1. Section Editor(s): THOMAS, JESSICA A. RN, MSN, CRNP


Bottle feeding [horizontal ellipsis] what an exciting time for you and your baby!!: This teaching guide gives helpful tips for feeding.


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When Will My Baby Be Ready to Bottle Feed?

Usually, premature babies are ready to start bottle feeding between 32 and 36 weeks' gestational age. The healthcare team will be helpful in deciding when your baby is ready to bottle feed.


Bottle Feeding Basics


Some babies wake up for feedings and cry when they are hungry. Other babies will need to feed on a schedule of every 3 to 5 hours. Feeding times should take no longer than 30 minutes.



Feed your baby in a quiet place and in a position that is comfortable for you and your baby.



Babies swallow air when they feed from bottles, and burping helps to get rid of the extra air. Hold your baby upright, either on your lap or shoulder, and gently pat your baby's back for 1 to 3 minutes. Burp your baby in the middle and at the end of each feeding.



Your baby may be choking if your baby starts to sputter, hold his/her breath, or have color change (pale or blue). Take the bottle out of your baby's mouth and sit him/her up on your lap and pat his/her back until your baby looks comfortable again.


How Can Parents Help with Bottle Feeding?

Learning to bottle feed takes time and practice. Try these tips:


* Feed in a quiet area


* Provide oral stimulation


* Provide nonnutritive sucking (NNS)


* Provide oral support


* Choose the right bottle nipple for your baby



What Is Oral Stimulation?


* Gently stroke your baby's mouth, cheeks, gums, and tongue with your finger.


* Do this before and/or after feeding times.


What Is Nonnutritive Sucking (NNS)?


* NNS is when your baby sucks on a pacifier or a finger.


* Infants may start NNS as early as 24 weeks' gestational age.


How Do I Provide Oral Support?


* Bundle your baby in a blanket, placing arms and legs close to the baby's body.


* Hold your baby in a semi-upright position (45-60 degrees).


* Hold your baby's head in your nondominant hand (the hand not holding the bottle).


* Your dominant hand should hold the bottle and give oral support:


* Index finger and thumb on your baby's cheeks give gentle forward and inward support.


* Middle finger supports the chin, lifting it slightly upward to improve the suck on the bottle nipple.


* Make sure this does not cause the baby to get too much milk in his/her mouth.


Which Nipple Should I Use for Feedings?


* Nipples vary in size, shape, firmness, and flow.


* Your nurse and/or feeding specialist can help decide which nipple is best for your baby.


How Do I Know If My Baby Is Not Tolerating the Feed?

Read your baby's "cues." If you see these cues your baby may not be comfortable:


* Fanning of the fingers


* Yawning


* Hiccups


* Choking (coughing, spitting, color changes to pale or blue)


* Head turning


* Gagging


* Biting


* Crying



How Do I Know if The Feeding Is Successful?

Feeding is easier when your baby is developmentally ready. Also, practice makes perfect!!


Enjoy this bonding time, and be patient as your baby learns how to bottle feed.

Figure 1: Oral stimu... - Click to enlarge in new windowFigure 1: Oral stimulation, such as stroking the cheek, can be done before and after bottle feeding.
Figure 2: Stroke the... - Click to enlarge in new windowFigure 2: Stroke the cheeks to wake up your baby for bottle feeding.
Figure 3: Nonnutriti... - Click to enlarge in new windowFigure 3: Nonnutritive sucking on a pacifier improves suckling behaviors.
Figure 4: Provide or... - Click to enlarge in new windowFigure 4: Provide oral support by placing your index finger and thumb on your baby's cheeks, applying gentle inward and forward pressure, and supporting the chin with your third finger.
Figure 5: Fanning of... - Click to enlarge in new windowFigure 5: Fanning of the fingers and head turning are cues that your baby is stressed and not tolerating feeding.