Ep #30: A Bottle Episode

Everything you ever wanted to know about bottle feeding, including some stuff you don’t know that you don’t know. Stay tuned! 

Welcome to Parenthood Prep, the only show that helps sleep-deprived parents and overwhelmed parents-to-be successfully navigate those all-important early years with their baby, toddler, and child. If you are ready to provide the best care for your newborn, manage those toddler tantrums, and grow with your child, you’re in the right place. Now here’s your host, baby and parenting expert, Devon Clement. 

Hello, hello and welcome back to the Parenthood Prep podcast.

I was thinking about the episode a couple weeks ago where I talked about sleep training yourself, because I just got back from a trip to Europe and getting over the jet lag and everything I’ve really had to deploy a lot of my own strategies to re-sleep train myself, including using the Forest app, which I think I told you about on that episode that I haven’t used in a while, that sort of blocks you from looking at your phone because you’re growing a tree, and in order to look at your phone you have to kill the tree. 

It’s working really well for me. I’ve been waking up super early in the morning and just not able to get back to sleep, because I start scrolling Instagram or responding to emails and all this different stuff. Anyway, just another plug for that strategy, because I am finally back on track and it’s great. 

Super enjoying this fall weather. I know I’m typically a fall hater, but if it’s going to be in the 80s and sunny and beautiful and not humid, I will take it. This time of year is great. So I hope everyone is getting out and enjoying the weather. 

Today, I want to talk about bottle feeding. It doesn’t matter what you’re putting in it. We’re going to talk about different options: formula, expressed breast milk. Those are the options. But I think there are some basic things that are not obvious when you’re a new parent, and people don’t necessarily tell you. The pediatrician might not necessarily tell you when it’s time to go up to the next nipple size or when it’s time to start feeding the baby more.

And I walk into situations a lot of times, especially sleep training, when I’m doing newborn care with a family and we’re starting with them from day one or in the first couple weeks, we can really get them on track and kind of show them as we go. “Oh, okay she’s really sucking down the two ounces. I think we should up the amount,” and that kind of thing.

But when you’re just kind of winging it, and then I’m coming into you at four months, five months, six months, and I see a five-month-old baby that’s still eating three ounces every three hours around the clock, I’m like, “Whoa, whoa, whoa, we’ve got to make some changes here.”

So I think there are just some basic things I want to go over about bottle feeding that you may or may not know. And even if you’re planning on nursing or you are nursing, of course I think it’s a great idea to introduce the bottle and introduce it pretty early, like somewhere in the two to four-week range if you’re not already supplementing from the beginning. 

Because that’s when you’re going to be able to start those good habits and keep the routine of taking a bottle every day or every couple of days. This way, when the baby is six months old and you want to go out to dinner and leave them with a babysitter or grandma, you are able to actually get out of the house and not worry that your baby is going to starve while you’re gone.

And if you’re one of those people that’s like, “Well, I never plan to be apart from my baby,” I love that for you. I don’t think it’s realistic, for a year or ten months or however long until the baby’s really consistently eating solid food, to think that there’s never going to be a situation where you might need to be away from your baby. You may change your tune four months, six months, ten months in and want to spend some time away. 

So just having that option of someone else being able to feed your baby is just so great. And worst-case scenario, you might be sick and it might be difficult for you to feed your baby, or you might have to go to the hospital or something. I hope that’s not the case. But it’s just nice to have those options. 

And of course, if you’re exclusively pumping or formula feeding from the beginning, you’re going to be using bottles. And there’s still a lot of technique and tips and tricks that you’re going to want to know.

For starters, in the beginning, in the first couple weeks, we always say the first two, three weeks are different from the rest of the time. In the first two to three weeks, it’s very individualized to your baby, their weight gain, and how early they were born. 

So for the first couple of weeks, we just want to do what the pediatrician says and follow the schedule that they give you, and do exactly what they tell you. They might have you waking the baby up every two hours, only feeding a certain amount. That’s totally fine. Whatever they say, always do it.

I mean, listen, if your pediatrician is telling you to do something, you should do it. This doesn’t apply to parenting advice, but definitely when it comes to medical stuff, weight gain stuff, if they’re concerned about the baby’s health in any way, you should listen. If they’re giving you parenting advice, you can take or leave that, that’s up to you. But when it comes to this stuff, you should listen to the pediatrician. 

So once we are out of that initial stage, where we have to feed constantly, and the pediatrician gives you the thumbs up to let the baby go a longer time between feeds, that’s awesome. Then we can start stretching them out overnight, which I’ll talk about in another episode.

But also, with bottle feeding, that’s when we can start playing around with it a little bit, increasing the amount that they’re taking. You may have heard that in the very beginning your baby’s tummy is so tiny. It’s like the size of a marble and then it goes up to the size of a golf ball in that first couple of weeks. But once you’re at kind of the four weeks, five weeks, six weeks stage, they can really start eating a decent amount more. 

Their stomachs have grown a lot. They expand a lot in those first few weeks when they’re eating. And so we want to feed them until they’re not hungry anymore. I think a lot of parents get stuck in this idea that ‘someone told me to only feed two to three ounces and that’s all they’ll take.’ Well, every baby’s different.

My rule of thumb for how to know when to increase the amount that you’re feeding your baby in the bottle is, are they sucking it dry? Are they draining every last drop? If they’re draining every last drop, they want more. My thing is, I always want a tiny bit left. I want that last half ounce to be a little bit of a push.

You don’t want to force feed them, but when they’re starting to lose interest and you’re like, “Come on, just have a little more, have a little more.” Especially if it’s breast milk, chest milk, body milk, whatever we’re calling it. You don’t want to waste it, of course, but you do want to leave a little bit behind. I know it’s so hard to imagine throwing it out, but just leave a tiny, little, few drops behind because that’s how you know your baby is truly satisfied.

If they’re always sucking the bottle dry and they’re hungry again in two hours, you want to be feeding them more per feed. Now, if they’re losing interest in the middle of the feed, they’re taking an ounce, an ounce and a half, and then they won’t take any more, you want to stretch them a little longer between those feeds.

Because a baby who is six weeks, eight weeks, three months, they should be going at least three hours during the day, and really starting to do a good, solid, long stretch overnight, of four to six hours at least one time, not all night long necessarily, but four to six hours at least throughout the night. 

So if your baby’s not doing that, they’re still eating every two hours around the clock or every three hours around the clock or they’re not making it to the three-hour mark during the day, you want to really try to feed them more per feed. Again, I come into these families with a five-month-old that’s still taking three ounces, four ounces because that’s all they’ve ever given them and they haven’t given them the opportunity to take more. 

Now, if you’re in that situation with your baby, the first time you offer him six ounces, he might not take it. It’s a little bit of a process. But honestly, they really do well very quickly, to start eating more per feed. It takes a couple of days sometimes, maybe up to a week, and then they’re going to start eating more. 

Are they eating really slowly and you just can’t get them to take anymore? What’s your nipple size? Nipples on bottles come in different sizes. I mean, the nipple itself is the same size, but the flow, either the size of the holes or the number of holes in the nipple are going to increase. And of course, every brand is different. There’s no universal sizing; it’s like clothes.

So you’re going to want to go with the recommendation on the package for the nipple, or also test it out with your baby or what your pediatrician says. Test it out with your baby. You don’t need to be on a super slow flow forever, even if you are combination feeding… which I know is a hot take. A lot of lactation consultants are going to tell you that if you’re breastfeeding, your baby should stay on the slowest flow nipple.

But that’s actually not giving your baby or your body enough credit. Some parents have a really fast flow and the milk comes out really fast. And so you give a baby a preemie flow or a number one nipple to suck on, and they’re like, “What is this? You’re making me eat my dinner with a toothpick when I could be using a fork.” I use that example when I explained to parents the difference between the nipple sizes.

If you’re trying to eat your dinner with a toothpick, you’re going to get bored before you’re full of food. So when you have the nipple too slow, the baby is going to get tired of eating before they actually eat as much as they want to eat. 

So you want to put them on basically the fastest flow that’s appropriate for their age that they can handle. Again, disclaimer, if it’s working for you, keep doing it. If you like spending an hour feeding your baby on the slowest flow nipple possible, go for it. But you probably have a lot more success with a fast flow.

When you first try the faster flow nipple, your baby, a lot of the time, is going to struggle with it. They’re going to splutter. They’re going to take too much. They’re going to say, “Oh, no, I’m not ready,” and you’re going to switch back to the slow flow. 

But I’m going to explain to you what’s happening there. When you’re on a certain flow, say they’re on the number one nipple, they are sucking in a certain force. They’re exerting a suction force on that nipple to get the amount of food that they want into their amounts, and they’re sucking at that force level.

When you suddenly give them a nipple where it’s coming out faster, they’re sucking that same force level that they’re used to sucking, and suddenly they’re getting fire hosed. So they have to learn to regulate their suck to be less forceful. “It’s going to come out more easily for you, babe. You’ve got to just suck a little less, and then you’ll get the milk faster. It’ll be great and you won’t be working so hard.”

Because honestly, a lot of the time, when babies are gassy or extra refluxy, I see that super slow flow nipple and I see they’re sucking so hard they’re swallowing air. They’re giving themselves gas. Bump up that nipple size. If you try it for a couple of days and it’s still not working, then fine. Switch back. But give it at least a day. 

And don’t switch back and forth. I’ve heard parents who say, “We use this size overnight and this size during the day.” Don’t do that, because then your baby’s confused; the one C we are not including in the 4C’s. Your baby’s confused and we don’t want that to be the case. We want them to know, when that nipple gets in their mouth, how hard and fast they need to suck to get the milk out at a pace that they want. 

So those are some transitions that you might be going through. When do we need to up the nipple size? When do we need to increase the amount that they’re taking? And then, when do we need to change the schedule? 

My favorite schedule for bottle feeding, and really for body feeding as well, is up until four months every three hours during the day and overnight letting them do as long of a stretch as possible; really trying to stretch them as much as possible, and then letting them go three to four hours after that.

But doing that bookend scheduling that I’ve talked about, you’re starting with your first feed in the morning, 7 a.m. or whatever time you get up, and that last feed at night at 7 p.m., and going about three hours in between. That’s because that is what works for most babies. 

If you are feeding your baby some amount, and they are not going three hours until the next feed, they probably are not eating enough at that feed. And now think about what’s happening. Are they taking a huge feed at 5 a.m. and then you’re feeding them again at 7am and they’re not taking very much? Then we need to tweak that. But basically, if they’re getting a nice, full feed at 7 in the morning, they should be able to go until at least 10am. 

Around that four-month mark, sometimes earlier, sometimes three months for a bottle-fed baby in particular, I really like stretching them to a four-hour schedule. We call it a “four-hour schedule”, but it’s not really. It’s kind of like three and a half to four because you’re feeding at 7am.

You’re not feeding at 7am, 11am, 3pm, 7pm because you want them hitting the sheets by seven. You’re kind of starting the night feed at 6:30pm. Anyway, it’s somewhere between three and a half to four hours in the daytime. And the reason that four-feed schedule is so beautiful is because A- it’s one less feed you’re doing, you’re putting the effort into. We’re still feeding the same amount; we’re just dividing it over four feeds instead of five. It’s one less bottle to wash.

And if they’re on a three-nap schedule, which is a good schedule for them to be on around that three to four-month mark, they’re going to be able to get three solid naps in between feeds. 

With the five-feed schedule, you end up in a weird limbo between three naps and four naps. Sometimes they’re going too long awake. So I would love to see, by four months, a bottle-fed baby on a four-feed, roughly every three and a half to four-hour schedule; whatever is working for you. 

Let’s talk about something I hate. People love that Baby Whisperer… it’s called the E.A.S.Y. schedule. Eat, Activity, Sleep, Your time; meaning, while the baby’s asleep you get your time. The idea is that you feed your baby as soon as they wake up from a nap, or as soon as they wake up in the morning, every time. Which is a fine idea. I love that it breaks up the falling asleep from the feeding. So you’re not feeding them to sleep, you’re feeding them when they wake up.

But what ends up happening is that they wake up because they’re starting to get hungry. Because if they’re not eating until they wake up from their nap at 10am, and then you feed them at 10am and then you play for 90 minutes, then it takes 30 minutes for them to fall asleep. So now we’re at the two-hour mark. They’re going to eat at that three-hour mark. They’re going to start getting hungry 15-30 minutes before. 

And what does that give you? That gives you a 30-45-minute nap, which is exactly one sleep cycle when they go through that lighter sleep state. And now we’re waking up at that 45-minute mark because we’re so hungry. So that is where I think that routine can lead to trouble. 

I’m going to do a whole episode about scheduling and stuff like that. But just be aware of that. I would keep your feeding schedule and your sleep schedule separate. Okay?

So now we know when to increase the amount we’re feeding the bottle. With that four-hour schedule, if the baby is sleeping through the night or only taking one feed, they could be taking six to eight ounces at a time. They can have a pretty decent feed.

Some babies are what I call “American” eaters, where they want to chow that whole bottle down at once. And some babies are what I call “European-style” eaters, where they want to have several courses. And this is different from snacking. We’re not allowing them to snack. We’re not allowing them to have small meals every 90 minutes to two hours. But a bottle is generally good for an hour once it’s made.

So you make that bottle, whether it’s heated up milk or formula or whatever, you make that bottle and then you feed it to them. And in the first 15 minutes they take most of it but there’s two ounces remaining. Give them a 15-minute break. Give them a 30-minute break. Keep that bottle active and then just offer them the rest. See if they want to finish it off.

And then you’re not making an extra bottle, you’re not washing an extra bottle, but you’re giving them the opportunity to eat more over the course of an hour. You may find that as you’re trying to increase the amount that they’re taking per feed, you need to do this more. And then, as time goes on, they start being able to take down six, seven, eight ounces in one shot. That’s what I typically find when I work with babies. 

So you may notice that, and then suddenly you don’t need to offer the top-up anymore. It’s rare for a baby to be taking more than eight ounces at a feed. I have certainly known babies to do that, but it’s pretty rare. And unless your baby is huge, you probably won’t need to give them more than that; average intake per day is somewhere between 28-36, I would say, averaging around 30, 32. 

And it doesn’t really increase a ton, because when they’re four months, five months, six months, you’re going to introduce solid foods and that’s going to add calories, so you’re not going to need to keep increasing the amount of milk that they’re drinking up until they’re taking 100oz/day in a year. They’re going to start taking about the same amount. 

At around nine months, ten months, whenever they start eating a decent amount of food, the amount of bottle that they’re drinking may also decrease. Which is fine. As long as they don’t start waking up wanting to feed during the night again, which they hadn’t been doing previously, you’re going to be fine there. 

What bottle to choose? Honestly, I don’t really care. I think there’s a lot of different ones. Some really purport to be anti-reflux, anti-gas, anti-colic. And that’s great, but I think most bottles now are better than the bottles we had as babies, and they have some kind of venting system. 

The Dr. Brown’s are really popular. They have all those extra pieces. I think in some situations, if the baby really needs it, it’s useful. But I wouldn’t necessarily start with that as the default, just because it’s annoying. I like the ones that are pretty simple; just nipple, collar, bottle, that’s it. No extra shenanigans to wash or whatever.

Another thing that I wanted to say… Oh, nipple confusion. This is a big question that we get when you are combination feeding, or you’re nursing and you’re thinking about introducing the bottle. What about nipple confusion? I think that nipple confusion is more of an issue for parents than for babies.

I think that, like I said, if you’re introducing the bottle in the right window, or if you have to supplement from the beginning but you’re also nursing, the baby’s not going to get that confused. They may prefer one method of feeding over the other because of the speed that it’s coming out. 

For instance, if you’re having a milk supply issue and the milk is coming out slowly, you may want to use that slow-paced bottle for supplementing so that they don’t get hooked on the milk coming out really fast. But if you have a good flow and you have a good supply, they’re probably not going to get that confused. 

What I have seen way more often than a breastfed baby who stops nursing because they like the bottle better… I very rarely see that unless there’s some kind of issue, like a tongue tie or something like that… what I see far more often when it’s a baby that refuses to take a bottle because they prefer the breast, it’s because they waited too long or they didn’t keep up the routine. So that is nipple confusion to me. 

Another little tip I’d just like to say is if you’re in those early days, your baby’s not on a feeding schedule, you’re trying to figure out if they’re crying because they’re hungry and you’re using a pacifier, offer the pacifier. If that calms them for good and they start to fall asleep, or it just relaxes them, they’re not hungry.

If you give them the pacifier, and they start sucking on it kind of frantically and then they cry, they’re hungry. Because they were hoping milk would come out and it didn’t. So that’s a good way to test if they’re hungry. I always say if they start sucking on it like it owes them money, they’re probably hungry. 

And another tip is if you have a baby that is struggling to take a bottle, whether it’s because they’re nursed or because they’re just giving you a hard time. I have worked with 100% bottle fed babies who sometimes are really difficult to feed.

There are a couple of different tricks and techniques you can try. One is, certainly, upping the nipple size, which I’ve already suggested. Trying different temperatures of the bottle. 

I don’t recommend having it be super warm all the time, being really precious about the temperature, because then when you’re out and about, you need to feed the bottle or it’s the middle of the night… you want to just mix the powder and go… then you want the baby to be used to room temperature. But if they’re struggling and they’re giving you a hard time about it, warming it up a little bit might help them take it. 

Another trick that I love, which kind of makes me feel like a jerk, is to put them in a seat, like a bouncy chair or something like that. Some babies get a little bit of sensory overload when they’re being held and they’re just not comfortable feeding in that position, even if you’re holding them upright. It’s just something about being held while feeding, they don’t like it. 

So you put them in a chair. This is also a great tip if you’re trying to get your breastfed baby to take a bottle. Put them in a baby chair and you feed them the bottle that way. They may take it happily and not give you any trouble. I’ve had a lot of success with that. 

So don’t be afraid to go up a nipple size. Don’t be afraid to increase the amount that you’re feeding your baby. Don’t be afraid to try to get them to stretch a little longer in between feeds, so that they’ll take a little bit more rather than snacking all day. If the bottle you’re using isn’t working for you, you can switch. Babies are flexible. We don’t give them enough credit. Even if you have a bunch of different bottles, you can give them different bottles, assuming your baby’s cool with that, give it a try. Sometimes they’re totally fine. 

I think we need to give babies a lot more credit than we typically do. Those are my bottle tips. I would love to hear your issues, your questions, if you have any tricks and strategies for bottle feeding, you can throw them in the comments on Instagram @happyfamilyafter. That’s the name of my business. That’s our Instagram page. And I would love to see you over there. 

Have a great week. 

Alright, listen up, folks. We love to joke around but it’s time to get real. And that real talk, it’s all about giving your babies the roasting they deserve. Yep, you heard it right. We’re calling for an epic Baby Roast. 

We want you to drop a voice note on our website and call out your little ones for their adorable crimes. Did your baby spit up on your brand-new dress the second you put it on? Maybe they decided to scream through your sister’s wedding vows? We want to hear all the juicy details. 

Head over to HappyFamilyAfter.com, or hit the link in the show notes. Every page on the site has a button on the side for you to record straight from your phone. Your story might just make it onto an episode of the Parenthood Prep podcast. We can’t wait to hear.

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Thanks for listening to this week’s episode of Parenthood Prep. If you want to learn more about the services Devon offers, as well as access her free monthly newborn care webinars, head on over to www.HappyFamilyAfter.com.