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In theory, babies who are breastfed prefer the wide neck model because the nipple is shaped more like a mother's breast; however, this isn't always the case.  In reality, there are anatomical features within a baby's mouth that can dictate which bottle is best for baby.  A high arched pallet and/or a tight frenulum (the delicate piece of tissue attaching the tongue to the floor of the mouth) can make it difficult for babies to latch on to a wide neck nipple.  If your baby has difficulty latching to your breast or a baby bottle, consider seeking help from a certified lactation expert. 

Q. When do you use a 5 oz. baby bottle vs. a 10 oz. baby bottle?

A. A 5 oz. baby bottle is typically used for newborn babies.  At around 4 – 5 months (sometimes earlier, sometimes later), your baby will want to eat more than 5 ozs. in one feeding session.  At this time you will move up to a 10 oz. bottle.  Another option would be to feed smaller 5 oz. meals more frequently, which many lactation specialists believe is the better choice.  Regardless of whether you use a 5 oz. or 10 o.z bottle, be careful not to overfeed your baby. This can create gastrointestinal distress and some experts believe can be linked to childhood obesity.

Q. Why are there three nipple flows available and when do you make the switch?

A. The three nipple flows correspond with baby's developmental stages: 

The age spans associated with the nipple flows above are general guidelines and although they are appropriate for most babies, be aware that all babies are different.  Some babies may use a slow flow nipple through 9+ months, while others may use a fast flow nipple at 4 months.  As with most things baby-related, it depends on the baby.  If a baby is breastfed, the nipple speed used can also relate to a mother's breast flow, which varies from woman to woman.  The best approach is to observe your baby carefully as he/she feeds and watch for indicators such as frustration or choking that may indicate an incorrect nipple flow choice.  

Q. What is nipple collapse?

A. Nipple collapse occurs when, as a baby is feeding, he/she sucks the air out of the bottle, which creates a vacuum effect and draws the nipple into the bottle.  If nipple collapse occurs when your baby is feeding, make sure you have not over-tightened the ring that attaches the nipple to the bottle.  This is a common cause of nipple collapse.  The ring should be well secured, but not so tight that is cuts off all air circulation into the bottle.  Nipple collapse can also result when transitioning a baby from one brand of baby bottle to another.  A small percentage of babies can develop a strong sucking pattern while feeding with one kind of baby bottle—especially vented systems—and have a difficult time modulating the amount of suction used when moving to a new bottle.  If your baby experiences nipple collapse, it's best to make the transition slowly.  Give your baby a week or two to adjust as you begin to integrate the new bottle into his/her daily feedings.  Begin by giving your baby the new bottle once a day and after a day or two try increasing to two feedings.  After two to three more days, try moving up to three feedings a day using the new bottle. Continue in this pattern over a 1 – 2 week period.  If after two weeks your baby is still experiencing problems with the new bottle, it's probably time to seek another option.  This is likely a sign that the fit is not right for your baby.

Q. When should I choose a hole opening over an "X" (also known as cross cut) or "Y" opening? 

A. There are two common types of openings for baby bottle nipples, a hole opening and a cross cut (or "X").  The hole opening is used primarily for breastmilk and formula, while the cross cut opening is used for thicker fluids such as pulpy juices or cereal.

Q. Is silicone a better material for baby bottle nipples than rubber? 

A. Silicone is an ideal material for baby bottle nipples due to its inherent ability to withstand repeated exposure to extreme temperatures such as those required for sterilization and because it is non-toxic and odorless.  Rubber can be an issue for some babies, particularly if he/she has a latex allergy.  Some synthetic rubbers contain carcinogenic chemical compounds named nitrosamines, which have been found to migrate from rubber into liquids.  If you decide to use a rubber nipple, be sure to check with the manufacturer to ensure it is a natural rubber free of nitrosamines. 

Q. Should I only be considering a baby bottle with an anti-colic feature? 

A. There is nothing that strikes greater fear in new parents than the threat of colic.  Many baby bottle manufacturers offer anti-colic features for their bottles, from vented nipples to vented inserts, which allow air to flow from the outside into the bottle.  The theory is venting systems neutralize negative pressure inside the bottle and cause less air to flow out of the bottle with the liquid and into baby's belly, alleviating painful gas.  But are these features really necessary and do they really work to cure colic?  The answer is, it depends.  In most cases that which is attributed to colic is not actually gastrointestinal distress, but rather a series of environmental factors that create stress for baby during the first three months of life (see Oh Dreaded Colic for more information).  In these cases, an anti-colic device will do little to solve the problem.  But in a much smaller number of instances there is the possibility that an anti-colic device may provide some relief for colicky babies.  I recommend starting with the bottle you like best, regardless of whether is offers an anti-colic system.  If your baby adapts well to a bottle without an anti-colic device and exhibits no signs of colic, great!  Fewer pieces to wash and keep track of.  If not, you can decide where to go from there. 

Q. Can baby bottles be safely heated in the microwave? 

A. Although technically most baby bottles can be sterilized in the microwave, it is not recommended for several reasons.  First and foremost, microwave ovens destroy vital nutrients found in baby's food, whether it be breast milk or formula.  Microwaves can also create hot spots that can potentially be dangerous to baby when feeding.  And lastly, it is never a good idea to microwave plastics of any sort, regardless of the type.  It's best to avoid repeatedly exposing plastics to extreme temperatures in order to preserve the stability of the molecular structure.  When plastics begin to break down they are likely to absorb odors and possibly to leach. 

Q. Can I wash my baby bottles in the dishwasher? 

A. Much like the answer to the microwave question above, most baby bottles can be washed in the dishwasher; however, I don't recommend this.  Dishwashers—in particular newer models with "quick dry," "heated dry," or "sterilization" functions—heat contents to extremely high temperatures, which is best to avoid with plastics in order to preserve the stability of the molecular structure.  When plastics begin to break down they are likely to absorb odors and possibly to leach.  I make this same recommendation for all plastics, even those that are BPA-free.  The best way to care for your plastic baby bottles is to hand wash them in hot soapy water using a gentle, non-toxic cleanser.  This method works just as well to kill germs and best preserves the appearance of your baby bottles over time. 

Q. Do I need to continually sterilize my baby bottles and nipples? 

A. There is a one-word answer to this question: no.  It is recommended that parents sterilize new baby bottles and nipples once for 3 – 5 minutes prior to first use.  After that a gentle, non-toxic cleanser and hot water work just as well to kill germs and to best preserve the appearance and performance of plastic baby bottles (unless your water supply is suspected of harboring contaminated bacteria).  Think about how much easier your life just became!  To learn more about the history of baby bottle sterilization and why it's not necessary to continually sterilize, please see: http://parenting.ivillage.com/baby/bnutrition/0,,b11b,00.html