Feeding Made Simple - Flipbook - Page 45
Combination
Feeding
Whether using breast milk or formula in a bottle,
the principles of nipple sizing are the same.
Parents are often unsure when and how to
introduce a bottle with pumped breast milk.
One of the most common issues I see is
moms introducing a bottle around 3 months
when returning to work, but still using a Flow
0 nipple (often the one bought at birth). By
this stage, many babies have already moved
on to a larger size.
To support combination
feeding, match the bottle
nipple to breast milk 昀氀ow.
This isn’t an exact science,
but a general guideline is:
So if you are introducing a bottle with
pumped breastmilk for the 昀椀rst time,
remember the following basic guide:
→ If a feed only takes 5 minutes, the 昀氀ow is
likely too fast
→ If baby is still not 昀椀nished after 20 minutes
or leaves a half-full bottle, the 昀氀ow is likely
too slow
Extra Slow (0): For any premature or
newborn baby less than 7lb
Slow Flow (1): Newborns between 0‑3
months and over 7lbs
Medium Flow (2): Infants between
3‑6 months
Fast Flow (3): Infants over 6‑months
If breastfeeding takes about
20 minutes, bottle feeding
should be similar.
If mom has a strong or fast letdown, you may
need a faster nipple 昀氀ow (often Flow 1 or 2)
to better match that pace of milk transfer.
If baby is actively refusing the bottle or
pulling away after just a few sucks, this
is often a sign of a 昀氀ow mismatch in
combination feeding—try adjusting one size
up or down.
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