Bottles for Breastfed Babies (Introducing a Bottle, Part 1)

I’m guessing you got a ton of different bottles at your baby shower, when you signed up for a baby registry, or even for free in the mail after Target or Buy Buy Baby or Amazon or whoever figured out you were pregnant.  If you take a peek at the marketing printed on the bottle packages, you’ll see a lot of pretty bold claims…

“The breastfeeding bottle! … the perfect companion to breastfeeding and the best possible transition to bottle feeding.”

Mimijumi

“designed to mimic breastfeeding… rescued so many families dealing with ‘nipple confusion’ and ‘bottle rejection’ that our Comotomo mama’s coined the term ‘Breastfeeding in a Bottle!'”

comotomo

“Switching from bottle back to breast has never been easier… your baby is able to maintain the learned feeding behavior that your baby exhibits when breastfeeding”

Medela Calma

“The wide breast shaped nipple promotes a natural latch on similar to the breast. Designed to give a more comfortable and contented feed for your baby.”

Avent Natural

What does all of this tell you (other than the fact that every single one of these bottles is somehow THE #1 MOST BEST BREASTFEEDING BOTTLE EVER)?  I know that it tells me– that bottle feeding can affect breastfeeding, and that it must happen often.  Why else would the manufacturers go out of their way to claim their bottles are just like breastfeeding and don’t cause problems?

So let’s say you’re breastfeeding and you really want to use bottles sometimes, too.  How on earth are you supposed to pick a bottle to even start with if every company has similar claims and the boogeyman of “nipple confusion” is lurking around every corner?

That’s where I come in. Get comfy. Let’s chat.

First, let’s quickly discuss nipple confusion.  We’ve come to see this is an incorrect term.  After all, babies aren’t stupid and they aren’t confused– but they quite often have a nipple or flow preference.  Babies are hard wired to breastfeed, if given the chance and properly functioning mouths and brains.  In the beginning breastfeeding is a learned skill for both of you, no matter how strong your instincts are.  

But babies are also smart, and they can be creatures of habit.  Breastfeeding and bottle feeding use the same muscles, but often they use those muscles in different ways.  Given a choice, they quite often will choose the option that is easier for them. They’re not confused- they’re making an educated choice!  Look at those baby geniuses go!

Now that you understand babies aren’t confused, we need to talk about something else.  There are no bottles on the market (yet) that act the same way as a breast.  I don’t care if it’s rounded like a breast, I don’t care if the nipple is colored like some fictional person’s skin tone, I don’t care if the manufacturer is so bold as to say it’s developed only for breastfeeding.

No baby is going to fall for these bottles because they're rounded like a breast (or even worse, because they're colored like someone's breast).

No. Bottle. Is. The. Same. As. Your. Breast.

When babies latch to the breast correctly they get a large mouthful of nipple and areolae- and depending which study you look at, your nipple and areolae swell 2-3 times in size to fit your baby’s oral cavity. 

There are no bottle nipples that expand this way in a baby’s mouth.  They would need to be incredibly soft silicone, so soft that they’d probably break down easily as they were used & washed.  You’d be running through them as fast as you run through diapers.

What am I saying here?  Ignore all the claims from all of the companies about their bottle being best for breastfeeding.  Instead, I want you to keep three things in mind- A) flow rate B) nipple/teat shape and slope and C) nipple tip shape.   Let’s discuss.

A) Flow Rate

When discussing baby bottles the term “flow rate” refers to how fast the milk comes out of the bottle nipple when baby is sucking.  Most bottle brands sell nipples of varying “flows” or “speeds”, and they suggest moving up in “speed” as baby gets older.

Unfortunately bottle flow rates aren’t universal.  It’s not like comparing the MPG of a new car or the carbohydrates per serving of your favorite breakfast cereals. 

What one company calls a “slow flow” nipple may let milk through just as fast as another company’s “level 3”.  What’s worse, flow rate is usually wildly inconsistent within the same brand and level of nipple.  Some brands are more consistent than others, but generally you even can’t be sure that two nipples in the same package flow at the same rate!

This baby is leaking milk from their mouth because the milk flow is too fast- and they're not latched deeply to the nipple.

Us IBCLCs generally like to have breastfeeding babies using the slowest possible bottle nipple.  We want babies to take the bottle slowly (since breastfeeding is usually a slow process) and we want them to have to actively suck to get the milk out.  Babies are smart.  Some babies will get a bottle with a fast flow nipple and say “heyyyyyy, that was easy. Why am I working so hard on nursing? Why have you been holding out on me all this time?!?” and bam, you’re stuck in flow preference land.

How do you know how much milk to send to daycare or to leave with your infant?

My back to work pumping planning sheet for exclusively breastfed babies is here to help you find the answer!

It’s also important to remember that all bottles drip when you invert them, and MOST bottles will give the baby milk even if baby is just chewing on the bottle nipple.  Do you want your baby chewing on your nipple when they’re hungry?  These factors make bottle feeding awfully attractive for some babies, so with a slow flow you can hopefully minimize the amount of milk baby can get without sucking.

There have been a few recent studies that measured flow rates from various bottle nipples using different methods; they found that the slowest flow nipples are usually not from the brands that are constantly advertising about how breastfeeding friendly they are.

Bottle Selection Tip: Choose a bottle with a slow flow rate, even if your baby isn’t a newborn.

B) Nipple/Teat Slope and Shape

If we want to encourage babies to get a good mouthful of nipple and areolae when they breastfeed, we want them to similarly get a good mouthful of the nipple when they bottlefeed. This can be difficult when a bottle nipple abruptly changes in shape from narrow to wide. 

These nipples (left to right Nuk Simply Natural, Medela Calma, Avent Natural, Tommee Tippee, and Chicco Naturalfit) have narrow nipple tips and wide bases. Babies will usually either stay on the tip and suck it like a straw, or they will try to fit the base of the nipple in their mouth and end up with air pockets where the tip meets the base.

Instead, look for nipples that gradually change in shape from narrow at the tip to wider at the base. If they are narrow at the base, you’ll want baby’s lips to be able to come up almost to the collar (plastic o-ring base); if the nipple is wide at the base but appropriately sloped, baby will be able to get the nipple deeply into their mouth with no air pockets.

These nipples (left to right Lansinoh, Dr Brown’s Original Narrow, and Evenflo Balance Standard) have nipples that gradually slope from narrow to wide, which is a more natural shape in baby’s mouth.  

Bottle Selection Tip: Choose a bottle with a nipple that gradually changes width from tip to base.

C) Nipple Tip Shape

I have no science to back this assertion up, but it makes perfect sense to me, so I’m adding it to my list. Look at the bottle nipple tip. Would you want YOUR nipple to be that shape after/while baby sucks on it?  No? Then avoid it when choosing a bottle. Some of these shapes are absolutely cringeworthy. 

Tilted nipple tip, flattened nipple tip, and I don't even know what to say about a nipple at a 30 degree angle...

When a baby is nursing and detaches from your breast your nipple should look round, or the same shape it was when it went into baby’s mouth.  A “lipstick” nipple, a flattened or creased nipple, a pointy nipple- these are all signs that baby may have been mashing your nipple against their hard palate. This causes nipple damage, makes it harder for baby to get the milk out, and it really freaking hurts. 

So if a bottle nipple tip is shaped in a way that you’d never want your nipple to look, why on earth would you want to use a bottle nipple in that shape? 

Bottle Selection Tip: Does the nipple tip look like a very painful, unhappy human nipple? Avoid it.

So after all that information… what bottles should you pick?

Generally I think it’s better to start with only TWO different bottles.  If you’re heading to the store, consider one bottle with a narrow nipple base, and another bottle with a wider base and a gradual slope from the tip.  You’ll of course want to choose the slowest flow available in whatever bottles you purchase.  In some cases this may mean that the bottle itself comes with a faster nipple and you’ll have to buy the slow-flow nipple separately.

These are the bottles I carry with me to home visits, and they’re a good starting point:

Lansinoh (left) and Dr. Brown’s Original (Narrow Neck) with Preemie Nipple (right)

FYI, the “slow flow” nipple that comes with the Lansinoh bottle is still pretty fast flow.  When I bring this bottle to home visits I also bring the slower version of the nipple, which is the Pigeon SS/Super Slow/Level 0 nipple.

Other bottles with nipple shapes similar to these:

Pigeon Bottle (left) and Evenflo Balance (right, standard neck shown)

Some bonus bottle shopping tips:

  • babies eating breastmilk usually only eat 3-4 oz per serving so there’s no need to buy expensive, giant 8 oz bottles!
  • avoid any bottle that requires you to hold it in an uncomfortable position for you or baby. 

  • avoid all “anti-colic” claims.  We don’t have a firm hold on exactly what colic is or why it happens (babies crying for 3+ hours a day, 3+ days a week, for 3+ weeks in a row) but if a bottle could really cure it, then all the other products marketed as anti-colic (infant gas drops, baby carriers, swings and other baby containers,  baby probiotics, belly wraps, tubes you stick up baby’s butt) wouldn’t exist…

Once you’ve got your two test-drive bottles all washed and sterilized and your milk pumped, you’re ready to give this bottle thing a try.  I often suggest parents start with the more narrow-based nipple that they’ve chosen; if it doesn’t work, use the wider sloped nipple the next time.

For directions on exactly HOW to give a breastfed baby a bottle, read on to part 2.

If you’d like to learn much, much more about bottles for breastfed babies, or if you are a lactation or baby care professional looking to broaden your skills I highly suggest you pick up a copy of Balancing Breast and Bottle: Reaching your Breastfeeding Goals.

Please note: This blog post includes Amazon affiliate links. If you purchase items through Amazon after following my links above, I earn 4% of the purchase price.

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46 thoughts on “Bottles for Breastfed Babies (Introducing a Bottle, Part 1)

  1. Hi Rachel! Dr. Brown’s has added a new “options + wide neck” bottle and nipple that looks more like the lansiloh and Evenflo bottle nipples. What are your thoughts on this nipple? Do you still recommend the Dr. Brown’s Options + Narrow Neck or are you liking the new Wide Neck more now?

    1. Good question- the Dr Browns wide neck is still a pretty steep transition so while it looks a little more like the Lansinoh, it’s still not a great fit for most babies and of all their bottles I like the narrow neck best.

  2. Thank you for this post. I notice you keep using the Dr. Brown’s original bottle in your links. Is the newer version (Options+ bottle) the same? I want glass but can’t find the original bottle in glass anywhere! I know they used to make it because I babysat for a family that used them years ago, but looks like it’s no longer made.

  3. My soon to be 4 month old was bottle fed formula in NICU until my milk came in. We continued using bottles with breast milk for 1 feeding a day so my husband could help. We fell off that nice schedule and life got a little more hectic.. now he does not like the bottle at all- we used dr.browns only, I’ve since tried como tomo and advent.. he doesn’t get super upset, just plays with and gums the nipples.. he will occasionally take it, but it’s kind of a battle and not consistent. Any suggestions?

  4. I’m preparing for baby’s arrival and wanted to have two of your suggestions on hand. I was trying to avoid the Dr Browns venting system and also use bottles I had on hand so I got Dr Brown’s premie nipples for use on other standard neck bottles (I checked that this worked without leaking). I have now determined I cannot buy Lansinoh, pigeon or the evenflo balance+ bottles anywhere (I’m in Canada and the evenflo ones recently disappeared from the market). Would the Dr Brown’s wide neck nipples fit the guidelines? I’ve never seen one in person but I don’t really know what other options are out there that meet the criteria and that wouldn’t cost me $40+ in shipping to get (which makes me nervous in case I needed more)

  5. Hi! I am an IBCLC and your bottle summary was recommended during during a GOLD conference presentation. I am wondering if your nipple shape recommendations are personal practice based recommendations or evidence based? If evidence based, do you mind sharing your resources? My go to has always been Dr. Browns narrow with a premie nipple as this is what the NICU uses. This post is very useful for other options! Thank you!

    1. My resource is linked in the blog post, but all of my words and recommendations are my own from my years of doing literally hundreds of bottle refusal consults.

  6. I just have to say, I was ecstatic to learn of a slower flow nipple compatible with Lansinoh. Fingers crossed this does the trick. We are 12 weeks in and she is finally sucking the Lansinoh nipple but the slow flow is still too fast. I just ordered the ss pigeon nipple so praying that works!!!!! I didn’t know it existed until reading this so thank you!!!

  7. Does the nipples on the evenflo bottle have a good slow flow, or does their tend to be fast like Lansinoh. Also, do you have a personal preference on their standard or wide neck bottle?

    1. The Evenflo Balance nipples are much slower than the Lansinoh! I like the standard neck better because babies tend to collapse the wide neck.

      1. What about Evenflo in comparison to Pigeon? Is Evenflo faster than Pigeon SS/S or about the same?

        Also, are the Evenflo/Lansinoh nipples interchangeable with the bottles?

        1. The Evenflo Balance+ slow nipple is slower than the Pigeon/Lansinoh S/level 2. The Pigeon SS is slower than the Evenflo.

          I am not a big fan of switching nipples on other brands of bottle collars, particularly the nipples like these that have a built in air vent, because a differently shaped collar can compress and close the air valve. Basically it’s not “if I fits I sits” 😂

  8. Rachel, do you have a recommendation for bottles/nipples that come with the popular breast pumps, i.e. Motif Luna, Spectra, etc.? I am trying to minimize the amount of milk transferring I have to do and would love to be able to utilize the milk collection bottles supplied with my breast pump.

    1. I’m not a big fan of ANY of the nipples that come with pumps. A better bet would be to see if you can can use adapters to screw the chosen bottle body to your pump- you’d still be minimizing milk transference but IMO if your choices are a crappy nipple with your current pump bottles or pumping into a different bottle with a better nipple/teat, I’d choose #2.

  9. Thank you so much for the post. My baby latches on Lansinoh beautifully but the flow is still too fast even with the super slow flow nipple… so can’t use Lansinoh.

    So right now we are trying Dr.Brown’s wide neck. Is that nipple good for breastfed babies compare to the narrow neck? The preemie nipple is actually better. However, my baby has hard time to latch…

    Should I try the narrow neck?

  10. Hi, do you recommend the evenflo standard OR wide neck nipples/bottles? My baby has failed 4 bottles so far (including the lansinoh), and he seems to gag/be overwhelmed by large nipple sizes. I have very small nipples so I’m wondering if this is why. I’m trying the evenflo next since the dr. Brown’s nipple looks long, but not sure which to get!

    Thanks!

  11. Hi is there a big diffrence in your opinion between evenflo balance standard you mention in the blog and evenflo balance wide?

    My 5 week old has a small tounge tie but breastfeed fine. He has been taking lansinoh bottles with slow flow nipple but milk often leaks out the side of his mouth.

  12. My Pediatrician said that my 4 month breastfed baby should be eating 4-6 oz per feed, and the charts say 4-8 oz per feed by the time they’re 6 months. I only nurse her, but am pumping and freezing for when I go back to work when she’s 6 months and have no idea how much she will need to eat at a time. I was going to buy larger bottles because all I have is 4 oz. Everything I read seems contradictory, and formula is different then breastmilk but a lot of charts dont differentiate. You said 3-4oz each feed, does that change at all at different ages?

    1. Hey mama I actually can answer this for you. Breastfed baby’s never eat more than 3 to 5oz no matter how old they get and it’s because your breastmilk chances for your baby’s needs. The older they get the more calories your breastmilk will have. With formula fed baby’s you have to go up an Oz ever so often as they get older because formula stays the same and doesn’t change like breastmilk does. So let’s say baby is 6 month old if breastfed they will most likely be eating 4oz every 3 to 4 hours and if formula fed they would get 6oz every 3 to 4 hours. I hope that helps.

  13. There is a new bottle that has come out since your post called the Chicco Duo Hybrid with the Intui-latch nipple. It appears to be sloped and look a little like lansinoh. I’m curious as to your opinion and if this would be a good option for us?

    1. So the Chicco looks like it has a graduated width similar to Lansinoh or Evenflo but when you look closer you can see it ALSO has a horizontally squished nipple like the Mam bottle, which means it’s going to encourage a narrow, shallow latch by default. Generally I avoid nipples like this unless baby is really tongue tied or has other oral function issues and cannot make suction work with a wide gape. Good question!

  14. Reading this post was SO incredibly helpful. Thank you, thank you! I was getting info from experienced moms that didn’t match with what my SLP friend has been giving. Yours laid it out so it was so easy to understand.

    We our due with our first in September. My question is regarding narrow vs. wide bottles. Do you have a preference to use in conjunction with breastfeeding? I am hoping to use glass bottles so I’m trying to find something that matches up with everything you suggested. Thank you!

  15. Great article, thank you!!! I have three questions:

    1) Any opinion on the original medela nipple (not calma) or the Lifefactory glass bottles (i think now discontinued, i dont know why. I hope nothing bad!)? Both are regular/narrow neck and both with slow flow nipples that came with bottles.

    2) How many bottles should you register for? Just the two kinds in smallest quantity possible?

    3) If baby seems to take the very first bottle you try (in your example dr. Brown narrow with preemie nipple), should you still try the #2 bottle choice or any others in case they like it or latch even better?

    Sorry for so many questions. Thank you so much!!!

    1. I’m also wondering about the original Medela bottle/nipple. It appears they are interchangeable with Dr. Brown so I would assume they are okay?

      1. They aren’t exactly interchangeable, unfortunately many of the nipples don’t flow or work the same when put on a different company’s bottle or collar so it gets tricky when you try to Frankenstein!

  16. Hi, I’m so glad I came across this information! Thank you! With that being said, I’m a mew Mama who has managed to successfully breastfeed, yay, but now when introducing bottles my babe refuses them. I have tried several bottles (como tomo, tomee teepee, avent) and various nipples, my husband has tried giving each of them too. Our babe just cries and fusses each time we give it a go. He also HATES a pacifier. Needless to say, we are stressed because I go back to work in a month and our new baby (now two months old) refuses to take any bottles we’ve tried so far. Now that I’ve read your tips, I’ll give the two brands you recommend a try (with the nipples recommended). We remain hopeful! You’re right about it being stressful. Thanks again for sharing this information and I hope it works out for us! Best, P

    1. OMG. This is exactly our story… actually every single detail fits ! 2 month old baby, 1 month “deadline”, all the different bottles…. And I’m desperate. I hope you had some luck with the bottle!!

  17. Hi! This is very helpful. I was wondering if you recommend WHICH feeding is a good one to try a bottle first (ie first of the day because baby is hungrier? Evening? ). I am interested in trying a bottle but don’t know when to start in terms of when to do it, pumping for it, etc.

    1. I like starting with the second morning feed of the day (so say baby wakes at 8AM, nurse for that one and then try the bottle at 10/11).

  18. I wish lansinoh had a preemie flow because I think the width of it is more similar to a breast than the narrow browns bottle. I think the new wide neck browns bottle that supposedly resembles a breast actually doesnt because it not naturally sloped, do you agree? And I think the pigeon nipples are like lansinoh and they DO have super slow flow, but I’m having trouble finding them!

    1. I agree, it’s super frustrating and Lansinoh and Pigeon are the same company… so if you make a slower flow of the SAME nipple and sell it in other countries why can’t you just sell it in the USA too?

  19. Have you heard of or seen the MAM brand bottles, the original ones. Would that be an acceptable bottle to use based on nipple shape? It also has a “0” flow nipple as an option. Before reading this article I went to the store looking for nipples that kinda anatomically looked like mine and grabbed a “MAM” bottle with a “0” nipple.

    1. Hi, not sure which MAM bottles are the “original” but the ones with the squished nipple are really only used for very tongue tied babies who have no tongue lift.

    1. Always start with Preemie no matter how old baby is. If they collapse the nipple or refuse to eat because it’s too slow, or take longer than 20 minutes to eat ~3 oz, move up to the next speed. Many babies taking breastmilk in bottles use the preemie nipple until they turn 1!

  20. Thank you! I thought the breast colored bottles are the most ridiculous marketing ploy. You are a breath of fresh air! I had low milk supply and I realized how much money I spent on goods that were marketed toward breastfeeding women that are useless.

  21. Do you have a recommendation for a longer, more narrow nipple base bottle that is not Dr Brown? I would really love to avoid cleaning all the components if possible

  22. Hi, I’m pregnant with my second child and my husband and I have kinde bottles that we would like to use this time around so that I can share feedings rather than just me breastfeeding. We have all flows but as far as the nipple shape is concerned what is your opinion in this brand if you have any experience with it? I really enjoyed logistics of this line but I’d like to know your opinion to see if many women have had success using this brand. Thanks!

    1. Hi! I really dislike the kiinde nipple if I’m being completely honest. It’s a odd shape which encourages a narrow latch. But every bottle works for at least one baby out there…

  23. Thank you Rachel for this article. There have been a few recent studies that measured flow rates from various bottle nipples using different methods; they found that the slowest flow nipples are usually not from the brands that are constantly advertising about how breastfeeding friendly they are.

  24. Wonderful blog post! I have very similar opinions and suggestions when I consult with a breastfeeding mama going back to work and introducing a bottle. THANK you for making it into such an easy and comprehensive read!! I will refer people to your posts!

  25. Have you heard of Mason Bottles? We used their nipples and they worked well. I chose them because of their design and that we could use glass mason jars that we already had. I would love to get your opinion of them though!

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