When should we use paced bottle feeding?
Every baby that is being fed with a bottle should have paced feeding!
Why use paced bottle feeding?
- Allows the breastfed baby to be bottlefed in a manner that supports breastfeeding
- Reduces the risk of overfeeding
- Allows a baby to control the flow of milk better
- Can help with symptoms of reflux and colic
The rationale behind paced feeding
We always start with breastfeeding as the biological norm. Therefore, our assumption is that any feeding pattern should mimic breastfeeding as much as possible. This means that we allow the baby to “latch on” to the bottle and draw the teat deeply into his/her mouth.
Next, we want to control the flow. When babies breastfeed, they suck, swallow, breathe, suck, swallow, breathe, at a rate of around 2-30 cycles before taking a break. Newborns can struggle to coordinate this suck, swallow, breathe pattern, and so when they take a break to stop sucking, they get a pause to rest before starting up again. During this break no milk flows into their mouth. Not so with bottle feeding. There is always a constant flow of milk into their mouth, which means that they have to suck constantly. By pacing the feed, you allow the baby to control the flow of milk and take breaks at his/her pace.
Since the baby can control the feed, there is less risk of the baby gulping down milk that he/she has no control over. This in turn means that baby swallows less air, swallows a more appropriate volume in total, and is less likely to regurgitate (or reflux) excess milk – read my post on reflux here.
Feeding becomes a more relaxed, calm experience which results in a soothing experience for baby, and there is less risk of trapped wind, resulting in less colic symptoms – read my post on colic here.
How to pace a bottle feed
- Hold your baby upright.
- Bring the teat to your baby’s mouth and gently stroke your baby’s top lip
- When baby opens their mouth, allow them to draw the bottle into their mouth. Their lips should be resting on the wide base of the bottle, not just on the teat.
- Hold the bottle horizontally, so the teat fills with milk. Don’t tip the bottle up, as this allows more milk to flow into the baby’s mouth.
- Allow the baby to suck and swallow at their pace, and to draw the milk in at a comfortable speed for them.
- When baby pauses, tip the bottle down so that milk isn’t flowing into the baby’s mouth.
- When baby starts sucking again, tip the bottle back up to allow them to get milk. SIGNS YOUR BABY IS STRUGGLING WITH THE FLOW: Splayed fingers, wide eyes, slightly panicky expression or loud gulping usually signals that your baby is overwhelmed with the flow of milk.
- When your baby has had enough milk, they’ll either push the teat out with their tongue, or turn their head away. This is a good opportunity to wind your baby – see my tips here.
- You can offer your baby some more milk after they have brought up wind, but watch your baby’s cues and don’t try to force them to finish a bottle.
- Remember to swap from side to side between feeds, engage with your baby by talking to them or stroking their skin, and you can even do some feeds skin-to-skin for a lovely, oxytocin-fuelled bonding experience.
All those wonderful claims by bottle manufacturers are marketing gimmicks. There really isn’t any bottle that is closest to breastfeeding – it really is just about the technique you use. Most babies actually do better on a narrow base – they tend to slip off those wide based teats that claim to be shaped like a breast. After all, when your baby is well latched on to the breast they actually compress the breast tissue quite a lot, they don’t sit with a wide mouth on the breast all the time. The key is for your baby to not just have their mouth on the teat, but to have their mouth on the base of the teat. So pick a teat your baby baby can hold well in his/her mouth. Always go with a slow flow teat, too. There is no need to change to a faster teat as your baby gets older.
What about volumes? Well, a baby’s stomach is around the size of their fist. While a baby’s tummy can be stretched bigger than that, it usually makes them feel a bit uncomfortable. In the first few weeks of life, 1-3 oz might be all your baby takes and that is fine. Breastfed babies rarely take more than 5 oz as they get older. Bottlefed babies should be fed on cue (when they are hungry) rather then on schedule, and be allowed to take a volume that they feel comfortable with.
A feed should usually last around 20 minutes or so. Some babies have a strong need to suck as this helps soothe them. After a baby has bottlefed, you can put them to the breast for comfort. If you are supplementing for weight gain issues, this can be a lovely way for them to associate breastfeeding with a full tummy, and allow them to practice breastfeeding without being under pressure to transfer milk. If you are exclusively bottlefeeding, a dummy can be helpful after a feed to satisfy this need to suck, without your baby overfilling their tummy with milk.