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Attentive Bottle Feeding

9 June 2024

Like us adults, infants also differ in eating rate and needs. Paced feeding is the most recommended way of bottle feeding infants. In paced feeding, the infant shows you with their body signs of hunger and satiety, when they want to slow the pace down, when they need a break and whether they want to continue or finish eating. When you bottle feed them, it’s important to support their head and hold the bottle at such an angle that the tip of the teat is full of liquid, but not necessarily all of it. The most important indicator that can help you know whether the infant is eating enough is weight gain based on growth measurements taken at family care centers.

Breastfeeding is the preferred way of feeding infants. However, if the mother is unavailable or for any other reason, breast milk may be provided by bottle too. Infant formula is also usually administered by bottle. So what is the best way of bottle feeding? How does the infant signal hunger or satiety to us? How can we know whether they’ve eaten enough. Here is comprehensive information, with important emphases, for bottle feeding infants.

Paced bottle feeding

Paced feeding is the most recommended way of bottle feeding infants. In paced feeding, the infant shows you with their body signs of hunger and satiety, when they want to slow the pace down, when they need a break and whether they want to continue or finish eating. Paced feeding allows infants to control the milk flow rate and consume the quantities that suit them. This form of feeding is important because it allows infants to maintain their natural hunger and satiety mechanism with which they are born, which is important for their healthy future and preventing being overweight in older ages.

In paced feeding, one does not force the infants to suck the bottle dry, or push the bottle teat into their mouths when they show no signs of wanting to drink anymore.

Signs of hunger

Early hunger signs

Moving around, opening the mouth, moving the head from side to side, looking for a teat.

Advanced hunger signs

Stretching, increased body movements, putting hands into the mouth.

Late hunger signs

Crying, irritable movements, flushed face. If the infant has reached this state, it may be necessary to sooth them first and only then feed them.

Signs of satiety

Every infant has their own signs, and you should get to know their characteristic signs that they make to us when they are full. Follow these signs such as slowing down, releasing or taking out the teat, moving their head away from the teat. At a later age, approximately 4 months, biting the teat can also indicate satiety.

Paced feeding: emphases for correct bottle feeding

  • 1
    Attention to signs

    Feed the infant when they start to show signs of hunger and stop feeding them when they show signs of satiety. Crying is a late hunger sign, so it is desirable to feed your infant before the crying stage.

  • 2
    Maintain eye contact

    Sit comfortably where you can see the infant’s face and talk to them during feeding. That way they will feel safety and love.

  • 3
    Support the head

    Hold the infant close to you, their head raised. It is important to support their head so that the infant can breath and swallow comfortably and also let air out (burp) as necessary.

  • 4
    Feed gently

    Invite the infant to open their mouth by softly rubbing or gently touching the teat on their upper lip. After their mouth opens, gently insert the bottle’s teat.

  • 5
    Keep a slow pace

    To prevent the liquid from flowing too quickly, the bottle should be nearly horizontal and slightly raised, with the end of the teat full of liquid but not necessary all the way. Don’t be concerned if there is some air in the teat. It is important to choose a nipple with a slow flow.

  • 6
    Feed on both sides

    Change sides during feeding: lean the infant first on one arm and then on the other. That way you can stimulate both sides of their body and both eyes and they will not develop a preference to eating on a certain side. This is like breastfeeding, so it also supports continued breastfeeding if necessary at the same time as bottle feeding.

  • 7
    Attention to satiety signs

    If the infant shows you that they want to stop eating, or they detach from the bottle’s teat by themselves, gently take the bottle out of their mouth and tilt it downward to stop the liquid flow. After a brief break, offer the infant a chance to continue eating and listen to their response and body language. If they are uninterested, they are probably full and have finished their meal.

  • 8
    Be patient

    The meal duration is not the same and may range from 10-20 minutes on average. Don’t encourage your infant to finish their meal quickly. Eating at a natural rate allows infants to identify satiety before they are actually full.

  • 9
    Do not force

    Infants know how much they have to eat. It is important not to force them to finish everything in the bottle. Excessive feeding that does not correspond with the signs of hunger and satiety that the infant shows may cause them discomfort, abdominal pain (colic) and overeating, and may increase the risk of future obesity.

  • 10
    Help the baby burp

    At the end of the meal, hold the baby vertically and gently rub their back to allow them to expel air (burp). Most infants expel a little air.

Emphases that you should know about bottle feeding

  • There is a connection between eating lying down and increased risk of ear infections and nursing bottle caries, so avoid giving a bottle when the infant is lying down.
  • Hold the infant in your arms during feeding and hold the bottle yourself, don’t feed them when the bottle is raised and leaning on any object.
  • Never leave the infant alone with a bottle without adult supervision!

Milk quantities

There is no exact definition of the quantities of milk suitable for infants, whether breast milk or infant formula. No professional authority will give an exact answer to this question. Over time, you will get to know your infant, their needs and ways of expressing hunger or satiety.

Every infant has a different eating rate and different needs. There are infants who need a large number of small meals, and others eat large quantities at greater intervals between meals. In most cases, the greater the infant formula quantity per meal, the greater the interval between meals. It is worth knowing that the quantity of infant formula required for infants may vary every day, during every meal and depending on the type of milk that infants consume (breast milk, infant formula or both combined).

Infants fed breast milk (by suckling or from a bottle) will usually consume less, over shorter intervals, compared to infants who are fed infant formula. When a switch is made to supplementary nutrition (eating solid food), the bottle milk quantity is expected to decrease. Infants fed on infant formulas usually do not need more than a liter of infant formula per day.

Note: the quantities stated on infant formula boxes do not always correspond with your infant’s needs. The recommended approach is paced feeding and focusing on your infant’s signs of hunger and satiety.

This way we can know that infants eat according to their needs

  • Weight gain

    If they gain wait, this means that they eat enough for them. You can track their weight gain and see whether they are in the normal range according to the growing curves that are followed in family care centers. In the first month, you can also monitor the infant’s bowel movements.

  • Urine

    as long as they urinate and have 4-6 wet diapers a day, this is a sign that they are eating and are not dehydrated.

  • Stool

    In the first 48 hours of life, infants are supposed to have one bowel movement. Later, from the fifth day, the number is supposed to increase to 2-3 times a day at least. On the first day the stool is black, and later becomes greenish-brown until becoming yellow.

  • Mood

    Full infants are calm infants. If your infant does not show signs of restlessness or discomfort, they have probably eaten enough.

Transition from bottle feeding to cup feeding

Bottle feeding for too long may cause dental caries and overeating. From six months’ age you can start using a special cup for infants (baby learning cup or sippy cup) to accustom them to drinking from a cup (breast milk, infant formula or water). If cups are used for feeding them with infant formula, they must be sterilized up to one year’s age.

It is important to emphasize: there is no medical need to give infants infant formula after one year’s age. From one year’s age, infants can already drink ordinary milk and water and are supposed to get enough nutrition from eating rather than drinking.

It is worth reading more about feeding infants from six months’ age.

Contacting and going to the family care center

  • Generally speaking, it is important to follow recommendations for routine follow-up at the family development center. In every visit up to two years’ age, your infant’s weight, height and head circumference will be measured (later the measurements will be without head circumference checking). This way you can know whether your infant is eating enough and growing according to the specific growth curves and provide appropriate care should it prove necessary.
  • If you are worried by the quantities of food that your infant consumes or have any questions about their weight, you can contact the family care center yourself and ask the nurses any questions and express any concerns you may have.

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