‘Make Bottle Feeds Comfortable’ – Lois Wattis
How to make bottle feeds comfortable for baby – Paced Bottle Feeding
Whether you are feeding your baby expressed breast milk or infant formula there are some key points to know to ensure it is a comfortable experience for your baby. Bottle feeding can easily become uncomfortable and even frightening for a baby if the milk flows too quickly, and the baby can’t pause and breathe between sucks without milk continuing to flood into the mouth. Spluttering, gagging and vomiting can result if baby can’t “pace” the feed the way they naturally learn to do when breastfeeding. Bottle feeding can also result in baby taking more milk than they want, resulting in overfeeding. Here are some tips to help baby and caregivers enjoy the bottle feeding experience.
Offer the feed based on hunger cues, ideally early cues such as stretching, licking the lips, turning the head when waking. Baby’s cues progress quickly to mid cues like sucking the hands, and becoming agitated and crying are LATE cues.
Select a wide-based bottle and a teat with a shape that encourages baby’s mouth to maintain a wide gape, similar to a breastfeeding latch. Teats with a narrow nipple at the end tend to result in pursed lips and a shallow gape, even if the base is wide. Choose a teat with a flow rate suitable for the age of the baby. Crosscut teats which stop flowing when baby stops sucking allow baby to control the feed better than teats with holes.
Hold baby in an upright or semi-upright position, with the head resting back a little. Positioning baby resting against the chest of the person giving the bottle can simulate a breastfeeding position.
When offering the teat, first stroke the baby’s lips gently, inviting him to open his mouth. Never force the teat into the baby’s mouth, instead allow baby to seek the teat.
Encourage baby to take the teat deeply into his mouth achieving and maintaining a wide latch. If baby drinks too fast, tip the bottle down or remove it to slow the pace of the feeding.
Allow baby to control the feeding pace. Turning the head and pushing the teat out of the mouth are signs baby is uncomfortable, or needs a break. Responding to baby’s discomfort signs by allowing a few minutes’ break several times through the feed allows baby to rest, and to bring up wind if needed. He will show hunger cues again when he is ready to continue the feed.
Head turning and pushing the teat out of the mouth are also signs baby has had enough and is finished feeding. Paced bottle feeding allows baby to engage in similar feeding communications they would demonstrate during a breast feed. A paced bottle feed should take 15-30 minutes, however timing will vary according to the age of the baby, the volumes being offered and how hungry the baby is at the start of the feed.
Following paced bottle feeding principles will reduce the risk of overfeeding and its consequences – gassiness, spitting up and vomiting, and childhood obesity.
Lois Wattis
RN RM FACM IBCLC
References:
Unicef BFI Standards 2012
Cleveland, K J Neo Nur 20110; 1:37-41
Lois Wattis is a Registered Nurse and Midwife, Lactation Expert and a Fellow of the Australian College of Midwives. Working in both hospital and community settings, Lois has enhanced her midwifery skills and expertise by providing woman-centered care to hundreds of mothers and babies, including more than 50 women who chose to give birth at home.