Are you thinking about introducing bottles to your baby? Most families use bottles to feed their baby at some point during infancy, either as a complement to breastfeeding or exclusively. However many families are unaware that certain bottle-feeding practices can lead to overfeeding and other feeding issues. So, how can you make sure to bottle-feed your baby well?
Our lab has spent the past decade researching how to support families to achieve healthy bottle-feeding interactions. In a recent study, we explored one popular approach – Paced Bottle-Feeding – to assess the extent to which families are aware of and use this approach. We also examined whether paced bottle-feeding was associated with healthier feeding practices.
Let’s first talk about Responsive Feeding
Before we discuss the Paced Bottle-Feeding method and how it can help you, let’s first talk about responsive feeding. Responsive feeding is recommended by the American Academy of Pediatrics, the Dietary Guidelines for Americans, and other authorities on early nutrition. During responsive feeding, caregivers are responsive to their babies’ hunger and fullness cues and use these cues to guide the pace of feeding and the amount consumed. Responsive feeders are also warm and positive during feeding interactions. They recognize that feeding is about more than just eating and that feeding interactions are great times to bond with their babies.
Responsive feeding supports baby’s abilities to self-regulate during feeding, meaning they eat enough to match their needs. In this way, responsive feeding supports healthy growth and development for babies.
Responsive Feeding During Bottle-Feeding
Responsive feeding is important during both breastfeeding and bottle-feeding. Previous research suggests breastfeeding parents are more likely to engage in responsive feeding. This may be due, in part, to some natural features of breastfeeding that are removed during bottle-feeding. For example:
| During Breastfeeding | During Bottle-Feeding |
|---|---|
| The caregiver cannot see how much milk is available and thus must watch their baby’s cues to know if they’ve consumed enough. | Most families use clear bottles and thus have more information about and control over how much their baby consumes. |
| The baby must latch onto the breast to initiate feeding. | The caregiver can push a bottle nipple into the baby’s mouth to initiate feeding. |
| The baby must actively suck to extract milk. | The baby can be a passive recipient of milk, especially if the caregiver is using a fast-flow nipple. |
| The caregiver must hold the baby and positioned baby in a way that allows them to engage in feeding actively. | The caregiver can position the baby and bottles in ways that encourage faster milk flow/eating (e.g., flat on their back) or can prop the bottle up and leave the baby alone to feed. |
Although many of the above “features” of bottles may help families who are struggling with breastfeeding, they can also lead to feeding issues and overfeeding. It is also important to note that the above “features” of bottles are not absolutes – they represent what can happen during bottle-feeding, but not what should happen.
The good news is that responsive feeding during bottle-feeding is possible!
What is Paced Bottle-Feeding?
One promising strategy for bottle-feeding is the Paced Bottle-Feeding method, which incorporates many feeding strategies consistent with the concept of responsive feeding. The Paced Bottle-feeding method was designed to mimic the natural breastfeeding experience. It involves a slower and more controlled bottle-feeding process, allowing your baby to self-regulate their feeding pace and feed in response to their hunger and fullness cues.
Implementing Paced Bottle-Feeding
Are you interested in incorporating Paced Bottle-Feeding into your infant’s feeding routine? Follow these steps:
- Initiate feeding when your baby shows hunger cues
- Hold your baby during the entire feeding
- Position your baby upright
- Position the bottle horizontally to encourage your baby to work
to extract milk - Gently brush your baby’s lips with nipple to start feeding
- Wait for your baby to actively accept nipple
- Take breaks and watch for your baby’s cues to pace the feeding
Taken together, the steps of Paced Bottle-feeding aim to slow the pace of feeding and increase the amount of effort babies expend during bottle-feeding. These steps promote balanced control between caregiver and baby because the baby can better set the pace of feeding and stop feeding when full, thereby reducing the risk of spitting up and overfeeding.
Awareness and Use of Paced Bottle-Feeding among Mothers of Infants
Within a recent study of 197 mothers with babies, we found that 41% of participants indicated that they had heard of Paced Bottle-Feeding, with 23% using it and 35% sometimes using it. Interestingly, mother or baby characteristics were not associated with the use of Paced Bottle-Feeding. This means that this technique that can be adopted by a wide range of parents and infants.
Our study also revealed a compelling finding. Mothers who used Paced Bottle-Feeding were significantly less likely to encourage their babies to finish the bottle. Encouraging babies to finish their bottles is not in line with responsive feeding and can lead to overfeeding. In the long run, this may contribute to obesity and other feeding-related issues. Therefore, this association is promising and suggests that Paced Bottle-Feeding may support responsive feeding interactions.
Want to learn more about responsive feeding? Read more here!
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