When a breastfed baby starts having bottles, this is the single technique I most want parents to know, because it keeps bottle feeds close to the breast. Paced bottle feeding is a slower, gentler way to give a bottle that lets your baby lead the feed, just as they would at the breast. Instead of the milk pouring in, your baby draws it out, takes breaks, and stops when they are full. It suits any bottle fed baby, and it is especially helpful if you are combining breast and bottle. This guide explains why it helps and how to do it.

Why pacing helps

When a bottle is tipped straight up, milk flows fast whether or not your baby wants it, and it is easy for them to take too much and feel uncomfortable. Paced bottle feeding puts your baby back in charge. It:

  • Lets your baby feed at their own pace and stop when full.
  • Helps avoid overfeeding, gulping, wind and discomfort.
  • Keeps the feed calm and responsive.
  • Protects breastfeeding by keeping the bottle experience closer to the breast.
  • Helps your baby move happily between breast and bottle.

How to pace a bottle feed

  • Hold your baby fairly upright and well supported, not lying back.
  • Use a slow flow teat, whatever your baby's age. There is no need to move up teat sizes.
  • Brush the teat gently against your baby's lips and wait for them to open wide and draw it in themselves, rather than pushing it in.
  • Hold the bottle level, roughly horizontal, so the teat is just filled with milk and your baby has to work a little for it.
  • Let your baby take a few sucks, then gently tip the bottle down or slide the teat forward to give them a natural pause, just as milk pauses at the breast.
  • Watch your baby, not the bottle. Follow their cues and let them set the rhythm.
  • Switch your baby to the other arm partway through, as you would swap sides at the breast.

Knowing when your baby has had enough

Let your baby decide when they are done. There is no need to finish the bottle. Signs they have had enough include:

  • Slowing right down, or stopping sucking.
  • Turning away, or pushing the teat out.
  • Relaxing their hands and body.
  • Seeming calm and content.

Forcing the last bit teaches a baby to ignore their own fullness, so it is always fine to stop with milk left. A paced feed should take roughly as long as a breastfeed, unhurried and led by your baby.

Get help from your midwife, health visitor or an IBCLC if:

  • Your baby gulps, splutters or seems overwhelmed during bottle feeds.
  • Your baby is very windy, or often uncomfortable after feeds.
  • You are combining breast and bottle and want to protect breastfeeding.
  • Your baby is starting to refuse the breast in favour of the bottle.

Call 999 or take your baby straight to A&E if your baby:

  • Is floppy or unresponsive
  • Will not wake for feeds
  • Is having trouble breathing, or their lips, tongue or gums look blue or grey
  • Has a sunken fontanelle
  • Is visibly jaundiced and unwell with it, for example floppy, hard to wake or not feeding. Yellowing shows most clearly in the whites of the eyes, the gums, and the palms and soles
  • Has dark urine or pale, chalky stools

How a consultation helps

Paced bottle feeding is easy once you have seen it, and it can make bottle feeds calmer and protect your breastfeeding at the same time. When I see you I can show you the technique with your own bottles, help your baby move smoothly between breast and bottle, and make sure combination feeding is working for you both.