Paced Feeding - Bottle feeding a breastfed baby

Sometimes it will be necessary for breastfed babies to be bottle fed. At times mom may not be available on demand and able to breastfeed. This is especially true for working moms who need to return to their place of employment after their maternity leave. 

As the name suggests "paced feeding" is a technique whereby the caregiver paces the flow of the breast milk, allowing your baby to be in control of the feed. 

It is also important to learn your baby's hunger cues and not just feed a scheduled amount of food in a day. 

When you traditional feed, your baby is in a reclined position and is able to lie down & guzzle the entire content of the bottle in a couple of minutes. This is not how milk would be drunk from your breast naturally. This may be a reason why some babies become lazy to return back to moms breast. Obtaining milk from the breast is hard work for babies vs just glugging down milk in a bottle. 

I often share this youtube clip with moms to show how this "Paced bottle feeding" can be done:

It’s important to feed your little one in a more upright or sitting position, rather than a reclined position.This is because the milk flow from a bottle can be increased when given in a reclined position, making it hard for the baby to control the flow.

 

Hold the bottle more horizontally

The bottle should always be held in a more horizontal position. This makes it easier to control the flow than a bottle that is held up-side down. Keep enough milk in the nipple so that your baby does not become overwhelmed with rapid milk flow. Because the bottle is horizontal, you can tilt it up just enough to help flow and then down to stop it. This will give you the pacing you need. You may also consider not allowing the milk to reach the nipple of the bottle for a few minutes while baby sucks. This will mimic the letdown of breastfeeding and can help reduce the chances of nipple preference. We are learning that babies don’t struggle as much with “nipple confusion” as with “flow preference.” If you are consistently giving a breastfed baby fast-flowing bottles, they will probably prefer that easier, faster milk versus working for milk at the breast.

 

Mimic Breastfeeding

Encourage the bottle feeding experience to mimic breastfeeding by allowing your baby to root for the nipple of the bottle and latch onto it as they do when breastfeeding. One way to initiate this response is by lightly touching the nipple of the bottle to your baby’s nose. Once they have a good latch, allow them to set the pace of the feeding. Try to stick to around the same amount of time they normally spend feeding at the breast. Also, if you feed your baby on both breasts in one feed, it is a good idea to move baby from one side to the other halfway through the feeding.

 

Pause 

Babies, while breastfeeding will pause and take breaks often throughout a feed. If you are bottle feeding your breastfed baby you should encourage pauses while bottle-feeding as well. If your baby gets a little tense or starts gulping, lean them forward to allow the milk to flow away from the nipple to give them a break. If they pause on their own - perfect!

 

Don't force an empty bottle

Don’t force them to finish the bottle if they indicate they are full. A few cues to look out for if baby is full: slower sucking, eyes beginning to wonder, hands are open and relaxed, falling asleep. Don’t wake a baby to finish the bottle if baby dozes during a feeding (an exception being newborns who may need to be awakened in the first few days to feed). To prevent wasting breastmilk if baby is prone to falling asleep while feeding you could start out with a fewer mls vs a full bottle. Add more milk later to the feed if your baby is still hungry.

 

 

A few benefits of Paced Bottle feeding

Breastfeeding is our bodies natural design of how we are to nourish our babies, thus it makes sense that we would want to replicate this dynamic as best we can when bottle feeding. 

Avoid under / over feeding - If the caregiver is in charge of when and how much baby eats, baby is not likely to get the correct amount of milk. Paced bottle feeding helps baby be in charge, just like when they are on the breast.

Less stress - Babies can become very stressed when laid on their backs to eat from a bottle. When baby swallows milk from a bottle, the negative pressure forces more milk out of the bottle. Baby has to keep gulping quickly to avoid choking. Paced feeding gives your baby the time and space to eat at their own speed.

Easier Pumping for mamma - If your baby is being overfed, you need to continually pump extra milk to replace the milk that’s being fed. Sometimes this leads to mamma believing they may have a low milk supply. When baby is in charge, it’s much more likely that the amount mom pumps is exactly what baby needs.

 

Which is the best bottle to use? 

Some lactation consultants like a narrower nipple found in traditional bottles versus the more breast-like nipples on some modern bottles. They prefer this style because baby can “latch” deeply on the narrower nipple, like with a breast. Other lactation consultants say it isn’t the bottle that matters as much as the pace of milk flow.

My two favourite options are the Medela Calma teat (which conveniently fits onto your Medela pumping bottles. As well as Natursutten Glass bottleswhich come with a slow flow teat. The bottle also has an anti-colic “double-valve” designed to ensure a more even milk-flow and prevent colic and gas—making feeding go more smoothly.