As lactation professionals, we understand that there are many reasons why you might choose to offer your baby a bottle. You may want to offer pumped milk while away from your baby, your partner or other caregivers may want a chance to feed, or you may choose to only bottle feed. We often get asked what is the best way to feed with a bottle, while still protecting your breastfeeding relationship.  That is where Paced Bottle Feeding comes in.  

 

What is Paced Bottle Feeding? 

 

Pace feeding is a technique of feeding a bottle that aims to mimic the flow and rhythm of feeding at the breast. This method allows the baby to be in control of the feeding pace, just as they would with breastfeeding. When a baby is nursing from the breast, the feeding is very responsive. Baby comes skin to skin with mom and latches on to the nipple, a process which signals to the brain to release the hormones prolactin and oxytocin. 

 

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This hormone release, along with the sucking motion from the baby, allows the milk ducts to open and release or “let down” milk into the nipple. The process repeats as the baby feeds, which means the milk flow depends on the baby’s suction and therefore ebbs and flows throughout a feeding. This is quite different when bottle feeding, where suction is all that is required for a steady stream of milk.  

 

How to Pace Feed

 

Each feed should take approximately 10-20 minutes. This allows time for the stomach and brain to communicate, and along with the physical breaks in pace feeding, prevents overfeeding. We encourage using the slowest flow nipple that your baby will tolerate. 

 

Paced Bottle Feeding

 

– Follow hunger cues (not a schedule) to feed the baby. This is often referred to as “feeding on demand” or “responsive feeding.”

 

Hold baby in an upright position, supporting the head/neck by holding the base of the head and neck. Avoid laying baby down while feeding. Feeding in a horizontal position can make it harder for your baby to swallow, and has been associated with bottle carriers and ear infections.

 

Hold the bottle horizontally and gently place the nipple near the baby’s mouth, allowing the baby to draw the bottle nipple into his or her mouth. Do not push the nipple into the baby’s mouth, but instead encourage them to find the nipple and latch on their own. 

 

Rock the bottle back and forth from horizontal to just above horizontal to mimic the slow flow of breastfeeding. The suck-swallow pattern should be rhythmic, suck, suck, swallow. If the baby is gulping or losing milk out of their mouth, you may need to give more break time, or use a slower flow nipple or a different nipple shape.

 

Switch the side you are holding your baby, halfway through the feeding. Again, this break helps slow the baby down, mimics the breastfeeding experience, and helps to promote proper oral development. 

 

– Feed to satiation, following baby’s cues that they are full. Baby should not feel pressured to finish every last drop, so avoid forcing the nipple back in their mouth. If you are worried your baby is falling asleep or stops sucking before they may be full, you should gently stroke the jaw or chin to encourage sucking, or remove and reintroduce the nipple and allow your baby to choose to latch back on. If your baby turns away when the nipple is offered again or your baby falls asleep, gently remove the nipple from your baby’s mouth and take that as a sign that your baby is satisfied. 

 

*These tips apply to all bottle feeds, not just breastmilk feeding. While many of the principles of pace feeding are to promote a smooth transition from bottle to breast, paced bottle feeding also has benefits for babies who are primarily bottle-fed.*

 

Nipple Confusion vs. Flow Confusion

 

Because of the difference in flow, a bottle can be “easier” or less work for a baby. This is where “Flow Confusion” can become a problem. You may have heard of the term “Nipple Confusion” when discussing bottle feeding a breastfed baby, but actually it is less about the nipple and more about the flow. When a baby latches onto a bottle (or a bottle is put into baby’s mouth) and they no longer have to work for the flow of milk, they can become confused and frustrated when they are offered the breast and have to do a little bit more work or stimulation to get the milk flowing. 

 

Can a baby also have “nipple confusion”? The latch on a bottle nipple, regardless of its shape, should be a deep, wide latch, with the tip of the nipple stimulating the soft palate. If a baby is learning a shallow latch on a bottle, that can carry over to the breast. So while different nipple shapes work best for different babies, it is still important to maintain a good latch, no matter the feeding method. 

 

 

How Much Milk Does My Baby Need? 

 

Current research tells us that exclusively breastfed babies, between 1 month and 6 months of age, take about 25 oz (750 ml) of breastmilk each day. There are variations of normal, and different babies may take different amounts per feeding or day-to-day. This amount may range from 19 oz to 30 oz in a 24-hour period.

 

This information can help us estimate how much milk your baby will need each feeding or while you are separated from them. To decide how much milk your baby needs, you can take the average number of nursing sessions in 24 hours, and divide that number into 25. This will give you a good idea of how many ounces your baby is taking at each feeding. 

Example: Baby nurses 7 times a day. 25 divided by 7 equals 3.5 oz per feeding.

 

Another way you can determine how much your baby needs is to calculate feeding between 1 oz and 1.5 oz per hour, and then let baby’s cues determine at what amount they are satisfied. With this method, you would estimate how often your baby eats (for example every 3 hours) and multiply using 1-1.5 oz per hour. 

Example: Baby nurses every 3 hours. 3 multiplied by 1-1.5 equals 3-4 oz to be offered per feeding. 

 

Alternatively, you can meet with your lactation consultant for a series of weighted feeds, to estimate how much your baby will need each feeding. Weighted feeding, also known as test weighing, is a method to find out how much breast milk an infant takes during one breastfeeding session, using a high-precision baby scale. If doing weighted feeds, the process should be monitored by a lactation professional and recorded over a number of feedings, as each feed can vary in the amount of milk taken in by your baby. 

 

You can bottle feed your baby confidently, knowing that you understand paced bottle feeding and why it is so beneficial for your little one. Pace feeding will help you meet your feeding goals, whatever they may be. 

 

Twist Active Latch® Nipples – The Best Nipples for Pace Feeding 

 

Twist Active Latch Nipples are designed with breastfed babies in mind. These nipples aid in teaching and rewarding a deep, wide, natural latch.  Both suction AND massaging of the nipple are required to remove milk with Twist Active Latch Nipples, mimicking the experience at the breast and making the transition from breast to bottle smooth.  

 

Active Latch Nipples work with Kiinde’s Twist Squeeze Pouches as well as our Active Latch Silicone Bottle. Both prevent unwanted air in your little one’s meal, which can cause gas and discomfort, and both simplify your life with easy cleanup and no complicated venting parts. 

 

Twist Active Latch Nipples are available in three flow sizes:

Slow-Flow

Medium-Flow

Fast-Flow

 

Nipples are recyclable, BPA-free, phthalate-free, and PVC-free, and top-rack dishwasher safe and steam sterilizer safe.

Aryn Hinton

Aryn is a Certified Lactation Counselor on the Kiinde Lactation team. She is also a mother of two, writer, and maternal mental health advocate.

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