Best baby bottles for breastfed babies

Frequently Asked Questions (FAQs)

I am returning to work soon and need to transition my baby to a bottle while I am working. I want to continue to breast feed when I am home. Which bottle should I choose so that my baby does not become confused? There are so many that say that they are good for the breastfeeding baby, it is confusing. I want to pick the best one.

It is true, there are so many bottles on the market and each one claims that they are the best. The sad part is that most of the claims are not backed up by any research and are just marketing statements. Often, there is no reasonable medical basis to support their claims. An ultrasound study of infant’s oral motor feeding patterns (tongue, lips and jaw movements) during breast-feeding was compared to the oral motor patterns of the same infants during bottle feeding using a variety of bottles. Of all of the nipples researched (classic hospital nipples, Nuk nipples, Playtex nipples), the classic hospital nipple encouraged tongue patterns most similar to the tongue patterns used during breast-feeding. Based on these results and over 25 years of clinical experience, I can make some recommendations to consider when looking for a bottle.

Understanding the properties of a bottle nipple and how they can impact the movement patterns of the tongue, lips and jaw, will allow you to pick the best bottle for your baby. Many people don’t realize that the way your baby uses his tongue, lips and jaw can impact how well your baby learns to spoon feed and chew, how well your baby talks, the shape of the palate (roof of the mouth) and teeth alignment. If your baby does not use correct tongue patterns, it may be more difficult for him or her to swallow, speak clearly and may increase the likeliness of orthodontic work (braces).

While there is no best bottle for everyone, there are some things to consider when looking for a bottle. Most people pick a bottle based on what their friends or family used or the marketing information on the bottle package. Some people even pick a bottle because it is cute. The shape, softness or firmness and flow rate of the nipple all impact the way your baby uses his tongue, lips and jaw during sucking. Sucking really has two components, suction (the draw in) and compression (the squeezing). If these two components are not balanced, your baby’s suck pattern can cause pain during breast feeding and reduce the effectiveness of milk transfer, especially during breast feeding.

A soft bottle nipple could encourage continued biting instead of effective sucking patterns for the baby who has a “bite” (compression) suck pattern. Firmer nipples often encourage stronger tongue patterns and provide the support necessary for balanced compression and suction. Research and clinical experience indicate that faster flow nipples require less active tongue patterns. Think of the difference in your tongue movements when you take one sip from cup vs. chugging the liquid. Fast flowing nipples can make your baby’s suck patterns lazy and could increase the risk of choking. Weak, “lazy” suck patterns can negatively impact your baby’s effectiveness during breast feeding. If the bottle nipple is short or small or the base of the nipple is so wide that your baby does not latch on it, your baby may respond by biting the nipple. The wide based or “natural nipples” are enticing based on the claims of “most like breast feeding”, however, it is rare that I see a baby use these bottles as intended. Most babies latch onto the short nipple as the wide base is difficult to latch on to. If a baby latches onto the short part of the nipple, they have no choice but to “bite” the nipple because there is not enough to latch onto. This in turn often encourage “biting” during breast feeding.

Wow, who ever thought that there was so much to think about when choosing a bottle! Below are some guidelines in picking the best bottle to support correct oral patterns for breastfeeding and future feeding and speech development.

 Classic shaped nipple

 Correct firmness (make sure that your baby does not flatten the nipple when feeding)

 Appropriate flow rate so that your baby’s suck/swallow/breathe pattern is coordinated and rhythmic

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Discuss with your health care provider any concerns about your baby’s feeding ability or if he is choking/coughing/gagging during feeding. These can be feeding red flags and may require evaluation by a specialist.