How to Bottle Feed a Baby: Paced Feeding, Positioning and Burping

The short version

Hold the baby fairly upright, keep the bottle close to level, let the baby set the pace, and stop when they show they're full. Paced feeding works for breast milk or formula, and for any caregiver. For how many ounces by age, see the feeding amounts guide.

Positioning

• Sit comfortably with your arm supported. Hold the baby semi-upright (head higher than tummy, about 45 degrees or more), head and neck in line, not tipped back or chin to chest.
• Never feed a baby lying flat. It makes swallowing harder and may raise ear infection risk.
• Switch arms halfway through. It rests your arm and mirrors switching breasts.

Paced bottle feeding, step by step

1. Start at early hunger cues: stirring, rooting, hands to mouth. Crying is a late cue; calm first.
2. Brush the nipple down the baby's upper lip and wait for a wide-open mouth. Let the baby draw the nipple in rather than pushing it in.
3. Hold the bottle nearly horizontal, tipped only enough that milk fills the nipple tip, so the baby works for the milk as they would at the breast.
4. Aim for a rhythm of a few sucks, a swallow, a breath. After every 20-30 sucks, or if the baby gulps or milk spills, tip the bottle down so the nipple empties while still in the mouth. Tip it up again when they start sucking.
5. Halfway through, burp and switch sides.
6. Stop when fullness cues show, even if milk is left.

Most feeds take about 10-20 minutes. Much faster usually means the flow is too fast; much longer can mean it's too slow or the baby is tired. See the nipple sizes and flow guide.

Hunger and fullness cues

• Hungry: rooting, sucking on hands, lip smacking, alert and eager.
• Full: slower sucking, turning the head away, pushing the nipple out, relaxed open hands, falling asleep, closed lips.
• Not finishing the bottle is fine. Babies vary feed to feed and day to day. Don't coax the last half-ounce, and throw out what's left (see the formula preparation and pumping guides for timing).

Overfeeding

• Signs: large or frequent spit-ups after feeds, a tight tummy, squirming, gassiness or pulling up the legs, and in time faster weight gain than expected.
• A baby who sucks after a bottle may just want to suck. Try a pacifier or a cuddle before more milk.

Burping

• When: halfway through, at the end, and any time the baby squirms or pulls off. Many formula-fed babies burp every 2-3 oz (60-90 mL).
• Over the shoulder: baby high on your shoulder, cloth underneath, pat or rub the back.
• Sitting on your lap: lean the baby slightly forward, supporting the chest and jaw (not the throat) with one hand.
• Face down across your lap: head supported and a little higher than the chest.
• No burp after a minute or two? Carry on. Keep the baby upright 10-20 minutes after feeds if they spit up. See the spit-up guide.

Safety

• Never prop a bottle. A baby can choke and can't push it away, and propping is linked to ear infections and tooth decay.
• Never put a baby to bed with a bottle. Feed, then lay them on their back in their own flat, firm sleep space.

Partners and other caregivers

• Anyone can learn paced feeding; show them once and watch a feed.
• Hold the baby close, make eye contact and talk softly. Responsive feeding is about connection as much as ounces.
• For a breastfed baby's first bottles, see the combination feeding guide.

When to check in

Call the pediatrician the same day if: - The baby often coughs, chokes or turns dusky during feeds even after slowing the flow. Call 911 for blue lips, limpness or pauses in breathing. - The baby refuses several feeds in a row, has fewer wet diapers, or is unusually sleepy. - There's forceful or green vomiting, or a baby under 3 months has a temperature of 100.4°F (38°C) or higher.