Breastmilk is often touted as having more benefits than formula, but the biggest factor in the disparity might actually be the bottle-feeding itself, regardless of what’s on the menu—and paced bottle feeding can help close the gap.
When babies feed at the breast, they easily self-regulate how much they eat, hence the expression “you can’t overfeed a breastfed baby.” Breast- and chestfeeding parents are also usually advised to feed on demand and they intuitively interact with their babies while feeding. This leads to a responsive feeding relationship, one that helps babies to communicate their needs and allows their caregivers to respond appropriately.
Introducing a bottle regularly, whether it’s filled with pumped breastmilk or formula, can disrupt this responsive feeding relationship. Since bottles, unlike breasts, are transparent and have ounces marked along the side, many bottle-feeding parents transfer their attention from baby’s cues to the bottle itself, determining how much to feed based on numbers and schedules. This can result in overfeeding as well as your little one losing touch with their own internal hunger and satiety signals.
But don’t despair just yet! Whether you exclusively formula feed, occasionally offer bottles of pumped breastmilk or give some combination of the two, there’s a way to bottle feed that is responsive and can be its own special bonding experience. It’s called paced bottle feeding, and it helps you learn how to read your baby’s cues, respond to their needs and avoid overfeeding.
Ready to try it? Here’s everything you need to know.
What is paced bottle feeding?
Paced bottle feeding, sometimes called cue-based feeding or responsive feeding, is a method that allows babies to set the pace and gives them time to feel and express their needs. Rather than working to fill them with milk or formula as efficiently as possible, this method puts your baby in control of their speed and stresses tuning into your little one’s specific wants and needs.
“Paced feeding allows your baby to control the flow of milk and determine how much they drink,” says Angela Horn, a doula who has spent 22 years working with families as a certified infant feeding specialist (they help parents with bottle, chest- or breastfeeding during baby’s first year).
What are the benefits of paced bottle feeding?
While responsive feeding takes a little more time and effort, that’s actually part of the benefit.
“It requires attention, it requires closeness, it requires connection to read the baby’s cues and then respond to them,” says Horn. “It’s this ‘dance’ you do together that makes feeding a bonding experience, regardless of whether you’re offering a breast or a bottle.”
According to Robyn Price, a lactation consultant and pediatric registered dietitian in Moose Jaw, Saskatchewan, “the flow from a bottle can be faster than the flow from the breast. When you’re pacing your bottle feeds, you’re letting your baby draw out milk, instead of just tipping it upside down and letting gravity help.”
Babies tend to prefer a faster flow that they don’t have to work for, which can lead to “flow preference” when switching between bottle and breast. Essentially, because milk flows more quickly and easily from a bottle nipple than from a breast, some babies start to prefer the bottle over the boob.
Filling the nipple only partially and pausing through the feed replicates the ebb and flow inherent to breastfeeding, which makes it easier for them to transition between the two. It also helps prevent overfeeding for breast-, chest- and formula-fed babies.
When bottle feeding the standard way, your baby may seem very hungry, because they guzzle down several ounces in a few minutes, but that might not be the case. If milk is continuously pouring into their mouth, they’re likely just trying to keep up with the fast flow.
Slowing down the feed allows your baby to check in with their hunger level throughout the feed, similar to putting your fork down between bites at the dinner table.
Does paced bottle feeding reduce gas and reflux?
Paced feeding is believed to relieve painful gas and acid reflux in babies, though with little research being done in this area the findings are largely anecdotal.
“By having your baby more upright, there’s less chance of physiological reflux during and after feeding,” says Horn. “Giving them that break to swallow and really let the milk get into the digestive tract is also really helpful.”
And eating too quickly can lead to gas in babies. Babies who are pace bottle fed usually eat more slowly and take in less air, so they can be less prone to gassiness.
How to bottle feed your baby responsively
Hold your baby in an upright position, says Horn. “Then tickle your baby’s lips with the bottle to elicit the rooting reflex and allow them to latch onto the nipple themselves.”
Keep the bottle parallel to the floor so some milk is in the nipple, but your baby has to actively suck in order to get it. Horn says that “this allows them to get some sucks where it’s just a drip or two of milk and other sucks where they get a good flow.”
After a few good sucks, you’ll either tip the bottle down, so that no milk is in the nipple, or remove it from their mouth entirely. This gives your baby a chance to slow down their sucking, check in with their body, and decide if they want to keep drinking.
Then you’ll either tip the bottle back in, so the nipple fills about half way with milk, or reintroduce it by tickling your baby’s lips again and allowing them to latch back on if they’d like.
As for exactly how often to pause and whether to completely remove the bottle or not, Horn says that “hard and fast rules don’t allow for individuality in the feeding relationship,” which is the entire point of responsive feeding. If your baby is feeding very vigorously, they may prefer that you leave the bottle in, so they can suck on the empty nipple for a moment. Or they may need you to remove it completely, so they can take a minute to breathe.
Conversely, Horn says, “if they’re doing little fluttery sucks, but it’s still early in the feed, then you can tip it a little bit more into their mouth, to see if an increased flow will elicit them to drink more actively.”
And if they’re taking pauses and pacing themselves, there may be no need to tip the bottle out of their mouth at all.
What are the best bottle feeding positions?
Any position where your baby is supported well and more upright than reclined will work. You can cradle your baby in your arm or sit on a sofa with your knees bent and your baby propped up on your thighs, either facing you or lying on their side. Get comfortable, so that you and your little one can both relax into the feed.
How do I know when my baby is full?
Paced feeding allows for signals of satiety to reach your baby’s brain. Then they can signal this by slowing their sucks, turning away or spitting out the bottle.
“Feeding responsively means tuning into and honouring these cues,” says Price. You want to feed based on your baby’s hunger and fullness, not based on how much milk is left in the bottle. While there are ranges for how many ounces of milk your baby should get per day, based on their age, there is no set amount that’s required per feed—and their preference for more small meals or less large meals can change regularly based on factors like growth spurts.
And babies don’t just suck to receive nutrition, they also find it soothing. So they may continue drinking past fullness as they suck on the bottle nipple for comfort.
“If they’re showing you signs that they don’t want more milk, but they’re also showing you signs that they want to feed or suck… you can honour that need by offering a pacifier,” Price explains.
Do I need to bottle-feed on a schedule?
Horn and Price both recommend bottle feeding on demand, by watching for hunger cues and following your baby’s lead. “This allows babies to remain in tune with their bodies,” says Price, and can set “an amazing foundation for their food relationships in life.”
Following your baby’s lead also allows you to catch their early hunger signals. Responding to their early cues means they won’t start the feed ravenous, so they can eat more calmly and avoid overeating, says Horn.
Early signs that your baby is hungry can include licking their lips, putting their hands in their mouth, opening their mouth and rooting around for a nipple.
Horn points out that feeds will take longer with paced feeding, usually around 15 minutes, but that babies don’t usually drink more milk than if they ate more quickly. It’s often the same amount or less, they’re just eating more slowly, which is good for their digestion.
Does it matter what kind of bottle I use?
A slow flow nipple is ideal for paced bottle feeding and you can use a nipple marketed for preemies or newborns throughout the entire first year.
Price recommends choosing a bottle that’s similar to your nipple when it’s in your baby’s mouth. This will usually be a nipple with a medium to wide base that slowly tapers to the tip. This allows your baby to take more of the teat into their mouth and get a proper latch. Avoid nipples with a very wide base and small protruding nipple, as this will encourage your baby to latch onto just the tip.
That said, Horn and Price agree that the type of bottle you choose isn’t as important as pacing the feed. “Responsive feeding is beneficial for most bottle-fed babies,” says Price. “And you can feed responsively with any bottle you have.”