Frequent flexible bottle feeds help make sleep easy if you're not direct breastfeeding (and baby is under six months of age)

It's normal for bottle feeding babies to fall asleep with a feed

Babies often fall asleep with a feed, especially very young babies. This is evolutionarily normal. It happens because (regardless of whether the bottle contains breast milk or formula) the milk causes

• A rise in the neurohormones of relaxation and sleepiness due to milk in the tummy. (Not all bottle feeds transfer much milk and this is normal too as long as your baby is gaining weight well overall.)

• Dialling up of the parasympathetic nervous system, which is the ‘rest and digest’ part of the involuntary nervous system.

• Deep relaxation and enjoyment from sucking (which further dials up the parasympathetic nervous system). Sucking is soothing for your baby's nervous system and also dials down the sympathetic nervous system.

• Physical closeness and loving interaction, which also dial down your baby’s sympathetic nervous system.

From an evolutionary perspective, feeding is a crucial part of your baby’s sleep ecosystem. If parents feel they can’t feed their baby to sleep throughout that first year of their baby's life, then sleep often becomes a lot harder than it needs to be for the whole family. Bottle feeding parents and carers are able to attune with their baby’s evolutionary needs as closely as possible by using paced bottle feeding. You can find out about paced bottle feeding here.

Paced bottle feeding responds to your baby's cues

Offering the bottle whenever you think it will dial your baby down makes sleep easiest for your family. Milk is a 'tool' for keeping your baby dialled down. Sleep pressure kicks in easily for a dialled down baby. Offering frequent flexible milk using paced bottle feeding can be so helpful for families who are not able to breastfeed that frequent flexible feeds with the bottle is a baby-sleep superpower. You can find out about paced bottle feeding here.

Your baby’s sleep needs decrease throughout the first year of life. This means that your baby will drop off to sleep at the bottle less and less often during the day. But many parents bottle feed their baby to sleep into toddlerhood. They find it easiest. There are some things to be aware of though if you have a toddler who is bottle feeding.

Is it possible to overfeed with the bottle?

Your baby will let you know if he doesn’t want the bottle, by back arching, turning his head away, tensing up and clenching fists or splaying fingers, or keeping his little mouth firmly closed. These are not signs of reflux or allergy or gut pain.

Sometimes we think our baby must be hungry despite these signs, and we're tempted to try to persuade the baby to keep on going with the feed. But it’s important not to. Any pressure with feeds can cause a conditioned dialling up. You can offer again in a short period of time if you wish. In the meantime, just focus on changing environments – perhaps stepping outside – and finding richer sensory nourishment to dial down your little one.

Research does show a link between formula-fed babies with rapid weight gain in the first two years of life and unhealthy body weights in later childhood and adulthood. It’s thought this results from thinking of the feed as a complete meal so that parents feel responsible for emptying the bottle.

For the most part, until your baby starts solids, it's best to use the bottle whenever you think it would dial the baby down, accepting irregular and sometimes small volumes and the need to discard formula or expressed breast milk at times. Keep an eye on the recommended volumes for your baby’s weight on the formula container, and speak with your GP or other qualified health professional if your baby has a pattern of taking more than the recommended amount or is on a percentile line higher than that of birth.

Make sure you're not accidentally pressuring your baby to feed

It’s normal to find ourselves feeling rather desperate to get the baby to sleep at times. Sometimes, in the hope of sending baby to sleep, we might be tempted to encourage the baby to continue to bottle feeding, even when the baby is pulling off or looking unhappy about it. But unfortunately, any pressure with feeds can backfire, and result not just in a conditioned dialling up with the bottle, but in worsened sleep.

Selected references

Appleton J, Russell CG, Laws R, Fowler C. Infant formula feeding practices associated with rapid weight gain: a systematic review. Maternal and Child Nutrition. 2018;14:e12602.