Choosing bottles and teats

Choosing a bottle can seem surprisingly complicated. Walk into a shop or search online and you will find bottles described as anti-colic, breast-like, natural, physiological, orthodontic, wide-neck, slow-flow, variable-flow and more. Teats come in different shapes, lengths, widths, materials and flow rates, and some bottles contain valves or several separate components.

It can be difficult to work out what actually matters and what is simply clever packaging.

There is no single bottle or teat that is right for every baby. The NHS also states that there is no evidence that one type of bottle or teat is better than another, and suggests that simple bottles which are easy to wash and sterilise are probably best (NHS, 2026a). At the same time, research does show that the characteristics of a bottle and teat can influence how milk flows and how a baby sucks, swallows and breathes. The important distinction is that this does not mean one particular brand or design is universally better.

Your baby's mouth, palate, oral movements, sucking skills, milk flow, feeding position and overall coordination all contribute to how a particular teat works for them.

Teat shape matters

Teats are not all shaped in the same way. Some are relatively short and flat, some are rounded, some are long and narrow, and others have a broad base which gradually tapers towards the end.

The shape changes the way the teat sits inside the baby's mouth and the way the lips, tongue and jaw can interact with it. Bottle feeding is not simply a matter of milk dripping through a hole. Babies use a combination of suction and compression to remove milk, and the characteristics of the teat can influence how that happens (Kotowski et al., 2020).

A short, relatively flat teat may encourage more compression of the teat between the tongue and palate or gums. A broader, gradually tapered teat provides a different structure for the mouth to work around. This does not mean that one shape will automatically produce a better feed, or that a particular teat will suit every baby.

I generally favour a broad, gradually tapered or sloping teat, particularly when a family is combination feeding. There is some research suggesting that teat design can influence oral movements and sucking patterns. For example, Segami et al. (2013) studied an experimental teat with a wide base and firm shaft and found similarities in some perioral movements and sucking patterns when compared with breastfeeding. However, this was a small study involving an experimental teat, so it cannot be used to conclude that every broad teat is more physiological or better for breastfeeding.

This distinction is important because bottle manufacturers increasingly use terms such as "breast-like" or "designed to mimic breastfeeding". A 2025 study of bottles marketed in the UK found that claims about mimicking breastfeeding physiology, supporting combination feeding, reducing bottle refusal or preventing nipple confusion were common, but the scientific evidence underpinning those marketing claims was scarce and often inadequate (Maxwell, Self and Bould, 2025).

A broad, gradually tapered teat may therefore be a practical choice for some babies, particularly alongside responsive or paced bottle feeding, but it cannot guarantee that a baby will continue to move comfortably between breast and bottle.

It is also worth remembering that compression and suction are not the same thing. Babies can use both during bottle feeding, and the balance between them can vary according to the teat, flow and the individual baby's oral movements. A baby using more compression is not necessarily "doing it wrong", but if the feeding pattern is inefficient, tiring or uncomfortable, it is worth looking at the whole feeding picture rather than simply changing the bottle.

You don't have to stay loyal to one teat brand

Babies change as they grow, and the teat that works well at one stage may not always be the one that works best later on. Their mouth grows, their oral skills develop, their sucking becomes more coordinated and their feeding needs can change. A teat that was comfortable and effective when a baby was younger may eventually feel too slow, too fast, too short or simply different from what they now manage comfortably.

This is one reason I would be cautious about becoming too attached to a particular brand or assuming that moving up within the same range is always the answer. Different manufacturers use different shapes, materials, flow rates and age recommendations, so a "next stage" teat from one brand may behave quite differently from another brand's equivalent. Watching how your baby is actually feeding is more useful than relying on the number or age printed on the packet.

The same applies if you are combination feeding. A teat that worked alongside breastfeeding in the early weeks may not necessarily remain the best option as your baby's feeding skills develop. Equally, changing a teat is not something that needs to happen simply because a manufacturer suggests a particular age. If your baby is feeding comfortably, maintaining a good suck-swallow-breathe pattern and managing the flow without difficulty, there may be no reason to change it simply because the packaging says they have reached the next stage.

Sometimes, however, a change can be helpful. Your baby's developing oral anatomy, palate shape, sucking skills, milk flow needs or overall feeding pattern may all influence which teat works comfortably for them. This is where looking at the whole feeding picture becomes more useful than choosing a teat based on brand loyalty alone.

Your baby's palate can make a difference

The roof of the mouth provides part of the surface against which the tongue works during feeding, so palate shape can influence how a teat sits and how the tongue and jaw interact with it.

A high or narrow palate does not automatically mean that a baby will struggle with bottle feeding, and there is no single teat designed for every baby with a particular palate shape. However, if a teat repeatedly slips, is difficult for the baby to maintain in the mouth, or feeding involves considerable compression, dribbling or fatigue, the shape and dimensions of the teat may be worth considering alongside other aspects of the feed.

There is some evidence that oral cavity dimensions and teat dimensions are relevant to sucking performance, although much of the research is older and does not provide a simple prescription for which teat should be used (Hummel and Herrmann, 1989). A case report has also described a newborn with a high arched palate whose feeding improved when a larger-hole teat was used, although a single case cannot be used to establish a general recommendation (Eren, Bilgin and Kara, 2015).

This is a good example of why a teat should not be selected solely because it is marketed for a particular oral shape. The individual baby's response matters more than the label.

Premature babies may have different needs

Premature and very-low-birth-weight babies may have different feeding requirements because their sucking, swallowing and breathing coordination is still developing. Teat choice can therefore become part of a more individualised feeding assessment.

Research in very-low-birth-weight infants has shown that different bottle nipples can affect sucking and milk transfer (da Costa, van den Engel-Hoek and Bos, 2008). This does not mean that there is one particular "premature baby teat" that is best for every baby. The appropriate equipment may depend on gestational age, oral size, feeding maturity, respiratory status and the baby's ability to manage the flow.

For a premature baby, particularly one who is still developing coordinated oral feeding, bottle and teat selection is best considered alongside the wider feeding assessment rather than by age or packaging alone.

Teat flow is not standardised

One of the most confusing things about bottle feeding is that a "slow", "medium" or "fast" teat does not have a universal meaning.

Manufacturers use their own terminology and their own testing methods. A slow-flow teat from one company can therefore behave very differently from a slow-flow teat from another.

This has been demonstrated in research. Pados, Park and Dodrill (2019) measured 375 individual nipples representing 25 different types and found milk flow rates ranging from 0.86 to 37.61 mL per minute. The information printed on the packaging did not accurately reflect the measured flow rates.

The physical characteristics of the teat also matter. Material, shape, hole size, rigidity and compressibility can all affect milk flow, alongside how much pressure the individual baby generates (Kotowski et al., 2020).

This is why the age printed on a packet should not be treated as a developmental requirement. It is manufacturer guidance. The NHS similarly advises that as babies become used to bottle feeding and grow, changes in flow can be considered, but this should be led by the baby rather than a rigid age rule (NHS, 2026b).

Faster is not necessarily better

It can be tempting to think that a baby who is getting older should automatically move to a faster teat. Sometimes a faster flow is appropriate, but faster is not inherently better.

A flow that is too fast for an individual baby can make it harder to coordinate sucking, swallowing and breathing. You might notice coughing, spluttering, gulping, milk leaking from the mouth, pulling away from the bottle or becoming unsettled during the feed.

A flow that is too slow can also be difficult. Some babies may suck for a very long time, become tired or frustrated, or fall asleep before taking enough milk.

Research has demonstrated that babies can adapt their sucking patterns to different teat flows. Lagarde et al. (2019), for example, found differences in swallow rate and suck-to-swallow ratios when healthy infants used teats with different flow characteristics. The study was small, involving 16 term-born infants aged two to five months, and one of the teats had a higher measured flow than the other.

The aim is therefore not to find the fastest flow a baby can tolerate. It is to find a flow that allows that particular baby to feed comfortably and coordinate their sucking, swallowing and breathing.

What about variable-flow teats?

Variable-flow or vari-flow teats allow the milk flow to change according to how the teat is positioned or how the baby sucks. They can be useful in some circumstances, but I am cautious about them for babies who already have difficulty with oral-motor coordination.

For a baby who has tongue restriction or other difficulty coordinating their sucking pattern, a flow that changes according to pressure or positioning can sometimes make the feeding experience less predictable. That does not mean that variable-flow teats are unsuitable for every baby with a tongue-tie, but they are not a choice I would make automatically.

If a baby is already struggling to control milk flow, it can be useful to simplify the variables and consider whether a consistent, predictable flow would make feeding easier to assess.

What does the valve actually do?

Many bottles contain a valve or venting system. The basic mechanical purpose is quite simple: as milk leaves the bottle, air needs to enter the bottle to replace the lost volume. Without adequate venting, a vacuum can develop and the teat may flatten or collapse.

A valve can allow air to enter the bottle and help regulate the pressure inside it. Different bottle designs achieve this in different ways, and some have additional components intended to keep air away from the milk pathway.

The term "anti-colic" is much broader than the mechanical function of the valve, though. A valve can change airflow through the bottle; it cannot guarantee that a baby will not have colic, wind or unsettled behaviour.

Colic and digestive discomfort have many possible causes, and a bottle described as "anti-colic" should therefore be understood as a description of the bottle's design rather than a promise about what your baby will experience.

The material a teat is made from

Most modern bottle teats are made from silicone or rubber. These materials do not behave in exactly the same way.

Silicone is a synthetic material. It is generally clear, relatively firm and does not contain natural rubber latex. Natural rubber, on the other hand, is derived from natural rubber latex and tends to be softer and more flexible. Natural rubber products can also change more noticeably with repeated use and sterilisation.

For most families, the choice may simply come down to how the teat feels, how the baby responds to it, how durable it is and how well it fits the bottle system.

Latex sensitivity is another consideration. If a baby or caregiver has a known natural rubber latex allergy or sensitivity, the material needs to be checked carefully rather than assuming that all soft or rubber-like teats are silicone.

Whichever material you choose, inspect the teat regularly. Teats can become damaged, split, sticky or otherwise deteriorate with use and sterilisation. NHS guidance specifically recommends checking bottles and teats for damage and replacing damaged equipment (NHS, 2026a; NHS, 2026c).

Glass, plastic or collapsible bottles?

The bottle itself can be made from several materials, with glass and plastic being the most common choices.

Glass bottles are durable and can be straightforward to clean, although they are heavier and can break if dropped. Plastic bottles are lighter and easier to carry, which can be useful for everyday life, but they can become scratched or worn over time and should still be checked regularly.

Some bottles are soft or collapsible. These can be particularly useful in specialist feeding situations, but a soft bottle is not simply another bottle to squeeze whenever a baby seems to need more milk. Some specialist systems require the caregiver to use the bottle in a very specific way.

This is particularly important for babies with a cleft palate, where specialist bottles may use squeezing or valves to help provide milk. These systems should only be used following guidance from the baby's cleft feeding team.

For everyday bottle feeding, there is no requirement to buy an expensive bottle. NHS guidance states that simple bottles which are easy to wash and sterilise are probably best (NHS, 2026a).

What about anti-colic and self-sterilising bottles?

Anti-colic bottles often combine a valve or venting system with a particular bottle and teat design. The mechanical features can be useful, but the name "anti-colic" should not be interpreted as a guarantee that a baby will not experience wind or colic.

A self-sterilising bottle is designed so that the bottle components can be assembled in a particular way and sterilised, usually using steam in a microwave according to the manufacturer's instructions.

This can be convenient, but it does not remove the need to clean the bottle properly before sterilisation. Sterilisation and cleaning are separate steps. Milk residue needs to be removed before the sterilisation process.

If you are considering a bottle with several valves, membranes and separate components, it is also worth thinking about whether you will be able to clean every part thoroughly and consistently. A theoretically sophisticated bottle is not particularly useful if it becomes difficult to clean properly.

Sterilising still matters

Whatever bottle or teat you choose, hygiene remains important.

NHS guidance recommends sterilising bottles, teats and other feeding equipment until your baby is at least 12 months old. Equipment should be cleaned in hot, soapy water as soon as possible after feeds and rinsed in clean, cold running water before sterilisation (NHS, 2026c).

There are several recognised methods, including cold-water sterilising solution, steam sterilising and boiling. If boiling is used, NHS guidance recommends boiling the equipment for at least 10 minutes and checking that the equipment is safe to boil. Teats can become damaged more quickly with boiling, so they should be inspected regularly (NHS, 2026c).

Steam sterilisers and self-sterilising bottles should be used according to the manufacturer's instructions. Cold-water sterilising solutions also need to be prepared and changed according to the instructions.

The important part is not which sterilising method looks most impressive. It is that the method is suitable for the equipment and used consistently.

Babies with cleft palate need specialist advice

Babies born with a cleft lip and/or palate can have very different feeding requirements because the opening in the palate can make it difficult to create the seal and vacuum normally used for feeding.

Specialist bottles and teats are available for babies born with a cleft. CLAPA supplies specialist feeding equipment used and recommended by NHS Cleft Nurse Specialists, and advises families to speak with their Cleft Nurse Specialist about which equipment is appropriate (CLAPA, 2026a; CLAPA, 2026b).

Some specialist systems work by squeezing a soft bottle while the baby sucks, while others use valves or specially designed teats. These systems need to be demonstrated and used according to the advice of the baby's cleft team.

This is not an area where I would recommend buying a specialist bottle based simply on an online description. The baby's cleft anatomy, feeding ability and the equipment available through their specialist service all need to be considered together.

What if your baby refuses the teat?

Bottle refusal can be surprisingly complicated. Sometimes the issue is the teat itself, but sometimes it is the flow, feeding position, temperature of the milk, the person offering the bottle, the baby's previous feeding experiences or simply the fact that the baby is not interested in drinking at that particular moment.

A baby who has previously breastfed may also respond differently to a bottle from a baby who has always bottle fed.

If you are trying different approaches, it can be helpful to change one variable at a time. Changing the bottle, teat, flow, feeding position, caregiver and routine all at once makes it very difficult to work out what your baby is responding to.

Repeatedly persuading or forcing a baby to take a bottle can also turn feeding into a stressful experience. Watching your baby's communication and allowing pauses is part of responsive bottle feeding.

I have written more about this in When Your Baby Suddenly Refuses the Bottle.

If bottle feeding continues to be difficult, it is worth considering the feeding itself rather than simply buying another bottle. Teat shape and flow, oral coordination, positioning, respiratory factors and other aspects of feeding can all contribute. Bottle-feeding difficulties do not automatically mean that a baby has a tongue-tie, and a tongue-tie does not automatically explain every bottle-feeding difficulty.

A bottle is not always necessary

There are circumstances where a baby needs to receive expressed breast milk, donor milk where appropriate or infant formula but does not need to use a bottle.

Depending on their age, development, health and feeding ability, an alternative feeding method may sometimes be considered. This might include cup feeding or another method recommended by an appropriately trained healthcare professional.

For an older breastfed baby who can sit independently and is developmentally ready for a cup, there may not be a need to introduce a bottle simply because they need another way of receiving milk. Going directly to a cup can sometimes be a practical option.

I have written more about the different possibilities in Alternative Feeding Methods for Babies.

The appropriate method depends on the individual baby. Alternative feeding methods should not be selected simply because a particular method is described online as being "better", and some methods need to be demonstrated face to face because the safety of the method depends on the baby's ability to coordinate sucking, swallowing and breathing.

If you are using a bottle alongside breastfeeding

Combination feeding can work in many different ways. Some babies have one or two bottles a day and breastfeed for the remaining feeds. Others have expressed milk or formula at different times of the day, or alternate between breast and bottle according to what works for their family.

If maintaining breastfeeding is important to you, the way the bottle is offered may be worth considering alongside the bottle and teat themselves.

Paced bottle feeding can give your baby more opportunity to control the speed of the feed, take pauses and communicate when they have had enough. Holding the bottle relatively horizontally rather than allowing milk to pour continuously into the mouth is one part of this approach.

I have written more about this in How to Pace Bottle Feeds: A Calm Practical Guide.

Position can also make a difference. Some babies are more comfortable in one bottle-feeding position than another, particularly when they are managing a faster flow or are still developing their suck-swallow-breathe coordination. You can read more in Bottle Feeding Positions.

A broad, gradually tapered teat combined with responsive or paced feeding may be a useful practical approach for some babies moving between breast and bottle. What it cannot do is guarantee that a baby will avoid teat preference, continue breastfeeding or experience exactly the same mechanics as breastfeeding.

The 2025 UK research into bottles marketed as "breast-like" is particularly useful here. It found that manufacturers commonly make claims about supporting combination feeding, reducing bottle refusal, preventing nipple confusion and reproducing breastfeeding physiology, but found very little high-quality scientific evidence to support these claims (Maxwell, Self and Bould, 2025).

That does not mean that families should avoid trying different teats. It simply means that the choice is better viewed as an individual feeding decision than as a guarantee attached to a particular brand.

There is no perfect bottle

The most expensive bottle is not necessarily the most suitable bottle, and a bottle described as "natural", "physiological" or "breast-like" is not automatically going to work better for your baby.

At the same time, it is reasonable to pay attention to the shape, flexibility, material and flow of the teat because these characteristics really can affect the mechanics of bottle feeding. Research shows that babies can adapt to different teat characteristics, but that does not mean every baby will respond to every teat in the same way (Lagarde et al., 2019; Kotowski et al., 2020).

For one baby, a broad tapered teat may feel comfortable. Another may manage a different shape more effectively. One baby may need a slower flow for several months, while another may become frustrated by the same flow. A baby who feeds comfortably from a particular teat at three months may respond differently as their mouth and feeding skills develop.

The useful question is therefore not simply "Which bottle is the best?"

It is "How is my baby managing this bottle and teat?"

Are they able to maintain a comfortable seal? Are they able to coordinate sucking, swallowing and breathing? Is the flow manageable? Are feeds comfortable rather than exhausting? Are they able to pause and communicate when they need a break? Are they taking enough milk for their individual needs?

Those questions tell you much more about whether a bottle is working than the name printed on the packet.

References

CLAPA (2026a) About CLAPA's services for the UK cleft community. Cleft Lip and Palate Association. Available at: https://clapa.com/about-clapa/what-we-do/

CLAPA (2026b) Feeding babies born with a cleft. Cleft Lip and Palate Association. Available at: https://clapa.com/support-and-community/for-parents-and-families/feeding-babies-born-with-a-cleft/

da Costa, S.P., van den Engel-Hoek, L. and Bos, A.F. (2008) 'Sucking and swallowing in infants with very low birth weight: the effect of different bottle nipples', Acta Paediatrica, 97(4), pp. 473–476. doi:10.1111/j.1651-2227.2008.00704.x. Available at: https://pubmed.ncbi.nlm.nih.gov/18393901/

Eren, M., Bilgin, S. and Kara, B. (2015) 'Feeding an infant with high arched palate by high flow rate bottle nipple', Asia Pacific Journal of Clinical Nutrition, 24(4), pp. 756–758. doi:10.6133/apjcn.2015.24.4.16. Available at: https://pubmed.ncbi.nlm.nih.gov/26693762/

Hummel, P. and Herrmann, W. (1989) 'Physiologic sucking performance and the shape of the oral cavity in infants and young children with respect to the design of nipples for nursing bottles and pacifiers', Fortschritte der Kieferorthopädie, 50(5), pp. 384–391. doi:10.1007/BF02171173. Available at: https://pubmed.ncbi.nlm.nih.gov/2583621/

Kotowski, J., Fowler, C., Hourigan, C. and Orr, F. (2020) 'Bottle-feeding an infant feeding modality: An integrative literature review', Maternal & Child Nutrition, 16(2), e12939. doi:10.1111/mcn.12939. Available at: https://pubmed.ncbi.nlm.nih.gov/31908144/

Lagarde, M.L.J., van Alfen, N., de Groot, S.A.F., Geurts, A.C.H. and van den Engel-Hoek, L. (2019) 'Adaptive capacity of 2- to 5-month-old infants to the flow, shape, and flexibility of different teats during bottle feeding: a cross-sectional study', BMC Pediatrics, 19, 477. doi:10.1186/s12887-019-1859-y. Available at: https://pubmed.ncbi.nlm.nih.gov/31805974/

Maxwell, C., Self, B. and Bould, K. (2025) 'A descriptive investigation of infant feeding bottles marketed in the UK designed to replicate breastfeeding and the evidence that underpins them', Maternal & Child Nutrition, 21(3), e70008. doi:10.1111/mcn.70008. Available at: https://pubmed.ncbi.nlm.nih.gov/40023778/

NHS (2026a) Bottle feeding advice. Available at: https://www.nhs.uk/baby/breastfeeding-and-bottle-feeding/bottle-feeding/advice/

NHS (2026b) What you need for formula feeding. Available at: https://www.nhs.uk/best-start-in-life/baby/feeding-your-baby/bottle-feeding/how-to-make-up-a-feed/things-you-need-for-formula-feeding/

NHS (2026c) Sterilising baby bottles. Available at: https://www.nhs.uk/baby/breastfeeding-and-bottle-feeding/bottle-feeding/sterilising-baby-bottles/

Pados, B.F., Park, J. and Dodrill, P. (2019) 'Know the flow: Milk flow rates from bottle nipples used in the hospital and after discharge', Advances in Neonatal Care, 19(1), pp. 32–41. doi:10.1097/ANC.0000000000000538. Available at: https://pubmed.ncbi.nlm.nih.gov/30028734/

Segami, Y., Mizuno, K., Taki, M. and Itabashi, K. (2013) 'Perioral movements and sucking pattern during bottle feeding with a novel, experimental teat are similar to breastfeeding', Journal of Perinatology, 33, pp. 319–323. doi:10.1038/jp.2012.113. Available at: https://pubmed.ncbi.nlm.nih.gov/22975983/