Paced Bottle Feeding

Ideally, bottles should be avoided because of the potential risks of using bottles. Alternatives to bottles and the risks of using bottles have been shared here. 

But, if the family wishes to or if the baby does not accept the alternatives to bottles, Paced Bottle Feeding can be helpful. Paced Bottle Feeding is a technique in which the milk from the bottle does not flow at a high pace, which could later cause preference to bottle feeding and thereafter breast rejection.  It involves pacing the feeds so that the baby can be in control of her intake of milk only until satiety and will not typically overfeed.

Paced feeding to an extent helps to avoid nipple confusion or nipple preference to bottle teats because the baby is directed to consume milk slowly and work harder as compared to regular bottle feeding. 

1. Use a broad teat bottle so that the baby’s mouth is flared around the bottle nipples, just like she would be latched with a mouthful of mother’s areola. 
2. Very important to feed the baby on demand only when she displays hunger cues like smacking the lips, thrusting the tongue out, rooting by taking hands to mouth etc (hand to mouth is not a hunger cue after 2.5-3.5 months). Offer a small batch of Expressed Breast Milk or Breast Milk Substitutes (BMS) (until the baby is weaned off it).
3. Baby is held at an angle upright and is not lying down on the lap of the caregiver or mother.
4. The caregiver tickles the baby’s lips with a bottle and encourages the baby to open her mouth wide.
5. The bottle teat is then put into the baby’s mouth.
6. The bottle is held horizontally, which slows down the flow significantly.
7. After 20–30 seconds of feeding, the bottle is tipped downward or removed from the baby’s mouth to stop the flow of milk (creating a similar pattern as in breastfeeding, where milk does not flow continuously).
8. Switch sides while Paced Bottle  Feeding – move baby from one side to the other halfway through the feeding. This helps the baby avoid a side preference, and allows for new views and eye contact.

Signs to stop feeding

1. Baby unlatches from the teat
2. Slower sucking
3. Eyes wandering
4. Falling asleep
5. Hands are open and relaxed

It is best to offer Expressed Breast Milk/ Breast Milk Substitutes in small batches so that there is lesser waste and lower chances of overfeeding when the baby is done.  Once you observe the above signs, please stop the feed, and do not force the baby to finish the milk in the bottle if there is any leftover milk.

If you are seeking one-on-one lactation support from the comfort of your home, Breastfeeding Support for Indian Mothers offers Online Lactation Consultation, which can be booked here.

We also provide volunteer support on our 24X7 support group on Facebook, which you can join by clicking here.

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