There is no single bottle-feeding position that is right for every baby, and exploring different positions What makes a comfortable bottle-feeding position? What about the bottle and teat? Position is only one part of bottle feeding. Position is not the same as paced bottle feeding Positioning and pacing are closely related, but they Is there a best bottle-feeding position?

Position your baby Hold your baby close to you in a semi-upright position, with their head and neck well position, allowing milk to fill the teat. When your baby resumes active sucking, gradually bring the bottle back towards the horizontal position Choosing the flow rate The flow rate of the teat matters just as much as bottle position. If there are concerns about flow, positioning or feeding comfort, a health visitor, midwife, infant feeding

A baby can take a bottle and still find feeding hard. They can also arise from milk flow, positioning, feeding pace, temporary nasal congestion, reflux-like Responsive bottle feeding can reduce pressure for many families. or other bottle-feeding concerns. References Academy of Breastfeeding Medicine (2021) ‘Academy of Breastfeeding Medicine position statement

Changing the bottle, teat, flow, feeding position, caregiver and routine all at once makes it very difficult Teat shape and flow, oral coordination, positioning, respiratory factors and other aspects of feeding Position can also make a difference. Some babies are more comfortable in one bottle-feeding position than another, particularly when they You can read more in Bottle Feeding Positions.

For information about responding to a baby's cues during bottle feeding, see Responsive Bottle Feeding Bottle position and support can also affect how comfortably a baby feeds. See Bottle Feeding Positions. / NHS (2026d) How to bottle feed. /guide-to-bottle-feeding/ ```

Try changing the position Some babies feed more comfortably in one position than another. Responsive bottle feeding guidance recommends a semi-upright position and keeping the bottle relatively position. the feed location bottle and teat used position approximate amount offered and taken coughing, gulping feeding cues positioning bottle and teat milk flow sucking, swallowing and breathing oral function discomfort

tongue function alongside positioning, prematurity, birth experiences, neurological development, nasal For bottle-fed or combination-fed babies, an effective feed usually looks more important than a fashionable feeding position, the caregiver’s pacing, the time since the last feed, or the teat itself. For families combining breast and bottle feeding, assessment should include both feeding methods where UNICEF UK Baby Friendly Initiative (2019) Responsive bottle feeding.

The position used for bottle feeding is therefore worth considering as part of the assessment. My article on Bottle Feeding Positions explains how positioning can be adapted while keeping the infant's easier than another; appearing less comfortable when bottle fed in a particular position; repeatedly It may involve observing a breast or bottle feed, considering the infant's position and attachment, and ; reviewing bottle-feeding position, pacing and teat characteristics where relevant; assessing oral function

For bottle feeding, positioning, pacing, teat flow and the way the bottle is offered similarly influence Further information on breastfeeding positions, breastfeeding latch, bottle feeding positions and paced bottle feeding is available from D-Restricted Ltd®: Breastfeeding positions Breastfeeding latch Bottle feeding positions Paced bottle feeding These aspects can be considered alongside the baby's head, Available at: https://www.nhs.uk/baby/breastfeeding-and-bottle-feeding/breastfeeding/positioning-and-attachment

a positive relational experience, whether the bottle contains expressed breast milk or infant formula The same principle applies to bottle feeding. Bottle feeding, paced feeding and recommended volumes Responsive feeding applies to bottle feeding as , bottle feeding, infant formula, combination feeding and changing feeding methods. Available at: https://www.nhs.uk/best-start-in-life/baby/feeding-your-baby/bottle-feeding/bottle-feeding-your-baby

positioned for that method. If breastfeeding is difficult, a skilled feeding assessment can consider positioning, attachment, milk Bottle feeding with responsive support Bottle feeding is an alternative feeding method in its own right A small tube is positioned so that milk can flow while the baby remains at the breast. These systems can also require preparation, positioning and cleaning, and the baby's feeding pattern

An infant’s preferred head position, limited comfortable movement or difficulty maintaining a feeding position may be relevant observations during assessment. Head and neck movement, positioning and any relevant asymmetry. Breastfeeding and bottle-feeding assessments need to reflect the different mechanics and practical demands The teat and bottle flow rate, positioning and pacing may also be relevant.

Bottle feeding and swallowing Bottle feeding also requires coordination between sucking, swallowing Bottle position and feeding technique can influence this flow, which is why paced and responsive bottle A feeding assessment may consider the baby's oral movements, sucking pattern, breathing, milk flow, positioning Available at: https://www.nhs.uk/best-start-in-life/baby/feeding-your-baby/bottle-feeding/bottle-feeding-your-baby Available at: https://www.nhs.uk/best-start-in-life/baby/feeding-your-baby/bottle-feeding/bottle-feeding-your-baby

The same applies to bottle feeding. difficulties and bottle-feeding difficulties. Positioning and attachment For breastfeeding, positioning and attachment can make a substantial difference The NHS identifies positioning and attachment, feeding frequency, maternal and infant illness and several The same principle applies to bottle feeding.

Breastfeeding, chestfeeding, bottle feeding, expressing and combination feeding are all valid ways to For a bottle-fed baby, it is helpful to consider how the baby manages the feed, rather than assuming the mouth, difficulty maintaining a latch, bottle refusal, distress at feeds or concern about milk transfer These signs may relate to positioning and attachment, feeding pace, flow, infant health, prematurity, , bottle feeding and other feeding approaches, with individualised assessment and guidance to support

breastfeeding before birth getting feeding established after birth positioning and attachment painful use flange fitting and pumping technique responsive bottle feeding feeding expressed breast milk infant formula feeding combination feeding transitioning between breast, bottle and other feeding methods relactation , infant regulation, maternal factors, positioning, milk transfer and other aspects of the feeding relationship involves breastfeeding, chestfeeding, expressing, bottle feeding, formula feeding, combination feeding

The tongue also changes position as babies develop, and its resting position and movement need to be a link between lip-tie or buccal-tie and breastfeeding or bottle-feeding issues (ATP, 2026). During breastfeeding or bottle feeding, a baby needs to coordinate sucking, swallowing and breathing. Oral anatomy, feeding and breathing Breastfeeding and bottle feeding both require coordinated use of Assessment may include looking at: how your baby feeds at the breast or from a bottle positioning and

Breastfeeding, chestfeeding, expressing, bottle feeding, combination feeding and feeding donated human , an unsettled baby around feeds, reluctance to feed, bottle refusal, coughing or leaking during bottle They may relate to positioning, timing, infant maturity, feeding cues, milk supply, breast or nipple , expressing and providing human milk, combination feeding, formula feeding, bottle feeding and the introduction A specialist may consider the feeding environment, infant state and cues, positioning, attachment or

of the teat and the feeding position influence how the infant manages the feed. position. This can affect attachment at one breast, positioning during bottle-feeding or the infant's ability to For bottle-feeding families, the choice of bottle and teat, feeding position and pacing can also influence Further information is available in Choosing Bottles and Teats and How to Pace Bottle Feeds: A Calm,

Positioning, comfort, milk flow, the feeding environment and previous feeding experiences can all affect developmental signs that should be present together from around six months: your baby can stay in a sitting position They may relate to normal developmental changes, milk flow, positioning, breast or chest comfort, bottle-feeding National Childbirth Trust (NCT) (2025) ‘Breastfeeding: cues, attachment and positions’. Available at: https://www.nct.org.uk/information/baby-toddler/feeding-your-baby-or-toddler/breastfeeding-cues-attachment-and-positions

Possible feeding signs include: milk coming through the nose during or after feeds clicking during feeding However, a baby with a submucous cleft palate may breastfeed or bottle-feed effectively and may have This may include consideration of positioning, attachment, feeding efficiency and, where necessary, alternative Support can be provided whether the baby is breastfeeding, bottle-feeding, receiving expressed milk, formula feeding or combination feeding.

Positioning, attachment and breast shaping Effective positioning and attachment are important because A feeding assessment can help identify whether positioning, attachment, oral function or another factor The approach needs to take account of the baby's position, the shape and size of the breast, nipple direction Breast shaping, positioning and attachment should be considered together rather than as separate rules For milk-fed infants, possible contributing factors include ineffective suckling, ineffective bottle

Positioning, attachment, milk supply, breast anatomy, milk flow, infant muscle tone, prematurity, oral Bottle feeding Tongue-tie is not exclusively a breastfeeding issue. Teat shape and flow, bottle positioning, feeding pace, oral coordination, nasal congestion, prematurity because of positioning, attachment, milk flow or another oral-motor issue. , chestfeeding and bottle feeding all included within infant feeding support.

Clicking can occur for several reasons, including changes in seal, positioning, milk flow or oral function For bottle-fed or combination-fed babies, possible signs can include very prolonged feeds, milk leaking Bottle-feeding assessment should include the feeding position, teat flow, pacing, the baby’s health and A clinician may then observe a feed, considering the baby’s state and positioning, attachment, sucking Whether feeding is directly at the breast or chest, by expressed milk, bottle, combination feeding or

Searching for the best feeding positions for reflux is a sensible practical step, but position is only Feeding positions There is no single “best” reflux position for every baby. Bottle feeding A semi-upright position can help some babies coordinate sucking, swallowing and breathing When feeding position is not enough If changing feeding position is not making a meaningful difference An IBCLC can help assess breastfeeding or bottle-feeding mechanics, milk transfer, positioning, feeding

Potential signs of feeding difficulties include: Feeding that is persistently ineffective or poorly coordinated Feeding assessment should therefore consider the whole feeding picture, including milk transfer, swallowing feeds and whether they need to be woken for feeds. Waking a sleepy baby to feed may be part of an agreed feeding plan, but a baby who is unusually sleepy Are not feeding or cannot feed effectively.

Babies may change their position as they become sleepy, as the breast softens during a feed, or when This is not about achieving one “perfect” position. Bottle feeding, teat choice and flow Clicking can also occur during bottle feeding. bottle-feeding experience. For some families, simple changes to positioning, attachment, bottle feeding technique or teat choice

It can affect all methods of feeding, inclusive of bottle feeding, the introduction of solid foods, dentition of tongue motility differs in bottle feeding.  Association of Tongue tie Practitioners (ATP)  (2022) “Disruptive wound management-Position statement ” https://www.tongue-tie.org.uk/atp-position-statements .  /baby/feeding-your-baby/bottle-feeding/bottle-feeding-challenges/tongue-tie-and-bottle-feeding/  (accessed

Changing position during a feed There is no reason to remain in one position for an entire feed if another Some feeding dyads naturally move between positions during a feed, while others find one position that The best position for you may change from feed to feed, breast to breast, day to day and as your baby Available at: https://www.nhs.uk/baby/breastfeeding-and-bottle-feeding/breastfeeding/positioning-and-attachment /breastfeeding-positions/ NHS (2026) ‘Feeding twins and multiples’.

Appointments can include observation of a feed, discussion of positioning and attachment, consideration Bottle feeding also involves more than choosing a bottle. support Bottle feeding positions Choosing Bottles and Teats How to make up a formula bottle safely How Additional feeding support may also be useful for families who need more time to explore positioning, Feeding difficulties, feeding positions, attachment, milk transfer and feeding patterns.

Flow rate, teat shape, feeding pace, positioning, health factors and a baby’s wider oral-motor development Bottle feeding Bottle-fed babies can experience difficulties that may prompt an assessment of oral function Teat shape and flow rate, bottle positioning, feeding pace, oral-motor development, coordination, prematurity With bottle feeding, teat shape and flow rate, bottle positioning, feeding pace, oral-motor development This might include adjustments to positioning and attachment, responsive feeding guidance, help protecting

Bottle feeding Bottle feeding can involve different amounts of swallowed air depending on the bottle , teat, flow rate, feeding position and the way the feed is offered. Paced bottle feeding Paced bottle feeding is about allowing your baby to control the pace and flow of Bring the bottle towards a horizontal position so that milk fills the teat. Responsive bottle feeding.

During bottle-feeding, the assessment considers the baby’s position, teat type and flow, the seal around Bottle-fed babies can be affected by restricted tongue movement, but bottle-feeding difficulties do not It means attention can turn to other factors, such as latch and positioning, bottle-feeding technique Babies are learning a new range of tongue movement, and parents may need help with attachment, positioning , bottle-feeding or protecting milk supply.

position temporarily difficult. Is the feeding position comfortable, particularly if the baby is sore? Could the baby have associated the breast or a particular feeding position with something unpleasant? Read more about paced bottle feeding. There is no need to turn feeding into a battle over breast versus bottle.

milk supply, positioning, a baby’s state of regulation, or other factors that may be affecting feeding However, bottle-feeding difficulties can relate to feeding position, flow rate, timing, gastrointestinal Consider feeding history, perinatal history, breast and nipple factors, bottle-feeding mechanics where relevant, milk availability, infant health, growth, positioning and attachment, and the possibility References Academy of Breastfeeding Medicine (2021) ‘Academy of Breastfeeding Medicine position statement

Positioning and attachment, milk supply or flow, breast and nipple anatomy, bottle teat flow, reflux-like What you might notice with bottle feeding Tongue function can matter in bottle feeding too, although Teat shape and flow rate, paced feeding, positioning, coordination and medical factors also need consideration They will consider your baby’s positioning, latch or seal, sucking pattern, swallowing, comfort and ability For example, a shallow latch may be influenced by positioning; clicking may relate to flow or coordination

For families who bottle feed, combination feed, express milk, or use feeding methods that change over Conversely, feeding difficulty can arise from positioning, milk flow, prematurity, birth-related factors Families may describe pain, frequent feeds, clicking, dribbling, unsettled feeds, prolonged bottle feeds For breastfeeding, this may include the baby’s positioning, attachment, audible swallowing, milk transfer Conservative feeding support may be appropriate when feeding mechanics, positioning, pacing or comfort

or pumping is difficult a caregiver is unsure about flange fit or expressing technique bottle feeding is proving difficult combination feeding is being considered a family is moving between breast, bottle introducing or increasing bottle feeds returning to breastfeeding after a period of expressing or bottle Bottle feeding is therefore not outside the scope of infant-feeding support. Appropriate support may include understanding feeding cues, responsive bottle feeding, pacing, positioning

production, positioning and attachment, bottle-feeding technique, infant maturity, birth history, sensory A function-focused feeding review may explore what happens across a feed or bottle feed: the baby’s ability For bottle-feeding families, the review should be equally respectful and practical, considering comfort It may involve targeted lactation support, a review of milk supply and breast comfort, practical bottle-feeding References Academy of Breastfeeding Medicine (2021) ‘Academy of Breastfeeding Medicine position statement

Positioning and attachment, milk supply, breast or nipple pain, flow preferences, prematurity, jaundice For bottle-feeding families, the research is more limited. Those alternatives may include skilled lactation or feeding support, adjustments to positioning and attachment , paced bottle feeding where appropriate, monitoring, or choosing not to intervene. Please see www.tongue-tie.org.uk/position-statements.

It is a careful consideration of anatomy, tongue function, feeding, milk transfer or bottle-feeding efficiency Consensus guidance and position statements emphasise that ankyloglossia is a functional diagnosis, requiring feed: repeated slipping at the breast or bottle, long feeds, distress, coughing, dribbling, nipple pain For example, positioning and attachment may need adjustment; a parent’s milk production may require support References Academy of Breastfeeding Medicine (2021) ‘Academy of Breastfeeding Medicine position statement

this is affecting breastfeeding, bottle feeding or both. support positioning and attachment adjustments support with milk supply where needed expressing and For practical support with bottle feeding, see How to Pace Bottle Feeds: A Calm, Practical Guide. What about bottle feeding? Bottle feeding can also be affected by teat flow, positioning, pacing, coordination, oral-motor skills

Other possible contributors may need consideration, such as positioning, milk supply, breast or teat Evidence concerning bottle feeding is more limited. flow, pacing, feeding position, respiratory comfort, oral coordination and the individual feeding history Families who bottle feed, combination feed, express milk or use donor milk deserve the same careful, A plan may include feeding support, review of positioning and attachment, paced bottle feeding where

Positioning your baby for breastfeeding There is no single correct breastfeeding position. position. formula, or bottle feed their baby. Bottle feeding is a skill too. or bottle feeding.

positioning, attachment, milk production, infant wellbeing and oral function. Bring baby to the breast in a stable, close position. infant growth, positioning, attachment and oral function. Available at: https://www.nhs.uk/best-start-in-life/baby/feeding-your-baby/bottle-feeding/how-to-make-up-a-feed Available at: https://www.nhs.uk/baby/breastfeeding-and-bottle-feeding/bottle-feeding/sterilising-baby-bottles

Positioning and attachment, milk flow, supply, feeding frequency, bottle-teat flow, prematurity, birth For formula-fed and bottle-fed babies, NICE also recommends responsive bottle-feeding support, observation of feeds, consideration of positioning and pacing, recognition of feeding cues and appropriate support For a bottle-feeding family, assessment may include bottle flow, teat–mouth seal, suck efficiency, pacing For a bottle-fed infant, the focus may instead be on maintaining a safe and effective bottle-feeding

Another may be experiencing painful feeds, unsettled bottle feeds or concerns about milk transfer, yet Function must be considered in the feeding relationship Feeding is not simply an oral task. Breastfeeding, chestfeeding, bottle feeding, combination feeding and expressing all bring different practical , parental wellbeing, positioning, supply, bottle and teat choice, and any relevant birth or health history A baby who finds feeding challenging may be affected by positioning, flow preference, feeding pressure

This is an important positive aspect of pacifier use. The same principle applies to bottle-fed and combination-fed infants. The tongue's resting position One consideration that is sometimes overlooked is what happens to the Rather than having unrestricted opportunity to adopt a natural resting position within the mouth, the Bottle feeding itself should not be presented as harmful, particularly because bottles may be an essential

For a breastfed or chestfed baby, this may include observing positioning and attachment, comfort, milk For a bottle-fed baby, it may include observing the feed, suck-swallow-breathe coordination, teat flow Think about what helps your baby settle: feeding at the breast or chest, bottle feeding, a familiar blanket A baby may need support with positioning, attachment, bottle-feeding pace or settling into a new feeding References Academy of Breastfeeding Medicine (2021) ‘Academy of Breastfeeding Medicine position statement

comfort where relevant, milk transfer concerns, bottle-feeding mechanics, growth, supply, positioning What happens when positioning, attachment or bottle-feeding pace is adjusted? Families may be breastfeeding, chestfeeding, expressing, combination feeding or bottle feeding. or bottle feeding has changed. communication, rather than positioning surgical release as the default response.