Picking Bottle Nipples for the Breastfed Baby

With Amy Peterson, IBCLC

This post made possible by the support of EvenFlo Feeding

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Lots of breastfed babies will also use a bottle. Most of us have heard that introducing a bottle can potentially have a negative impact on the breastfeeding relationship. But thankfully, we can control these risks.

Lower risks

Latch:  The way your baby latches on the breast needs to be similar to the bottle. Look at your baby while s/he is feeding at your breast.  Notice how the bottom lip flares, and the top lip rests in a neutral position. Observe how the corners of the mouth seal on the breast, and how milk doesn’t leak from the lips while baby feeds. Pull down baby’s lip slightly and see the baby’s tongue cup or curves around your nipple. We look for these same characteristics when baby sucks on a bottle nipple.

gradual wide leaking bad

Not a good latch: Averted gaze (no eye contact), top lip rolled in, leaking at corners, latched more toward the tip.

wide abrupt good no leak

Decent Latch: Eye contact, flared lips, deep latch near collar of bottle, relaxed posture, no leaking at corners.

 

Flow preference: You want your baby to prefer the flow of your breast over the flow of a bottle. There is no standard flow rate for bottle nipples, so you might have to try more than one bottle to find a similar swallow pattern. Most babies will use a slow flow nipple, but slow flow isn’t best for every baby–match your own flow. For detailed information, Balancing Breast and Bottle lists bottle flow rates in Appendix C.

Milk supply:  Anytime the baby takes 2 ounces from the bottle, ideally you will be able to pump this amount so your body knows how much your baby is taking and can maintain your supply. But don’t worry if you don’t pump exactly what your baby eats every time, baby is likely more effective at removing milk from your breast than a pump will be. Adding a pumping session may be necessary to ensure you’re producing the amount needed for your child’s bottle feed.

 

breastfeeding and bottle feeding

Good latch: Eye contact, flared top and bottom lips, no leaking, medium depth latch, relaxed posture.

 

Reduce risks by picking a nipple shape

One way to reduce bottle risks is in choosing the nipple shape we use to bottle-feed our baby.

Nipples have three general shapes: narrow, wide-abrupt, and wide-gradual.  

bottle nipple - narrowbottle nipple - wide abruptFullSizeRender

Narrow neck nipples fit narrow neck bottles, and most have a gradual transition from nipple length to base where the baby’s lips can slide easily to latch deeply.

Wide neck nipples fit wide neck bottles.  Wide, abrupt shapes have an abrupt transition (like a 90 degree angle) between the nipple length and nipple base. Make sure your baby is able to rest their lips opened widely on the nipple base, not suck on the nipple length like a straw. Also, make sure your baby is able to fully seal the lips without gaps in the corners of the mouth.

Wide, gradual shapes gradually blend from the nipple length to the base. This shape may help the baby’s lips to rest on a portion of the base, and help the lips to form a complete seal. Make sure your baby is able to keep the nipple inserted deeply during feeding, rather than sliding down to the tip of the nipple.

 

Best does not exist

Different bottle nipple shapes work for different babies. One bottle will not be best for all babies, but you can find which bottle is best for your baby.  Therefore, beware of marketing and packaging claims. You’ve probably noticed many bottles claim to be best for breastfed babies, or to look just like the breast. But neither of these statements matters. How your baby latches onto the bottle nipple matters, not the packaging claims. You have found the right nipple when the nipple tip reaches deeply into the baby’s mouth; tongue cups the nipple; lips open widely and rest on a portion of the base; lips form a complete seal.

Additionally, now that you know that one bottle will not be best for every baby, don’t be swayed when you hear which bottle is “best” from other moms; what’s best for their baby might be terrible for your baby. You will need to look at your baby’s latch and then decide.

Picking bottle nipples - evenflo cobranded

Buying bottles

If you are having trouble finding a bottle your baby accepts, make sure you have tried all three types: narrow, wide-abrupt, and wide-gradual.  A lot of moms tend to buy various bottles marketed for breastfed babies, and then end up with a bunch of wide-abrupt shapes. Make sure you try the other shapes.

Chances are you will own more than one type of bottle, either bottles you have experimented with, or baby shower gifts that your baby can’t achieve a good latch with. Don’t despair.  As your baby grows, the mouth grows as well.  Nipples that do not work for young babies often work well when the baby’s mouth is bigger, say 4 months or so. Feel free to try the other nipples you have when your baby is older, and check the latch again.

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Amy Peterson is a mom of 4, IBCLC, Early Intervention coordinator, and retired LLL Leader. She works alongside a speech-language pathologist, and together they co-authored Balancing Breast and Bottle: Reaching Your Breastfeeding Goals. They have also written a series of tear-of sheets available through Noodle Soup: Introducing a bottle to your full-term breastfed baby, Pumping for your breastfed baby, Pacifiers and the breastfed baby, and Bottle pacing for the young breastfed baby. Amy’s passion is helping others find fulfillment and confidence in parenting, regardless of feeding method. Visit Amy’s website at breastandbottlefeeding.com.
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Bottle-feeding Tips- A Bottle-feeding Overview for The Breastfeeding Family

by Amy Peterson

This post made possible by the support of EvenFlo Feeding

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Moms who breastfeed often feel afraid, or even sadness, at the thought of introducing a bottle. The truth is bottles are a tool, a useful tool, and they don’t need to be scary, even if you need to use a bottle in the early days because breastfeeding isn’t going well. If you think your baby is lazy, you need someone to evaluate what’s going on because it’s not laziness, it’s something we’re not recognizing. It is a sign of something else. In the meantime, pump your milk and feed your baby. The bottle can be a tool you use to protect your breastfeeding journey, not to end breastfeeding.   

It can feel overwhelming when it comes to picking a bottle for your breastfed baby. Many bottles claim to be “more like mom,” but that is a marketing gimmick. Babies are unique, and a bottle that works for one baby may not work for another, siblings included. Below are some tips that may help parents looking for a bottle for their breastfed baby.

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Think of how a baby latches on the breast. There are many ways to evaluate if breastfeeding is going well. As it relates to picking a bottle, we specifically observe the baby’s mouth. It should open widely, resting the lips on the areola. The lips will roll out (flange) and be visible, with the corners of the lips sealing against the breast. Your nipple will reach far into your baby’s mouth. This is what you want to mimic with a bottle latch.

There are three predominant nipple shapes: narrow, gradually sloped wide, and classic wide.  Any shape is okay so long as your baby has a similar latch on the bottle nipple as on the breast. The right nipple for your baby should a) reach deeply into your baby’s mouth, b) allow the lips to open and rest on a portion of the base, and c) allow the lips to form a complete seal.  On a narrow nipple, let your baby latch and then wiggle it in deeper into your baby’s mouth so the lips are almost “kissing” the collar. On a gradually sloped wide, again, wiggle the nipple in deeper, then observe to see if your baby’s mouth remains opened widely rather than slipping to the tip.  On a classic wide, make sure your baby’s lips can rest on a portion of the base and form a complete seal rather than sucking on the nipple length like a straw.  

You will probably want to buy two or three nipples to try. Rather than reading packaging claims, look at the nipple. Ask yourself, “Will this nipple reach deeply in my baby’s mouth so the lips can rest on the base? (yes) Will this nipple shape help hold my baby’s lips open? (yes) Does it look like my baby will suck on this like a straw? (no)” Try different shapes until you find the shape that allows for a good latch for your baby.          

Start with a slow flow nipple. However, it is important to note that there is no industry standard for “slow,” and flow rates vary greatly between brands. It is also important to note that dripping is different than flow. Bottles that are advertised as “no drip” may flow very fast compared with other bottles that do drip.  With any bottle, you can control dripping by letting your baby latch on to the bottle before tipping it up so milk fills the nipple. You can’t control flow, but you can try different brands to see how your baby responds, and you can tip the bottle down and let your baby rest if he looks overwhelmed when swallowing Balancing Breast and Bottle lists bottle brands from slowest to fastest flow.  

The million dollar question—which bottle nipple is best for my breastfed baby—has no absolute answer. It all comes down to how your baby latches and swallows with a specific nipple.

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Amy Peterson is a mom of 4, IBCLC, Early Intervention coordinator, and retired LLL Leader. She works alongside a speech-language pathologist, and together they co-authored Balancing Breast and Bottle: Reaching Your Breastfeeding Goals. They have also written a series of tear-of sheets available through Noodle Soup: Introducing a bottle to your full-term breastfed baby, Pumping for your breastfed baby, Pacifiers and the breastfed baby, and Bottle pacing for the young breastfed baby. Amy’s passion is helping others find fulfillment and confidence in parenting, regardless of feeding method. Visit Amy’s website at breastandbottlefeeding.com.
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