There are many learning curves in motherhood, and learning how to bottle-feed a baby (if you choose to do so) is one of them. Here are some common difficulties you may run into and how to fix them.
Your doctor says that your baby is gaining weight, so there must be nothing wrong. But, what if there is something wrong, and what can you do about it? Beyond that, what is good bottle feeding actually supposed to look like, and how do you know if you are doing it right?
Keep reading to learn the answers to the above common bottle-feeding questions and more tips on how to make bottle-feeding a success.
Why are these difficulties overlooked?
Most pediatricians are not trained in feeding – this includes their ability to assess any oral restrictions, including tongue, lip, and cheek ties. Instead, they are concerned about weight and overall health rather than specific feed difficulties. They are general health practitioners, and we need them. But if you are having concerns related to feeding, seek a specially trained professional.
I bottle feed and I am a good mom.
The Feeding Mom
How do I know if my baby is having difficulties?
What do you look for to determine if your little one is having trouble eating from a bottle?
The top signs of bottle-feeding difficulties include:
- Clicking
- Loss of milk
- Spit-up or reflux
- Frustration
- Crying
- Back-arching
- Falling asleep
These signs all indicate that baby is having difficulty somewhere. Is it muscle function, muscle tone, intaking air? That is what needs to be assessed.
It is imperative to find the root cause for your baby’s frustrations. Modifications and compensatory strategies do not solve the problem; they mask it and, in some cases, make it worse.
Read next: The Basics of Safely Preparing Formula for Your Baby
Common bottle-feeding difficulties
Know that weight gain does not equal feeding success, and because feeding is a multi-factorial event, we need to find the reason for these red flags showing up.
Feeding is one of the first motor movements that baby engages in and can help us identify potential issues in future feeding skill development and early identification in other areas of development. Below we list a few common feeding difficulties as well as why they occur.
Bottle feeding takes skills on baby’s part
It requires the coordination of different muscles working in perfect synchrony, not only for the act of feeding but also for safety. Bottle feeding is individualized, and no experience from one baby to another is the same. It’s those differences that need to be acknowledged and which are often overlooked.
Slower flow-rate and the impact on facial muscles
When there are bottle feeding difficulties, the most common recommendation I hear is simply to increase the flow rate. This allows the liquid to flow easier without the baby having to suck. A baby passively swallowing liquid is not the answer.
Additionally, by doing this, we are taking away the natural functions of the oral mechanism. Negatively changing how the systems are supposed to work is not the answer. The goal of any feeding method – from a medical standpoint – seems to be weight gain.
But bottle feeding is more than that, like all other feeding modalities. Feeding is a bonding experience.
It comprises a motor and sensory functions that require work to maintain and continue to develop the muscles of the tongue, lips, cheeks, and swallow mechanism. These muscles improve their strength and coordination for continued feeding progression onto table foods and the ability to drink from a cup or straw. They are also the facial muscles responsible for facial development and production of speech sounds.
There are also muscles within a system responsible for airway integrity and swallow effectiveness. These muscles and how they perform can give us insight into the rest of the body. For example, the tongue is connected all the way to the toes; so, if there is a dysfunction in the tongue, there will be a dysfunction in other parts of the body.
Pin-pointing bottle-feeding challenges
If your baby has low muscle tone
Low muscle tone could lead to an open mouth posture which will impact the ability to effectively nasal breath. In turn, a lack of muscle tone can impact facial development, dentition, sleep, and behaviors.
If your baby has difficulty with tongue movements
Difficulty with tongue movements could lead to further compounding deficits in feeding progression onto table foods.
With this, I see babies who turn into “picky eaters” when the motor deficit was never addressed upfront. They aren’t choosing to be picky; they physically can’t eat the more advanced food textures.
If your baby is intaking too much air
Increased air intake could lead to reflux and subsequent recommendations for medication or thickening of liquids, both of which can cause problems to their immature gut systems.
Thickened liquids will lead to impaired satiation cues, over-feeding, and excessive weight gain. Additionally, thickened liquids can change how the muscles function and can alter movement and development.
Bottles like this one are designed to help slow the air intake rate and are thought to help reduce reflux and colic issues.
Now what? Finding success with bottle-feeding
What do you want to see in a successful feeding relationship? A calm baby has their hands relaxed, their body is aligned, and more importantly, seem to be enjoying a pleasant experience.
Trust your instincts. Ask your pediatrician for local support including feeding therapists or lactation consultants with experience in infant bottle feeding. Reach out for 1:1 support.
Article resources
- Corvaglia L, Martini S, Aceti A, Arcuri S, Rossini R, Faldella G. Nonpharmacological management of gastroesophageal reflux in preterm infants. Biomed Res Int. 2013;2013:141967. doi:10.1155/2013/141967
- Manno, Cecilia & Fox, Catherine & Eicher, Peggy & Kerwin, Marylouise. (2005). Early Oral-Motor Interventions for Pediatric Feeding Problems: What, When and How. Journal of Early and Intensive Behavior Intervention. 2. 10.1037/h0100310.Kotowski, J, Fowler, C, Hourigan, C, Orr, F. Bottle‐feeding an infant feeding modality: An integrative literature review. Matern Child Nutr. 2020; 16:e12939. https://doi.org/10.1111/mcn.12939
