Bigger Baby, Bigger Nipple? Changing formula and nipples as your baby grows

If you’ve ever stood in front of the nipple display at Babies R’ Us with a pounding migraine, or stared anxiously at the Enfamil ads proclaiming that your baby is NOT A BABY BUT AN INFANT!!!, this one’s for you.

Even in the two year span between my babies, the commercial infant formula and bottle-feeding landscape has changed dramatically. New formulas have leaped onto the market, and the old ones now have different packaging which imply improvements…. bottle choice has expanded exponentially, with Born Free offering a new line, Tommee Tippee bursting onto the market with their space-age, breast-shaped bottles, and a new study coming out that suggests Dr. Brown’s may do more than alleviate gas pains. But even two years back when I was feeding FC, there were products marketed to older babies, and I do remember wondering what the hell that was all about. In case you’re in the midst of that particular freak out, I want to share a couple of things to help save you and your checkbook some unnecessary stress.

Holy Holes: Do I need to change to faster-flow nipples as my baby grows?

My son was a voracious eater. A true bottomless pit, he’d drink whatever you put in front of him, and drink it fast. Now he’s a scrawny toddler who will barely consume 500 calories a day, but the minute you put a drink in front of him, watch out. Luckily he’s like a camel, otherwise potty training would’ve been a real challenge.

Back when he was a baby, though, we always wanted to slow him down; he was on $30/can hypoallergenic formula, and he’d suck down the bottle so rapidly that I worried his stomach wouldn’t get the message that he was full. (Sometimes, I think this is some residual side effect of being starved in the womb and in his first few weeks of life; the first time he had a bottle he drained it, and never stopped drinking in that same desperate way. Weird.) So even though he had a before-bedtime bottle well into his toddler years, we kept him on the Stage 2 nipples his entire bottle-drinking career. He didn’t seem to have a problem with it, so what was the point to switching to a faster-flow nipple which would make his meal times mas rapido?

The deal with the nipple “stages” is that as babies grow bigger and stronger, they supposedly get frustrated with the slow flow preferable for newborns; they can handle, and indeed expect, a faster flow. If your baby suddenly starts acting pissed off during feedings, or fussing at the bottle, it may be an indication that he’s ready to change it up. The people who market these things are clever, so the nipples will often be labeled in a confusing way – “newborn”, “0-3”, “3-6”, “6+” – implying that you need to buy new nipples the day your kid turns 3-months. This just isn’t the case. It’s more of an individual thing… most babies do need to move up from the newborn flow, but you could feasibly skip these altogether if your brand of choice offers a 0-3, or “Stage 1” version.

My advice? Buy the 0-3 or Stage 1 to start; if your baby ends up having trouble with the flow and needs to downgrade to the Newborn, you won’t have wasted your cash, because she’ll be ready for the 0-3’s soon enough. You can stay on these until your feedings become little battles, with her pulling away, sucking furiously on the bottle, or furrowing her little brow and giving you the baby equivalent of stink-eye. At this point, move on to the Stage 2; you may find that you can stick to this level until you wean off bottles. There’s no need to buy the next level up simply because you have a baby of the corresponding age range.

Just one more little tip: don’t get confused by the Y- or X-cut nipples. The only reason to use these is if your kiddo is on thickened feeds. And god bless you if he is, because finding the right nipple for Fearlette’s thickened formula was a flipping nightmare. We sliced holes in regular nipples (not something I recommend, but Fearless Husband likes to MacGyver things), and tried the Y-cut nipples of 3 different brands before finding one that worked. Makes me wonder why anyone would add cereal to bottles unless absolutely necessary…


When Your Baby is Not a Baby: Different ages, different formulas?

Oh, Enfamil. I’d really like to have a chat with your marketing team. From those recent banner ads which warn that some frightening percentage of babies have feeding problems, to your “Restful” formula which promised to stuff babies into submission… you make some really misguided choices.

However, I’m kind of on the fence with this “stages of formula” concept. I strongly believe that formulas do differ, contrary to what most websites will tell you. To be clear, though, this does not mean that all formulas, generic and brand name, don’t have to meet certain nutritional standards. No matter what commercial formula you choose, you can rest assured that your baby will be adequately nourished.

Formula companies want our money. They try and get our money by advertising, and yes, some of the time, this advertising is smoke and mirrors. But another way to make money is by providing a product which is needed, and which works. For example, by offering Nutramigen and Alimentum, Enfamil and Similac answered a need: they created products which could be tolerated by babies with food allergies and sensitivities. Then, they were able to market these products to the masses by promoting them as a solution for colic. Despite the impressive statistic listed on the can, the studies didn’t necessarily show that these formulas can “cure” colic; I think it’s more likely that a lot of kids diagnosed as “colicky” were actually food intolerant in some way, and the hypoallergenic just made their poor tummies feel better – hence creating a happier, less “colicky” kid. Regardless, both the need and the marketing led to sales for this product. The less-admirable intent of one does not necessarily negate the worth of the other, you know?

That’s why I’m trepidatious to come down too heavily on formulas which claim to serve the needs of different stages of babyhood. Breastmilk changes over time; why shouldn’t formula? One of the arguments against formula is that it is “static”. I’m not saying Enfamil has countered that argument with these formulas, but I think the products open the door for competitors to come up with formulas more tailor-made to a baby’s growth and developmental stages.

For now, though, until I see some research which makes me think otherwise, I don’t think you need to buy into this advertising. There’s nothing wrong with using these age-specific formulas, but if you love Good Start or Sam’s Club Sensitive or whatever, there’s no harm in sticking to it for the entire first year. Remember that between 4-6 months, you’ll be starting solids; this will “change it up” enough for your little one, giving them nutrition from a variety of sources. Until then, all formulas have the nutrition your baby needs to grow and thrive, and what changes will be the amount that they take in, and at what times (which will be the topic of my next post in this “formula feeding tips” series – how much, and how often, to feed formula).

That said, you *may* find that your baby is more sensitive in the beginning; I have heard from some FFFs that their babies needed a sensitive (more broken-down) formula for the first few months, and then were able to move on to a “regular”, milk-based version. I always suggest that people start with a more broken-down product (Similac Sensitive, Good Start, Gentlease, etc.) because there’s no harm in doing so, and it will avoid the potential stress of wondering if your baby needs sensitive formula. Might as well skip that step, because there will be enough to obsess about in those first weeks.

To sum up:

  • Only change to a different nipple size when your baby is acting like the current one is too slow; it’s totally fine to be using a Stage 2 nipple at 10 months, as long as s/he is satisfied and eating well.

  • Don’t feel the need to spring for stage-specific formula until there is research proving that these formulas really do differ and answer the needs of various stages.

Suzanne Barston is a blogger and author of BOTTLED UP. Fearless Formula Feeder is a blog – and community – dedicated to infant feeding choice, and committed to providing non-judgmental support for all new parents. It exists to protect women from misleading or misrepresented “facts”; essentialist ideals about what mothers should think, feel, or do; government and health authorities who form policy statements based on ambivalent research; and the insidious beast known as Internetus Trolliamus, Mommy Blog Varietal.

Suzanne Barston – who has written posts on Fearless Formula Feeder.


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21 thoughts on “Bigger Baby, Bigger Nipple? Changing formula and nipples as your baby grows

  1. We use the Playtex VentAire bottles, so there's “slow” (which comes with the 5-oz. bottles) and “fast” (which comes with the 9-oz bottles), and I think there's a “medium” too, but I'm not sure. We, however, have just stuck with the “slow” nipples the whole time, and LO is 8.5 mos old, no feeding problems, etc. I guess I could try to step up to the “fast” nipples, but I just don't see the point. I figure, if he's hungry, he'll eat, and I'm okay with him having to work a little at it. 🙂 Also, we're working (slowly) on transition to (sippy) cups anyhow, so, you know, if he wants a faster flow, he can have a cup!

  2. “The less-admirable intent of one does not necessarily negate the worth of the other, you know?”

    Can we put this on t-shirts, please? It sums up so much.

    We tried the 3 month nipples at around 3 months and it was not a smart move. I can second your assertion to not worry about the age range on the package and go with what your child actually needs. She got gassy and fussy, so we swapped back to the newborns, which we used till she was probably 8 months and then we went back to the 0-3 month ones. I'm with Laura, I suspect this helped in motivating her to learn to use a cup. The sippie was very hard, but one thing that ultimately helped was that it was easier than the bottle. Given how much people freak about bottles and babies' teeth (even when they don't have any, sheesh) this was a plus for my sanity, if nothing else.

    I think our kids might secretly be twins, or maybe it's something in the water in the Midwest…she drank formula like a champ and ate GREAT till she was about a year, and now I feel like doing a touchdown dance if I can get more than a piece of fruit into her. People get surprised when they hear her talk so much because they assume she's 9-12 months and not almost 18. Can I conclude the formula made her smart? It's about as valid a conclusion as any I read on breastfeeding threads on parenting websites. 😉

    Thanks, by the way, for covering the issue of bottle-feeding for older babies. When there is good bottle information (which is rare) it seems to be geared toward newborns.

  3. My daughter is still using Stage 1 nipples and she's almost a year. She never complained in that regard. I tried to switch to some variable flow nipples but they were too fast for her and she would never take them. LOL

  4. My daughter had reflux so we kept her on stage 1 nipples (Born Free) until she was 6 months old. We also used the formula with added rice starch, although we mixed it 50/50 with regular formula during the day because it constipated her. It usually took 45 minutes for her to finish a 6oz bottle. 30 if I was lucky, an hour if I wasn't. But I was okay with it because I knew eating faster would just mean more spit up. Also we always hear how formula fed babies are fatties because they eat too fast. Around 6 months the reflux magically went away. We switched to stage 2 and phased out the rice starch formula. She dribbled more but she eats much faster. She could finish in 15 minutes if she wanted to, but she rarely wants to eat a whole bottle in one sitting anymore, which is rather annoying. We will probably just skip stage 3, and I don't know what variable flow means. I think any faster than what she has now would be a mess.

  5. Wait a minute, if it's a Midwest thing then my days with a champion eater may be numbered. Come to think of it, his oldest cousin was in the 95th percentile as an infant and then could barely be convinced to eat more than 2 bites a meal once he hit toddlerhood. Yeah, the great appetite won't last, will it?

  6. Yeah, honestly, it might be a better idea to just switch to sippies as the kid gets older, considering that could help the bottle weaning process in the long run…

  7. Teri, yes… it does sound like our kiddos have a lot in common! I'm happy to say that at least so far, Fearlette is a WAY better eater than her brother ever was. Although she was a nightmare on bottles – horrible reflux, weight checks, refusing food….but the minute we started her on solids she chunked up like a champ. Go figure. 😉

  8. I do not get the point of those variable flow nipples, for the life of me! Apparently they are supposed to work for thickened feeds, but none of the ones we tried worked for that; they seem way too fast and I don't understand how you can “turn” the nipple to adjust the flow. Although I am spacial-relations learning disabled so it could just be me.

  9. The idea of slower flow nipples helping with regulating infant eating is a really interesting one. I wonder if anyone has done research into this? I'll look into it…

  10. I got the theory behind it. We use born free so I'm basing this off their nipple. When viewing the nipple instead of having a little wee circular hole it has a straight line shaped opening which when you turn is supposed to open a bit for “slow” a bit more for “medium” and all the way for “fast” based on if it is turned thusly:

    — for slow flow (one drop facing upwards)
    \ for medium (two drops facing upwards)
    | for fast (three drops facing upwards)

    I guess the theory is that the way the nipple will be compressed in the mouth will make it so that the opening will allow a different amount of formula through.

    In practice however I found her making this SLURPING sucking noise and then rejecting the bottle right away over and over and it didn't matter which way I had it, it all sounded the same – too fast. She wouldn't ever take them again. And I didn't feel like buying more so I just stayed with the Level 1s that came with the bottles. LOL

  11. My sister formula fed and when I asked her this question, she said that felt the nipple itself changed over time, so the slow flow became faster because of regular sucking.

    My mom also cut the nipples with little x's for cereal back in the day for me and my sisters.

    I should also add that my daughter did not like the infant-specific formula. When I used the powder, it was very thin, despite my husband's precise and scientific (see: borderline obsessive) measurements.

  12. As a combo feeder I stuck with the stage one (Dr. Brown's) nipples through 6 months and then switched to the #2 nipples b/c child would get impatient and was eating so much more that feeds started to take 20-30 mins with the slower nipple. At some point we switched to #3 nipples but those made him burp and get uncomfortable a lot so we switched back to #2 till he was a year old. He does still love his bottle for milk now that he's on milk proper.

    Anyone have thoughts on formula for 11-14 month olds? We continued on Neocate even after introducing milk b/c baby was not so into solids at first and was not getting enough calories and peds said not to overdo the milk (especially as he had the whole milk protein intolerance issue as a wee baby) so one bottle a day till about 14 months was still formula. Neocate stopped making their toddler formula so we stuck with the Infant version, but i wondered if it was nutritionally correct. Tried Nestle formula while travelling but that made him really constipated. Has anyone successfully switched their child from Alimentum/Neocate to a regular formula?

  13. The new Enfamil newborn formula actually came in handy for us to test out whether my daughter would be able to transition to cow's milk from her Nutramigen at 1 year old. The LC (yes, she still helped me the whole year even though my daughter was completely formula-fed for most of it) suggested trying her out on the newborn formula because the protein balance might be easier for her to tolerate – there was less of the protein to which she was sensitive. So this formula was a safer way for us to test the waters of her intolerance than just trying cow's milk or regular formula. Ultimately, she had a similar reaction, but not as bad, so we delayed cow's milk introduction and so far she has tolerated goat's milk really well. But I was glad that the newborn formula was available as an option for us to try the transition.

  14. FWIW, if you read the ingredients, the Enfamil Newborn (light blue tin) is EXACTLY the same as the yellow tin (Enfamil Premium Lipil) except it had MORE Vit D. For my combo feeding purposes, it made no sense to switch her to yellow since breastfeeding babies needed Vit D supplements anyway, according to my Doctor. We only switched to yellow tin because I could buy it in bulk at Costco. 😉

    Oh, and we still use Stage 1 nipples. I figured MY nipples didn't change, so why should the bottle ones? She drinks the bottles faster now, never got frustrated… I wonder if the holes just stretched out over time. Personally, I think it's all trying to make us buy more. I figured if it wasn't broke, I wasn't going to fix it.

  15. Nope, the protein ratio is also different. This is from the product description on the Enfamil website:

    Enfamil PREMIUM Newborn provides an easy-to-digest, 80:20 whey-to-casein protein blend patterned after typical early breast milk of days 3 through 5 of lactation.15 With appropriate levels of essential and nonessential amino acids, the protein is of excellent quality and supports healthy growth and development.

    And here is the description of the yellow tin:

    The protein in Enfamil LIPIL is patterned after breast milk with 60% whey and 40% casein.7 With appropriate levels of essential and nonessential amino acids, the protein is of excellent quality and promotes good growth and development.

    Newborn is an 80:20 ratio, and infant is a 60:40 ratio. When you have a child with a casein protein intolerance, that 20% makes a huge difference. So the difference definitely goes beyond the extra vitamin D.

    Sure, if you just look on the can, both are going to list protein in the same amounts – but not all protein is the same. Having a milk protein intolerant child makes you look at the details a little more closely.

  16. We use the same bottles and started with Slow as well. Even thought the larger bottles come with more “fast” nipples, I have gone and specifically bought the slow nipples for them for a few reasons. #1 My daughter is 7 months old and a hungry lady, but the slow flow has never seemed to bother her. #2 I tried a fast flow (since they came with the bottles) and it came out so fast when she was 6 months, that as she fell asleep during a feeding, it would keep dripping into her mouth (even though she wasn't sucking) that it would build up at the back of her throat and she would wake up gagging on it 🙁 #3 Human nipples do not magically change their opening size as the baby grows, so I didn't expect to need to change the opening size of our artificial nipples 😉 #4 I also like FFF think that the slow flow, just like we are encouraged to eat more slowly, helps her decide when she is full AS she is eating, instead of after she's eaten too much 🙂 We too, are just moving on to sippy cups. So far, I prefer the slow flow.

  17. Hello! I’m desperately trying to figure out the next step for my daughter. She’s 5 1/2 months old and is the size of a large 9 month old, so obviously a good eater. Even though she was colicky, she still needed to move up in nipple size and has made it to the stage 3s already (Tommee Tippee anti-colic bottles and nipples and they were a Godsend!) Now, she’s showing signs that she is getting impatient with the level 3s, but I cannot figure out how to remedy this situation. What suggestions do you have?

    • Hmm. Well, unless you want to switch to a different type of bottle that has a faster flow (my memory of the Tommee Tippee bottles is that they intentionally have a “slower” flow to mimic breastfeeding), I think your only option would be to widen the hole of the nipple with a (sterilized) safety pin or toothpick or other sharp instrument that won’t fray the nipple. That’s what I usually recommend for moms using thickened formula, when the nipple doesn’t allow for a thicker flow to come through. Does Tommee Tippee have a variable flow nipple option? That might be worth a try too…

      Also, are you sure she’s frustrated with the flow? Sometimes babies are fussy at feedings for other reasons. Maybe she’s uncomfortable for another reason? Can you describe her behavior so I get a better idea of what’s going on?

    • I also use tommy tippee and my daughter is nearly 5 months old and weighing 9 kgs. I changed to the vari flow nipples around 3 months and for the first day or two nearly drowned herself but she got use to it and realised that she didnt have to suck as hard. No problems with the vari flow, and she can use them till weaning onto sippy cups.

  18. My daughter is 2 weeks old and has been having trouble and getting frustrated with the slow flow nipple. I am using the avent natural with her. I tried a stage 2 nipple yesterday and she seemed to have better luck with that. I’m just curious if its too soon for her to be on a stage 2 nipple? She has also been drinking 4oz every 4 hours. Our pediatrician said to feed her whenever she is hungry and how ever much she will eat. Is 4oz too much for a 2 week old baby?

    • Every baby is different! If she’s not spitting up excessively or having any other feeding issues, and she seems happy and satisfied, you’re all good. 🙂 And if she likes the Stage 2, that’s fine too.

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