Nipple Flow When Bottle Feeding: How to Detect the Appropriate Flow Rate

Eva Healey
7 days ago
4 min read

Bottle Feeding Nipple Flow Questions:

Is my baby appropriately gaining weight?
How long does it take my baby to eat?
Is my baby refusing the bottle or getting frustrated during a feed?
Is my baby calm and able to sleep between feeds?

Keys to Success:

Understanding weight gain
Necessary supplies
Interpreting baby's communication
Assessing change

Weight Gain

In the beginning, you are making frequent trips to the pediatrician's office where they will obtain your child's weight. Leave it up to the pediatrician to determine what is an appropriate weight gain for your child. Instead of focusing on percentages, focus on their personal growth curve.

You can purchase bath tubs or changing pads with scales included, but, similar to adults, this can lead to an unhealthy obsession with weight and create avoidable stress. Even worse, it may influence your ability to pick up on secondary cues because you are solely focused on their weight.

Instead, we recommend you spend that energy focusing on your baby during bottle feeds and how to handle the feed to determine if the nipple flow is appropriate or needs adjusting. Adjusting could be slower or faster.

Supplies

I recommend purchasing a set of nipples in each size for your specific bottle brand so you have them on hand when you need them. Also, if you can afford it, buy enough supplies for the amount of feeds (8) in a day or however many bottles you are giving if you are combo feeding. It will make your life easier so you don't have to hand-wash dishes between feeds. Finally, if you are using different bottle brands, know that the nipple sizes don't correlated across all brands! You can research the size conversions online, or you can fill both bottles with water and tip them over to see if they drip out at a similar speed.

Baby asleep with pacifier on plane, leaning against seat near window. Wrapped in light blanket, soft light illuminating peaceful face.

Communication

First, you should know that interpreting your baby's communication is one of the hardest things to learn when adjusting to life with a new baby. There are a few signs cues that can help determine if and when the transition is appropriate.

The most obvious cue is the time it takes to consume a bottle. Feeds should take no longer than 30 minutes. Beyond 30 minutes creates a situation where the amount of work it takes to eat is greater than the amount of calories they consume. This will therefore cancel out the feed and will potentially slow down or create a stagnant weight gain.

If you notice your child starts taking longer to finish the same number of ounces, that is a sign to try a faster flow nipple which is usually the next size up. If you miss the cue they may show signs of frustration.

Frustration can present as your baby refusing the bottle or "popping off" and losing their latch. Frustration can lead to fussiness due to hunger because they aren't eating enough. Frustration can also lead to fussiness due to gas because every time they "pop off" and lose their latch they are taking in unnecessary air.

The opposite form of frustration can occur if the flow is too fast and you may need to revert back to a slower flow nipple. In this case, your baby start to refuse the bottle by "popping off" or pushing the bottle away because they are overwhelmed by how fast the milk is flowing. Additionally cues of a faster than necessary flow is if you hear your baby gulping or taking in air at the back of their throat during the feeding session. This is something that needs recognizing and correcting immediately.

If you notice your child is waking between meals more frequently without another reason associated with their fussiness, this can be a sign of hunger. Instead of offering them another feed and creating a cycle of cluster feeding, you should be using this information as a cue or communication to complete a more thorough and efficient feed which often goes back to my first point of time. Additionally, when this is happening, take note of suckling on the bottle nipple instead of nutritively sucking which will require them to swallow the consumed milk. This is where your attention and recognition is imperative and excessive suckling during a feed will lead to inefficiency.

Change

Here are some things to consider when increasing your flow.

Baby may need a few feeds to adjust. That isn't to say they aren't ready.
You may notice increased drooling out of the corners of their mouth. This is a sign to give them more breaks or include a more "paced feeding" approach. (Reach out if you need help with executing a paced feed!)
Baby may need more opportunities to burp and more patience getting the burp out since they are eating faster and consuming more milk. Without this opportunity, you may notice more spit ups or discomfort due to gas.