Feeding
Bottle Nipple Flow & Selection
Nipple flow rate affects how fast milk comes out. Wrong flow causes problems: Too slow = frustration, long feeds, giving up. Too fast = choking, gulping, gas, overfeeding, bottle preference over breast.
Flow levels: Preemie/newborn (slowest), Level 1 (slow, 0-3 months), Level 2 (medium, 3-6 months), Level 3+ (fast, 6+ months). Breastfed babies should usually stay on slow flow longer.
Nipple shape also matters: Standard, wide-base (like breast), orthodontic, angled. May need to try different brands to find what baby prefers.
What to Do
- Start with slowest flow (preemie or level 1) for newborns
- For breastfed babies: Use slow flow even past 6 months (prevents bottle preference)
- Signs flow is too fast: Choking, gulping, milk leaking from mouth, refusing bottle, gassiness
- Signs flow is too slow: Frustrated crying, falling asleep mid-feed, feeding takes >30 min
- Watch baby during feeding - should see steady suck-swallow-breathe pattern
- Try different nipple shapes if baby has trouble latching or keeping nipple in mouth
- Replace nipples every 2-3 months or sooner if cracked, sticky, or discolored
- For combo feeding: Slow flow helps maintain breastfeeding (prevents nipple confusion)
- Anti-colic bottles/nipples have vents to reduce air swallowing - may help gassy babies
- It's OK to stay on same nipple flow for months if baby is happy and gaining well
When to call a doctor
No emergency. Call doctor if baby is choking frequently, refusing all bottles, or not gaining weight. Frequent choking may need swallow evaluation.