Why Does Flow Matter?
For a baby to be able to feed effectively from a bottle, they must be able to use their oral muscles to suck on the nipple, regulate the flow of the milk, and close the airway when swallowing. This process requires perfect coordination on the baby’s part.
Healthy, full-term babies can feed on any newborn bottle nipple. They are comfortably able to alter their sucking pressure to manage the milk flow. Their oral muscle tone is strong enough, enabling them to swallow and close their airways to prevent substances from entering. In contrast, babies that have health conditions that affect muscle coordination and swallowing such as Down syndrome, or have cardiac or respiratory diseases, as well as preterm babies, the process can be a challenge.
You can also read our full guide on the best baby bottles 2020.
When the nipple is introduced in the mouth, the baby can choose to swallow or allow it to collect into a pool until it starts leaking or refuse to suck altogether. The airway must be closed when swallowing every time, to prevent choking.
If the flow rate is high, the baby is forced to swallow faster to prevent the milk from accumulating. In contrast, if the flow rate is slowed, it will take longer to pool, swallowing will also be slowed, and the baby will have more time to breathe as they feed. The infants with respiratory or cardiac problems are challenged by this difference in flow rate; sometimes, sucking from a high flow rate will not let them maintain steady oxygenation when feeding, and this can make them too fatigued to continue feeding. Likewise, babies with low muscle tone like those affected by Down syndrome, a slow flow is perfect because they will have more time to coordinate a safe swallow and keep the airway free of fluid before another bolus of fluid forms.
When the flow is high, the baby with feeding challenges will try to slow the flow by chewing on the nipple or clamping it; this reduces the effectiveness of feeding. Also, the oral muscles are not exercised enough for them to gain the necessary skill that will be used to handle long-term breastfeeding and bottle feeding, as well as oral feeding or speech in the near future.
Nipple flow rate study
This study was done to demonstrate how different nipples cause variations in the average flow rate. You should note, however, that babies use different sucking pressures and rates even when using the same nipple, hence this study is only to compare nipples and without considering the baby’s influence.
The research tested 45 types of nipples commonly used for feeding babies in the hospitals and the community. For each nipple type, 10 nipples were tested for the study. A standardized testing procedure was developed using a breast pump to mimic sucking and measured the quantity of formula expressed in one minute.
The Testing Set Up
The nipples tested gave a wide range of flow rates from as low as 2ml/min to more than 80ml/min. It was interesting to find out that the flow rate does not always match the claim from the nipple brand. For instance, single-use premature nipples from Enfamil and Similac were faster than either their slow or standard flow nipples. Also, Enfamil slow nipple was even faster than Similac Premature. Avent Natural Newborn was the slowest, while DR. Brown’s Y nipple was the fastest, although it was tested using standard- thickness formula, whereas it is usually used with thickened milk.
It was observed that there was a lot of variation in the flow between nipples from the same type. Only 10 nipple types from the 45 tested showed minimal variations(less than 10%) between their nipples. For instance, DR. Brown’s brand had the most consistency, with 6 of their nipples having low variations, others were Tommee Tippee, Medela Calma, and etc. 19 of the 45 nipple types tested had a high variation of more than 20% between their nipples.
It is important to consider variations between nipples because we normally attribute the amount of milk the baby feeds to other factors like fatigue, but from the study; how much a baby feeds, is also influenced by the nipple.
This study has demonstrated that if your child is not feeding well, it might be helpful to change to a nipple that has shown less variation or try several nipples from of the same type.
NB: the study factored only negative pressure (mimicking sucking) and not positive pressure, which may be present with a baby.
Other Interesting findings were:
- Tightening the nipple to tight on the bottle can lead to a buildup of suction pressure causing the nipple to collapse; as a result, the infant would find it hard to suck from the nipple.
- More fluid in the bottles increases the gravitational pressure on the nipple leading to high flow. Likewise, less fluid means less pressure hence slowed flow.
Why Use A Slow Flow Nipple
If feeding a newborn: A slow flow nipple is the most suitable for a newborn because it allows them to suck slowly without being overwhelmed, and this ensures they take the proper amount of milk with each feeding.
To avoid/manage a health problem: feeding an infant with an improperly sized nipple can cause health problems. For instance, a bigger nipple would cause a high flow forcing the baby to swallow too much too fast. The stomach would then become overloaded and reject the excess milk forcing the baby to have excess spit ups. Also, the baby swallows too much air causing them to have acid reflux. Starting with a slow flow nipple would ensure your little one does not experience these uncomfortable issues.
For older babies: Some larger nipples have special slow flow features to eliminate tummy issues that would result from the baby using an improperly sized nipple.
What To Look For When Purchasing A Slow Flow Bottle In 2020
Reusable/Disposable: Nipples fall in these two categories, and of course, there are advantages and disadvantages to either choice; reusable nipples can save you money in the long run, but you have to keep cleaning and sterilizing which requires commitment and effort. With the disposable nipples, on the other hand, you can just feed your baby whatever time without needing to clean first hand, but then you have to keep stocking more and more, which could be expensive, not to mention piling up trash.
Cost: this is mainly determined by the brand and quality of the nipple. You want to make sure you do not compromise on your baby’s feeding and healthy for a cheaper, low quality nipple. One way of cutting costs without compromising quality would be buying in bulk.
Ease of cleaning: Nipples and baby bottles must be spotlessly cleaned and sterilized. Ensure the bottle you buy allows for drier washing and using boiled water. Also, such measures involve using high temperatures that are unsafe with plastic and silicon that releases BPA and other toxic chemicals.
Here is a list of all our best slow-flow bottles in 2020:
- Tommee Tippee Closer To Nature First Feed Bottle
- Philips AVENT BPA Free Natural Slow Flow Nipples
- Comotomo Natural Feel Baby Bottle
- Enfamil Slow Flow Soft Nipples-Latex Free $ BPA Free
- Playtex Nipple Variety Kit Slow Flow
- Similac Slow Flow Nipple And Ring
- Brown’s Original Nipple Level
- Nuk Simply Natural Bottles
- Medela Breast Milk Bottle Set
Reviews Of The Best Slow Flow Bottles
Tommee Tippee Closer To Nature First Feed Bottle
The Tommee Tippee is our favorite bottle so far because it has all the fantastic features you would wish for in a feeding bottle. It is dish washable and microwave usable safe. It also has a good grip and lightweight weight.
The nipple is shaped and made from soft silicon to provide the feel of a real breast. It also includes an anti-colic valve on the inside to provide extra slow flow. The silicon allows it to stretch, bend, and twist during feeding without allowing the baby to swallow too much milk or the air too fast.
The bottle is suitably designed for feeding preterm babies and for moms who want to feed newborns with expressed milk in the process of transitioning to bottle feeding.
Even more wonderful, the bottle comes with a milk storage pot that moms can use to store the milk they express and then feed the baby from a bottle.
This product is free from BPA (Bisphenol A), so you can relax knowing your toddler is not exposed to harmful chemicals.
- Breast-like shaped nipple
- An anti-colic valve on the nipple to reduce excess airflow
- Closer to nature breast milk storage pot
- 3- Way easy to hold bottle
- BPA free
- Guarantees no choking when feeding
- No more spit ups, gas and tummy problems in colic babies from swallowing excess air
- Provides clean feeding with no dripping
- Provides a storage pot for extra milk
- The rim inside the bottle catches fluid so you can fully empty without swishing it around
- The nipple might tear from frequent hard bites
Philips AVENT BPA Free Natural Slow Flow Nipples
Our second best slow flow nipple is the bottle from Philips Avent. This nipple does an excellent job of reducing airflow as well as the amount of milk your baby swallows at a time; as a result, we find it to be a perfect solution for babies who experience acid reflux and gas from swallowing too much air.
The nipple is wide, breast-shaped and made from soft silicon that is odorless and durable. It features twin anti-colic valves that work to push back the air into the bottle rather than the baby’s tummy. The petals on the inside enhance the softness and flexibility of the nipple, as well as preventing the nipple from collapsing during feeding.
This nipple was designed to cater for babies 1 month of age and above. It is dish washable and also compatible with Phillip Avent bottles.
- Designed for babies from 1 month of age
- Made from flavorless, odorless silicon
- Anti-colic twin valves
- BPA free
- Provides a perfect latch
- Provides the perfect milk flow while reducing airflow
- Easy to clean, steam, and sterilize
- Nipples are soft and durable
- Not suitable for newborns
Comotomo Natural Feel Baby Bottle
The Comotomo bottle is our third best choice on this list. The bottle is designed to have a breast-like feeling: the nipple is made from soft silicon with a wide mound to help your baby adapt easily, switching from breast and bottle. The bottle features dual anti-colic vents that promote circulation to facilitate consistent milk flow and eliminating unwanted air intake. This feature makes the Comotomo bottle suitable for preventing stomach gas, spit up, and reducing colic.
It is so easy to clean because it is uniquely designed with a wide opening that allows you to be able to reach with your fingers inside to clean. You can sterilize it, boil, or clean it with a dishwasher. It is also safe to use in the microwave.
As a bonus, your baby has fun with it as they feed because it has a soft, skin-like silicone that your baby will love to play with.
- Designed for newborns up to 3 months of age
- Dual anti-colic valve
- BPA, PVC, and phthalate silicone material
- Heat resistant
- Soft and squishy for the baby
- Easy to clean
- The perfect bottle for breast-bottle transitioning
- The frosting on the bottles sometimes does not allow you to see the level of the milk
- A bit expensive in comparison
Enfamil Slow Flow Soft Nipples-Latex Free $ BPA Free
The Enfamil nipples are unlike others we have reviewed in this list so far. A pack of these has 12 disposable nipples made from soft BPA free silicon. They serve the purpose well, and therefore they take the fourth position on our list.
The nipples are hygienically packed with each nipple being individually wrapped to make sure they are safe to use any time your baby needs to feed. They can be used on any standard or classic bottles. You could also disinfect with standard sterilizer before use.
The nipples have one hole on the nipple designed to provide extra slow flow and are also vented to allow air circulation as the baby sucks. As a result, they are suitable for newborns and younger babies who need to suck slower for longer.
Enfamil slow flow nipples are perfect for moms who travel a lot and in a hospital set up for feeding babies while eliminating the risk of contamination.
- A pack of 12 nipples
- Compatible with standard sized infant bottles
- Provides perfect slow flow
- You can reuse them after sanitizing
- Convenient while on the go or hospital setting
- They are disposable, so you have to keep purchasing more
Playtex Nipple Variety Kit Slow Flow
If you have been hunting from bottle to bottle trying to look for a suitable nipple for your baby with no luck and you are on a low budget, Playtex kit might be the perfect solution for you. It offers you a kit with a variety of nipples with four distinct shapes and sizes to mix and match with the Playtex bottle until you get the right combination for your little one’s unique preference.
The four nipples have different sizes and textures are designed as follows: breast-like shape designed to mimic the breast shape, natural latch designed most like mom’s, full sized designed for wider mouths, and angled for upright feeding. The good thing is all of them have a wide raised and textured area to provide a latch for easy switching between breast and bottle.
We think this is an excellent package that most babies will find their preference from while saving you the hassle of trial and error and the much-needed money!
The Playtex nipple is our number five best slow flow nipple.
- For babies 0-3 months
- A 4 nipple variety kit
- BPA free
- It can be a perfect gift for a baby shower
- Provides the perfect milk flow
- Makes transition to bottle easier
- You get a variety to create your custom feeding bottle from
- Doesn’t include caps
- Packaging can be confusing
Similac Slow Flow Nipple And Ring
The Similac nipples are similar to the Enfamil slow flow nipples we have just reviewed on this list; they come 50 pieces in one pack and are disposable. They also have only one hole on top for a more controlled flow, unlike other slow flow nipples that have multiple holes. The nipples are made from latex free materials.
We find them so convenient, especially for moms who are always on the go because they eliminate the hassle involved in washing and sterilizing. They are also ideal for nurses feeding infants in hospitals where multiple use of the same nipple is prohibited due to the risk of infections. Also, the ring is compatible with most commonly available infant feeding bottles.
Having considered these factors, we give the Similac nipple the sixth position on this list.
- 50 nipple pieces with a ring in a pack
- Has a single hole
- Made from latex free rubber
- Convenient for travel and hospital use
- Provide perfect flow
- Fits on most infant feeding bottles
- Some moms find the smell of the rubber nipple offensive
- Can be expensive because you need to keep buying more
Brown’s Original Nipple Level
We love these nipples from DR. Brown because you get two uniquely designed nipples in a pack for you to choose the one that is most suitable for your little one. They are made from durable high quality grade silicon.
Each nipple varies in size and shape to provide different flow rate; preemie Flow nipple being ideal for tiny mouths needing slow flow and Y-cut nipple that allows higher milk flow.
Because of how well the milk flow and air bubbles are controlled with these nipples, we find them ideal for reducing gas, spit ups, acid reflux, and colic.
DR. Brown nipples are the seventh on this list.
- 2 replacement silicon nipples in a pack
- Phthalate, latex, lead, and BPA free
- For newborns and above
- Dishwasher safe on top rack only
- Provides perfect flow
- Helps with gas and colic
- Pricey in comparison
Nuk Simply Natural Bottles
Nuks Simply natural is our eighth most favorite slow flow bottle. It among the best in the market, designed with the closest feel to mom’s breast.
A pack has two nipples that are carefully crafted to provide an extra soft feel and a nipple cavity to allow the baby move the tongue and jaw comfortably, just like if they were breastfeeding. The nipple with 3 holes for milk flow and anti-colic vent system to help reduce the air the baby would suck in.
From the design, the bottles ensure the breastfeeding bond between you and your little one remains strong even through the process of transitioning to bottle feeding. The bottle helps reduce spit ups and colic due to gassiness.
- Bottle made from Tritan’s high quality plastic bottles
- 2 pack
- Anti-colic air system
- Safe to micro-steam
- Provide perfect slow flow
- Easy to clean
- Baby latches just fine
- Good for fussy and gassy baby
- Some moms find the caps relatively difficult remove
Medela Breast Milk Bottle Set
The Medela nipples are designed to help with an easier breast-bottle transitioning in mind. They have natural feel and shape that like the breast, with a wide base for latching on.
You will also find them easy to clean by hand or dishwasher and can safely be micro-steamed or boiled since they are BPA free.
The nipples are compatible with Medela breast milk bottles and can only be used with wide base collars. It is our number ninth on this list of best slow flow nipples
- For babies 0-4 months
- Dryer safe, boilable
- Made from silicon
- Easy to clean
- Compatible with other bottles
- Baby loves the natural feel
- Some parents find the milk flow is faster than claimed
- It allows spillages
- Some parents experience nipple-bottle compatibility problems.