Does my baby need to be able to hold their own bottle?
Foodie Judy here - welcome! Megan and I have the privilege of interacting with thousands of families on Instagram and our private Feeding Littles Clients Only Facebook Group for those who have taken our online or in-person courses. One question we have heard often is, "Should my baby be able to hold their own bottle?"
The short answer: yes. We want babies to be able to hold their own bottle, as doing so is an important skill and strength-building exercise that develops their hands at a midline position. However, for a variety of reasons we always want to hold/supervise baby as they bottle feed - more on this later.
Note: taking milk from a bottle is a skill that many exclusively breastfed babies never need to do. Some babies never accept a bottle and go straight to a cup. If your baby doesn't need to or won't take a bottle, they're not missing a key developmental skill as long as they're also practicing "hands to midline" in other capacities. More on this below.
First, let's discuss midline position, why it's critical in your child's development, and how to help promote bringing hands to midline or crossing midline.
What is "midline" and why does it matter?"
The midline is an invisible line from the top of our head to bottoms of our feet, separating the two sides of the body. We cross that imagery line any time we move a foot, hand or eye into the space of the other foot, hand or eye. We also cross the midline with our tongues when we use the tongue to laterally move food from one side of our mouths to the other.
The ability to freely cross the midline allows us to do almost every daily life activity, including bathing, brushing our teeth and hair, driving a car, using a keyboard or playing sports. Midline is necessary for visual tracking. We rely on visual tracking for reading, as our eyes must continually cross the midline as they scan the page. Watch a young reader as they learn to read a simple book: at first, they may have to turn their head slightly as they read the book, then they progress to pointing to the works as their heads stay mostly still. Eventually they no longer need to point to the words as their eyes do all of the work - crossing midline has become automatic.
Not only is crossing the midline essential, but it's also important for your baby to be able to hold objects at midline. When toddlers can't hold their own cup, they struggle to stay hydrated. Babies who can't successfully hold food at midline may have trouble learning how to self-feed. Check out baby Bryson (7 months), below, holding his own water cup at mealtime. (For more on water and hydration needs in babies, toddlers and kids, click here.)
Thus, the reason why we want baby to eventually hold a bottle is because it leads to holding other objects like water cups, food, toys and eventually books, crayons and pencils in their hands. It's part of a progression that eventually supports independence and learning.
OK, so midline is important...but how do we develop it during bottle feeding?
Around 3 months of age, babies begin to notice touch inputs in their hands as they take shape of an object like a rattle, toy, bottle or breast. By 4-6 months, babies begin to transfer objects from hand to hand. This is a very exciting fine motor milestone - you may notice that your baby practices this repeatedly. It's essential in their development of a sense of midline.
Since we know hands at midline are important, here are some techniques I use to help babies work toward holding their bottle - and eventually other objects - at midline when you are holding them for a feeding. We always want to hold/supervise babies with bottles.
I'm breastfeeding. Does my baby need to hold a bottle? How can I develop their hands at midline?
Some breastfeeding moms choose to not give a bottle of expressed milk to baby and go straight to a cup when offering water (6+ months). Perhaps mom doesn't respond well to a pump or baby refuses a bottle. If your baby doesn't ever take a bottle, they're not missing out on a developmental skill. They don't need to learn how to drink from a bottle to be a successful self-feeder and cup drinker.
It's still important for breastfed babies to bring their hands to midline while feeding. Below are some techniques I use with my breastfeeding clients to help promote hands to midline:
My baby can hold their own bottle? Can I just let them do their own bottle feeds?
Once your baby has the ability to hold their own bottle, many parents want to let them bottle feed independently without holding baby. You may see babies drinking bottles independently and wonder if your baby is "too old" to be held for bottle feeds.
I'm a realist. I bottle fed my children and work with parents every day in my private practice. I completely understand that sometimes it's just easier to hand baby their bottle in the stroller at the zoo and let them do their thing once they're able to hold it themselves. We always come from a place of gentle education without judgment. Take this information and do what works best for your family.
The concerns I have regarding independent bottle feeding are two-fold:
The flow of a bottle can be fast, and sometimes babies can't keep up with it or can't pull the bottle away while drinking. This is why it's especially important to avoid propping a bottle for baby to drink. When a baby is unsupervised while drinking a bottle, their risk of overeating or choking on the liquid is increased. Furthermore, a baby drinking on a completely flat surface like in a crib has an increased risk of ear infections, as milk can pool in their mouth and flow back into their Eustachian tubes.
Note: if you are breastfeeding, laying a baby flat during breastfeeds (for example, while side lying) does not carry the same ear infection risk because milk doesn't pool in their mouth the same say.
When babies drink from a bottle while sitting straight up (e.g. in a high chair) they have to tilt their head back to drink, which leads to poor sucking skills. If your baby needs milk while seated, we recommend working on a cup instead of a bottle. Start with an assisted open cup and work to a straw or other cups as described in this post.
Bonding and Interaction
Bottle feeding, like breastfeeding, is meant to be an interactive experience. Similarly to family meals with solid foods, bottle feeding time is an opportunity to bond. Holding your baby while they bottle feed - even if they hold their own bottle - promotes communication, language, social interaction, eye contact, rhythm (if you rock or sway), trust in their caregivers, and a sense of security. Encourage them to hold their own bottle when they're ready, but I encourage you to hold them at a 45 degree angle and interact with them while they bottle feed.
I hand my toddler a bottle in the middle of the night to drink in their crib and go back to sleep. How do I get them to stop?
Check out Taking Cara Babies, our dear friend and internationally-renown sleep expert, who has plenty of resources that will help you and your child get a good night's sleep.
What if my baby won't sit still for bottle feeds?
Older babies (7-12 months) start to get mobile and may not want to sit still for a bottle feed. If they have been crawling, cruising or walking with their bottle it can be hard to get them interested in cuddling during bottle feeds. Sometimes their refusal to sit still may tell us more about their development than we realize.
If you're peeked around our website or followed us on Instagram, you're well aware that we love Baby-led Weaning (Infant Self-Feeding). I (Megan) have been teaching it since 2013 to thousands of families in the Phoenix, Arizona area, and Judy and I released an online version of the course in 2017 utilizing feeding therapy and nutrition therapy techniques. Read what our clients are saying about our courses here.
With that being said, BLW is not appropriate for all families. We are not here to judge or recommend only one type of infant feeding; our goal with this post is to provide a resource for friends and family members who may be confused about BLW or may want to learn about its benefits. If your child has any medical or developmental issues, be sure to speak with your pediatrician before going this route.
Click the link below for a PDF version of this downloadable!
Feeding a baby or toddler can seem very overwhelming. There are so many routes to take, potential products to buy, things to consider. In a time when parents are bombarded with too much information, choosing the right approach for introducing solids may be more overwhelming than ever.
Our followers know that while we love the Baby-led Weaning (infant self-feeding) developmental approach (and even have an online course all about it), we also support all families on their feeding journey and recognize that what works for some doesn’t work for all. Yes, we work with families who spoon feed and love to help them make that a positive experience. No, we don’t think spoon feeding is unnecessary for some families, nor do we think that there’s one right way to feed a baby. Ultimately, we want feeding to be a positive experience where the caregiver follows the baby’s lead. We also want the caregiver to have positive feelings about the feeding experience, since babies can pick up on anxiety surrounding mealtime.
Eventually, the goal for every baby (barring health or medical issues) is independent, safe self-feeding. This may happen at a different rate for each baby. We’ve seen some confusion about how long to spoon feed, transitioning from spoon feeding to self-feeding, if food before one is even important, and other feeding fiction over the last few months in our Feeding Littles Group on Facebook. We want to set the record straight from a nutritional and developmental perspective on a few key feeding issues.
1. There are essentially two main approaches to infant feeding - Baby-led Weaning (infant self-feeding) and traditional feeding (sometimes referred to as Traditional Weaning). While the approaches seem different, the eventual goal for both BLW and traditional feeding is self-feeding all safe textures.
Baby-led Weaning is defined by babies feeding themselves whole foods (not exclusively purees) from the start. These foods are offered in the shape of a stick or strip because 6-month-olds usually lack the pincer grasp and cannot pick up a small piece of food. However, many parents are nervous about babies eating textures like avocado, banana, cooked sweet potato, or softly cooked chicken, so a modified approach may work better for these families. Offering pureed or mashed food on loaded NumNum GOOtensils (or dumping a puree on baby’s tray!) can be a good way to start letting your baby feed herself a texture that makes you feel more comfortable. Once you see her maneuver the food in her mouth, you may be willing to offer her other foods. Learn more about smart spoon feeding here.
2. Anything that’s not breast milk or formula is considered a “solid” or a “complementary food,” and we don’t recommend offering these foods until baby is ready.
Some parents confuse the guidance on offering complementary foods because they assume that pureed food is not a “solid.” Recommendations to wait until around 6 months for solids apply to feeding your baby any type of food that isn’t breast milk or formula. In assessing readiness, keep in mind that sitting with minimal assistance is key. For most babies, this is around 6ish months. Read more about developmental milestones for solid readiness here.
3. Food before one is not just for fun.
In fact, introduction of food in the second half of infancy is extremely important for a variety of reasons. The term “food before one is just for fun” sounds catchy and has gained in popularity since the BLW movement has gained momentum, but the unfortunate reality of this phrase is that some parents take it to mean that food has no importance before one and breast milk is all a baby needs. Some parenting circles consider it best to not give baby any food except breast milk until 1, which can set baby up for a host of developmental, allergenic and nutritional issues.
Yes, breast milk or formula fulfills the majority of baby’s nutritional needs in infancy, but at or around 6 months of age baby needs some iron and zinc from food. Allergenic foods are important to introduce by around 6 months as long as baby does not have a high allergy risk (parent with an allergy or eczema/other allergic condition – if this applies, talk to your doc). If you skip offering food until 1 year of age, you may potentially miss a key allergen window. Plus, babies who don’t have exposure to various food textures by around 9 months run the risk of feeding issues later in life. They also miss exposure to a variety of flavors and may be less likely to accept strong flavors as they get older. We work with toddlers who have struggled to accept new textures and flavors for a variety of reasons, including lack of exposure in infancy, and it can be tough on the entire family. Of course, sometimes kiddos end up in feeding therapy or nutritional counseling for many reasons out of a parent’s control, but not offering food to babies after around 6 months of age and letting them play, explore, taste, chew and learn about food is a concerning trend in the parenting world.
Above all of these reasons, we encourage parents to watch their baby’s cues and to follow their lead with feeding. Many babies are interested in food as they approach 6 months of age. Not letting them eat food of any kind until 12 months hinders their natural interest in the world around them and doesn’t let them model what they see adults and other children do every day – eat food! They also miss out on the social and language-building element of eating together. Yes, we need to wait until baby is ready for food, but waiting much past 6-7 months doesn’t give your baby some sort of advantage (barring medical issues); it may prevent him from being the eater he’s meant to be.
This phrase may also be taken to mean that food introduction can be casual. We strongly support keeping mealtimes fun and low stress and not worrying if baby misses a food meal due to teething or illness, but we've seen in time and time again that babies who get more practice with food are more skilled, successful eaters.
4. Make sure baby can pick up the size food you offer.
This is especially important in Baby-led Weaning, where baby feeds herself from the start. Since 6-month-olds lack a pincer grasp, offering diced up food can make them frustrated. As your baby becomes a more skilled self-feeder, she can handle smaller pieces of food.
5. It’s important to follow your baby’s lead.
Some parents become frustrated when their spoon-fed baby starts grabbing for the spoon. Remember, we want all babies to eventually self-feed, so this is a great first step! Offer her the spoon (or a NumNum GOOtensil) loaded with some mashed or pureed food, and try some soft finger foods like avocado or banana spears, softly cooked chicken, or cooked sweet potato spears after that.
6. If you have decided to spoon feed your baby, we recommend encouraging independent self-feeding by no later than 14-16 months.
Of course, if your baby has developmental or medical issues, this may not be the case. Some parents love spoon feeding their baby and enjoy making baby food. If that works for you, great! Spoon feeding is not meant to be forever, and the term “traditional weaning” doesn’t mean that baby is always fed by his parents. That’s why technically you don’t “switch” from traditional weaning to BLW – inherent in traditional weaning is the idea that your baby eventually self-feeds.
Even though it’s a messy process, let your baby and toddler feed himself a variety of foods. Regularly putting food in your toddler’s mouth and not letting him try it himself prevents him from developing the skills needed to self-feed. It can also lead to distracted eating or overeating and a host of other feeding issues.
7. You do not have to wait 2 weeks between spoon feeding a baby and giving her finger foods.
The myth that there should be a “rest period” after stopping spoon feeding and before letting your baby self-feed whole foods has been flying around BLW boards for years, and it’s simply not backed by science. The theory behind this “guideline” is that when babies go from being fed a puree to putting foods in their own mouths, they are more likely to choke because they will swallow the food without chewing. Well, babies new to BLW who have never had any kind of food may also try to swallow without chewing - that’s what they have the protective airway mechanism that is the gag reflex. In fact, Judy uses smart spoon feeding and self-feeding other textures within the same feeding therapy session all the time. The entire premise behind BLW is that it is safe for a baby to self-feed all textures; if this 2-week “rule” were true, it wouldn’t be deemed safe to let baby self-feed yogurt, hummus and guacamole while simultaneously letting them self-feed spears of avocado or cooked broccoli.
8. Gagging is a reflex and is your baby’s way of safely protecting her airway. However, gagging should improve over time.
For many babies new to self-feeding whole foods, gagging is a common thing. It should get better with practice. If your baby continues to gag very frequently after many weeks of practicing with real foods, talk to your pediatrician. Excessive gagging can lead to a feeding aversion.
9. A choking hazard is a choking hazard for all babies, independent of feeding style.
Just because a baby starts food utilizing BLW doesn’t mean he can “handle” choking hazards better than another baby. Cut grapes, cherries, and cherry tomatoes into quarters, and remove skin or small bones from meat. Avoid popcorn, chips, gum, and hard candy until age 4. Apples and raw carrots are unexpected choking hazards; we recommend softening both or shredding before serving (until age 4).
10.You do not have to offer only vegetables if you want to raise a veggie-lover.
Fruit won’t ruin your baby. Have you ever tasted breast milk or formula? Yup, very sweet. Your baby already knows what sweetness is, and starting on just vegetables hasn’t been shown to improve his diet quality long-term. What does help foster adventurous eating is exposure to ALL foods, with lots of repetition - some babies don't like foods until they've seen them 20-30 times!
You don’t have to offer fruits with every meal, but rather make sure to have at least one veggie and/or fruit at every meal for exposure to different flavors and nutrients. Don’t forget to pair the produce with a high-iron food like beef, salmon, chicken, lentils or beans!
11. When your baby turns 1, you can offer a sugary cake – or not.
Do whatever makes you feel comfortable. (Judy and I gave our kiddos real cake, for what it’s worth…and my first didn’t even touch hers!) If you want your baby to eat a Paleo cake, fruit, or a cupcake made with applesauce, great – just don’t overly stress yourself. Many, many babies don’t eat their first birthday cake – offering one is more for fun, tradition, even just photos. We've also seen funny taco, BBQ and watermelon first birthday smash photos that look just as fun if you want to try something unique. Read more about our philosophy on this here.
If your baby eats some cake, he will be OK. Remember that all foods fit, and we need to teach our kiddos that it’s not a big deal to have some cake eventually. Focus on the fact that you survived your first year with baby! That calls for some cake (or champagne!) for you!
Megan and Judy, co-owners of Feeding Littles, bring you helpful info on food, nutrition, picky eating, and feeding young children. Megan McNamee MPH, RDN is a Registered Dietitian Nutritionist based in Scottsdale, Arizona. Judy Delaware, OTR/L is an Occupational Therapist specializing in feeding therapy with children 3 and under in Boulder, Colorado. Megan and Judy are both moms of two and love helping families develop a healthy appetite for all foods!