What is Paced Infant Bottle Feeding

Paced bottle feeding is a way to bottle feed your baby that is more like breastfeeding. This type of feeding helps your baby learn to eat more slowly and stop when full.

This can help prevent overfeeding and discomfort. Paced bottle feeding may also help your baby feel comfortable with both bottle feeding and breastfeeding.

The goal is to provide a bottle feeding that is similar to the pace and flow of breast milk from the breast. This is done by holding the bottle in a way that controls the flow of milk, and by taking periodic breaks during feedings.

Paced bottle feeding works well if you want to continue breastfeeding but will sometimes need to bottle feed your baby with pumped breast milk or formula. You may also want to consider this method if:

• You are unable to breastfeed.
• You want others to feed your baby, such as if you are returning to work.

How to plan for paced bottle feeding

Before you start bottle feeding, talk to your child’s health care provider or a lactation consultant. Ask what type of formula and bottle would work best for your baby. In general, a 7-ounce bottle with a slow flow nipple works well. If you are going to pump breast milk, ask how often you should pump, and learn how to pump and store your milk safely.

Plan to bottle feed on demand, which means feeding whenever your baby shows signs of being hungry. Your baby may:

• Put fingers or a hand into his or her mouth.
• Clench fists over the tummy or flex arms and legs.
• Turn the head and open the mouth as if looking for a nipple (rooting).
• Make sucking noises.
• Cry. This is usually a late sign of hunger.
• Act fussy or restless.

How to prepare the bottle

To get the bottle ready for bottle feeding:

• Wash your hands.
• Make sure the bottle and nipple are clean.
  • If you are using the bottle for the first time, sterilize all parts in boiling water for 10 minutes; cool and air-dry.
  • After the first use, you can clean all the bottle parts in hot, soapy water and rinse thoroughly once a day.
• If you are using formula, follow the directions for mixing the formula or the instructions from your child’s health care provider.
• If you are using breast milk, thaw the milk in the refrigerator. Do not use breast milk after it has been thawed or stored in the refrigerator for longer than 24 hours.
• You may heat the bottle in warm water. Make sure it is not too hot or too cold. Never use a microwave to warm up a bottle.

How to perform paced bottle feeding

Follow these steps for paced bottle feeding:

1. Hold your baby close to your body at a slight angle, or semi-upright, as you would for breastfeeding. Your baby’s head should be higher than his or her stomach.
2. Support your baby’s head in the crook of your arm.
3. Place the nipple on your baby’s cheek. Let your baby root around to find the nipple. You may tickle or stroke your baby’s lips with the nipple to stimulate rooting. Let your baby draw the bottle nipple into the mouth on his or her own, just like the baby does with breastfeeding.
4. Once your baby latches on to the nipple, hold the bottle flat, parallel to the floor. This will help your baby control the flow of milk so that it does not come out too fast.
5. Tip the bottle slightly to let about half the nipple fill. Do not tilt the bottle straight up into the air. This will force too much milk or formula into your baby’s mouth.
6. After about three to five sucks, tilt the bottle back to flat, wait a few seconds, and tilt back up slightly. Continue tilting and pausing. This allows your baby to pace the feeding.
7. About halfway through the feeding, switch arms so you are holding your baby on the other side. This is similar to switching breasts when breastfeeding.
8. Watch for signs that your baby is full. When your baby has had enough to eat, he or she may:
   1. Eat more slowly or stop.
   1. Become distracted.
   1. Turn away and stop sucking.
   1. Become very relaxed or fall asleep.
   1. Have his or her hands open and relaxed.
9. When it is time to stop, gently remove the nipple from your baby’s mouth. Offer the nipple again and let your baby feed for about three to five sucks. Remove the nipple again. Keep offering and removing until your baby refuses the nipple or no longer sucks.
10. Try to have a bottle feeding last about the same amount of time as a breastfeeding session. This is usually around 15–20 minutes.

General tips

• Watch for the following signs that your baby may be overfeeding or eating too quickly:
  • Gulping.
  • Drooling.
  • Noisy feeding.
  • Coughing or choking.
• Start paced bottle feeding on demand. Over time, your baby will become hungry at predictable times.
• Feed your baby in a quiet and comfortable place. Avoid distractions. Pay attention to pacing and signs of fullness.
• Do not bottle feed your baby anything other than breast milk or formula until your baby’s health care provider says that you can start other feedings.
• Let your baby’s health care provider know if your baby:
  • Is fussy or seems uncomfortable after feeding.
  • Vomits after feedings.
  • Refuses to take the bottle or your breast.

Where to find more information

U.S. Department of Health and Human Services: www.womenshealth.gov/breastfeeding  

Summary

• Paced bottle feeding is a way to bottle feed your baby that is more like breastfeeding.
• Paced bottle feeding helps your baby learn to eat only when hungry and to avoid overeating.
• Ask your baby’s health care provider to recommend types of bottles and formula. If you plan to use pumped breast milk, learn how to pump and store your milk.
• Follow the steps for performing paced feeding and stop when your baby shows signs of being full.