Medium Flow Nipple for BF Baby?

By nanilani Feb 24, 2016

Has anyone had success using a medium flow nipple when feeding a breastfed baby a bottle of expressed milk? Or did it introduce any bottle preference over breast?

A while back, a LC told us to always use a slow flow nipple when feeding LO bottles of expressed milk. This morning I found out that he takes an hour to finish each bottle at daycare -- and now his ped wants his volume to increase too! I'm willing to try out a faster flow nipple to see if it helps speed things along, but I don't want to create any issues when he's feeding at the breast.

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10 comments

regberadaisy
GOLD / wonderful pomegranate / 28905 posts

Feb 24, 2016

@nanilani: is he EBF or are you supplementing too?
With both girls I never went above a level 1 nipple for bottles.
I am curious as to why your ped wants his volume to increase? How old is he? At one point with DD2 we did have to slightly increase her bottle volume. But generally speaking, BF babies volume intake doesn't need to increase. The idea is that your BM calorie/fat content changes per his needs. But I'm sure there are exceptions to every rule!

I would find out more from daycare as to why he's taking an hour to finish a bottle? Is he self feeding? If so, can they feed him for a portion of it to speed it up? Is he getting distracted? If so, can they sit with him in a separate space away from all the action?
nanilani
apricot / 374 posts

Feb 24, 2016

@regberadaisy: He's four months and EBF. His doctor wants the volume to increase because he's a tiny guy -- below 1st percentile for weight, just made it onto the chart for length (2nd percentile). His growth had also flattened out a bit a few weeks back, although the rate seems to be back on track now, more or less.

I've read the same thing about the volume intake holding steady, but about half of his daycare bottles each day come from my freezer stash (we try to rotate through so it doesn't expire) so the calorie content is probably not as high as the portion that comes from more recently expressed milk. Regardless, we've been slowly bumping up the bottle volumes over time in hopes of avoiding a failure to thrive diagnosis. His ped also mentioned the option of fortifying the caloric content of his bottles by mixing formula into BM, but I'm hoping not to have to go that route again (we did this when he was first released from the NICU).

I tried to ask our daycare provider for more info this morning, but didn't get too much out of her. When I told her about the extra volume she had a strong reaction and (finally) told me that all of his bottles take an hour to eat. I have no idea why she never brought this up before when I ask how his feeds went that day! I've known that he gets distracted by activity in the afternoon (she can't leave the other kids, we're at an in-home daycare), but she'd never mentioned an issue with his first two bottles until now.
Adira
wonderful pomelo / 30692 posts

Feb 24, 2016

We never went above the slowest flow nipple for my kids, after a while, the nipples do kind of wear out. I realized at around 7 months with Xander that his nipples were so worn out that milk was just gushing out of them like a fast flow nipple and he could down bottles in less than 5 minutes. He still nursed just fine for me, so being able to drink bottles quickly didn't create a preference for him.

You could certainly try a faster flow nipple. If it's really taking him an hour to drink a bottle, he might be spending more calories trying to drink it than he should be (vs. his intake), so I think it might be worth-while to try the next size nipple and see if that makes any difference.
yerpie110
nectarine / 2771 posts

Feb 24, 2016

Dd1 (who was ebf for her first year) went on a bottle strike around 10 weeks. I tried a host of different things and in the end, it was due to the nipple. I have an overactive letdown and by then she was used to getting milk FAST and got frustrated from the slow flow nipples. As soon as I changed it to medium, no problem. She was in medium/fast from then on and never had any problems with nipple confusion. So I think it's worth a try? If it doesn't work, you can always go back to the slow flow. Good luck!
T.H.O.U.
wonderful clementine / 24134 posts

Feb 24, 2016

It sounds like the faster flow may be a good choice for you guys. What you want to watch for is that they dont develop a bottle preference (aka they want the bottle because its less work than the breast). You also need to make sure they aren't over eating because of the faster flow but thats obviously not an issue for you.
MrsBrewer
coconut / 8854 posts

Feb 24, 2016

I EBF and my 9 month old uses a size 3 nipple. She gets way to frustrated at the slower ones and loses interest. She nurses just fine with me, she only has bottles 3 days a week with babysitter
SweetCaroline
pear / 1718 posts

Feb 24, 2016

I breastfed without supplementing and we used medium flow nipples. Baby wasnt drinking/gaining enough from her daycare bottles. If she did, it would take her an hour go finish a bottle. I was hesitant because "they" say you shouldn't with a breastfed baby, but it worked great! No impact on breastfeeding.
nanilani
apricot / 374 posts

Feb 24, 2016

Thanks for all of the input! I'm waiting on a call back from the pediatrician, but it sounds like I don't necessarily need to be scared of trying a higher flow nipple if we decide to go that route. It took so much effort to get into a BF groove that I'm hesitant to make any changes that might eff it up. I'm glad to hear that other parents have had success with the faster nipple, it makes me feel like I have more options to work with.
nanilani
apricot / 374 posts

Feb 26, 2016

The first day of stage 2 nipples seemed to work out well! His feeds at daycare dropped from 1 hour to 20 minutes each, and he still nursed as well as he ever does last night and this morning. Hopefully that is still true on Day 2!
T.H.O.U.
wonderful clementine / 24134 posts

Feb 26, 2016

@nanilani: Great update! The other thought I had for you, is you dont have to do all of one flow. I think for a while for my older son we alternated between 1 and 2 nipples.

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Medium Flow Nipple for BF Baby?

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