Feeding your little one is a wonderful bonding experience. But if you’ve opted to bottle feed, it can also be a bit overwhelming as you start weighing all of the available choices. Some bottles may be best for younger babies. Other bottles claim to help gassy babies. How to decide?
Don’t worry--Pathfinder Health is here to talk you through everything you need to know about selecting the best baby bottle for your child, safety and cleaning guidelines, and other tips that can make feeding time smoother for everyone involved.
In this article:
Why parents use baby bottles
Bottle feeding is truly a lifesaver for millions of parents. It untethers the mother from sole responsibility for feeding the baby, permitting her to work, care for other children, and leave the house for longer periods without her baby.
It also allows the father and/or other caregivers to feed the baby and enjoy the bonding that comes from that one-on-one time.
Formula feeding
Baby bottles are a must for formula feeding. Parents may choose formula for their babies for a variety of reasons:
Parents cannot--or choose not to--breastfeed
Babies either cannot nurse or are unable to drink breast milk for medical reasons
Parents need to supplement breastfeeding with formula
To learn more about baby formula, see The Basics of Baby Formula.
Pumped breast milk
Many families also use baby bottles to feed their baby expressed (pumped) breast milk. A mother may pump and then provide bottles if she works outside of the home or if she cannot--or chooses not to--breastfeed.
In other circumstances, babies may be unable to breastfeed for medical reasons but can still benefit from receiving breast milk.
Other liquids
As a general rule, babies should not drink anything other than breast milk or formula from a baby bottle.
From birth to six months, breast milk or formula provide all of the nutrients and hydration that your baby needs. They should not have any additional water.
After six months, you can begin giving your baby small amounts of water, but this is a good opportunity to help them practice drinking from a cup.
After your baby turns one, you can begin transitioning to cows milk (in the absence of an allergy or sensitivity). This is a good time to start weaning them off of a bottle and encouraging them to drink from a cup.
You should not give a baby juice or soda at all.
There are no reliable statistics showing the total percentage of babies who are least partially bottle fed. However, the data shows that at least 75% of babies drink some formula. Add to that the total number of babies who drink pumped milk from baby bottles. That's a lot of bottles!
How to choose a baby bottle
Just like other types of baby gear, there are an overwhelming variety of baby bottles on the market today. To help you understand your options and select the best baby bottles for your child, we'll go through all of the features of baby bottles and describe some of the ways that different types might benefit your baby.
Parts of a baby bottle
Bottle
This is the main part of the baby bottle--where the liquid goes!
Bottle Sizes
Baby bottles come in two basic sizes:
Small: 4-5 oz
Large: 8-9 oz
The small size is intended for young babies, who drink less at one sitting. Once your child reaches around four months, you'll likely find that they are eating more and it's time to switch to eight or nine ounce bottles.
It's also totally fine to skip the smaller size bottles entirely and start with larger bottles filled only halfway. The smaller ones just take up less room in a dishwasher or diaper bag.
Bottle shapes
Standard
Standard baby bottles have straight sides and are the easiest to fill and clean.
Angled
Angled bottles look like a straight-sided bottle that was bent into an L shape. They are designed to prevent a baby from swallowing excess air and reduce gas and spit up. This bottle shape can be harder to clean.
Wide neck
Wide neck bottles are designed to use with wide nipples. Some suggest that these imitate the experience of breastfeeding and may be the best baby bottles for breastfed babies.
Material
Plastic bottles
Plastic bottles are the most commonly used type and come in numerous types and styles. They travel well but may be harder to keep clean since they scratch easily and can retain odors.
Although you may have heard concerns about the possibility of the chemical BPA in plastic baby bottles, rest assured. In 2012, the U.S. Food & Drug Administration banned the use of BPA in baby bottles and sippy cups, so new bottles must be made from BPA free plastic.
Glass bottles
Glass bottles are easier to get really clean and can last forever--unless they break! They are also heavier and therefore harder for babies to drink from independently. A silicone sleeve can both protect the glass bottle from breakage and help your baby grip it.
Many parents prefer glass over plastic for environmental reasons.
Silicone bottles
Silicone bottles are a newer option and harder to find. They are a middle road between plastic and glass in a number of ways--a silicone bottle is lighter than glass and easier for babies to hold, unbreakable, and easier to get clean than plastic (although not as easy as glass).
Some silicone bottles collapse as your baby drinks, which squeezes out air and prevents air bubbles from becoming trapped in your baby's tummy.
The following table compares some of the factors to consider in choosing baby bottles:
Nipple
Material
Nipples come in two materials: latex (rubber) and silicone, each with its advantages and disadvantages:
Flow rate
Flow rate refers to how quickly liquid moves through the nipple and into your baby's mouth.
It's important to make sure that you are using a bottle nipple with a flow rate that is appropriate for your baby’s development, health, and feeding style.
If the flow rate is too slow, your baby will have to work harder to get milk/formula and may become frustrated. If the flow rate is too fast, your baby may not be able to keep up and may gasp or choke. This also causes them to swallow more air bubbles, leading to gas and spit up.
For more information about gas and spit-up, see Burping Babies: How You Can Ease and Prevent Discomfort and Why Babies Spit Up and How To Help.
The best flow rate for a baby is not necessarily tied to their age. Breastfeeding babies--even older babies--might do better with slow flow nipples because the flow rate is closer to the experience of breastfeeding. We'll discuss this more under "paced bottle feeding," below.
Nipple shape
Baby bottle nipples come in several shapes and types:
Standard: tall and bell-shaped
Orthodontic: wide at the tip and base and narrow in the middle; designed to protect a baby's gums and promote tooth formation
Wide: resembles the shape of a breast and can make the bottle more appealing to a breastfed baby
Consult with your pediatrician to see if your baby should use a certain nipple shape. If there are no medical considerations, you can try different shapes to see which your baby likes best.
While you can often use different styles of nipple with the same bottle, keep in mind that most bottle brands are not interchangeable. You may be limited in nipple material and shape options if you prefer one type of bottle, and vice versa.
When to replace baby bottle nipples
You should replace a bottle nipple immediately if it shows any sign of cracking or tearing, becomes discolored, or otherwise appears to be wearing out. Check bottle nipples regularly to make sure they are still in good shape.
You can also move up to the next flow rate if your baby seems to be taking a long time with a feeding or is becoming frustrated. If your baby seems content, though, there is no need to fix what isn't broken!
Vent system
Some brands of baby bottles feature a vent system--a straw-like tube that runs down from the mouth of the bottle and prevents air bubbles from entering the milk. These bottles may help to reduce gas, colic, and spit up for some babies.
Other considerations
Ultimately, choosing a type of baby bottle and bottle nipple depends on both your and your baby's personal preference. Some important factors to consider are:
Are you breastfeeding as well as bottle feeding?
Does your baby have any medical issues to consider, such as a tongue tie that has been diagnosed by a doctor or speech language pathologist?
Does your baby have colic?
How much money are you able and willing to spend?
Some companies offer a baby bottle sample pack that allows you to test a few different bottles to see which type your baby will like best before you buy multiples.
And keep in mind that you may need to change baby bottle types as your baby grows and their needs change!
Best for colic: Dr. Brown's Natural Flow Anti-Colic Options+ with narrow bottles
Dr. Brown’s bottles use an internal vent system to prevent air intake during feeding, which can reduce colic and spitting up. They offer multiple flow rates to optimize feeding at each stage of a baby’s growth.
Best for breastfed babies: Lansinoh Breastmilk Feeding Bottles
Lansinoh bottles have a gradual slope and tapered nipple that imitates the natural breast and is great for kids going from breast and bottle. With only three pieces and a wide mouth, this bottle is simple to use and easy to clean.
Best for paced feeding: Philips AVENT Natural Baby Bottle with Natural Response Nipple
The nipple only releases milk when the baby sucks, allowing them to control the feeding pace.
If you bottle feed, what type of bottle do you use for your baby?
Dr. Browns bottles
Philips Avent Natural bottles
Comotomo bottles
MAM bottles
How to use baby bottles
Ages for bottle feeding
Beginning bottle feeding
If you are exclusively bottle feeding (either formula or pumped milk), the answer is simple: Your baby will start drinking from a bottle on their very first day!
If you are planning to both breastfeed and bottle feed, this question becomes a little trickier.
Nipple confusion
You may have heard the term "nipple confusion" to describe a baby who becomes fussy and frustrated while breastfeeding–or even refuses to breastfeed–as a result of also drinking from a baby bottle, which may have a faster and more consistent flow rate.
The concept of nipple confusion is still not widely accepted in the medical community, although there is some evidence that babies might come to prefer one type of feeding to another.
So what is a parent to do? It’s ideal to wait around four weeks before introducing a bottle, if possible. This gives some time for the mother’s milk supply and the breastfeeding routine to be well-established. However, not every family can wait four weeks before introducing a bottle. Your baby will adapt!
Weaning your child from a baby bottle
Age
Babies should generally be weaned off of a bottle between 12 and 15 months. Although weaning can be challenging, it's important because prolonged bottle feeding can contribute to tooth decay.
Additionally, children who are overly reliant on drinking from bottles may not eat enough solid foods to meet their nutritional needs. They can also have trouble developing self feeding skills that can further inhibit their consumption of solid foods.
Tips for weaning from a baby bottle
Your child may be very attached to drinking from a bottle and may resist the weaning process. It's best to begin at a time when there aren't any other big changes happening in your family.
Around six months, begin helping your baby take sips of water from a cup so they can get used to it.
Around eight to ten months, begin substituting an open cup (with your help) or sippy cup for one scheduled bottle feeding. Use a cup for this same feeding for one week.
The next week, substitute a cup for a second feeding. Continue gradually replacing bottles with cups for one feeding every few days to one week.
Because an evening bottle may be part of your child's comforting bedtime routine, you might want to replace it last.
Once you switch to a cup for a feeding, be consistent and don't go back to offering a bottle.
Be patient!
Methods for bottle feeding a baby
Paced bottle feeding
Paced bottle feeding is a method of using a bottle to mimic breastfeeding. It lets babies drink more slowly and take breaks when they need to. Putting a baby in control of their feeding pace can help to prevent them from overeating and can reduce gas and discomfort.
Paced feeding can be beneficial, regardless of whether your baby is both breast and bottle fed or exclusively bottle fed. However, it is not necessary for all babies.
Formal paced feeding involves the following steps:
Feed your baby when they show hunger cues, such as fussiness, rooting, or sucking on their fists.
Use a slow flow nipple.
Hold your baby in a semi-upright position (leaning back only slightly) so that you aren't pouring milk into their mouth.
When your baby roots or opens their mouth, place the bottle nipple across your baby's lips and let them latch on as they would when breastfeeding.
Hold the bottle almost horizontally, to better let your baby control the flow.
Let your baby suck for around 20 to 30 seconds, then give them a break of a few seconds.
Continue this pattern until your baby shows signs of being full. For example, they might turn away from the bottle or not start sucking again after the break.
Consult with your pediatrician to see if paced feeding is right for your baby. They may suggest trying a less formal version.
If you do try paced feeding, don’t be intimidated! It may seem complicated at first, but it will quickly become second nature. Also, your baby will get used to this eating rhythm and begin pacing themselves!
Self-feeding with a baby bottle
It can be hugely helpful for your baby to hold their own bottle.
There is a range of ages when your baby might be able to do this. Some babies are able to hold a bottle as early as six months. Most babies don't develop the strength and fine motor skills to both hold the bottle and bring it to their mouth until around eight to nine months.
Keep in mind that some babies are never interested in holding their own bottle, even if they are physically capable of doing so.
Even if your baby self-feeds during the day, you should never put a bottle in their crib at nighttime. We discuss this in more detail below.
Preparing a baby bottle
Breast milk
Pumped milk may be safely stored in the refrigerator in a bottle or milk storage bag for up to four days. It can be frozen for up to six months.
If you are using frozen breast milk, allow it to thaw in the refrigerator overnight, in a bowl of warm water for a few minutes, or under running water before preparing a bottle. Never leave it out at room temperature to thaw or microwave it.
Formula
Mixing infant formula
In general, tap water is safe to use in mixing formula, unless there are known contaminants in your area. Always use cold tap water and warm the formula after it is mixed.
If you are concerned about the safety of your tap water, you can boil it first and let it cool to room temperature or slightly above before using. Another alternative is to use bottled water.
You should also use bottled or boiled water to prepare formula if your baby is less than two months old, was born prematurely, or has a weakened immune system. Talk to your healthcare provider about any other steps that you should take for a higher risk baby.
Otherwise, when preparing formula, it is essential to follow the formula package directions regarding safe handling and mixing, in particular the correct ratio of water to formula. Watering down your baby's formula reduces the amount of nutrients they receive in a bottle, which can impact their growth and development. Adding extra water also throws off the balance of electrolytes and minerals in the formula, which can lead to kidney damage and seizures.
Warming bottles
There is no medical reason to warm a baby’s bottle–it is perfectly safe for a baby to drink room temperature or even cold formula or milk if they are willing to do so.
Some parents may choose to warm milk or formula before feeding it to their baby. In fact, it will likely be more palatable for breastfed babies that are accustomed to drinking warm milk.
If you do warm your baby’s bottles, you can use a bottle warmer or simply put the bottle in a bowl or mug of hot water for a few minutes. Swirl the bottle gently to even out the temperature. Before feeding your baby, shake a few drops on the inside of your wrist to test the temperature.
Best overall: Philips AVENT Fast Baby Bottle Warmer with Smart Temperature Control and Automatic Shut-Off
The Philips AVENT bottle warmer is very efficient. A medium-sized bottle takes about three minutes to evenly warm and a smart temperature control prevents milk and food from overheating. It also features a defrost setting that’s specifically designed to warm frozen breast milk or baby food.
This bottle warmer is designed to heat up both baby bottles and baby food quickly and evenly by using steam heat, which helps to prevent hot spots.
Most convenient: Kiinde Kozii Baby Bottle Warmer and Breast Milk Warmer
The Kiinde Kozii heats bottles faster than most other warmers and is one of the few that doesn’t need fresh water every time.
Budget option: The First Years Baby Bottle Warmer and Sterilizer
The First Years Simple Serve is one of the fastest and cheapest warmers on the market, but it requires the user to add an exact amount of water for each use, bottle parts come out hot, and it can’t thaw frozen breast milk.
Cleaning baby bottles
Hand washing bottles
The Centers for Disease Control and Prevention (CDC) provides the following guidelines for washing baby bottles by hand:
Washing in a dishwasher
The CDC provides these guidelines for washing in the dishwasher (where bottle parts are dishwasher safe)
Sterilizing bottles
You should sterilize both the bottle and the nipple before using them for the first time, usually by boiling them for five minutes. Always follow the instructions on the package regarding sterilizing--different types of bottles (especially glass baby bottles) may have different requirements.
After the first use, it is generally not necessary to sterilize bottles and nipples after every use, as long as you have a clean water supply.
Check with your doctor if you are worried about the safety of your water supply or if your child is premature or has other health concerns. In some cases, it may be best to sterilize bottles more frequently.
Safety precautions for using baby bottles
Preparing a baby bottle
Safely prepared bottles are essential to your baby's health. The following precautions will help to minimize the risk of bacteria or other contamination and protect your baby:
Always wash your hands thoroughly or use hand sanitizer before preparing a bottle and/or feeding your baby.
Be sure to use a fresh bottle for each feeding.
Prepare bottles on a clean, sanitized surface. Do not place bottle parts or formula lids or scoops on contaminated surfaces, such as counter tops or sinks.
Propping a baby bottle
"Bottle propping" refers to the practice of using a pillow, rolled blanket, car seat side, or any other item to hold a titled bottle in a baby's mouth so that the parent or caregiver does not have to hold the bottle.
Both the Centers for Disease Control and Prevention (CDC) and the Academy Of American Pediatrics (AAP) caution against bottle propping for a variety of reasons.
If the flow rate is fast and your baby can't pull away the bottle or move their head away when they need a break, they could choke. They could even aspirate (breathe in) the milk or formula, which can lead to pneumonia or even death.
Your baby may overeat if they can't stop feeding when they are full.
Propping a bottle while your baby lays on a flat surface increases your baby's risk of ear infections because the liquid can flow back into their Eustachian tubes.
Pathfinder Health understands that feeding a baby can be a time consuming task and it can be tempting to use shortcuts to save some of that time. But bottle propping is simply not a safe practice and is not worth the risk.
Sleeping with a bottle
You should not give your baby a bottle in their crib at bedtime. If your baby falls asleep with milk still in their mouth it can result in tooth decay.
Additionally, as discussed above, drinking on a completely flat surface like a crib mattress increases your baby's risk of ear infections.
Unfinished bottles
Discard any unused formula left in the bottle one hour after the feeding begins. Breast milk should be used within two hours after beginning the feeding.
Baby bottle FAQs
How many baby bottles do I need?
There are many factors that influence the number of baby bottles you should buy:
Are you exclusively feeding your baby with a bottle? If so, you'll likely want want eight to ten bottles. If you are also breastfeeding, you can get away with buying significantly fewer.
How often are you able and willing to clean bottles? You can buy fewer if you clean dirty bottles more often. On the flip side, they will wear out sooner and need to be replaced.
Are you preparing bottles ahead of time, for instance to give to a caregiver? You'll need more in this instance.
What are the best baby bottles?
Check with your pediatrician if you have any questions about choosing the best baby bottles for your child's particular needs, for instance if they spit up frequently or you are concerned about combining bottle and breastfeeding. Your pediatrician can advise on the best baby bottles for these situations.
But at the end of the day, the best baby bottle is the type that your baby is happiest to drink from! You may need to try a few different varieties and brands to find the best bottles for your baby.
How many bottles should a baby have a day?
If you are exclusively bottle feeding, the number of bottles that your baby will drink in a day will change as they grow. Generally, older babies eat less frequently as their tummies get bigger, they eat more at each feeding, and they start solid foods.
Of course, your baby will also go through periods where they might eat more or less frequently in a day due to growth spurts, sickness, or other factors.
On average, you can expect that your baby will eat approximately the following number of times per day depending on their age. The amount that they eat at each feeding will change significantly as they grow. Just remember to follow your baby's hunger cues to determine when and how much to feed them.
If you are breastfeeding as well as using baby bottles, you can divide each day's feedings between breast and bottle however it's most convenient.
How long can you keep using a baby bottle? Do they expire?
Baby bottles don't "expire" the way that some products do. But, depending on the type that you use, they may need to be replaced fairly often.
Plastic bottles have a relatively short lifespan. Daily trips through the dishwasher, being stuffed into a diaper bag, and other wear and tear causes tiny scratches to form in the plastic--this is why bottles begin to look cloudy and discolored. Bacteria can get into these cracks, which make it harder to get the bottle truly clean and safe for your baby.
High heat from washing and sterilizing can also cause the plastic to warp and make it harder to fully seal the collar, leading to leaks.
If you notice any of these signs, you should replace a plastic bottle right away. As a general rule, expect plastic baby bottles to last around four to six months.
Glass baby bottles tend to last much longer, since they do not scratch as easily. You should still check them before every use for scratches and chips and replace them if they are damaged. If they remain in good shape, glass bottles can last for years.
As discussed above, nipples should be replaced every couple of months.
Should you replace bottles with each baby?
As long as a bottle is not scratched, discolored, warped, or otherwise damaged, it's probably safe to use with a new baby. You should sterilize the bottles before using them again and replace the nipples, to protect your new baby's developing immune system.
If there is a chance that the older bottle was manufactured before 2012, when the FDA mandated BPA free bottles, you should discard and replace it.
Are [brand] bottles microwave safe?
Regardless of the brand, you should never microwave a baby’s bottle–this can create “hot spots” that could burn your baby's mouth.
Can [brand] bottles be washed in the dishwasher?
Check the manufacturer's instructions on the bottle packaging. As a general rule, all glass bottles are dishwasher safe. Most plastic bottles can be washed on the top rack of the dishwasher.
The Takeaway
Ultimately, when it comes to baby bottles there is no one-size-fits-all approach. Once you've found the right bottle for your baby, make sure to use it correctly and clean it properly so that your baby can be safe and healthy. If you ever feel overwhelmed or need advice on how to feed your baby with a bottle, don’t hesitate to ask your doctor or other parents who've been down this road before.
Sources:
Centers for Disease Control and Prevention, Proper Storage and Preparation of Breastmilk, available at https://www.cdc.gov/breastfeeding/recommendations/handling_breastmilk.htm.
E Zimmerman E, Thompson K. Clarifying nipple confusion. J Perinatol. 2015 Nov;35(11):895-9. doi: 10.1038/jp.2015.83.
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