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My baby spills milk while bottle feeding


Correctly bottle feeding your baby

Before becoming a NICU nurse, I didn’t even know there were different “ways” to hold your baby while feeding. I had only ever seen – and done – the “crook of the arm” feeding. This is the way babies, in my mind, were always fed!

Well, the NICU quickly changed that!

Did you know that the instinct to feed is not generally seen in babies less than 36 weeks gestation? This means that babies born before 36 weeks (also known as late preterm) may not show signs that they are ready to take a feeding by mouth (bottle or breast).

For this reason, it’s not uncommon to see premature + late preterm babies with a nasogastric (NG) tube. This tube allows baby to be fed breastmilk or formula straight into their tummy without the actual act of eating.

As babies approach their due date and become “term” (36-37 weeks+, sometimes a bit earlier), we test their readiness to feed by bottle.

We give them little tastes of milk on a pacifier to help them learn how to suck, swallow, and breathe correctly (we even give preemies a swab of breastmilk very early on to get them familiar with the taste!).

But giving tastes does more than just familiarize them with the taste and smell of milk – it actually tells us A LOT of information!

We can gather baby’s interest in feeding, neurological readiness (sleepy preemies can’t take a bottle!), and read their cues. Have they developed a negative association with oral stimulus (paci, bottle) from having a breathing tube for so long?

Is their reflux so painful that they associate feedings with pain? Are they overwhelmed while feeding (sleepy at the bottle, breathing fast, dropping their heart rate low, sticking their tongue out and pushing the bottle out?)

Suck, swallow, breathe is a coordination skill that some babies need a little help in mastering.

I say this all the time to my clients, but LOOK at your baby and LISTEN to cues as you feed! We can gather SO MUCH information by looking at our baby feed – including signs of hunger, satiety, oral aversion, reflux, etc.

We understand that bottle feeding can be challenging! We are here to help you! Click here to learn more about the supportive services we offer!


My baby isn’t a preemie. Do I still need to watch them closely while they feed?

Yes! Bottle feeding should still be to your term baby’s cues. Feeding and taking a bottle is a skill that baby needs to learn how to do.

And bottle feeding positioning is important for many reasons which we will get into below.

Why is it so important to know your baby’s feeding cues while bottle feeding?

It tells us a lot about how baby is feeling during a feed:

  • It tells us if baby needs to slow down the pace (size down on a nipple) or speed up the pace (upsize the nipple). See below.
  • It tells us if baby is full. We often try to feed all the contents of the bottle – but baby may not want all the contents. It’s MORE important for baby to control the amount they take in and have a positive experience, than accidentally force feeding.
  • It tells us if baby is still hungry BUT prevents overfeeding. If a bottle is completely finished, and baby is rooting or sucking, they may want more. We will talk about side lying feeding in a bit, but basically by following baby’s cues with side lying, baby is controlling the pace of the bottle.
  • So if baby does want more, it is available to take at their pace, rather then dripping out of the bottle due to gravity. Signs of being done with the bottle include yawning, sneezing, pushing out of the tongue, pushing the bottle out with the tongue, arching back away from the bottle, gazing up and away from the bottle.
  • It tells us if baby is overwhelmed. Persistent hiccuping, sneezing, yawning, gagging, or pushing out of the tongue all are signs of being “done” or overwhelmed with the bottle.
  • It prevents oral aversion. You wouldn’t like it either if someone was forcefully sticking food in your mouth! Repetitive accidental force feeding creates an oral aversion, refusal of the bottle, fussiness, and refusal to eat by bottle.
  • Try allowing baby to open BEFORE you place the bottle in baby’s mouth by gently tickling their upper lip with the bottle. Once baby opens, they are ready to latch and feed.

But who CARES?! My baby hasn’t shown any of these things and feeds just fine the way I feed her.

YOU are the parent! You have every right to make the decision for your baby! I am here to inform and help you prevent or reverse some possible negative symptoms of gravity-lead bottle feeding positioning.

Does it matter if the contents are formula or breastmilk?

No! Anytime you are bottle feeding, no matter the contents, side-lying is the way to go.

Correctly bottle feeding

SO – What do I DO?

SIDE LYING POSITIONING + INCLINED!

What the heck is side lying + inclined positioning?

Side lying positioning is when baby is laying on their side (ear, shoulder, and hip should all be aligned). Then, incline their head slightly with your hand or a pillow (I even just cross my legs!).

Why is side lying + inclined feeding important?

Side lying + inclined feeding mimics breastfeeding – both in position and flow. It allows baby to control the flow of the bottle, leading to a positive experience with the bottle, less choking and coughing, less flooding, and LESS EAR INFECTIONS!

A bottle has an opening at the nipple. This opening is consistently open, whether baby is sucking or not. Test by holding a bottle upside down – it drips!

This dripping also happens in baby’s mouth when we hold the bottle in a downward position where gravity is pulling the milk out of the bottle, not baby, such as in the “crook of the arm” feeding position.

When gravity pulls out the milk (aka dripping of the bottle), baby is actually getting more milk flow than they are sucking out. This causes baby to get flooded – meaning there is too much milk in baby’s mouth.

This makes it hard to baby to keep up with the amount of milk in their mouth – leading to gulping, choking, coughing, milk dripping out of the side of their mouth.

This can happen with a “crook of the arm” positioning because the nipple is angling down, allowing gravity to do the work.

Think about if you were trying to drink something using a straw. Then, someone was simultaneously pushing more liquid in your mouth.

It would be really hard for us to keep up! If this was consistently happening, we would pretty soon say, “I’m not drinking out a straw anymore!”

This same thing happens to baby – they simply can’t keep up and may start to associate the feeds negatively.

How do I feed baby in side lying position?

  1. Bend your knees and elevate your legs on a coffee table or ottoman. If you don’t have those available, cross your legs or place a pillow on your lap.
  2. Place baby in side lying position on your lap with their head closest to your knees.
  3. Support baby’s head and neck with your non-dominant hand.
  4. Hold the bottle parallel to the floor.
  5. Feed baby.

Tip: Watch my reels on how to correctly bottle feed your baby and how to burp your baby!

Ear infections + how they related to feeding position

Ear infections are also called otitis media. They are very common, especially in infants. Side note – ear infections are NOT contagious.

The eustachian tube in the ear connects the middle ear with the back of the throat. If formula or breastmilk continually is entering the eustachian tubes, this causes bacteria from the mouth (naturally occuring bacteria) to enter the middle ear, causing ear infections.

Bacteria feed on the nutrients in breastmilk and formula, making easy for them to multiply, causing and infection.

“Crook of the arm” is gravity lead, which leads to flooding, making the risk of formula or breastmilk entering the eustachian tubes much higher (and therefore the middle ear), which in turn increases the risk for ear infections.

Side lying feeding is baby lead, meaning baby is pulling the amount they can handle from the bottle. This prevents flooding, and therefore, the risk of ear infections is much lower.

I heard that breastfeeding lowers the chance of ear infections. Is that true?

To an extent. Breastmilk does contain antibodies that can help prevent infections, including ear infections. However, bottle-fed breastmilk poses basically the same risk as formula since the positioning is actually what causes the ear infections.

Breastfeeding from the breast does help reduce the risk for ear infections due to proper positioning and flow, however, it does not eliminate the risk.

I see air in the nipple. Should I be concerned?

No. Air at the top of the nipple is normal – the milk still fills the tip of the nipple so baby won’t suck in air.

My baby is gulping and chokes on the bottle. What can I do?

Your baby may need a smaller size nipple. If you’re already using the smallest size, try paced feedings. Paced feedings allow baby to “catch up” and swallow the milk in their mouth, then breathe, then suck.

Too much milk will cause them to gulp, not be able to take a breath, etc. Click here for a demonstration.

My baby gets frustrated at the bottle and when I take the bottle out, the nipple is completely flat and collapsed.

Time to move up to the next size nipple! Baby is sucking harder than the nipple flow allows.

It takes FOREVER for my baby to feed from the bottle, more than 45 minutes. What can I do?

Try upsizing the nipple! If baby is dripping, gagging or choking, the flow is too fast and move down a nipple size. Or try paced feedings with the larger nipple.

My breastfed baby WILL NOT take a bottle. HELP!

Your wish is my command! We offer 1:1 virtual consults from the comfort of your own home to introduce the bottle to your breastfed baby in a way that promotes a positive association with the bottle.

We also offer in home bottle feeding consultations for the Chicagoland area!

Click here to view the consultations we offer!

Watch our workshop! Watch our recorded workshop, “Bottle Refusal and Tips.” Join Lauren, NICU RN and mother of 2, discuss tips for bottle refusal in infants. She discusses different strategies for avoiding bottle refusal along with tips and tricks for reversing bottle aversions. She also goes over alternative methods for giving breast milk/formula to babies who have ongoing issues with bottle refusal. 

WATCH BOTTLE WORKSHOP NOW

 

Have more questions? Schedule a text or video chat consult with Kate, Lauren or Natalie (NICU RNs) and they can help answer any questions that you have!

BOOK CONSULT NOW

 

PRO TIP: I highly recommend these Lansinoh bottles (I use them all the time in consultations). I also really like these Evenflo bottles for newborns too!

 

Other helpful blog posts:

  • How to supplement with formula
  • Everything you need to know about acid reflux
  • Transitioning from formula to milk
  • Everything you need to know about formula
  • Diaper bag essentials 
  • How to travel with kids 

 

**This post is educational and not meant to take the place of your provider. Bumblebaby makes a small commission on some of the items listed above

Bottle Service: Tips For Better Bottle Feeding

Your baby’s meals have valuable nutrition that makes weight gain, brain growth, and a ton of other important physiologic functions they need to thrive possible. Some worry about “what should I eat while breastfeeding,” and others bottle feed; some use formula, and others use expressed breast milk. 

When it comes to creating a positive and responsive feeding experience, it’s not only what they eat, but also how they eat. We may think that a baby bottle is self-explanatory, but there’s just as much to learn about feeding from a baby bottle as there is from a breast!

The classic bottle feeding method, in which the little one is reclined, and the baby’s bottle is tipped back so that air bubbles do not form, can often result in more stress than satisfaction for your little one. Milk drips out constantly when a baby’s bottle is held upside-down, even in slow flow nipples. This means that baby has to keep swallowing to avoid choking, even if they’re not ready, too tired, aren’t hungry, or just want a break. Caregivers often don’t recognize the signs of a stressful feeding experience, so we’re here to help navigate how to bottle feed a baby.

Here are signs of stress you want to avoid:

  • Pushing the bottle away
  • Gulping/coughing with startled look
  • Splayed fingers and toes
  • Milk spilling from corners of the mouth
  • Turning head away from the feeding bottle

Paying attention to your baby's feeding cues will be essential to having a positive experience while getting the hang of paced bottle feeding. Here’s a few simple feeding tips for the baby’s first year to help keep your baby happy while gulping down the goodness he or she needs:

 

 

  • Hold baby upright (sitting) rather than reclining to help him control the milk flow.
  • Touch the bottle nipple to his bottom lip and wait for him to open his mouth (do not force the bottle nipple in his mouth). When baby takes the nipple into his mouth, his position should be upright enough that the bottle should be almost horizontal. Tip the bottle just enough to fill the nipple with milk.  
  • Check mouth placement:
    • Look for fish lips (upper and lower lips sealed around the nipple and rolled slightly outward)
    • Little or no milk should leak from the mouth
  • Note the rhythm of baby swallowing, which should happen after every 1-3 sucks. It’s natural for baby to pause about every 20 seconds.  When this happens, you can tip the nipple towards the roof of the baby’s mouth (since the milk will continue to drip out) until the baby starts to suck again.
  • Switch sides during feeds to allow for stimulation to both sides of the body (including the eyes, arms, brain, and more).   
  • Baby should appear relaxed during feedings (hands and body at ease, eyes looking at you).  

A few things to avoid when learning how to bottle feed a baby:

  • Don’t prop a bottle: Newborn babies should always be watched while they’re feeding, whether they are bottle-feeding or breastfeeding.
  • Don’t force your baby to finish a bottle, follow their physical cues instead.
  • Don’t feed your baby while he’s facing away from you. Feeding time is just as crucial for social interactions as it is nutrition.  Encourage engagement by making eye contact and talking with your baby.
  • Don’t put anything other than breastmilk or formula in the bottle unless directed by your baby’s physician.

With all this in mind, remember that the most important thing is to relax and enjoy this time together. These moments are precious for you, too. The gaze in your baby’s eyes, the sounds of his cooing, the sweetness of his satisfied sleep – these will feed your memories for a long time to come.

— Nicole Meadow, MPN, RD, CSP, CLC

Registered Dietitian + Lactation Counselor

We aim to provide you with the most honest and credible information possible. This article was reviewed for accuracy by The Honest Team and was written based on trusted sources that are linked at the bottom of the article.

 

 

We aim to provide you with the most honest and credible information possible. This article was reviewed for accuracy by The Honest Team and was written based on trusted sources that are linked at the bottom of the article.

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Baby won't take a bottle | Philips Avent

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any problems. If your breastfed baby refuses a bottle, don't worry. This is a common occurrence in many babies who are used to breastfeeding. Obviously, this can create certain difficulties for moms, especially if you need to return to work in the near future.

3 Philips Avent products to help you bottle feed:

So why is your baby refusing to bottle and crying? There are many ways to quickly and easily teach a breastfed baby to a bottle. Here are important tips on what to do when your baby refuses a bottle.

Is the baby refusing the bottle? Take a step back


If your baby cries while bottle feeding, the first thing to do is to start over and rethink your feeding approach and technique. Try the following steps when bottle feeding your baby: [1]

  1. Lift and tilt your baby's head forward. Before inserting the pacifier into the baby's mouth, make sure that the baby's head is raised and tilted over his body to avoid choking: so that the baby does not choke and have the opportunity to burp during bottle feeding.
  2. Insert the pacifier. Bring the pacifier to the baby's lips and gently guide it into the baby's mouth. In no case do not try to press the nipple on the baby's lips and try to push it into his mouth. After touching the pacifier to the baby's lips, wait for the baby to open his mouth and take the pacifier.
  3. Hold the bottle at an angle. Tilt the bottle at an angle so that the nipple is only half full. So the child can eat at his own pace.
  4. Let the baby burp during and after feeding. It can be useful for a child to burp not only after feeding, but also approximately in the middle of the process. This will help reduce gas or tummy discomfort that your baby may experience from swallowing too much air.
  5. Stop in time, do not overfeed the baby. If the baby begins to turn his head away from the bottle or closes his mouth, then he is full and you need to stop feeding.
  6. Perhaps the flow of milk from the nipple to the baby is weak or, on the contrary, too fast, so he is naughty and refuses the bottle. Try changing the nipple to a nipple with a different flow.​

Other tips if your baby refuses the bottle


If you've followed the steps above and your baby still refuses the bottle, don't worry. There are other ways to help bottle feed your baby. Here are some simple tricks you can add to your bottle feeding process. [2]

1. Remind your child about mom.

Sometimes a child can be fed by someone other than his mother - dad, grandmother or, for example, a nanny. If your baby fusses while bottle feeding, try wrapping the bottle in something that smells like mommy, like a piece of clothing or some fabric. This will make it easier to feed the baby when the mother is not around.

2. Try to maintain skin contact while bottle feeding.

Some babies need contact with their mother, so try bottle feeding while leaning against you. However, some babies are better at bottle feeding when they are in the exact opposite position than when they are breastfed. For example, there is a position with bent legs. Lay the child on your bent knees, facing you, pointing the child's legs towards your stomach. During feeding, the baby will be able to look at you and contact you in this way. If your baby refuses a bottle, experiment to see which works best.

3. Move while feeding.

Sometimes all it takes to get your baby to take the bottle is a little wiggle or walk. The next time your baby starts crying while bottle feeding, try moving around a little rhythmically to calm him down.

4. Try changing the milk temperature.

If the baby still does not want to take the bottle, check if the milk in the bottle is too hot or too cold. Before feeding, put some warm breast milk on the inside of your wrist to check the temperature. Milk should be warm, but if it seemed hot to you, just place the bottle for a short while under a stream of cold water.

Choosing the right bottle for your baby If you plan to combine bottle feeding with breastfeeding, it is advisable to choose bottles with a nipple that will have a wide base as the bottle will grip closer to the breast.

Also pay attention to the fact that the nipple is firm and flexible, the child must make an effort to drink from the bottle, as well as from the breast. Give preference to nipples with an anti-colic valve that vents air out of the bottle.

​Natural bottle allows you to combine breast and bottle feeding. 83.3% of babies switch from a Natural bottle to breastfeeding and back.*

If you choose a bottle for artificial feeding, traditional bottles are fine, but it is desirable that the nipple is made of a hypoallergenic material, such as silicone, has an anti-colic valve and did not stick together when bottle fed. In case your baby spit up often, then use special bottles with anti-colic and anti-reflux valve, which reduces the risk of spitting up and colic.​​

Bottle with unique AirFree valve reduces the risk of colic, gas and spitting up. With this bottle, you can feed your baby in an upright or semi-upright position to reduce spitting up. Due to the fact that the nipple is filled with milk and not air during feeding, the baby does not swallow air, which means that feeding will be more comfortable.

Both bottles are indispensable if you want to breastfeed, bottle feed or just bottle feed your baby.

“My baby refuses to breastfeed but bottle feeds – help!”

Sometimes a baby gets used to bottle feeding and refuses to breastfeed. Therefore, it is important to use bottles that are suitable for combining breastfeeding with bottle feeding. If, nevertheless, you are faced with the fact that the child refuses to take the breast, try using silicone nipple covers to make the transition from the bottle to the breast and back more imperceptible.

Remember that if you want to combine breastfeeding and bottle feeding, it is worth waiting at least a month before offering a bottle, so that you are lactating and have time to get used to each other and develop a breastfeeding regimen.​

Breastfeed and bottle feed your baby with pleasure


Remember that it takes a while for your baby to get used to bottle feeding. This is completely normal. If you have to go to work, be sure to set aside enough time to bottle train your baby beforehand.

Remember that every child is different, so what works for one may not work for another. With a little time and patience, you will find out what works best for your baby when he refuses a bottle.

You will identify your child's unique needs. However, if your baby still refuses the bottle after all the steps above, check with your pediatrician.

Articles and tips from Philips Avent

References:


*O.L. Lukoyanova, T.E. Borovik, I.A. Belyaeva, G.V. Yatsyk; NTsZD RAMS; 1st Moscow State Medical University THEM. Sechenova, "The use of modern technological methods to maintain successful breastfeeding", RF, 10/02/2012 3 llli.org - The Baby Who Doesn't Nurse

llli.org - Introducing a Bottle to a Breastfed Baby

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Bottle feeding | Bebbo

Submitted by Ilya Danshyn on Wed, 12/08/2021 - 18:40

Sometimes the baby cannot breastfeed, so you have to express milk and bottle feed the baby. Some babies are formula fed because for some reason breastfeeding is not possible, or lactation has stopped prematurely, or you have chosen to formula feed your baby.

  • Make sure that the rate at which milk flows from the bottle through the nipple is appropriate for the baby.
  • To check this, turn the filled bottle upside down.
  • Milk should drip quickly, not squirt. If you have to shake the bottle hard to make the milk drip, it means that the nipple is not providing the normal intensity of feeding.
  • The baby can fall asleep even before he has eaten everything from the bottle.
  • It is normal for a small amount of milk to leak from the corners of the mouth; it will stop when the child gets older.
  • If you can't find the perfect nipple, choose the one that produces the most milk; it's okay if you have to go through how many nipples before you find one that's right for you and your baby.

How to bottle feed your baby
  • Sit back and hold your baby in your arms, gently but firmly. It is better for the baby to be in a more upright position, similar to the position when breastfeeding.
  • Place the pacifier between the baby's lips; he will open his mouth and start sucking.
  • Hold the bottle at an angle so that the nipple and mouth of the bottle are constantly filled with milk; this will prevent the child from swallowing air.
  • When the baby stops actively sucking or has eaten half the milk from the bottle, carefully remove the bottle and check if he wants to burp; after that, you can continue feeding.
  • Change the position of the baby during feeding or at least at each feeding; this allows even stimulation of the baby's sensations on both sides of the body and prevents positional deformation of the head.

How much milk does a baby need?
  • The number of meals and the amount of milk is determined by the baby! Different babies require different amounts of breast milk or formula. Feeding time is not always evenly distributed over the time of day, sometimes children eat more during the day, followed by a long night break.
  • If you are formula feeding, check the chart on the box. Of course, the recommended serving size for your age will only serve as a guideline and may not necessarily be appropriate for your child.
  • When a baby begins to receive complementary foods, as the amount of solid food increases, the baby's need for milk decreases.
  • The amount of formula your baby eats will decrease when he switches from bottle to cup.
  • By the age of 12 months, when a baby can switch to cow's milk, he usually receives 500-600 ml of breast milk or formula per day.

Some babies never eat the recommended amount of milk for their age and height. For some, this "recommended" volume is not enough. At least six wet diapers during the day, constant but not excessive weight gain, a healthy and active child - all this indicates that everything is in order. If you are concerned that your baby is not getting enough milk or formula, contact your doctor.

Responsive feeding from the bottle in accordance with the needs of the child
  • Feed the baby when he shows that he is hungry and not according to the schedule, follow his signals.
  • Do not feed the baby if he is not hungry, just because the formula is already prepared - this can lead to overfeeding the baby.
  • When a baby is bottle fed, there is no difference between foremilk and hindmilk that affects the feeling of fullness in a breastfed baby.
  • The child is often held so that the milk simply flows into the mouth, rather than actively suckling; in this case, he eats too much milk too quickly.
  • During feeding, watch the baby for signs of satiety - he turns away from the bottle, sucks lazily - and stop feeding in time.
  • Hold the baby close to you during feeding, hug and talk to him; it stimulates growth and development and also strengthens the bond between you and your child.
  • The baby did not eat everything from the bottle and fell asleep while eating.
  • Don't worry if the baby didn't eat everything; he knows how much formula or breast milk he needs.
  • If the child falls asleep while eating, put him on your shoulder, stroke or pat him on the back and legs; Changing diapers is also an effective way to wake up a baby.
  • Wait until the baby is awake before giving the rest of the milk.

Always empty the remaining milk from the bottle if more than an hour has passed!

Night feeding