If you’ve ever cared for a breastfed baby who has trouble taking a bottle, or who has difficulty switching back and forth from breast to bottle, you may have heard of paced bottle feeding. Paced bottle feeding is often recommended by lactation professionals to parents and caregivers to help prevent a variety of feeding issues.
Although this method is often recommended for breastfed babies, Dr. Cindy Rubin, a pediatrician and lactation consultant who owns In Touch Pediatrics and Lactation in Westchester, Illinois, says that she recommends this practice whether or not a baby is breastfed.
“I recommend this method in all babies,” Rubin says. “It is particularly useful in babies who need to use bottles, but it can also help prevent overfeeding in general, and it can keep a baby interested in nursing even though they are sometimes or always being fed by bottle.”
Let’s take a deeper look at the benefits of paced bottle feeding, a step-by-step guide for doing it, some troubleshooting tips and how to introduce the concept to your baby’s caregivers.
What is paced bottle feeding?
Paced bottle feeding is a technique that allows a baby to have greater control of their milk or formula intake. This method is much slower than typical bottle feeding, and the caregiver is instructed to watch the baby carefully for signs of fullness.
“By allowing breaks during feeding and giving babies time to pause or rest, it ensures that they have more control over their feeding experience, leading to better feeding self-regulation.”
— Nicole Peluso, board-certified lactation consultant
The way the bottle is presented to the baby during paced bottle feeding — at a horizontal angle and with a slower flow nipple — is a major part of what sets the method apart. Feeding in this way discourages overfeeding and helps to mimic the pace of breastfeeding. The goal of paced bottle feeding is to make bottle feeding as similar to breastfeeding as possible.
What are the benefits of paced bottle feeding?
There are many benefits to paced bottle feeding — for babies, parents and for anyone who may care for babies while parents are away, such as grandparents, babysitters and nannies. Here’s what they include:
Self-regulation
Paced bottle feeding can teach babies to become more intuitive eaters, says Nicole Peluso, a board-certified lactation consultant and manager of lactation services and education at Aeroflow Breastpumps in Asheville, North Carolina. “It helps babies recognize their own hunger and fullness cues,” she says. “By allowing breaks during feeding and giving babies time to pause or rest, it ensures that they have more control over their feeding experience, leading to better feeding self-regulation.”
Easier movement between breast and bottles
Paced bottle feeding is most commonly recommended for parents who are combining breastfeeding with bottle feeding. Feeding from the breast and from the bottle are different, and paced bottle feeding makes bottle feeding more similar to breastfeeding. “By mimicking the slower flow of milk from the breast, paced feeding helps prevent flow preference because it helps slow the milk flow and reduces the risk of a baby preferring the bottle over breastfeeding,” Peluso says.
Less bottle rejection
Kristina Tinsley, mom of three and blogger at All About Momma from Doylestown, Pennsylvania, says that her breastfed babies would often reject the bottle, especially if she was anywhere near them. This was a problem as she prepared to send them to daycare. Paced bottle feeding, with its emphasis on a slower flow, made it easier for her babies to accept bottles. It also helped her and her husband determine when her baby was full. “When they stopped sucking on the bottle as it was held horizontally, it was a cue they were done,” she describes.
Fewer digestive issues
Paced bottle feeding not only helps prevent overfeeding, but also reduces the chances that a baby will develop digestive issues like reflux, excessive spitting up, gas and even colic, says Peluso. “When babies do not have milk entering their mouths via gravity, they are not forced to swallow air and milk simultaneously,” she explains. “Less burping is required for paced bottle feeding than with traditional gravity-fed bottle feeding.”
How to pace bottle feed
To pace bottle feed, all parents and caregivers need to do is implement a few extra steps into their normal feeding routine. Here’s a step-by-step guide to paced bottle feeding technique, as per the Arizona Department of Health Services:
- While supporting the baby’s neck and upper back with your hand, sit your baby in an upright or semi-reclining position in your lap.
- Tickle your baby’s lips with the bottle nipple and let them latch onto it when they are ready, emphasizing a wide, deep latch.
- Hold the bottle horizontally as you feed the baby so that the bottle nipple is about half-filled with milk.
If the baby stops sucking while feeding, tilt the base of the bottle down so it’s vertical and no milk is left in the nipple. If the baby resumes sucking, this is an indication they still want to eat, and you can start holding the bottle horizontally again, so that milk flows once more. As the baby feeds, watch them for clues of fullness, such as:
- Decreased sucking.
- Starting to fall asleep or seeming more sleepy.
- Turning away from the bottle or pushing it out of their mouth.
- Showing less interest in feeding; may look around the room or seem distracted.
- Appearing more relaxed; you may notice your baby’s fists become less clenched.
If you are a more visual or auditory learner, this paced bottle feeding video from Victoria Facelli, a board-certified lactation consultant, may be helpful as well:
Which types of bottles are best for paced feeding?
The best bottle for paced feeding isn’t necessarily a specific brand, but one that meets some basic requirements in terms of nipple shape, size and flow. “I generally recommend using a wider-based, straight and round nipple, because this is most similar to a human nipple and areola,” says Rubin. “I also recommend using the slowest flow nipple you can find for whatever brand of bottle you are using — this may be a preemie nipple, slow flow or size zero, depending on the brand.”
A slower flow requires a baby to suck in order to transfer milk, as opposed to the milk flowing on its own, which is often the case with bottles, Rubin explains. “It also helps a baby practice or learn sucking skills, such as how to use their tongue to hold onto the nipple and also how to draw the milk into their mouth and then coordinate swallowing as well,” she says.
Will paced bottle feeding give my baby gas?
Perhaps the most frequent question lactation professionals get about paced bottle feeding is whether it will give a baby gas, likely because of a fear that the baby will be taking in too much air. Peluso assures parents that this is unlikely to happen.
“To troubleshoot this, I encourage caregivers to burp their baby midway through a feeding and at the end while also keeping the baby upright after the feeding is over,” she advises. “The reality is that lactation consultants see far more stomach upset and gassiness from babies gulping and drinking too rapidly than the slow-flow experience of paced feeding.”
How to introduce paced bottle feeding to your baby’s caregivers
Instructing a caregiver — such as a grandparent, babysitter or nanny — in paced bottle feeding has many benefits, especially if you are a parent who pumps breast milk for your baby. Caregivers are often accustomed to feeding formula-fed babies, who tend to feed less frequently than breastfed babies and who take in more at each feeding. When these same rules are applied to bottle feeding breast milk, this can result in overfeeding and wasting previously pumped milk, Rubin says.
“When your baby’s caregiver uses paced bottle feeding, they may find that they are caring for a happier, less gassy and more self-regulated baby.”
— Cindy Rubin, pediatrician and lactation consultant
As you prepare your baby’s caregivers to practice paced bottle feeding, it can be helpful to explain three things:
- The differences in intake between breastfed babies and formula fed babies.
- That paced bottle feeding can reduce overfeeding and gastrointestinal discomfort.
- How to recognize the fullness cues listed above so they know the baby is eating enough.
“Explaining typical milk intake for babies fed human milk can be helpful in reassuring caregivers that they are not doing harm to these babies, and helping them understand the reasoning behind paced bottle feeding can make them much more amenable to using the technique themselves,” Rubin says.
The bottom line
Paced bottle feeding is a simple technique that helps your baby regulate their own food intake and decreases overfeeding. It can also help babies have fewer tummy upsets, and it’s a helpful technique for breastfed babies who need to go back and forth between bottle feeding and breastfeeding.
It may take a few extra steps to learn paced bottle feeding yourself and to introduce it to your baby’s caregivers, but Rubin says that in the end, using paced bottle feeding will usually mean that you have a more contented baby. “When your baby’s caregiver uses paced bottle feeding, they may find that they are caring for a happier, less gassy and more self-regulated baby after all is said and done,” Rubin assures.
