Tips for Baby-Led (Paced) Bottle Feeding
Use a bottle with a fat teat and a short nipple. A “bottle nipple” is both a nipple (skinny tip) and a teat (fat base). Look for a teat that’s as fat and round and possible, with a short nipple that blends smoothly into it – no abrupt connection, no narrower neck, no long, stiff nipple section. The cheapest ones usually work well, mostly made of clear silicone. The slowest flow version is usually best for a breastfed baby. Suggest that the mother test each new package; there can be huge variability between packages from the same company.
Hold the baby snugly. The chest and head should be upright, elevated, back straight, chin not tucked. Your hand is supporting the shoulders and head as a unit.
Touch the baby’s upper and lower lips with a vertical nipple the way you would put your finger to your own mouth to say “Shhhh”. Wait for an open mouth.
When the baby’s mouth is wide and the tongue is down, rock the teat and nipple in so that the baby can draw the bottle in and flange lips on the fat part of the teat. No “prissy lips” on the skinny part. It may take some very gentle pressure to encourage a deep latch. If the baby gags, you may need to work up to this.
Keep the baby upright enough that the bottle teat is not full of milk when baby isn’t sucking. This helps the baby control the flow. Baby won’t swallow more air that way; that’s a marketing ploy. Babies swallow air when they gulp, not when they drink smoothly. When the baby sucks, the teat will fill with milk. A nearly horizontal bottle encourages smooth swallowing. Laying baby back and having the bottle above means that baby has to “swallow or drown” – not a pleasant way to eat and a recipe for swallowing air.
Mimic the normal rhythm of breastfeeding, tilt baby and bottle to drain the milk away, (or just twist and remove the bottle, but keep the nipple in the “shhh” position) to let baby wait for first flow of milk, but also to pause, breathe and begin to suck again. If baby can’t put the pauses in on a bottle, you can do it by tilting the bottle after about every 15-20 sucks. Baby will soon learn to pause without help. Also pause to mimic the time between your fast and slow flowing breast milk. The baby does not get milk unless actively sucking.
Feedings will frequently take about 20 minutes with this method. The amount the baby takes will likely be much more like it is while breastfeeding typically 1-3 oz up to 10 pounds of weight, 2-5 oz for babies over 10 pounds, about 1-1.25 oz for every hour. A furrowed brow, wide-open eyes and a hand up, open like a stop sign are signals that the baby is getting stressed and either needs to pause, stop and burp or is done with the feeding.
Videos: https://youtu.be/UH4T70OSzGs
http://www.breastfeedingmaterials.com/video/A7H39D-teaching-pacing-twin/index.html
adapted from Diane Wiessinger www.normalfed.com
who freely adapted from a technique developed by Faith Ploude, IBCLC
12/7/2015
who freely adapted from a technique developed by Faith Ploude, IBCLC
12/7/2015