Stop the Bottle Madness

Babies make my heart happy. They truly fill my heart with joy. Another thing that makes my heart happy? Seeing new parents feel confident in caring for their new baby. Something that doesn't make my heart happy? The overwhelming amount of

bottles being sold all with the marketing tagline "natural nipple" and promising to be "just like the breast". These marketing strategies are designed to call on the heart strings of mothers to provide the best for their babies and play on the continued mom-shaming of mothers who choose bottle feeding over nursing. This marketing is what caused the mother of an infant I recently evaluated to have EIGHT different bottles. All with the exact same shape and size nipple - but each promising to be "the best". One of them was literally 6 inches in diameter. If I had used that bottle, there's no possible way I could have seen the baby's face!

These bottles are marketed this way because they have a shorter nipple with a wide base - similar to the appearance and shape of a breast. There are lots of other proposed features such as softer silicone or the shape of the nipple tip. Guys, no bottle is going to be like a breast. It's just not. And while some babies do well with these types of bottles, others (like the baby I saw recently) don't. No artificial product can mimic the shape and movement of a breast during feeding.⁠

You might be thinking, "What's wrong with these bottles?". Well, to answer this question let's talk about the four oral-motor components needed to obtain a successful latch.

#1 - Labial Seal: when the bottle enters the infant's mouth, their lips should form a seal around the nipple. This prevents spillage and maintains the intra-oral pressure that will be created when the baby begins sucking.

#2 - Jaw Excursion - as the infant sucks, their jaw will move forward and back to assist in creating the intra-oral pull that extracts liquid from the nipple.

#3 - Lingual Cupping: the infant's tongue will cup around the underside of the nipple. This is necessary to, again, create intra-oral pull.

#4 - Intra-oral Pull: aka suction. The muscles within the oral cavity as well as the other components listed above work together to create pressure within the oral cavity to repeatedly extract liquid from the nipple all while maintaining a suck:swallow:breathe pattern.

These bottles that are marketed to be "the best" sometime fall short due to the length of the nipple which make prevent adequate lingual cupping and limit the range of motion needed for adequate jaw excursion. Wider bases are also not always appropriate for some babies as it could impact their labial seal. If any of the first three components fall short, it disrupts the intra-oral pressure which throws a wrench in the SSB pattern.

Ultimately, it's important to know that every baby is different. No bottle works universally for all infants - and there is room for parent choice and preference. Some babies do well with these "natural nipples" while others don't. As speech therapists, make sure you are looking past the marketing and examine the child's oral structures and physiology. Then consider what shape and size is appropriate for their oral cavity and functioning. But please, don't fall for this marketing strategy!

If you are a mother/parent/caregiver reading this: please consult your child's primary care provider if your child is experiencing difficulty feeding. The information presented here is meant to advise other speech therapist in successfully caring for their patients. I cannot make recommendations or provide clinical guidance without having seen your child.