Choosing a baby bottle and nipple that’s right for your breastfed baby can be tricky. Your baby now has to work with a rigid plastic nipple rather than your soft, flexible skin. Brands have made put a lot into nipple designs to make them more ‘breast like’, however ultimately it will be down you and baby’s preference.
Let’s look at what you should consider when looking for the best baby bottle nipples.
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Baby Bottle Nipple Basics
1. Flow
For a breastfed baby, the nipple flow of the nipple is the most important factor when choosing a baby bottle. Basically the flow of the bottle is dependent on the number and shape of the holes or slits in the top of the nipple, which lets the milk out. Most brands will label there nipple flow similar to clothing sizes, the smaller the number the slower the flow.
Size 0
Also known as preemie flow or first flow. These bottle usually have one pin thin hole in the nipple. They are ideal for premature babies or new born babies who struggle with new born nipples.
Size 1
Also known as new born flow. These nipples have one standard side hole and are designed for a term new born up to 1 month old. Some breastfed babies may prefer these at any age if they struggle with bottle nipple flows.
Size 2
Also known as slow flow. Designed with 2 holes for babies around 1-2 months old or breastfed babies who are fine with a slightly faster flow.
Size 3
Also known as medium flow. These nipples have 3 holes at the top and are designed for babies’ age 3-6 months old. We would not recommend these for a breastfed baby of this age. This size can be a replacement size for breastfed babies who are weaning and can hold a bottle themselves.
Size 4
Fast flow teats. Designed with 4 holes for babies over 6 months old. As above, we wouldn’t recommend these for a breastfed baby unless you are exclusively pumping. The flow is too fast if baby is still nursing and risk of bottle preference will increase.
Variable Flow
These nipples have a straight or Y shaped slit rather than holes at the top of the nipple. These are designed for babies over 3 months and for thicker liquids such as hungry baby formula. We recommend these are avoided for breastfeeding babies as the flow is often too fast for breast milk and can lead to overfeeding and colic symptoms.
Slow flow rates are much more suited to breastfed babies as they have more control over the speed. Ultimately the choice will be down to you and whether you feel the rate is too fast or too slow for your baby.
Slow Flow Nipples
Advantages
• Ideal for younger babies
• Similar to breastfeeding rates
• More control of flow
Disadvantages
• Older babies can become frustrated
Fast Flow
Advantages
• Good for older babies
• Fine if baby mom is exclusively pumping
Disadvantages
• Baby can choke or splutter if too fast
• Increase likelihood of bottle preference
• Overfeeding
Remember to check the packaging for the flow rate as the sizing can vary between brands, most confusion comes between the first flow and new born flow sizes.
2. Shape
The shape of the nipple will have a huge influence on whether baby prefers the bottle or not. You should choose a shape according to your needs. Let’s explore bottle nipple shapes
Standard
Easy to find and inexpensive nipples. They are your long, ‘old fashioned’ type nipples with a narrow base. The narrow base makes these suitable for preemies or new-born to have a wide but relaxed attachment. Older babies have a tendency to suck at the nipple with these bottles as the base it too narrow for them, we’d recommend wide neck bottles in this case.
Wide Neck
Designed to mimic the roundness of a breast. The shorter teat and wider base makes it easier for breastfed babies to mimic the attachment of a real breast. These are more suited to larger or older babies who can relax their lips around the base. Wide base bottle may be too wide for some smaller or premature babies to attach correctly.
Orthodontic
A slightly angled and flatted nipple. They are designed to mimic the shape of a mother nipples when it’s inside the baby’s mouth. Breastfed babies tend to accept these more than other nipples particularly if they are exclusively breastfed. Be careful when using these nipples as they often have right way up and holding it the wrong way can cause an almost non-existent flow for baby.
Specialist Breastfeeding
Some specialist breastfeeding brands such as Medela and Breastflow have made nipples specifically to mimic breastfeeding. Rather than regular teats which use tongue thrust to release milk, baby need to use compression for milk to flow. The idea is to make the transition between breast and bottle easier. These nipples often have mixed reviews and are quite expensive compared to regular nipples. They are worth their weight in gold to parents looking to reduce the risk of your baby preferring bottles and ceasing to breastfeed.
3. Material
Latex
For many years bottle nipple have been made from latex. Also known as rubber, its a tan colored material which is soft and quite flexible. The texture is preferable to some babies as it is similar to mom’s nipples. The drawbacks with latex nipples are that some babies may be allergic, aftertaste and collapse easy due to lack of structure. We find that exclusively breastfed babies and younger babies tend to do better with latex nipples.
Silicone
A modern nipple material which is clear and structured. Using silicone nipples eliminates the problems with latex teats as they are structured to prevent collapsing, odorless, easy to clean and suitable for babies with latex allergies. Silicone nipples are more suited to older babies as they have a tendency to be firm and less flexible.
Common Problems with Bottle Nipples
The WHO recommend that babies do not use any artificial teats until breastfeeding is established. The reasoning is due to two common problems caused by using nipples.
Nipple Confusion
This is term given to a situation when baby refuses to breastfeed after being introduced to a bottle. There are many reasons babies suffer this problem including:
- Inability to adapt to different suckling techniques
- Muscle memory is pre-disposed to bottle feeding
Risk factors for moms include:
- Separation form baby
- Delayed milk ‘coming in’ (common after C-section or large blood loss)
- Illness (in both mother and baby)
- Premature baby
- Baby with oral problems
- Attachment issues
It’s rare to find a true nipple confusion as most babies will readjust with help. Until you are offering baby regular feeds with correct positioning and attachment then nipple confusion should not be diagnosed. It’s best to seek help for a lactation specialist who can check your nursing and baby’s feeding technique.
Bottle Preference
Just as the name suggests this is when baby prefers to feed from a bottle rather than from the breast. The two main reasons being:
- Baby prefers larger volumes of milk from bottle
- Bottle feeding is less work for baby
The risk factors are the same as with nipple confusion. Bottle preference is more common with babies who have difficulty suckling. It can be seen as a survival instinct as more energy is used when breastfeeding, whereas less effort is required for larger volumes with a bottle.
For breastfed babies the best way to avoid bottle preference is to use the slowest flow nipple possible so that baby still need to make effort to get the milk. Check out our advice on pace feeding – the best method for bottle feeding your breastfed baby.
4 Best Baby Bottle Nipples
Best Newborn – Philips AVENT Natural New-born Flow Nipple
These Avent nipples are easily available to buy in most stores including Babies R us Target, Walmart. Soft flexible and easy to clean. What more can you are for? Well they also don’t leak! The best rated teat for new born babies who are struggling with the preemie size teats. We particularly love that these nipples can be used with the Avent glass bottles, which we highly recommend for breastfeeding. Read more about our top bottle recommendations here.
Best Anti Colic –Tommee Tippee Nipple Slow Flow Nipple
With its air vented design, the air can escape from theses Tommee Tippee nipples whilst baby feeds to prevent it going into baby’s tummy. Ultimately it won’t stop your baby getting colic, but it should reduce the symptoms of trapped air or gassiness. Plus these bottle have a nice wide base with a short teat, which is a great design for breastfeeding babies to mimic breast attachment.
Best Preemie – Dr. Brown’s Natural Flow Preemie Nipple
With the a tiny hole and fantastic flow control these Dr Brown’s Nipples are perfect for both premature babies and expressed milk for breastfed new-borns. If you feel your baby is drinking a bottle far too quickly with the new-born size teats, switch to these and you’ll see the difference. More control over the flow leads to a less cranky and windy baby.
Best Breastfeeding – The First Years Breastflow Slow Flow Nipple
Let’s be honest, you’re either going to love these Breastflow nipples or hate them. You baby will have to work hard and mimic the compression motion of breastfeeding to get the milk out. The up side is that your baby is much more likely to continue breastfeeding without any hitches. The downside is they are quite complicated to use and you can lose some precious breast milk into the nipple which you can’t get out. Proceed with caution when thinking about these nipples, but if the risk of nipple confusion is too high, they can reduce the worry.
