58: Should I Pace My Baby’s Bottle Feeds?

Have you been told to “pace” your baby’s bottle feeding? Maybe you’ve read about this strategy or have been given strict instructions on it, but regardless of how the term came to you, it’s good to know It may mean different things depending on who’s recommending it. So today we are going to break down the meaning and purposes of “paced” bottle feeding.

Paced bottle feeding, generally means that the person feeding the baby is setting the pace for the feeding. They are often creating little breaks for the baby during the feed. Now, there are subtle and not so subtle ways of guiding a baby to take a mini break. A caregiver might be initiating little breaks by gently tiling the milk out of the nipple while it’s still in the baby’s mouth to suggest baby pause drinking. While others are taught to take the bottle nipple out of the baby’s mouth entirely, which can be frustrating to a hungry baby, and require them to get reorganized and relatch when their quick “break” is deemed over. But again generally speaking, pacing is when the person feeding the baby is setting the pace for the feed and creating breaks.

The lactation consultant and the speech language pathologist each use pacing as a tool. However, it’s used very differently. Let's talk about the SLP first. When an SLP (trained in infant feeding) recommends paced bottle feeding, it’s likely because a baby is having trouble coordinating their sucking-swallowing-and breathing. An SLP will use what we call “strict pacing” to count the sucks and swallowing and then gently insert breaks so the baby pauses to breath. This is done to protect the baby from aspirating milk down into their lungs, to reduce their risk of choking, and to help them learn to coordinate their suck-swallow-breath pattern. It’s a common recommendation for premature babies, or baby’s who need that support while they are learning, and usually comes with a clear guideline on how many sucks before tipping the bottle and how to watch for when the baby starts taking their own breaks, etc. Usually, this would be a baby who is in therapy and the plan would be changed according to skill progress.

Now let’s talk about the other use of pacing, which might be recommended by a lactation consultant. This, also named “paced bottle feeding” stems from the idea that if bottle feeding is too quick and easy, then babies will end up with a preference to the bottle over breastfeeding. And, a lactation consultant is there to support breastfeeding and lactation. So you may hear the recommendation that when you give a breastfeeding baby a bottle, you want to intermittently pause, take breaks, stop the milk from flowing too consistently. The theory is that it would mimic the breast, since there are let down times and milk speed varies. Okay I kind of get that, but I’d like to push back on this one. I see a lot more frustration and disorganization come from so-called “pacing” this way. Imagine having a meal and the bottle is taken away at random, before you are ready. Or it’s moved around in your mouth while you are drinking. Personally, I think it’s a little unfair to make the bottle harder just to make it less desirable for a baby. It’s my, totally personal, opinion that regardless of how we feed our babies we should opt for the most comfortable, positive, and safest option- regardless of how we feed them.

Now don’t get me wrong, I am all for watching your baby and giving them breaks when they need it! I’m also for offering the right bottle for them, that’s not so fast they require constant intervening. What I’m not for, is trying to make the bottle less enjoyable. Lots of breastfeeding babies are also given a bottle at some point here in the U.S. It’s just the way our culture, especially for working moms, is laid out right now. My suggestion is to thoroughly establish a happy breastfeeding routine before introducing the bottle. It’s unlikely your baby will fall out of wanting to snuggle close to breastfeed if it’s been well established. If you want help on knowing when to introduce the bottle so breastfeeding is established but you haven’t missed the window- check out episode 40: When Should I Introduce the Bottle?.

Now you may say, okay Barbara, but what if breastfeeding didn’t start out easy or positive. What if things didn’t go to plan and we had to introduce the bottle, while trying to troubleshoot nursing. This is often the case for those recommended to pace bottle feed, make sure the bottle isn’t too much easier on the baby. Well, I stand by my opinion on this. And look, I’m open to the idea that I may be wrong. But here’s the thing, a newborn baby who is trying to eat, sleep, adjust to this new world, and learn to latch and breastfeed when it hasn’t gone easily so far- might benefit from a non-stressful feeding. I agree, that they shouldn’t eat so fast from a bottle that they don’t even have to put in any skills, just open their mouth and let the waterfall of milk flow to them. No that is not ideal. But when you get the right flow rate, and watch their cues for them to tell you when they need breaks- it’s so much better for them. And a calmer, less stressed baby? Well doesn’t that make them more poised to practice a new skill? So in the end, I’m for exchanging the paced bottle feeding to make bottles harder in an effort to encourage breastfeeding, for following your baby’s cues to make feeding as positive as possible (no matter how they are eating). And there may be many lactation consultants out there who are teaching just that.

So if you hear about or are asked to pace your baby’s bottle feeds. First, consider if it is strict pacing for coordination purposes. Next, consider if it’s being done in a way that is soothing, positive, and follows your baby’s cues- or if it’s just creating pauses and confusion in the name of breastfeeding.

If you have any questions on this, or are curious about my favorite bottles for newborns- shoot me an email at Barbara@feedingbyjanuary.com. I’d love to hear from you and know you are benefiting from this podcast. And with that- I’ll see you next week!