How to bottle-feed a baby correctly, step by step

To know how to give a baby a bottle, we need to know what the recommendations say about how a newborn takes a bottle. It is a topic surrounded by a great deal of controversy: even at the level of scientific evidence there are different positions on many points. That is why our midwives at Happymami have prepared the following post for you: how do you give a bottle?

How to give a bottle to a newborn: what is the correct way to give a baby a bottle feed?

There are different schools of thought on how to give a bottle, and the best approach would be to adapt them to your particular case. For us, the main recommendation is the one given by Uptodate (a clinical medical resource based on evidence), which gives us the following recommendation:

Position for giving a bottle to a newborn. Guidelines for giving the baby a bottle feed.

1. Place your baby in as upright a position as possible

2. Stroke your baby's mouth with the bottle teat and, when they open their mouth, insert the bottle

4. Tilt the bottle upwards so that the teat is partially filled with milk, and let your baby suckle for a few minutes

5. When your baby pauses, tilt the bottle downwards to empty the teat

6. Repeat this process until your baby shows signs of fullness.

7. A bottle feed should last at least 10 to 15 minutes, just like at the breast.

How do you give your baby a bottle feed?

There is another interesting school of thought from the USA for offering the bottle. This school, promoted by sites such as “legendairymilk”, proposes adding to the recommendations given by Uptodate, which already suggests giving the bottle with the baby as upright as possible, the feature of offering it in a side-lying position, always keeping the baby as upright as possible.

This new recommendation for giving the bottle can be an option for those cases where parents have not managed to get their babies to take the bottle. And below, here are the guidelines to follow.

Guidelines for giving a bottle feed with the baby lying down

1. Sit in a place where you feel comfortable and place your feet on a stool, a table, a sofa or a bed, with your knees bent and your legs from the hip to the knee at an angle of approximately 45 degrees.

2. Place your baby on their left side on your lap, with their bottom against your belly and their head towards your knees. Your baby's legs should be in front of them, with the ear, shoulder and hip in a straight line.

3. The natural position of the stomach is on the left side, and food is digested more easily when we lie on our left side. Gravity helps to remove the waste that travels from the small intestine to the large intestine

4. Your baby's arms can be in front of them.

5. With the bottle horizontal to the floor, place the base of the teat on your baby's chin and wait until they open their mouth wide. Waiting for it to open wide mimics how they get a deep latch at the breast.

6. When your baby's mouth is completely open, place the teat in their mouth with the bottle still in a horizontal position in relation to the floor.

7. When your baby starts to suck, tilt the bottle to fill the teat with milk.

8. Follow your baby's cues: if they stop sucking, tilt the bottle towards you to reduce the flow of milk.

9. After giving approximately half the bottle, stop to burp your baby and then change them so that they lie on their right side, and carry on feeding them until they show signs that they have finished.

Points to consider about this guideline for giving the bottle lying down

As you will have seen, unlike Uptodate, it does not refer to stopping giving the bottle when the baby pauses; it directly recommends splitting the feed in two with a pause in the middle.

It is true that we have searched for evidence for this school of thought and, although it seems interesting to us, we have not found evidence to support it. So using this guideline of positioning the baby lying down as a second option, and keeping the baby as upright as possible, seems to be a valid option if, after following the UPTODATE guidelines, we do not manage to get your baby to take the bottle.

Although we insist: the evidence from Uptodate is undeniable, and for us, to this day, their recommendation is the most up to date and the one we will recommend.

Bear in mind that perhaps your baby does not take the bottle because you are using a generic bottle, completely different from your breast, and that may be the reason for not accepting the bottle and not the way you give it. That is why we recommend using a made-to-measure Happymami bottle.

How do you give a baby a bottle to avoid wind?

To reduce wind when giving a bottle, it is essential to pay attention to the feeding technique and the equipment you use. A good example is the Happymami bottle, designed with an anti-colic system that minimises the intake of air and makes feeding easier. This type of bottle, combined with a teat customised to the mother's teat, can make a big difference. During the feed, place the baby in a semi-upright position, with their head higher than their stomach, and make sure you tilt the bottle so that the teat is always full of milk. This prevents the baby from sucking in air and reduces the risk of discomfort.

It is equally important to take pauses during feeding so that the baby can burp. If you notice that they suck quickly or become restless, stop for a moment, help them to release the air and then carry on. At the end, keep the baby in an upright position while you pat their back gently or sit them on your knees with gentle movements. These practices not only prevent wind, but also promote calmer digestion and a more pleasant experience for both the baby and the parents.

How long should a bottle feed last?

As we have seen, the recommendation for the length of the feed should be between 10 and 15 minutes. In the end, these bottle feeds try to mimic a breastfeed as closely as possible, and the average tends to be those times. But always bear in mind that every case is different, and every baby has their own likes and preferences, and if they feed for 20 minutes at the breast, then it would be advisable for them to take just as long with the bottle.

How do you count the time between feeds?

Here there is controversy too. If you offer your baby breastfeeding, it is well known that the breast is on demand, so there will be babies who eat very little every 20 minutes and others who eat a lot every 3 or 4 hours, and both cases are feeding well. The point is that each baby's pattern is different and you have to offer the breast when the baby asks for it.

It is also true that as the baby grows these feeds become more spaced out, and the most “normal” thing, understood as frequently normal, will be for a baby to have between 8 and 12 feeds a day.

If in your case you give a bottle, there are two schools of thought: one that promotes feeding every 3 hours (8 feeds a day) and others that recommend feeding on demand, with the quantities and everything.

The most important thing is to keep up with the paediatrician's check-ups and to check that your baby's weight gain and growth are normal. We currently have a very good healthcare system, and if your baby is not putting on enough weight, it will surely be detected and you will be given recommendations for supplementation.

When should you start giving a baby a bottle?

The WHO recommends breastfeeding as the essential and only food for the first 6 months of life, and as a complement up to the age of 2. Obviously, every case is different and we must adapt to the endless possibilities that exist today.

A mum, for example, may need or want to breastfeed and give a bottle from day one after birth, just as she may need to introduce the bottle at 4 months when she returns to work. The most important thing is to use the bottle that best represents your breastfeeding, in order to prevent the newborn's teat-nipple confusion and protect your breastfeeding. A made-to-measure Happymami bottle is the best option.

Design your Bottle ®

Which bottle do paediatricians recommend?

There are currently many types of bottles and we are lucky to have some very interesting options; the most important thing is to offer your baby the best option for your particular case.

If you breastfeed and need or want to use a bottle, the best option is a made-to-measure Happymami bottle. Because science warns us that 50% of babies who use a generic bottle stop breastfeeding. With the made-to-measure Happymami bottle, you design the bottle that is most similar to your breast, you prevent confusion in your baby and you protect your breastfeeding.

Which bottle is most similar to the nipple?

The bottle most similar to the nipple is the made-to-measure Happymami bottle. It is the only made-to-measure bottle that takes into account the size and shape of the nipple, whether it lengthens horizontally or not after a feed, the flow at each stage of the baby…etc. A set of parameters that make the Happymami project the only one in the world that designs made-to-measure bottles. Because all generic bottles are sold as the bottle most similar to the maternal breast, but which breast? Yours or mine? We can help you.

When does a baby take a bottle?

There are many cases in which a baby needs to use a bottle, for example by medical prescription because the baby is not putting on enough weight, or simply by the mother's decision because she wants to do mixed feeding. The important thing is to adapt to your particular case and, above all, to use the bottle that is most representative of your breastfeeding in order to protect it.

Conclusion: how do you give a bottle?

To finish, and as a conclusion on how do you give a bottle?, let me tell you that the most important thing is to know what you need, what your case is, and to offer your baby the best option, always based on scientific evidence.

Frequently asked questions

How do you offer a bottle to a baby who does not want it?

If your baby refuses the bottle, try offering it at a calm moment, when they are relaxed but not too hungry or tired. Try a teat with a different flow, or a different milk temperature, so that it adapts better to their preferences. Changing position or asking another person to feed them can help, especially if they are used to breastfeeding. Make sure they have no discomfort such as colic or sore gums from teething. If the refusal persists, consult your paediatrician.

Is your baby taking an hour to finish the bottle?

If your baby takes a long time, check the teat: a flow that is too slow could be making feeding difficult. Keep the bottle tilted to prevent them from sucking in air and feed in a calm place to reduce distractions. Assess whether you are offering more milk than necessary; perhaps they do not need that much. If the problem continues, consider adjusting the amount or frequency of feeds and consult the paediatrician to rule out other reasons.

My baby finishes the bottle very quickly

When a baby takes the bottle very quickly, use a teat with a slower flow to control the speed. Take pauses during the feed so that they can burp, and avoid offering the bottle when they are very hungry, as that increases their anxiety about eating. A semi-upright position helps them feed more calmly. These measures will prevent discomfort such as wind and will promote calmer digestion.

Bibliography

Hill MD FAAP D. Bottle Feeding Basics . American Academy of Pediatrics. 2012 . Available at: https://www.healthychildren.org/English/ages-stages/baby/feeding-nutrition/Pages/Bottle-Feeding-How-Its-Done.aspx

Lisa Enger, RN, BSN, IBCLCNancy M Hurst, PhD, RN, IBCLC. Patient education: Pumping breast milk (Beyond the Basics) . Uptodate.com. . Available at: https://www.uptodate.com/contents/pumping-breast-milk-beyond-the-basics?search=biberon&topicRef=4996&source=related_link

Granniss S. Side-lying bottle-feeding . Legendairy Milk. 2022 . Available at: https://www.legendairymilk.com/blogs/news/side-lying-bottle-feeding