How to Choose the Right Bottle Nipple Size and Flow Level

Transitioning your baby from breastfeeding to bottle feeding can be tough. However, choosing the right bottle nipple size and flow level and knowing when to switch the size or level will help. These two factors can be determined through your baby’s age and feeding pattern.

Baby bottle nipples are not one size fits all. As a parent you want to purchase bottles and nipples that are right for your baby. This article will help guide you through determining what works best for your baby. Also do note that every baby is different. Their feeding rate and preference could be very different for their age. We will discuss ways to identify if a particular bottle nipple size and flow level works or not for your little one.

Understanding The Right Bottle Nipple Level

The right bottle nipple level is based on the flow rate of a bottle which simply indicates the rate at which milk flows through a bottle nipple to your baby as they feed. The flow rate appropriate for your baby is determined through their age. The flow rate is often indicated on the packaging. This rate varies by the number and type of hole on the silicone nipple . The chart below will help guide you to choose the right bottle nipple size and flow level to match with your baby’s development.

Significance of Right Bottle Nipple Sizes 

Choosing the right nipple size is an important factor to consider. Choosing the wrong nipple size could lead to a bad feeding experience which no parent wants to go through. 

You want your baby to get the right enough food and by choosing the right bottle nipple your baby is eating at a pace comfortable to them. Smaller nipples could cause them to eat too slowly where they get frustrated at the slow flow rate and not eat at all. At the same time, too big of a nipple size can prevent them from latching on, excess milk spilling or too fast of a flow could make them gag and cough out milk. This discomfort could discourage your baby from wanting to eat in the future.

To prevent a bad feeding experience, there are signs to lookout for to know if you’ve picked the right bottle nipple size and flow rate:

Indicator of a nipple being too small

• Sucking too hard and fast
• Nipple collapsing as they forcibly suck through
• Taking a lot longer to feed 
• Getting annoyed and pushing the bottle away or squirming

Indicator of a nipple being too big

• Excess milk spilling as they feed
• Coughing, gagging or choking 
• Swallowing forcibly
• Uncomfortable after feeding and gassy baby
• Refusing to feed
• Lead to a reflux

A bigger size nipple and faster flow could also create digestive issues. While bottle feeding, babies tend to gulp too much air which could cause gas related discomfort for babies. A smaller bottle nipple could help to reduce the flow rate and will let your baby drink at a slower pace  which will reduce the intake of air. It also helps to tilt the bottle to the point where the milk fills up the entire nipple with milk. 

Signs to Switch to the Right Bottle Nipple Sizes 

There is no defined time or age to change to the right bottle nipple size for your baby. Not all babies are the same and some can stick to the same nipple size throughout their feeding time. But at the same time there are babies who need to advance and switch to a bigger or faster flowing nipple. There are different cues parents can look out for:

• Sucking, gulping too hard and nipple collapsing
• Taking a lot longer to finish feeding
• Getting frustrated, squirming or pushing away the bottle
• Refusing to eat but getting hungry a lot faster later on

If none of these cues are noticed then it is most likely that your baby is comfortable with the size and flow rate of the nipple and there is no reason to switch if they are comfortable and are feeding well.

If you do decide to switch, look for the signs below which could clearly indicate that it is best for your baby to go back down a level that is comfortable. These signs could be:

• Coughing, gagging or choking or spitting out
• Excess milk dripping out
• Gulping and swallowing too hard
• Refusing to eat

Right Bottle Nipple Sizes for Breastfed Babies 

As you stop or reduce breastfeeding and transition to bottle feeding can be a new experience and you may want to mimic the feel of breast feeding as much as possible. It is highly recommended to use a slow flow for newborns or babies transitioning. 

It is important to start with a slow-flow nipple because a mothers breasts don’t release milk at a fast rate and babies need to work at it to feed. Whereas bottle feeding often has a faster flow and babies would receive milk at a faster rate. There is a tendency for babies to prefer bottle feeding and not return to the breast due to the ease at which they receive milk. Babies are also used to the slower flow and so leveling up nipple sizes could cause a baby to take way too much milk and too quickly causing digestive issues. The bottle flow should mimic the slow flow of breast milk and therefore it is best to start with a level 0 or level 1.

There are other steps that can be taken to help your little one transition smoothly from breastfeeding to bottle feeding and avoid nipple confusion:

• Avoid overfeeding your baby with bottle feeding. Paced bottle feeding helps.
• Feed in a semi upright position supporting their head in your arms.
• Tilting the bottle making sure the milk covers the nipple to avoid air intake.
• Selecting a suitable bottle style, nipple size and level or texture.

Selecting the Right Bottle and Nipple 

Selecting the right bottle and nipple can be an overwhelming task especially with all the brands, variety and specifications available in the market. Nipple Size and flow rate being one of the many such as bottle material, shapes and size, Nipple material and levels, and other bottle specifications for like double duty bottles that support pumping and others like vented bottles.

There can be slight variability between brands in relation to the bottle nipple size and flow rate. Almost all brands indicate the nipple size and flow level on the silicone nipple or packaging. 

Well recognized brands like Dr Browns may focus on different categories too. For instance the focus is more for preemie’s who may have to bottle feed for reasons such as a mother not producing enough milk, traumatic birth, latching issues, etc. 

Products like the Ultra-Preemie Nipple are ideal for premature babies and medically fragile babies that need a very slow flow rate. This nipple of Mr Brown’s offers the lowest rate compared to other brands.

Other brands like Tommee Tippee which are quite innovative in design, provide closer to nature anti-colic bottle nipples with powerful anti-colic bottles that keep air away from your babies milk and it also indicates if your babies feed is too hot through built in heat sensing strip that turns pink based on the temperature of the milk. 95% of mothers have highly recommended this bottle nipple for its distinctive design in providing a natural latch which is great for babies transitioning from breastfeeding to bottle feeding which mimics the feel of a natural nipple.

When to Change Nipples 

Changing nipples is not only for times when your baby requires a level up or down size and flow rate. In fact nipples need to be changed regularly. Nipples wear off really fast with the sucking and tugging during feeding. It is recommended to replace nipples every 2 months if signs of damage or weakness show.

Here are signs indicating a new bottle or nipple is required:

• Change in color of bottle or nipple. More of a stained look
• Thinning of nipple silicone
• Any sign of tears, cracks or breaks that can cause a choking hazard
• Weak nipple- Determined by pulling at the nipple top and it not returning to its original shape

Choosing the right bottle nipple size and flow level is of utmost importance. Ensuring your baby gets a good feed and is healthy and well is every parent’s concern. Based on your little one’s age you can easily decide on a suitable nipple size and flow rate. However every baby is different and feeding preferences can vary. It is important to look for cues discussed in this blog and make adjustments based on what works best for your baby. Figuring this out will take time and patience and a lot of trial and error but you will soon be able to determine what works best as you progress with bottle feeding. Change can be tough for your little one but many brands support with various specifications and variety and knowing when to replace nipples will eventually lead to a great feeding experience for both you and the baby.