Paced bottle-feeding

Whether you’re formula feeding from the start, pumping the occasional bottle for the sitter or practicing for the return to work, there are best health practices for bottle-feeding.

A bottle-fed baby should be fed according to feeding cues (mouth movement, rooting, sucking on hands and eventually crying — just as you would feed a breastfed baby) rather than on a pre-determined schedule.

That said, a sleepy newborn should be roused to eat every 3 to 4 hours — depending on his or her size and health — whether breastfeeding or bottle-feeding.

The most important trick to bottle-feeding success is a method known as paced bottle-feeding. The idea is to mimic some of the biological aspects of breastfeeding, which correspond to Baby’s reflexes and developmental needs.

I know the bottle-feeding crowd can sometimes get a bad rap and that the phrase “Breast is Best” is forcefully fed to the mother from the start of gestation. 

To talk about paced bottle-feeding and how it aims to imitate breastfeeding biology is not to further exaggerate the “feeding wars.” 

It’s simply a bottle-feeding technique that helps Baby remain physically comfortable, calm and satisfied, but not overfed.

How it works

  • Baby is held somewhat upright, as if sitting up, only slightly reclined. Make sure to support the neck.
  • Rather than force the nipple into your baby’s mouth, brush the tip of it against his lips and let him actively take it.
  • Hold the bottle at a horizontal angle so that Baby must actively suck to receive the milk.
  • Take pauses every five minutes or so. This emulates rhythm of the letdown reflex of breastfeeding and is the instinctive pattern to which a baby is designed to nurse and — eventually — feel satiated.
  • Switch “sides” midway through the feeding, changing arms, so that Baby is stimulated evenly and sees you, the bottle and the world from all angles.
  • When Baby has indicated that she’s done — refusing the nipple or turning her head — be done. Don’t force her to finish the bottle. Overfeeding a baby will likely cause her to spit up and/or become fussy with gas.

 Dispelling concerns

  • Assumption: Bottle-fed babies are often found to be gassier than breastfed babies. 

Truth: Not with paced bottle-feeding. 

  • Assumption: One of the main benefits of breastfeeding is the development of the muscles associated with rooting and sucking reflexes. 

Truth: This can still be achieved with paced bottle-feeding.

  • Assumption: Bottle-fed babies were previously thought to have more earaches and ear infections than breastfed babies. 

Truth: This is because they were fed while lying down, often flat on the back, placing pressure on the ears rather than allowing the food to go down into the digestive track.

  • Assumption: Bottle-fed babies are thought to spit-up more. 

Truth: Paced bottle-feeding lets Baby decide when she’s full, avoiding overfeeding.

  • Assumption: You can’t properly bond with your baby when you bottle-feed. 

Truth: Taking time to have a long feeding with Baby allows for more cuddle time, eye contact, cooing and lullaby.

Don’t forget to hold and cuddle your baby as much as he wants and needs, and as much as YOU want and need.

You can’t spoil a baby with affection, and it’s important to have physical contact outside of feeding time so Baby doesn’t ask to be fed in order to be held.

Of course, you and Baby will figure out your own particular quirks and rhythms that work best for you when it comes to feeding. 

Trust those instincts, but also trust the wisdom of Baby’s biology. Follow those cues!

One more thing: Burping

As a postpartum doula, I burped a lot of babies. 

Traditionally people pat-pat-pat on the back, with Baby hoisted over the shoulder. This is tried and true — and it works! 

But for stubborn, stuck, fussy gas, try sliding your hand up the back (to sort of squeeze the air out) with gentle pressure. 

You can also usually feel the gas bubble as a firm pocket on the tummy. Concentrate your burping efforts to the corresponding area on the back side.

Jen Wittes is a certified postpartum doula and writer who now works in marketing and communications. She lives in St. Paul with her two kids, her two cats and her husband. Send questions or comments to