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Episode 21: Bottle Feeding: What You're Doing Wrong and How to Fix It

June 4, 2020

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Jacqueline Kincer  00:37

Welcome back to another episode of Breastfeeding Talk. In this episode, we’re actually not gonna be talking about breastfeeding so much as we are going to be talking about bottles. This is a question I get all the time.


Very little of the time are my clients using the proper bottles for their babies. If you have seen any bottles out there on the market that you thought were more like the breast, this episode is going to blow your mind because that’s usually not the case at all.


And so before I get into specific bottles, and yes, I will be mentioning brands on this episode. And I’m not affiliated with any bottle company out there in any way, shape or form. But I want to talk about why it’s important to have the right bottle for your baby.


When we’re talking about a baby who’s not just solely bottle fed. And maybe that’s the case for your baby, maybe you’re an exclusive pumping mom. But maybe you’re going back to work, maybe you just want to be able to give your baby a bottle occasionally, maybe you need to supplement whatever the reason is that you’re using a bottle for the reason why we need breastfeeding to be going well meaning a perfect latch, a great milk supply, all the things, perfect positioning, all of that is the same reason why you want to be really careful about picking out a bottle.


And this is always really tough for me because in some ways, I feel like bottles kind of fall under the realm of like a medical device meaning like, under normal circumstances, we would not need to be using bottles.


But we live in a modern industrialized society, where we may be separated from our babies for longer periods of time. And so we don’t have wet nurses and all that. So babies need bottles, right?


Problem is that there’s so much predatory marketing out there, just like there’s predatory marketing with formula companies. And we have to be aware of it. I want to share a story with you. That’s really interesting to me. So I’ve been a faculty member and instructor for a midwifery school. And one of the assignments that I have the midwives do is to figure out what would be some of the best bottles for breastfed babies.


And inevitably, they all come back with some of the ones that are the worst bottles, like the worst, and I’ll be sharing with you which ones those are.


But it’s funny because they feel like they’re doing the research. But the research is often on these companies’ websites, because there aren’t any studies to back up these particular bottles, right?


And the ones there are studies on are usually some of the best ones out there. So why is it important that you have the right bottle for your baby?


Well, every baby is different. So I want to preface this episode with that this is not medical advice. This is not me recommending a bottle for your baby, every baby is different. There are some general guidelines.


But when I work with my clients, I don’t just refer them to this podcast episode, I actually do see which bottle is right for their baby. So it matters.


And if you have a lactation consultant who’s not super skilled with that, you may want to find a speech language pathologist here in the US is how they’re known. They can be the ones who can direct you but your pediatrician doesn’t know I guarantee you they have zero training on bottle feeding.


It’s going to be a speech language pathologist or an IBCLC . Not a lactation counselor, not a lactation educator. They are typically not going to have this training.


So you want the right bottle for a lot of reasons but like on a broader view, we want your baby’s feeding time to be relaxed. You want it to be hassle-free. Okay, and so just think about the way that you eat and the way that we should be eating.


Now, if you’re a new mom, I’ve been a mom for a while, you may eat too quickly for your own good because you know that baby’s gonna wake up anytime soon.


But you want feeding to be a happy time, right? We don’t want it to be causing discomfort. We don’t want it to be frustrating. And a lot of bottles can do that.


So your baby’s feeding experiences at the bottle  if it’s overwhelming, if it’s frustrating, if it’s scary in any way, they’re going to have a hard time. And we’re teaching them feeding skills for Life.


With breastfeeding, or bottle feeding, we’re actually teaching your baby to have a relationship with food. And we want it to be a healthy relationship with food. We do not want to be raising children who are over eaters. We don’t want to be raising children who have a negative experience with feeding and swallowing. So it’s very, very important that we set the stage correctly. So it’s not so much the bottle itself.


This is the misconception if you want to use plastic fine, if you want to use glass fine. Do I think glass is better than plastic? Yes, I mean, I suppose so. The plastics these days with bottles, they’re free of a lot of the chemicals that we’re concerned about. I’m not overly concerned about it. Because really, I mean, if you think about how you’re storing breast milk, you’re probably storing it in plastic breast milk storage bags, you should not generally be storing breast milk in a bottle with a bunch of air sitting on top of it it is going to break down faster, you should be storing it as much as you can in an airtight container, which is usually a breast milk storage bag, and those are plastic.


And stored at cool temperatures. Most of those things aren’t going to leach into the milk. So I’m not super, super worried. But if you are, then by all means use glass bottles, I will tell you, though, that what’s most important, is the bottle nipple. It’s not the bottle itself, it’s the bottle nipple.


And you may not always have a bottle, that is glass that goes with the bottle nipple that would be suggested. So what’s more important is proper feeding mechanics and a proper feeding experience, versus what the actual materials the bottle is made out of.


If they have it in glass, great, by all means that’s the best. Okay, but the nipple of the bottle is generally going to be made out of silicone. And they come in a large assortment of sizes and flow rates.


Flow rate is just as important as the size and the shape of the nipple. And so, you know, you may just be buying whatever looks cute, has the best packaging, has the best marketing. And believe it or not, you do fall victim to those things. When you see a brand that looks very sophisticated, like it’s well researched, how do you determine that way?


You determine that based on the colors they use, based on the fonts that they use, based on the name that they use. And there’s all these things that happen on a subconscious level in terms of branding, and marketing, that make you think that this brand knows what they’re doing. This brand seems like a smart brand. You look at other brands, and you’re like, Oh, that’s too cutesy, probably not well researched, right? But you look at another brand, and you’re like, oh, wow, this seems really sophisticated. I feel like I can trust that. That’s all branding. By the way, it has nothing to do with whether or not it’s a good bottle. And just something for you to be aware of.


So if you’re listening to this, and you’re putting together your baby registry, which if you have a pregnant friend who’s in the process of trying to decide what bottles to use, things like that, definitely send them this episode.


Because inevitably, what happens is people buy all the wrong stuff on the registry. And then during their nesting phase, they open up all the packages, they sanitize it, they wash it, they have it all ready to go. Problem with that is now you can’t return it. So what if you’ve bought the wrong bottles and you haven’t opened them?


This episode is for you because then you have a chance to return them. And so there’s the bottle size, or the nipple size. Generally speaking, from newborn stage to about three months, you’re going to be having a more narrow base nipple for your baby.


So let me explain some of the mechanics here. And I’ll try to find a video of a bottle-feeding baby and a breastfeeding baby that I can link up for you in the show notes.


There’s a lot of bottles on the market that look like a breast that’s not in a baby’s mouth. So it’s got a round, wide base with a short stubby nipple. Those bottles again look like a breast that’s not inside a baby’s mouth.


When a baby who is breastfeeding well and is breastfeeding functionally, the breast looks totally different inside their mouth. It is long, it is elongated, it is narrowed, and it goes back very far in their mouth.


If you’ve learned anything about breastfeeding, you may have learned that the nipple of your breasts should go back to the hard and soft palate junction very far back in the mouth.


If you look at the baby bottles on the market, you will see that there’s no way that most of those bottle nipples will ever get back that far in your baby’s mouth. That’s Clue Number one, that’s not the right bottle for your baby. Ever, at any point, I never, almost never recommend a wide base bottle with a short nipple, because it’s going to create dysfunctional feeding patterns.


Now, if that is the only bottle your baby will take, and you’ve tried the correct bottle feeding techniques. Maybe temporarily, we use one like that as a set of training wheels, before we transition them to a proper more functional bottle.


But in general, wide-based, short, stubby nipples, that’s a breast that’s not in a baby’s not that’s like your baby trying to latch on to and encourage breast. Well are they going to have a deep latch? No, they’re not. Are they going to be as effective at removing milk. If it’s the breast? No


We want to keep breastfeeding and bottle feeding as similar to one another as possible. Even if your baby is exclusively bottle-fed, we want to keep bottle feeding as similar to breastfeeding as possible for the proper oral-facial development. For proper feeding patterns, there’s a lot of reasons why.


So the base of the nipple, so where the nipple meets the bottle, or the ring that connects it to the bottle should be narrow enough that it can fit inside your baby’s mouth.


So there’s the tip of the nipple, and then there’s the base of the nipple. The base of the nipple, all of that base should generally be able to fit inside your baby’s mouth. If it can’t, your baby cannot accommodate that, that nipple is too big.


The other thing you want to look at is the bottle nipple, the tip of the nipple should be able to get back to the hard and soft palate junction, which is pretty far back in the mouth. At least maybe an inch to two inches, somewhere in there. Probably closer to two inches, depending on, how big your baby is.


So you want to look at the length of the nipple and the nipple. How do I explain this? There’s like the base of the nipple, and there’s the tip of the nipple, don’t just measure the tip of the nipple like again, they should be able to get the whole base and the entire bottle nipple into their mouth.


So I’m going to give you some examples of bottles that don’t work well. But will never fit that description, the Tommee Tippee.


If I have to hear that closer to nature phrase again, I am just gonna lose my mind. There’s nothing natural about a Tommee Tippee nipple.


It is completely dysfunctional in so many ways. The base of that nipple is way too broad. It will never be able to be compressed because it’s bound to the sides of the bottle. So your baby can’t get their whole mouth around it. And they’re just going to be nursing on the tip of the nipple, which is not what we want to happen for breastfeeding.


Same thing goes for a lot of these, Phillips Avant bottles. I don’t like those either. One of the worst ones on the market that I’ve ever seen is the como tomo. The como tomo, please, please, please stop buying the como tomo.


For many reasons, one, not even just the bottle itself, it’s impossible, nearly impossible to try to do paced bottle feeding, which we’ll talk about a little bit later in this episode. But that matches the description to a tee that I’m telling you those are the worst types of bottles on the market.


And is that silicone base? A little more stretchy and flexible than other bottles? Yes. But it’s not at all like breast tissue. But yeah, the avent natural is one that you know that natural phrase gets people Oh, it’s natural. No, it’s not at all like breastfeeding. I’ve got to tell you, it’s just not.


I’m trying to think of some other big brands. I’m not going to cover a lot of these niche brands, because quite honestly, they’re just too hard to keep up with. But the neck bottle, that’s another one.


First of all, the base on that is way too wide and then you have this short stubby nipple again. But then it’s this “orthodontic nipple”, which is orthodontic on it like a pacifier or a bottle nipple. It’s orthodontic in the sense that your kid will need orthodontics later in life.


That’s the only orthodontic quality to it is that it’s going to screw up their oral facial development. So much so that you will need an orthodontist to correct it.


Just stay far away… If you see, typically if you see the words natural, more like the breast or orthodontic, those are bottles you should probably never buy. I hate to say it, someone’s going to come out with a bottle that does have those things. And it’s going to be a great bottle.


Mam is another one. The mam bottle, these compressed nipples, you don’t ever want your nipple of your breast to be compressed when your baby is nursing, because that causes you breastfeeding pain, it causes damage to the breast tissue.


If that is happening, that is a sign of dysfunction, it’s a sign of poor latch, it’s a sign of poor feeding, the last thing that we would want is for your baby to be trained to compress a bottle nipple, because then when they go back to the breast, they’re going to compress the breast nipple. And that’s just going to be really painful for you.


We do not want your baby to have dysfunctional patterns at the breast, it’s super important that we make sure that they don’t by choosing the right bottle for them. I hope that makes sense.


Now the other thing that’s really important is the flow. The flow is another very important aspect that is often overlooked. What I see happen a lot of the time is that people will say ”My baby’s having a hard time getting the milk. I chose this higher flow.”


I chose level one, I chose level two, I went from slow to medium,  something of that kind of nature. The problem, though, is that we don’t want feeding to be super easy for your baby. Now, before everyone goes, “What are you talking about?” Well, we don’t want it to be too easy. We want them to learn to work their muscles in the right way to get the milk. If they can’t do that, then they’re never going to develop the proper muscle strength and the muscle motion that’s required for them to be good at feeding, whether it’s solid foods, or whether it’s going back and forth between the breasts in the bottle.


The flow rate needs to be the slowest rate possible for your baby. For a newborn, usually up until about three months, we actually want them to be using a preemie nipple. If it’s a preemie, we want to be using a preemie nipple or an ultra preemie nipple. We want them to have to create the proper mechanics to get the milk. We don’t want milk just pouring into their mouth with very little effort. Why is that? Well, a couple of reasons. One, is that they could over feed. And if your baby over feeds, they’re going to have digestive discomfort, it’s very hard on their digestive system. When they eat too much, while in the first several days of life, their their stomachs don’t stretch, they’re not flexible. It’s going to cause them a lot of pain, they’re going to spit up. If they’re overfeeding at the bottle, they’re not going to want to take the breast.


But beyond the first several days of life, it’s going to stretch out their stomach. This is bad for a couple reasons. One is that you may have an overweight baby, and you’re throwing off their metabolism. This is where we start to see signs of metabolic disease, things like diabetes, you do not want your baby to be overfeeding. Just having a complete metabolic crash, we don’t want to stretch out their stomach. Four ounces no longer makes them feel full, they need six to feel full. Breast fed babies would never take six ounces out of breastfeeding session.


Breast-fed babies will only ever take beyond their first week of life. A couple weeks, they’ll only ever take two to five ounces, they don’t take more breast milk over time.


Your breast milk increases in caloric density as your baby gets older. What that means is that your baby never needs more volume of milk. Breast milk just changes its composition to meet your baby’s increased caloric needs. Whereas formula is the same formula. That’s why it’s called formula. That’s the same formula 24/7 No matter what age they are, and they are going to need more volume. They will be taking eight ounces at some point if they’re solely formula fed. But a breastfed baby is not going to be drinking over five ounces. They Should not be drinking over five ounces at any time.


The problem I see is that with bottle feeding, it’s usually happening way too quickly. We don’t want your baby to be fed too quickly. In fact, the pace of bottle feeding should be around seven to 10 minutes per ounce.


I’ve heard this a lot where people say, “Oh, my gosh, breastfeeding takes so long”. “It’s 30 minutes for feeding, 15 minutes on this side, 15 minutes on that side.” Yes, that is how long it takes.


Especially in the newborn period, it may take longer. There are studies that have shown that breastfeeding takes 30 hours a week. But guess what also takes a good 30 hours a week, if you’re doing it right , bottle feed. It takes 30 minutes for your baby to drink a three ounce bottle.


Bottle feeding isn’t your solution to feeding your baby faster, because if you’re doing that they’re not learning the proper feeding skills. It’s really important that for their swallow, we don’t want them swallowing air, we don’t want them gulping. We don’t want them taking more milk at a time than they can handle. We want to make sure their tongue is engaged, that their lips are in the right position, that they’re creating the right flow rate for themselves. The right suction level for themselves. We can only do that if we use the slowest flow nipple possible.


We also don’t want them to choke, milk should not be leaking out of the corners of their mouth when they’re bottle feeding. Now, if you are using a narrow bass nipple, and you still see milk leaking, that could be the sign of a tongue thrust. Which could also be a sign of a tongue tie.  If bottle feeding is dysfunctional, if there’s air swallowing and milk leaking,  and a lot of different things going on, a clicking sound a lot of choking, that’s when your baby needs to be accessed for a tongue tied.


First check if it’s the bottle. Bottles I do like for newborns, I love the doctor browns. I think Doctor Brown is a phenomenal bottle, it’s actually very well researched. It’s the bottle that’s used in most NICUs for a reason, because speech language pathologists, feeding therapists, IBCLCs all over, have seen great results with it.


Not just with the vent in there, that helps eliminate any air bubbles in the bottle. But, it’s the shape and the flow of the nipple. Now, when people are asking me about the flow rate of the nipple, you have to understand that across brands, and across the market, flow rate is not the same. A slow flow bottle in AVENT, is not the same as a slow flow bottle in Dr. Brown’s.


It’s not some standardized thing. It’s very different. The thing I like about Dr. Brown’s is they are so accurate with their flow rates. What I usually recommend for most newborns, is starting out with a doctor Brown’s bottle with a preemie nipple. A lot of these are hard to find, you have to kind of hunt for these now, which is unfortunate, not a level one, not a level zero, but a preemie nipple.


That bottle nipple is narrow enough and long enough to be in the proper position. Also, we want the nipple to be narrow enough that your baby’s tongue can curl up around the sides of their tongue. When you have a bottle that’s got a wide base, like a Tommee Tippee or a Comotomo. It’s flattening their tongue.


The tongue has to curl to grab onto the breast and to milk the breast. If it doesn’t, we have a problem. If you want a baby to be able to go back and forth between breast and bottle, I would highly recommend something like Dr. Brown’s.


Now beyond three months or if your baby has a great, wide, deep latch on the breast and is doing very well with breastfeeding. I might recommend a slightly wider base. I like the Lansinoh Momma bottle. That’s a great one. It’s got the natural wave nipple.


I said I normally don’t like things with the word natural in it. But the Lansinoh Momma, can be a great bottle. It’s got a nice curve slope from the tip of the nipple to the base. The base is wide enough that it can help support the mouth being open wide enough. That’s what I really like about it.


Any of these bottles that have an abrupt transition from the tip of the nipple to the base of the nipple. There’s a nipple and then, it flares out to the sides at a sharp angle and then the base. None of those are at all like a breast. Something that’s got a nice sloped, gentle transition to the base of the nipple from the tip of the nipple, like the lansinoh momma, I really appreciate that bottle. They also call it the Lansinoh breastfeeding bottle with a natural wave nipple. That one is actually really great.


Some parents do really well with a bottle that looks very similar to that, that I happen to like even better than In the momma, and it’s the even flow balance.


I’ve seen this bottle that you can buy at Walmart, it’s very similar to the Lansinoh Momma bottle, the reasons I like it are the same. These bottles only come in small, medium, and fast or slow, medium and fast. Make sure you do get the slow flow on those. But, this is either a bottle, probably not gonna use for the newborn stage. But beyond that, or around three months, you’re going to transition to a bit of a wider base, but still a base that your baby is able to get in their whole mouth. I would suggest either one of those two bottles.


There’s a lot of other bottles on the market. I’m really only just going over some of the more major brands out there so that you have that information, there are a lot of niche ones on the market. It’s if you follow the general guidelines.  Here’s another one I don’t like. I’m gonna tell you mostly the bottles I don’t like because I don’t like most of the ones in the market. I see terrible feeding with these.


I watch BBC for these bottles, and I’m thinking that it is the wrong bottle. The Munchkin latch, that one is not good either. Again, it’s got a really abrupt transition from the tip of the bottle nipple to the base of the nipple. It’s too wide of a base. It’s unfortunate that they chose to use the word latch and the name. Companies like that I just kind of have to shake my head and go, “you’re just being pretty predatory towards breastfeeding moms, I really don’t think that’s appropriate at all.” You know, the Nano Bebé.


First of all, you can’t pace the feed because those bottles are so incredibly wide. Again, it only looks like a breast that’s not in a baby’s mouth. They made the bottles so wide that it looks like a breast that’s not in a baby’s mouth. Again, I don’t know what the point of that is. It doesn’t promote functional feeding in any way.


I know a lot of pumping moms will use the Kiinde. I understand the convenience factor and I think their bottle nipples aren’t the worst, they do seem to be more flexible. The tip of the nipple is a bit more elongated. But again, it’s not really something that is breast shaped once it’s in the baby’s mouth. I don’t see the benefit of using it. Might it be okay for Super occasional feeding? Sure.


But in general, I just wouldn’t say that, it’s a bottle that I would say is a top pick, by any means. Those are some of the more major ones. There are a lot of people asking me about the Medela bottles. So many moms have the medalla pumps, and they come with these bottle nipples.


Generally, those bottle nipples are too fast of a flow. Are they more similar to a Dr. Brown’s shape? Yes, they are. I still completely love the shape of those. But, the flow is generally too fast. You need to be using a preemie nipple with a newborn most of the time.


This is really important to know. I’m actually just right now kind of cruising Amazon and looking at baby bottles, like what sort bottles come up. There’s some interesting ones out there. There are these anti- colic bottles, PopYum. What is that? That’s not an anti colic bottle. In fact, I could see how most babies would swallow a ton of air while nursing on a bottle like that. It sometimes takes a trained eye. I’m just trying to give you information as the consumer, where you can take a look at these bottles and go, “Is that a good fit for my baby or not.” Then again, like I said, there’s all these sort of niche brands out there, unfortunately, but there’s ones I would stay away from.


Now what I want to talk about is pace bottle feeding. There’s a couple bottles already mentioned that you cannot do paste feeding in. That’d be the Comotomo and the Nanobebé. But, the reason for that is that, when you’re bottle feeding, your baby should not be laying on their back.


Now, this might be a revolutionary idea to you that you’ve never heard or seen demonstrated before. But your baby should not be lying on their back. The thing I have to remind people of is that, we as adult humans, do not eat laying on our backs. In fact, if you ever tried it, go ahead and try it. Try to drink water laying on your back.


You will likely notice that your swallow may be even painful. It’s going to be harder for you to swallow, because part of the swallow is that you bring your tongue forward a bit when you’re laying on your back, gravity is pulling your tongue back. Imagine a baby who may not have as much tone in their tongue, as much muscular strength in the same muscle memory that you do. It’s going to be very hard for them to get a proper swallow.


You don’t breastfeed your baby on their back, hopefully, if you’ve worked with me, you’re seeing anything that I’ve shared, the baby should never be laying on their back for feeding ever, not when breastfeeding, not when bottle feeding. They either need to be laying on their side, or sitting upright, those are the two positions you’re going to breastfeed in. And those are the two positions you’re going to bottle feed in.


There’s a lot of different ways you can do that. You can do a sideline bottle feed for your baby where you hold your baby, they’re usually facing outward away from you. You can have the bottle in their mouth. That way, their head, just like with breastfeeding, should be higher than their hips, to make sure that’s happening.


Most of the time for bottle feeding, what I recommend is an upright position. So babies seated in your lap, maybe leaning against your chest, the base of their head is supported, you’re never holding the actual back of their head, but just the base of their skull is supported, their neck is supported. And you’re bottle feeding.


That means the bottle is not vertical, the bottle should not ever be held upside down. That means the nipple of the bottle shouldn’t be down and the base of the bottle itself should be up. That’s the wrong way to hold the bottle, the bottle should be horizontal.


It doesn’t need to be parallel to the grounds. Although, it may start out that way if you’re starting out with a full bottle, but it could be a little bit angled up. Meaning, that the bottle nipple is slightly lower than the base of the bottle itself. So it’s more or less horizontal.


The reason for that is, not just the flow of the nipple itself, but the flow of the milk itself. If we have a completely upside down bottle, milk is dripping out of that bottle nipple whether we want it to or not, that means your baby does not need to put in the effort to get the milk. They’re never learning the proper muscle patterns, swallow patterns, all of that. The other issue with that is that gravity is just going to pull that milk down and it’s forcing it through the nipple.


Even  the slightest suck, is going to bring through more milk than it otherwise should have. That is going to lead to overfeeding, reflex, tummy discomfort, air swallowing, all sorts of things. You want your baby to be seated upright or on their side, I like upright the best.


But if you know your baby’s going to fall asleep after this feeding, a sideline bottle feed works great. You want to keep this bottle as horizontal as possible. Remember, the entire nipple of the bottle does not need to be filled with milk, only the tip of the net of nipple needs to be covered in milk. Milk only comes out of one teeny tiny hole at the tip of the nipple, as long as that is covered in milk, your baby shouldn’t be swallowing air.


But the other thing about pacing the bottle feeding is that realistically, your baby takes a lot of breaks when they’re breastfeeding, right when they have several swallows, and then they take a pause. And after a few more seconds, they take some more swallows, it’s kind of like if you’re doing weight training at the gym, right, you’re going to do several reps. And between those reps of lifting, you’re going to take a little break, you need a little bit of a time for recovery. Same thing is happening with your baby. Now I know as adults, we can just shuffle our food in our face and eat really quickly without taking a break. But the normal way to eat the optimal way to eat would be to chew our food thoroughly to take a swallow and take a pause. Maybe we’re chatting to the other people we’re dining with. Maybe we’re taking a sip of water, but we generally don’t just eat then be done. That’s not usually how it works. It shouldn’t work that way for your baby either. Again, we want to teach them a healthy relationship with food. Not one that is just about nutrition. Okay, it’s yes, it’s about nutrition, but it’s also about the way that they eat their relationship with food. That food is something that quenches their need for hunger, right? They’re they’re hungry, right? We have to, we have to quench that need, but in a healthy way. We don’t want to overfill them or make it so easy. Okay, making


feeding a bit more of a challenge doesn’t mean that your baby won’t eat enough except in special circumstances. Okay, if you have a special circumstance baby, you should if you’re not already be working with some sort of a feeding therapist. Okay, whether that’s an ibclc or Speech Language Pathologist or whoever, occupational therapist maybe. So this isn’t about special needs babies and babies with feeding challenges. It’s about just normal babies who are doing well gather things. So you know, with pace bottle feeding so so you’re keeping the bottle, fairly horizontal milk just covering the tip of the bottle nipple, but after a certain amount of time, usually somewhere between 20 and 30 seconds, your baby should take a pause on their own.


When they do, you’re going to leave the bottle nipple in their mouth. Don’t take it out. This is the mistake that a lot of parents make. And this is where we get some air swelling. Leave the bottle on your baby’s mouth, but tilt it down so that there’s no milk in the bottle nipple. A lot of parents will say, Well, isn’t this if my baby sucks on the bottle and there’s no milk in the nipple? Aren’t they going to swallow air? No, generally not. And the way you could test this is you could just take a big inhale through your mouth right now. And try and swallow that air. Go ahead and try and swallow it.


Unless you had a lot of saliva in your mouth or other liquid in your mouth, you’re going to be pretty unsuccessful at swallowing that air. That’s incredibly hard to do. It’s also hard for your baby to do where we get air swallowing is when air and liquid mix. So don’t take your time, you know, quickly move the bottle down. Let them have five sucks maybe even 10 with no milk in that nipple. And then when they start sucking again, they’re going to take a pause when they start sucking again then tilt the bottle up. So when we’re breastfeeding our babies, we have multiple letdowns.


Okay, so the milk flows, flows, flows flows, then it slows down, and it’s your baby’s job to initiate another letdown. We need to teach them that same pattern at the bottle. The other thing I forgot to mention is when you start out with a bottle, this is the strategy you want to do no milk in the nipple, base of bottle pointing down nipple pointing up. So there’s no milk in the nipple, let them have a good 10 Sucks before you let them have the milk.


Because generally, most of the time when a baby goes to the process, they don’t get milk right away. It’s not just pouring into their mouth. Now, sometimes it is, but most of the time it isn’t. You can have a baby who starts further for the bottle over the breast, when you just give them milk right away. They’re very smart, they’re going to learn, their brains are like, “Oh, well, when I go to the bottle, I get milk right away, and I don’t have to put in any effort when I go to the breast have to suck for a while to get the milk going”.


You’re going to do that pacing, you’re going to do that up and down with the bottle the entire time. I generally recommend that you burp your baby after every ounce if you feel like they’ve swallowed any air. But that’s why it’s going to take seven to 10 minutes for every ounce that your baby has.


So that’s my advice on bottle feeding. That’s what I normally recommend. These are just general guidelines to help you to make sure you’re able to choose the correct bottle for your baby.


And I hope that you found this really, really helpful. It’s something that most of the time people don’t think lactation consultants are knowledgeable about.


I think parents hesitate to ask experts for their recommendations on things like this. Again, they just generally go off recommendations from friends, or, whatever was given to them at the hospital, or the pediatrician.


But bottle feeding is going to have a significant impact on your baby’s Oral Facial development if you’re using it more than just very occasional.


And so it’s important that you have the right one again to make feeding a peaceful joyful experience that isn’t overwhelming, that isn’t causing any sort of panic in your baby, but facilitating a proper swallow, proper tongue movements, proper lip position, all of those things.


And the other thing that I wanted to kind of end with was I had mentioned the position you hold your baby in with the bottle and the position you hold your baby in with breastfeeding. Breastfeeding is a postural experience. In fact, all eating is a postural experience. It’s important that we have straight backs, it’s important that we have proper posture.


And so if you see your baby hunched over, if you see your baby with their head down and their chin kind of tucked into their chest, well first of all, they really don’t have a fully open airway. So it’s going to be hard for them to maintain feeding. But second of all, that’s just really really poor posture.


So think about what’s good posture for an adult? And we’re going to try to replicate that in your baby. So if you have any questions about this, if you’re finding that you’ve struggled to find the right bottle with your baby by all means reach out for professional help.


We can give you a specific recommendation for your baby. Again, that would be an IBCLC such as myself, or a speech-language pathologist, those are generally the two professions that are going to be able to guide you properly. An occupational therapist who works with infants, may be another. But we’re going to be the ones who are able to guide you on the proper bottle selection for your baby.


So if you found this informative, I’d love for you to subscribe to the podcast to get more information just like this. Share this with friends who are expecting, who have recently had babies, even if it’s not so recently, this is a wonderful episode to provide a lot of education and go into why proper bottle feeding is so so important. I’m super passionate about it.


And bottles are sometimes necessary or sometimes they’re wanted and that is okay. But what I find is that when we use the wrong bottle, is when we start to see problems and babies preferring the bottle. Babies struggling to feed, babies who are colicky, babies who have reflux, babies who are overfeeding, all that kind of stuff. We want to avoid that as much as we can.


So please take these suggestions to heart. I hope you found this helpful. If you did, I’d love to hear from you on iTunes. If you leave a review there, it helps this podcast get found by other moms just like you. So thanks for listening, and I’ll see you on the next episode.

This episode is full of Jacqueline Kincer’s genius on what bottles are appropriate to use in the newborn stage and beyond. Not only does this matter for breastfeeding babies, but also exclusively bottle-fed babies. Most parents (and even professionals) are swayed by the heavy marketing and branding out there. Before you make your baby registry, or invest in tons of bottles, listen to the episode so you know what bottles to buy!

In this episode, you’ll hear:

  • Why it’s critical that your baby uses the correct bottle
  • Common mistakes parents make when choosing a bottle
  • Which brands are the worst (and which are the best)
  • How to properly USE a bottle to feed your baby