Paced Bottle Feeding

Key Points:

1. Paced bottle feeding mimics breast milk flow to let the baby control their feed pace, promoting a more natural feeding experience.
2. This method focuses on baby-led cues for hunger and feeding.
3. Proper technique involves holding the baby upright, the bottle horizontally to slow milk flow, and encouraging frequent pauses.
4. Benefits include preventing overfeeding and promoting a responsive feeding relationship.

Paced bottle feeding has become the new kid on the block when it comes to bottle feeding. And just when we thought there wasn’t much to holding a baby’s bottle when they feed, paced feeding advocates say that it’s worthwhile reconsidering that approach.   

Paced bottle feeding appears to have been popular in the United States for some time, though in Australia, it’s just starting to build popularity. In terms of evidence around its benefits, there is still some way to go before it’s been proven with certainty, that paced feeding is beneficial.  

If you do choose to pace feed your baby, it would be worthwhile checking with your baby’s healthcare professional first, just to make sure there’s no potential reasons why it may not be right for your baby.

What does it mean to pace feed my baby?

Essentially paced bottle feeding aims to mimic the flow of milk from the breast.  By doing this, the baby is exposed to a more ‘natural’ method of feeding, is more relaxed and in control of their feeds.  With time and practice, the baby learns to ‘pace’ their feed, and take their own sucking breaks and pauses before returning to sucking. 

Paced bottle feeding is all about the baby being in control of their feeds, not the person feeding them.

Paced feeding is also centred on following the baby’s cues or signals that they are hungry.  Rather than being ‘fed’ they get to ‘feed’ and it is the baby’s responses which are important.

Hunger cues

Healthy, hungry babies give cues that they want and need to feed.  And although every baby is an individual, most babies display typical hunger behaviours:

1. Unsettledness with whinging/crying.
2. Mouthing around and putting their hands in their mouth.
3. Looking as if they’re hungry – their eyes are open and they have a ‘searching’ look.
4. Clicking or tongue sucking.
5. Moving their arms and legs around.
6. Being increasingly alert and changing their facial expression.
7. Calming when they are offered a feed and start sucking.

Principles of paced bottle feeding

1. The parent is more ‘in control’ of the amount and flow of milk as it flows through the neck of the bottle and into the teat. The baby is more ‘in control’ of how much milk they drink.
2. Paced feeding isn’t relying on gravity to fill the teat with milk, but instead, the parent and baby are controlling the flow of milk.
3. The teat is not full of milk when they’re feeding. Holding the baby upright and the bottle in a horizontal position means the teat is only partially full of milk – this slows the flow of milk which goes into the baby’s mouth.
4. Paced feeding is a technique which allows the baby to feed more slowly and take frequent breaks and pauses when they feed.
5. Paced bottle feeding can be done whether a baby is only bottle fed or having solids as well.

Giving your baby a paced bottle feed

1. Follow the manufacturer’s recommendations on formula preparation. Check here for information about expressed breast milk (EBM).
2. Always test the temperature of the EBM or formula before offering it to your baby. The milk should feel warm, not cold or hot.
3. Position your baby upright so they’re supported by your body. Support their head and neck so they’re comfortable. Also consider your own comfort and sit supported in a comfortable chair.
4. Give your baby skin to skin contact and look into their eyes. Talk gently and reassuringly to them.
5. Hold your baby in alternate arms ½ way through the bottle. This mimics the changing of position which breastfed babies have midway through their feeds. It also helps to support your baby’s eye development as they learn to focus on your face from left/right sides.  
6. When offering the bottle, stroke the teat from their top lip to their bottom lip – this will help to stimulate their rooting response and initiate the baby’s feeding reflex.
7. When they open their mouth, gently allow them to draw the teat into their mouth, rather than pushing the teat into their mouth yourself. Again, this replicates the action of a breastfeeding baby as they draw the mother’s nipple into their mouth.
8. Look for your baby to have a wide, open gape to their mouth with relaxed lips which are flanged out.
9. It may help to count your baby’s sucks and swallows as they feed. If they don’t take a breath every 3-5 sucks, remove the bottle and let them take a breath.
10. Watch for signs that your baby isn’t coping with the flow of milk. Pulling away from the teat, choking and coughing and stiffening their arms and legs can all be signs that the milk is flowing too fast for them to cope with. They need to feed more slowly and be relaxed.
11. Hold the bottle in a horizontal, rather than upright position, this means the milk just covers the teat hole.
12. As your baby pauses and has rests with their sucking, lower the base of the bottle so that the milk is not filling the teat. Keep the teat in your baby’s mouth.
13. As your baby begins to suck again, lift the bottle back into a horizontal position so the milk fills the teat again.
14. Aim for feeding times of around 20-30 minutes.
15. If your baby stops sucking and gives cues that they are satisfied, don’t ‘push’ them to drink more.
16. Never leave your baby unattended when they are feeding. It’s important that they are held and supervised during feed times.

5 benefits of paced bottle feeding

1. Advocates of paced bottle feeding say that it helps to support the baby being more in control of the feeding and avoids overfeeding.
2. Avoids the potential for being ‘force fed’ because they have to keep swallowing in order to keep up with the flow of the milk to prevent choking.
3. Breastfed babies may be more receptive to accepting a bottle of expressed breast milk if they are ‘pace’ fed.
4. When the baby has control of their feeds, they don’t drink as quickly.
5. It requires a responsive feeding approach which is based around a close relationship between parents and their baby.

5 disadvantages of paced bottle feeding

1. It may be frustrating for babies who are hungry and don’t want frequent pauses.
2. It can lead to more ‘wind’ and discomfort because the teat is only partially full of milk.
3. It requires more attention and effort for parents who are already focused on a range of different things.
4. May cause parents to feel guilty if they’re not paced feeding and that somehow, they’re less sensitive to their baby’s feeding cues.
5. Paced feeding may not make a difference at all. Some health professionals feel that paced bottle feeding is a ‘gimmick’ and has no real benefits.

For more information on bottle feeding, speak with your Child Health Nurse, health practitioner or learn more in our Baby Feeding Guide.

About the Author:

Written for Nourish Baby by Jane Barry. Jane has qualifications in general, paediatric, immunisation, midwifery and child health nursing. She holds a Bachelor Degree in Applied Science (Nursing) and has almost 35 years specialist experience in child health nursing. She is a member of a number of professionally affiliated organisations including AHPRA, The Australasian Medical Writer’s Association and Australian College of Children and Young People’s Nurses.

References

https://www.breastfeeding.asn.au

https://www.brighamandwomens.org/assets/BWH/pediatric-newborn-medicine/pdfs/brigham-nicu-feeding-flowchart.pdf

https://www.health.state.mn.us/docs/people/wic/localagency/wedupdate/moyr/2017/topic/1115feeding.pdf

https://www.healthline.com/health/parenting/paced-bottle-feeding#What-Precautions-Should-I-Take-When-Paced-Bottle-Feeding?-

Paced Bottle Feeding - Patient Information Brochures - Mater Group