Paced bottle feeding: What is it and how to do it

By Rohit Garoo (BSc), Medically reviewed by Briana Violand (IBCLC, CSC)

Breastfeeding is the ideal way to provide nourishment to your baby. But there are times when you are unable to breastfeed and have to rely on the bottle. Unlike breastfeeding, which depends on the baby’s sucking reflex, bottle feeding relies on gravity to get the milk flowing through the nipple.

Gravity makes bottle feeding effortless but also increases the risk of overfeeding. This is where paced bottle feeding steps in to address the problem and ensures that the child gets enough nutrition from just the right amount of formula or pumped milk.

What is paced bottle feeding?

Paced bottle feeding is holding the milk bottle in a horizontal position instead of tipping it vertically into the baby’s mouth.

Such positioning of the bottle allows for a slow and gradual pace of milk flow, to keep the baby comfortable. Since the method is dependent on how the bottle is held, babies need little training and adapt to it quickly.

How is it different from normal bottle feeding?

Normal bottle feeding: When you feed the baby using a bottle, you may place them horizontally in your arms or a feeding pillow. You then set the bottle in the baby’s mouth nearly vertical and allow the milk to flow through the nipple at a pace set by the gravity.

Here, the baby has no control and has to exert no sucking force to get the milk flowing. There is a constant dribble of milk, whether or not the infant wants it.

Paced bottle feeding: It mimics breastfeeding and prevents free-flow of milk, giving more control to the baby. The technique is ideal for all infants including the breastfed ones, who occasionally have to drink from a bottle.

The style involves gradual or a “paced” feeding action that encourages the baby to suck the milk out like they would from a breast. Since the infant is in control, it prevents overfeeding and makes the bottle milk feeding experience more natural for the infant.

The style involves gradual or a “paced” feeding action that encourages the baby to suck the milk out like they would from a breast. 

What will you need to prepare?

You will require two items to begin:

• A straight bottle. Do not use bottles that have a curved design or are tilted near the neck.
• Rounded tip, slow-flow nipple. These nipples are usually yellow colored for easy identification. The slow-flow nipple prevents a gush of liquid from flowing into the baby’s mouth and facilitates a slow flow. Only use rounded tip versions and not orthodontic ones

How to feed a baby through paced bottle feeding?

Here are some simple steps to paced bottle feeding (1):

1. Sit on a comfortable chair or sofa. Make the baby sit in your lap, facing your right hand and with the back straight. You can tilt the baby back a bit, but not much. Hold them close to your chest, and support the baby’s head with your left hand. Hold the baby in an upright position and avoid feeding the baby in a lying down position.
2. Hold the bottle horizontally with your right hand, and Place the bottle nipple at the baby’s mouth and rub/tickle it softly against the upper lip. It will stimulate the infant to open the mouth.
3. Gently slide the nipple into the baby’s mouth. There is no need to worry if the entire nipple goes in. The baby will not gag since the nipple is designed to reach only up to a point inside the mouth. The nipple is latched when the baby closes their mouth around the nipple.
4. When the baby starts drinking milk, keep the bottle horizontal and do not tip it vertically.
5. Check if the baby is sucking the milk – observe the baby’s mouth for the sucking action and noise. Most babies take breaks while feeding, whether using a bottle or otherwise. When you notice the pause, gently tip the bottle downwards like straightening it. This way, you can prevent the milk from dripping into the baby’s mouth, without taking the nipple out entirely.
6. Wait to see if the baby makes the sucking action again. When the baby starts drinking after the pause, tilt the bottle to the horizontal position so that feeding can resume. If the baby does not take a break on his/her own and continues feeding, then you can give a break by tilting the bottle every couple of minutes.
7. Repeat the process till the baby stops sucking even after breaks. Once the baby is done, remove the bottle to stop feeding.

On an average, a single paced bottle feeding session should take about 15-20 minutes, and the baby may drink about three ounces (88ml) of milk in one session. Nevertheless, the time and quantity can vary as per the baby’s age.

What should you do after a paced bottle feeding?

After the one session of paced feeding, burp the baby. If you think that the baby might still be hungry, offer about an ounce (30ml) of milk through the paced bottle feeding method again. Babies, who are full, will not suckle at the nipple.

What are the advantages?

The paced bottle feeding method is beneficial in the below ways (2):

1. Prevents overfeeding: The baby has control over the flow of the milk, which allows them to have as much milk as they need. Regular bottle feeding may result in overfeeding, making the baby associate overfeeding with satiety. That could lead to overfeeding every time to satisfy hunger. Paced bottle feeding prevents all this.
2. Mimics breastfeeding: Paced bottle feeding resembles breastfeeding. It allows a breastfed baby to bottle feed without the risk of losing interest in breastfeeding.
3. Reduces risk of gagging: Free-flow milk may increase the risk of gagging, but that is not the case with paced bottle feeding.
4. Prevents nursing bottle caries: In regular bottle feeding, you may leave the bottle in the baby’s hands and let him or her fall asleep with the nipple in the mouth. That can lead to accumulation of milk inside the baby’s mouth, increasing the chances of nursing bottle caries, i.e., cavities (3). Paced bottle feeding prevents this risk as well.

Points to remember about paced bottle feeding (4):

• Do not force the baby to finish the bottle. If the baby is done with feeding, then end the session. Avoid trying to get the baby to finish the small amount of formula left in the bottle. It is tantamount to overfeeding, which defeats the purpose of paced bottle feeding.
• Swallowing air is not a problem. Many parents worry that their baby might get gas due to paced bottle feeding since they are gulping too much air. However, that is not a problem when you burp the baby after the feeding session.
• Have the regular number of feeds. You do not have to change the number of feeds for paced bottle feeding. You can continue with the pattern you usually follow. Your baby will feed as much as they need since they are in control of the quantity of milk.
• You can breastfeed along with paced bottle feeding. You may alternate between bottle feeding and breastfeeding. Paced bottle feeding is not a replacement for breastfeeding, and it is just a method that mimics breastfeeding.
• Bottle-fed babies can quickly adapt to paced bottle feeding: You can train the baby to drink with paced bottle feeding method. Follow the usual steps of the procedure. Your baby may find it awkward in the beginning, but will slowly adapt to it.

This article was first published by Mom Junction. You can read the original article here.

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