Using Paced Bottle Feeding With Your Baby

There are lots of reasons parents might choose to bottle feed their baby. An infant could be unable to tolerate breast milk. Mom might have to work, or just want to divide feeding responsibilities. Many babies will transition from breastmilk to bottle feeding at some point, whether with formula or breastmilk. Both breastfeeding and bottle feeding are valid options, and this very personal decision should be based on what’s best for your family.

Sabrina Freidenfelds is an International Board Certified Lactation Consultant and director of the new parent support platform Then Comes Baby. She’s got all the facts about bottle feeding — and a surprising number of topical jokes.

How To Transition to Bottle Feeding

Since your baby can become attached to breastfeeding, it’s important to have a slow transition to bottle-feeding, formula, or otherwise so they can adapt seamlessly. It’s a good idea to begin with one bottle a day starting when they’re between 4 and 6 weeks old. Of course, this transition also means you have to start thinking about how much milk to give. A good rule of thumb is 2.5 times their body weight in ounces per day. So, that would be 25 ounces a day for your 10-pound baby. Are there caveats? You know it!

Turns out the amount of milk per feeding changes a ton from day one (roughly 15 milliliters) to day 5 (about half an ounce). Most newborns less than 4 weeks old need 2 ounces or less. By 6 weeks, it’s more of a suggested range. Just note that older babies rarely need 8 or 9 ounces per feeding. It’s not a breadstick basket at the Olive Garden.

Don’t rely on a baby to tell you they’re full. “Babies can’t regulate; they have a suck reflex and a swallow reflex, so if it’s there and flowing in their mouth, they can chug down a bottle way beyond their needs,” says Freidenfelds. The reflex eases after a few months, but regulate volume early to avoid overfeeding and putting your kid at risk for childhood obesity.

How to Recognize Hunger Cues

If your kid’s old enough to say, “Pass the bottle,” it’s too late. Look for these baby hunger cues: Licking their lips while cocking their head back and forth, sucking on things like their hands, “rooting” (a reflex where newborns turn their heads in small arcs until they find whatever stroked their cheek or mouth), and generally getting more wiggly, squirmy, and tense.

Of course, babies won’t be quiet about it when they’re hungry. While crying alone isn’t a hunger cue, babies may emit a frustrated wail if parents fail to recognize a hunger cue. It’s a key distinction. “People feed the baby, see that they seem fussy, assume they’re still hungry, tank ‘em up, the baby chills and goes to sleep, and a cycle of misunderstanding starts,” Freidenfelds says. That cycle makes your kid’s brain think it needs more food than its stomach. This is a lesson they will forget every Thanksgiving.

How Often To Feed Your Baby

Newborns need about eight feedings a day. Freidenfelds says during a growth spurt “they’re gonna get wiggy” and want a bottle up to 12 times a day. That averages out to a feeding every 2-to-3 hours.

She also says to go by hunger cues, not the clock. “They’re not wearing a stopwatch saying, ‘It’s been 3 hours.’ If they’re throwing red flags but you don’t feed them because ‘It isn’t time yet,’ they’re saying, ‘WTF?’” Presumably, that stands for, “Where’s the food?”

How To Choose The Best Baby Bottle

Choose a bottle nipple based on your baby’s age: Stage 1 for newborns, stage 2 for 3-to-6 months, and stage 3 for 6 months and up. Remember, these are guidelines. It may be 6 months before you move to Stage 2, especially for breastfed babies transitioning to bottles. Milk flow is most important, especially at 3 months and younger, and you’ll have to feed your kid a few times before you can spot whether you have it right.

How To Feed a Baby Using Paced Bottle Feeding

• Hold your baby in a supported sitting position. Try the old La-Z-Boy — hasn’t failed you yet.
• Start with the bottle relatively flat (not angled down into the mouth) and the nipple angled up slightly towards their palate.
• Try to get the nipple about half-filled so they have to work a little to get the milk flowing like they would at the breast.
• Watch for a “suckle, pause, suckle, pause” rhythm. It’ll slow gradually as they get more full, which forces you to pay attention.
• You can intermittently tip the bottle back up towards the roof of their mouth, which forces them to work for it again.
• Flow control is key because depending on how fast the milk comes out, babies can guzzle 5-to-6 ounces in 6-to-7 minutes and get overloaded. “A bottle isn’t meant to be fast food,” says Freidenfelds. A feeding should take 10-to-15 minutes depending on the baby’s age.

How to Prep a Baby Bottle

How you warm the bottle depends on its contents. Formula — whichever kind you buy — will have preparation guidelines. Follow them precisely. For breastmilk, there are a few commonly used options:

• Microwave. The easy way, especially at 3 AM, is microwaving. Unfortunately, it’s also the wrong way. Besides killing some of the milk’s antibacterial, immune-boosting goodness, microwaving can create hot spots you might miss that could result in ER visits and serious burns for infants. Yes, you’re exhausted, but don’t ever do this.
• Hot Water. The traditional way is to sit a bottle in a pot of hot water until the milk warms up. It’s effective but slow, so you’ll have to learn those hunger cues and act early. “Otherwise they get all hangry on you,” says Freidenfelds, the realest lactation consultant in the game.
• Bottle Warmer. The convenient way is a bottle warmer. Citing her husband’s experience, Freidenfelds says, “Think of how many bottles you’ll prepare in an infant’s first year; how many late nights. To cut prep time by half or more, that investment can be a sanity saver.”