It was 2012 when I met my future mentor. She had spent a quarter of a century studying infant nutrition with funding from the National Institutes of Health. Her body of work is unparalleled as far as I know.

What did I hear?

  • Newborn babies automatically know how to breast-feed. The suck/swallow/breathe reflex and latch instinct are almost always intrinsic. But feeding is the biggest physical challenge a baby faces. They need skill, strength  and stamina to accomplish the task and any or all of these factors may be inadequately developed or compromised, especially in preemies.
  • Sometimes, the demands of breast-feeding are beyond the baby and we must use alternatives. But the alternatives should, as far as possible, serve the natural instincts and abilities of the baby. There are many circumstances where a bottle is either the only option or an important contributor to the feeding regime.
  • We know the baby is programmed to latch on to the nipple and draw milk into its mouth. We know that it tires easily. We know it switches rapidly between states of alertness and focus. We know that it is easily distracted and disturbed. It is not a scaled down adult. It is at a unique stage in life which will pass quite soon.

What did that mean? The bottle should, quite simply, give our baby what it needs; a nipple that is comfortable and a supply of milk available on demand without interference from hydrostatic or vacuum pressures. In other words, we should let the baby control the pace of feeding just as it does in the natural world. I later learned about the adoption of Dee Kassing’s paper Bottle-Feeding as a Tool to Reinforce BreastFeeding which reinforced the thinking.

The research showed a large uptick in the number of babies that could feed orally at birth with the adoption of Paced Feeding. All we needed to do was to switch mothers away from standard bottles designed to drip milk into the mouth (due to hydrostatic pressure) and relieve vacuum buildup as the milk depleted.


Now we could reduce the likelihood of tube feeding, get babies out of the NICU quicker, and generally reduce the incidence of feeding maladies caused by the forced-feeding that had become tradition.

But perhaps not.