With so many bottles on the market, and each of them claiming to be just like breast, it can be difficulty to navigate. For starters, there is no bottle on the market that is just like breast! But that's okay. We want a bottle that best matches skills at breast. IBCLCs and Speech-Language Pathologists recommend a bottle with a tapered/gradual sloped nipple shape. A tapered nipple promotes a wider, deeper latch and encourages optimal skills for going between breast and bottle feeding. It is recommended that parents avoid bottles with a wide base, abrupt nipple transition, skinny "straw-like" nipples, and flat nipples, as these bottles result in a shallow latch, encourage chomping on the nipple, and do not support optimal tongue function and sucking to transfer milk. Breast and bottle feeding are very different skills, and while a baby with good oral motor skills may be able to go back and forth without difficulty, some babies will depend on these compensations provided by maladaptive bottles, which does not promote successful breastfeeding. This may result in a preference for bottle, once they realize that it is easier than breastfeeding--not nipple confusion!
Preferred bottles for the breastfed baby:
Dr. Brown (standard neck)
Evenflo Balance (standard neck)
Have you tried one of the bottles on our preferred list and still no success? Start by modifying the flow rate. If baby continues to struggle, this may be an indication of oral motor dysfunction. Signs include:
Coughing
Poor coordination for suck-swallow-breathe
Milk dribbling out
Chewing/chomping on nipple
Frequently coming off
Taking in air (loud gulping noises)
Arching back
Excessive spit up
Fussy eater
Really long feeding times
Bottle refusal
Essentially, baby either lacks the skill to use their lips, cheeks, jaw, and tongue as intended, or they may have a structural limitation, such as a tongue tie. A "non-preferred bottle" may provide the compensations baby needs to be able to successfully bottle feed in the immediate, but it is important to follow up with a Lactation Consultant or Speech-Language Pathologist to assess feeding skills and intervene as needed. Infant feeding skills lay the foundation for future feeding milestones. A baby who is picky about their bottle may demonstrate difficulty transitioning to solids, and has a significantly increased risk of developing a Pediatric Feeding Disorder (**more than just picky eating, it's a lack of skill to manage certain textures).
At Nourish Therapy, we assess breast and bottle feeding, and determining if baby has oral motor dysfunction or tethered oral tissues impacting feeding abilities (ie, tongue tie). We can match your baby to the bottle that will best support them now, and also facilitate feeding therapy in order to optimize their skills. If a tongue tie is identified, we have a team here in Spokane, and will guide you through the process from beginning to end to make sure you get the best outcome. Want to know more about team approach to managing tongue ties, and the team players? Check out this post.