone (so no need to worry that they will suck in lots of air).

Watch your baby’s cues:

• They may start sucking again – this shows they are ready to feed again. Tip your baby back slightly so they are upright again and continue feeding for another few minutes – repeat this process until your baby shows no more interest in feeding after a pause/rest period.
• They may turn away from the bottle, go to sleep, or not return to sucking – this shows they are finished feeding for now.

It is important not to force your baby to finish the bottle, as they are the best judge of how full they are. Just like adults, babies are hungrier at some times than others and some “meals” may be bigger or smaller than others. Forcing them to finish the bottle can be traumatic for your baby and cause them to refuse feeds.

This is a great video that shows paced bottle feeding in action: https://youtu.be/JgEVn4ershA

References:

Australian Breastfeeding Association (2018). “Caregiver’s guide to the breastfed baby. https://www.breastfeeding.asn.au/bfinfo/caregivers

Australian Breastfeeding Association. (2015). Breastfeeding… Naturally. Australian Breastfeeding Association.

Australian Breastfeeding Association. (2020). Breastfeeding: Expressing and storing breastmilk. Australian Breastfeeding Association.