Whether you are comb-feeding, exclusively pumping, or formula feeding, this post is for you! What bottle you use and how your baby feeds from it is very important in supporting appropriate oral motor/sensory skills for feeding. There are many resources on fixing baby's latch on the breast, but not so many on how to bottle-feed appropriately, so here are my expert tips:

🍼 My favorite bottles right now to support the appropriate wave-like tongue movement that is ideal for sucking are the narrow-based Dr. Brown's bottle with the Level 1 nipple, or the Evenflo Balance bottle. For a baby with a shallow latch, the Dr. Brown's bottle is a great starting point to make sure the nipple can be fully inserted with the lips almost touching the white ring/base. This provides structure and sensory input to elicit the ideal tongue movements, including tongue cupping. The pyramid shape of the Evenflo supports a wide open jaw position but also supports adequate tongue movement and supports both suction and compression, which is the ideal oral motor pattern for feeding. Bottles that support compression only include the disposable hospital bottles and the Mam or NUK bottles.

🍼 Sucking is primarily a tongue movement with the goal being a passive lip seal to help create suction. Lips should not be curled in and the nipple should be fully inserted, NOT like the baby in this photo. If the nipple is only as far as the tongue tip or middle of the tongue, the baby resorts to a compression-only sucking pattern which is not efficient or ideal.

🍼 Babies need consistency when learning new skills. Avoid using several different types of bottles throughout a day or even week; if your baby is struggling with bottle acceptance, seek support.

🍼 Make sure to provide your baby with a firm base of support and an appropriate head position during bottle-feeding. This likely means cradling them in your arm so their torso is supported and making sure they do not tip their head back or tuck their chin too much.

🍼 Paced feeding for babies who are combo-feeding is often done incorrectly IMO. Choose a bottle nipple flow rate that most closely matches your own milk flow (i.e., if you have a strong letdown and flow, please do NOT use a preemie flow nipple!). If your baby is having difficulty with her suck-swallow-breathe coordination with bottle-feeding, insert breaks to cue her when to breathe or to burp her to pace the feeding. The nipple of the bottle should ALWAYS be full when baby is sucking; aiming for "half full/empty" results in a lot of air going in with milk and there is generally a lot of user error from what I have seen which is hard to avoid (i.e., toddler needing your attention suddenly while you are feeding baby).

There is an art to bottle-feeding and learning how to bottle-feed your baby well can be tricky. As always, if your instincts are telling you that baby is having difficulty with bottle-feeding, seek support from an infant feeding specialist as soon as you can.