Paced Feeding Explained: Who, What, Why

There are many things to cover with your childcare provider before you return to work.  Eat and sleep schedules, supplies you need to provide, what you need to label, and specific state laws or center policies your childcare provider may adhere to are just a few things you may want to discuss.  An additional item to add to your list is paced feeding, or the manner in which your caregiver will bottle feed pumped breast milk to your baby.

Related article: How to Pump Breast Milk: The Complete Guide

Paced feeding is the recommended technique for bottle feeding a breastfed baby.  As the term implies, it is a method of offering baby a bottle in a slower and gentler manner that is led by the baby instead of the person holding the bottle.  Allowing baby to self-regulate their milk intake similar to how they do when feeding at the breast will allow them to grow in autonomy and may even impact their eating behaviors later in life.  Additionally, paced feeding most closely emulates the breastfeeding experience–to the extent that it is possible with a silicone nipple and plastic or or glass bottle.

Related article: Pumping Supplies: All the Essentials You Need

Why is paced feeding important?

Paced feeding has a myriad of benefits for baby and you, both physically and emotionally.  These benefits include:

1. Keeps baby interested in breastfeeding and discourages baby from developing a bottle preference since the flow rate of milk from the bottle is similar to the flow rate from the breast.
2. Prevents overfeeding since baby can determine how much he wants to drink versus being forced to drink an entire pre-portioned bottle. 
   • Continually overfeeding a breastfed baby can lead to the expansion of a baby’s stomach.
   • If baby is fed a large quantity of milk with their childcare provider, they may be less interested in breastfeeding with mom. 
   • It is dangerous to a working mom’s breast milk supply if baby continually overeats. Childcare may ask mom to supply more breast milk than she is able to pump at work because they are overfeeding baby.  This puts a mother’s breast milk supply and their emotional well being at risk.
3. Aids in the prevention of tooth decay and ear infections since paced feeding requires baby to be fed in an upright position.
4. Enriches eye development and hand-eye coordination by stimulating spatial awareness as baby is switched from side to side.  This also prohibits baby from developing a side preference.   Side preferences can negatively affect a breastfeeding mom’s milk supply.
5. Helps prevent baby from drinking milk too fast.  Gulping milk too fast can cause gas or reflux issues from swallowing too much air.  Paced feeding deters this from happening by encouraging baby to drink slowly.

Related article: How to Increase Breast Milk Supply (Fast!)

Best Bottles for Breastfed Babies

You can use any brand of bottle to pace feed a breastfeed baby, though we do have a few bottles we prefer to use.  Based on our experiences, we have found the best bottles for breastfed babies to be:

• Comotomo
• Tommee Tippee
• Philips Avent Natural
• MAM

You can read more about why our working moms prefer these bottles in our article on The Top 5 Best Bottles for Breastfed Babies. Whatever brand you choose, we recommend using a smaller 4-5 ounce bottle and the slowest flow nipple possible.  Breastfed babies eat smaller quantities at shorter intervals compared to formula fed babies who prefer larger amounts spaced out at longer intervals. An average feeding for a breastfed baby is 3-4 ounces of breast milk for the first year of an infant’s life.  In comparison, a formula fed baby receives anywhere between 3-8 ounces per feeding depending on their monthly age during their first year of life.

Related article: How Often Should I Pump at Work?

It is also imperative that you choose the slowest flow nipple possible.  Babies have to work harder at the breast to suckle milk compared to drinking from a bottle.  In order to prevent a baby from developing a bottle preference (since drinking from a bottle is easier), select the slowest flow nipple possible to emulate the milk flow rate from the breast.  As baby gets older, you can move to a faster flow nipple or you can stay with the slowest flow possible for the entire time he is fed by bottle.

Related article: 12 Methods to Treat a Clogged Milk Duct Fast

How to Pace Bottle Feed

1. Hold baby in a semi-upright or upright position while supporting his head and neck.
2. Stroke baby’s lips from top to bottom with the bottle nipple, and allow baby to draw the nipple into his mouth.  Make sure baby has a deep latch by ensuring his lips are close to the base of the nipple rather than the tip or shaft.
3. As baby begins to suck, hold the bottle horizontally so that the bottle nipple is halfway filled with milk.  This will keep the delivery rate of milk slow and allow baby to take breaths between swallows without choking on milk.
4. Let baby suck nipple for 4-5 continuous swallows, or 20-30 seconds, then gently tip the bottle out of baby’s mouth to give baby a rest.  Note: if baby is swallowing too rapidly, tip the bottle down so that some of the milk flows out of the nipple.  Remember that you only want the nipple halfway filled with milk.
5. Place nipple on baby’s bottom lip and start again at step #2.  Continue this process throughout the remainder of the feeding.  Switch sides halfway through to mimic the switching of breasts while breastfeeding.
6. When baby stops sucking, does not want to take the bottle back in his mouth or gives another satiation clue (turning away from nipple, falling asleep, becoming more interested in something else, crying), stop the feeding even if there is still milk in the bottle.  This is baby’s way of saying he is done with the paced feeding.  Do not worry if he did not finish his bottle.  An infant will consume a volume appropriate to his size and age.  Allow babies to trust their instincts.

Related article: Baby Refusing Bottle? Try This.

How long should paced bottle feeding take?

In total the paced feeding should last 20-30 minutes.  Feeding slowly will allow your baby’s brain to provide satiety signals that would otherwise be missed if he was forced to gulp down an entire 4 ounces of breast milk in 10 minutes flat. If your baby is struggling with taking a bottle and/or flat our refusing to drink from it, read our article on How to Give a Breastfed Baby a Bottle for loads of helpful tips from experienced moms.

Related article: Supplementing with Formula: Advice from Experienced Moms

Does paced feeding cause gas?

While your baby will likely swallow more air than he would while breastfeeding, paced feeding prohibits baby from overeating.  Overeating can lead to gas and reflux.  Since your baby will swallow some air while paced feeding, make sure to burp baby just as you would after breastfeeding.

Related article: Lactation Fudge: The Perfect Breastfeeding Snack

Tips for Discussing Paced Feeding with Childcare Providers

If your childcare provider is unfamiliar with paced feeding, it may be beneficial for you to show the carer a video on how to pace feed a baby.  This is a great short video that shows the proper way to perform paced feeding:

Nancy Mohrbacher, IBCLC, FILCA, also has a great paced feeding handout available here that you can print out and give to your childcare provider.  Make sure to let your daycare or nanny know how important breastfeeding is to you.  Let them know that you need their support and cooperation in order to make breastfeeding successful.  Feeding your baby using this paced feeding technique will ensure baby is being properly fed, and will support breastfeeding at home.

Related article: How to Work from Home with Kids

If your daycare or childcare provider tells you they need more breast milk than you are sending or are able to pump, make sure they are feeding baby using this paced feeding method.  If you are sending 1-1.5 ounces of milk per hour that you are away, and they are asking for even more milk, investigate why they are asking for additional supply.  Are they feeding baby every time he cries instead of soothing him in other ways?  Are they feeding baby in a reclined position and not allowing baby to dictate the pace?  Maybe baby really does need more milk?  If necessary, speak with your pediatrician if childcare is pressuring you to send more milk than you believe you should.

Paced feeding is recommended for all babies, but especially those under 6 months of age.  In time, baby will be able to hold his own bottle and eventually use a sippy cup.  Paced feeding will set him up for success in self-regulating his caloric intake and will support his breastfeeding relationship with mom.

Related article: How to Transition Baby to Milk: Everything You Need to Know

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