It’s possible for babies to both breastfeed and bottle-feed. You might be returning to work but also want to continue to breastfeed when at home, or you might simply want your partner or another caregiver to occasionally feed your baby.
While both breastfeeding and bottle-feeding provide for a baby’s nutritional needs, the physical actions required to successfully breastfeed are very different to those required to bottle-feed. Your baby can control the rate of milk flow from your breast using her tongue, but she has very little control over the flow of milk from a synthetic nipple.
Assuming your baby is willing to accept and feed from a bottle, consider paced feeding.
Should I pace feed my baby?
When breastfeeding, your baby may need to suck for around 30–60 seconds before her mother’s milk lets down. Multiple letdowns during a breastfeed are separated by a brief pause when your baby might not receive milk, or receives very little. Plus, the flow rate while breastfeeding varies. One of the reasons that babies develop a preference for bottle-feeding is because they receive milk as soon as they start to suck from a bottle, and the flow rate is consistent. Paced feeding can help minimize the risk of bottle-feeding preference, but it also has other benefits.
Paced feeding aims to mimic the periodic letdowns your baby experiences while breastfeeding. Using this method, you can control the flow rate in a way that responds to your baby’s cues; it also slows down the flow of milk from the nipple, allowing your baby to eat more slowly, and take breaks.
What are the benefits of paced feeding?
Paced feeding is especially helpful when your baby is both breastfeeding and bottle-feeding, or when using expressed breast milk, as it more closely mimics the breastfeeding experience. It also supports with:
- Promoting self-regulation: by controlling the flow, your baby is more likely to stop when she is full, reducing the risk of overfeeding.
- Development of hunger and fullness cues: by allowing your baby time to pause and resume feeding on their own accord, she is better placed to develop and refine her hunger and fullness cues.
- Reduces gas and reflux: the slower pace of feeding can help minimize the amount of air your baby swallows, which in turn reduces the risk of gas and reflux.
- Reduced risk of developing a bottle-feeding preference: if you plan to do a combination of breastfeeding and bottle-feeding for a newborn, paced feeding may be helpful to minimize the risk of bottle preference.
How do I pace feed?
The following steps are a guide to pace feeding your baby. Note that there are some key differences to be considerate of compared to traditional bottle-feeding methods, namely with baby and bottle positioning:
- Test the temperature of the feed by shaking a little milk from the nipple onto the inside of your wrist. If it is body temperature it will feel neither warm nor cool.
- Seat your baby in an upright position instead of laying him horizontally like you would when breastfeeding. This allows her to have more control of the feed. Support her head and neck with your hand rather than with your arm.
- Gently brush down the middle of her lips with the tip of the nipple to stimulate a gape reflex response. When she opens her mouth, place the nipple into her mouth.
- Your natural response would be to hold the bottle upright. However, with paced feeding, the bottle should be held horizontal, which slows the flow and encourages baby to suck and pause naturally, similar to breastfeeding.
- Give your baby a break every 30 seconds or so to make the experience more like a breastfeed. Instead of pulling the bottle away from her mouth, lower the base of the bottle so that milk no longer fills the nipple while keeping the nipple in her mouth. As she begins to suck again, raise the level of the bottle back to the horizontal so that milk is again available in the nipple.
- Burp mid-feed or sooner if she pulls away, seems fussy, and then offer the bottle again.
- Switch sides halfway through the feed or with every other feed to mimic the experience of breastfeeding from both sides.
- Allow her to decide when she’s satisfied. If she becomes drowsy and releases the nipple before the bottle is empty, this signals she’s finished feeding. Stir her awake at the end of the feed to discourage her from developing a feeding-sleep association.
When do I stop pace feeding my baby?
Pace feeding is useful for newborns and young babies under the age of three months. During these first few months, your baby’s sucking reflex is still active, and she is at greater risk of overfeeding from a bottle.
While pace feeding is not essential for any baby, in particular, pace feeding is no longer useful for babies over the age of three months. By this age, a healthy baby has learned the different sucking actions involved in breastfeeding and bottle-feeding. She could become frustrated and upset if you were to continue to pause the feed by lowering the bottle.
Even if your baby is exclusively bottle-fed, if over three months paced feeding no longer provides benefits; at this age, babies can pace themselves, sucking when they choose to, pausing if they need to take a break, and ending the feed when they have had enough.
Can I pace feed using formula?
If you are planning to combine breastfeeding and bottle-feeding, you can use formula when bottle-feeding if this is your choice to do so. Ideally, however, you will pump or hand express to remove milk at regular intervals when you are separated from your baby so you can maintain your milk supply. Remember, breastmilk is produced on a ‘supply and demand’ basis. If the demand drops because you’re giving your baby formula, your breastmilk production will also drop.
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We appreciate that unless you have extensive experience in child development and the effect of different infant feeding and settling practices on a baby’s behavior, it can be difficult to know how and where to start to resolve a baby care problem. There are multiple ways in which we can help you gain a greater understand of your baby’s needs and your role as your baby’s parent and caregiver.
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Written with decades of experience to inform her and backed by current evidence and research, Rowena’s books on healthy sleep practices, bottle-feeding aversion and baby-led feeding principles provide parents with a wealth of practical advice and information to help guide them through their baby care problems. Available in hard copy and e-books through our website and leading online book retailers.
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By Rowena Bennett, RN, RM, CHN, MHN, IBCLC.
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