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How to Bottle Feed A Breastfed Baby: The Ultimate Guide for Paced Bottle Feeding

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Introducing bottle to a breastfed baby can be challenging. Learn how to bottle-feed a breastfed baby using paced bottle-feeding method to mimic breastfeeding.

While exclusively breastfeeding is always preferable over any other source of feeding, it is always not possible when you have to return to work or other obligations.
Oftentimes when you return to work you are faced with a new reality: Learning how to bottle-feed a breastfed baby.

Who said motherhood is easy?

If you are planning to go back to work, you may have already started storing pumped breast milk  and picked your best bottle for breastfed baby. All you need to do is learn how to bottle-feed a breastfed baby because, it may not be as straight forward as it sounds. Many breastfed babies refuse the bottle and many babies prefer bottle over breastfeeding when you are trying to combine bottle feeding and breastfeeding.

To ensure smooth transition into bottle feeding or to keep up with both method of feeding, you need to learn how to properly introduce bottle to your breastfed baby. Many moms have adopted Paced Bottle-Feeding method successfully to introduce bottle to their babies.

Here is your ultimate guide to Paced Bottle feeding;

In this article,

  • What is paced bottle feeding?
  • Why do paced bottle feeding?
  • How to pace feed a baby
  • Does paced bottle feeding cause gas in my baby?
  • Do I Need to Use Any Special Kind of Bottles?
  • How Do I Know My Baby is Full form the Bottle?
  • How much Should I Feed Baby from a Bottle?
  • Should you Paced Bottle Feeding Formula?
  • Final word

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What is Paced Bottle Feeding

Paced bottle feeding is an approach to feeding a baby with a bottle that is physiologically similar to the pattern of breastfeeding. Paced bottle feeding allows baby to control the milk flow and set the pace of the feeding of either breast milk or formula milk. It supports hunger cue-based feeding patterns and smooth transition between bottle and at the breast.

Why Do Paced Bottle Feeding? (Benefits of Paced Bottle Feeding)

Breastfed babies exhibit a coordinated “Suck-Swallow-Breathe” pattern in 1:1:1 ratio. However, when babies are introduced to a traditional bottle feeding, they may not pause to breathe regularly because of a fast flow of milk from a bottle.

It may seem like they are hungrily gulping the milk, but they are actually having trouble coordinating “Suck-Swallow-Breathe” pattern making them distressed.

A research study published in Journal of Pediatrics in 2010 (1) has shown that feeding baby by a bottle can influence their ability to regulate their milk intake. This result in overfeeding a baby by bottle which doesn’t occur feeding at the breast. This inability to self-regulate milk intake is related to higher risk of obesity.

Is doesn’t mean that you can not introduce bottle to a breastfed baby. Most babies can switch successfully between a breast and a bottle.

All you need to make sure is to “paced bottle-feed” them.

Originally, paced bottle feeding approach was applied to premature babies for transitional feedings in NICUs (2). In last 10 years, this approach became more popularized to help breastfed baby bottle-feed without interfering with breastfeeding.

Whether you pump exclusively, occasionally or separated from a baby for work, here are reasons why you should pace feed your baby.

  • Paced feeding allows babies more control over suck-swallow-breathe pattern that mimics breastfeeding (3-6).
  • Paced bottle feeding minimizes chances of overfeeding thereby preventing post-feeding fussiness (3-6).
  • If your baby is gassy or colicky while traditional bottle feeding, pacing the feedings helps them take smaller, more frequent amounts, which can make digestion more comfortable.
  • Paced bottle feeding allows babies transition back and forth between a breast and a bottle without causing a “nipple confusion” hence supporting breastfeeding relationship (3-6).
  • When babies feed from a bottle while lying on their back, Babies can become very stressed. This position not only cause increased risk of choking but higher rate of ear infection. Paced feeding gives baby the time and space to eat at his own pace.
  • Paced Bottle feeding is beneficial in teaching your baby to recognize when they are full

How to Pace Feed a Baby

Lets first look at this video by the milk mob on how Paced bottle feeding is done.

Here are 7 steps to pace feed a baby

1. Feed Baby on Hunger Cues:

Rather than watching a clock for feeding, feed your baby on hunger cues. Here are some signs to tell when baby is hungry;

  • sucking on their fist,
  • crying
  • rooting
  • Smacking lips
  • Fussing

Having said that, you also want to avoid giving them a bottle every time they fuss because they might not be hungry at all. They might need a diaper change or a nap.

2. Watch the Position

Whether you or your partner bottle feeding your baby, make sure to hold baby in an upright position (how you typically hold your baby while breastfeeding) as opposed to lying down. Keep your baby close to your chest to mimic breastfeeding.

Holding him in reclined position ensures that milk from the bottle isn’t poring down into your baby’s mouth.

If holding baby close to your chest doesn’t work for you -as it reminds them of breastfeeding- try holding baby facing same direction as you with baby’s back lying over your chest in reclined position.

3. Let your Baby “Latch” on the Bottle Nipple

When you offer a bottle to your baby, ensure you let your baby “latch” on the bottle to mimic breastfeeding rather then putting nipple into his mouth.

First tickle your baby’s lips with nipple of the bottle. Keep the nipple pointed up when baby start opening his mouth. Let your baby latch on the nipple of the bottle like he would latch on a breast. Make sure relaxed lips cover the base of the teat and not just the nipple.

4. Hold the Bottle Horizontal while Feeding

Once baby is latched on the bottle nipple, keep the bottle horizontal. This will allow milk to flow at slow pace.

You can also consider not allowing milk to reach the nipple initially when baby start sucking to mimic the let-down of breastfeeding. This will help avoid nipple confusion or nipple preference when you want to switch between a breast and a bottle.

During the entire feeding, keep the nipple half full to ensure slow flow of the milk. This will ensure bottle feeding to last 15-20 minutes rather then baby gulping entire bottle in 5 minutes.

5. Mimic the Pace of Feeding

To mimic suck-swallow-breath pattern of breastfeeding, encourage pausing while bottle-feeding as well.

Monitor your baby for coordinated feeding by swallowing with every 1-2 sucks and take a break every 10-15 swallows.

When you notice baby start gulping milk, take the bottle out of the baby’s mouth or tip the bottle downward or lean baby forward so the milk does not reach the nipple hole to let baby catch the breath.

6. Switch Sides

Just like breastfeeding, switch baby from one side to the other side in between bottle feeding session. This will help avoid side preference when baby nurse again at the breast.

7. Stop Feeding on Cue

There is a risk of overfeeding when you bottle-feed your baby. When baby hints at being full –

  • Falling asleep
  • Slower sucking
  • Releasing the nipple
  • Relaxing fingers and hands

-stop the feeding. Some babies may also keep sucking the nipple while letting the milk run out of the corners of their mouth. This indicates that baby is using the nipple as a pacifier. At this point take a nipple out of his mouth and wait for few seconds to offer the nipple again. If he takes it in, give him few sucks then take it out again. Repeat this process until he no longer wants the bottle.

Do not force your baby to finish a few drops of milk left in the bottle. If your baby is leaving too much milk with each feed reduce the amount of breast milk within the next bottle.

People Also Ask

Does Paced Bottle Feeding cause Gas in my baby?

Babies are usually gassy because of their immature digestive and nervous systems. Swallowing of air while eating and crying can also cause gas. However, gassiness due to swallowing of air can be fixed by frequently burping baby while feeding and after feeding.

If you notice an increase in gas in your baby, switch to a slow flow breast-shaped nipple bottle.

Do I Need to Use Any Special Kind of Bottles?

You do not need any special kind of bottles for paced bottle feeding. However, you want to make sure that bottle that you pick do not cause nipple confusion and it mimic breastfeeding as you want to ensure a smooth switch between the breast and the bottle.

To encourage slow and responsive feeding, Bottle should have

  • Wide base-to encourage a baby to open his mouth wide and latch on deep.
  • Slow flow Nipple- to prevent flooding baby’s mouth with milk and making baby to work for milk to mimic breastfeeding

How Do I Know My Baby is Full form the Bottle or has had enough from the Bottle?

When you are feeding your baby on demand, it is important to pay attention to amount they are taking in. If milk is running out of the corner of their mouth or showing any other sign of fullness, it may indicate that your baby needs a break.

Here are some signs of fullness;

  • Baby’s hand and fingers are open and relaxed
  • Baby is more peaceful
  • Baby falls asleep
  • Sucking decreases
  • Releasing nipple from the mouth
  • Baby turns head away

How much Should I Feed Baby from a Bottle?

A research study (7) suggest that exclusively breastfed babies take in an average of 25 oz of milk per day between the age of 1-6 months. If your goal is to reduce overfeeding and mimic breastfeeding, consider feeding around 3-5 ounces of breastmilk per feeding. So if you are feeding your baby 8 times a day than, per feeding session aim for 3.5 oz (25/8).

Again, these are just estimate. Your baby may take more during growth spurt or less when not hungry.

Should you Paced Bottle Feeding Formula?

Yes! Paced feeding can be practiced using expressed breastmilk or formula. With Paced bottle feeding baby learn to be more in control of feeding and recognize when they are full.

Final Word

Paced bottle feeding is a great way to introduce bottle to a breastfeed baby. Whether you are going back to work, exclusively pumping or formula feeding paced bottle feeding can ensure that you are in touch with your baby’s hunger cues. Remember, it also teaches your baby to recognize when they are full, which is great for their healthy future.

How About You?

Have you tried paced bottle feeding? Has it helped your baby?

References:

  1. 1. Ruowei Li, Sara B. Fein, Laurence M. Grummer-Strawn Do Infants Fed From Bottles Lack Self-regulation of Milk Intake Compared With Directly Breastfed Infants? Pediatrics. Jun 2010, 125 (6) e1386-e1393; DOI: 10.1542/peds.2009-2549
  2. 2. Law-Morstatt, L., Judd, D., Snyder, P. et al. Pacing as a Treatment Technique for Transitional Sucking Patterns. J Perinatol 23, 483–488 (2003) doi:10.1038/sj.jp.7210976
  3. 3. Australian Breastfeeding Association [ABA]. (2009). A caregiver’s guide to the breastfed baby. Electronic copy retrieved (2011) from: http:// www.breastfeeding.asn.au/bf-info/breastfeeding-and-work/caregivers-guide-breastfed-baby.
  4. 4. Wilson-Clay, B. Hoover, K. (2008). The Breastfeeding Atlas. (4th ed). Manchaca (TX):BWC/KH Joint Venture, 107–116.
  5. 5. Lauwers, J., Swisher, A. (2011). Counseling the nursing mother: A lactation consultant’s guide. (5th ed.) Sudbury (MA): Jones & Bartlett 515–524.
  6. 6. Kassing Dee. Bottle-Feeding as a Tool to Reinforce Breastfeeding. Journal of Human Lactation. 2002; Feb;18(1):56-60. doi: 10.1177/089033440201800110.
  7. 7. Dewey KG, Lonnerdal B. Milk and nutrient intake of breast-fed infants from 1 to 6 months: relation to growth and fatness. J Pediatr Gastroenterol Nutr. 1983;2(3):497-506.
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