Baby Insights: Side Lying Bottle Feeding (Not Just for NICU Babies!)

An Alternative to Upright Feeding

Side lying bottle feeding^1,2 is a great alternative to upright paced³ or responsive⁴ feeding and I wish I had known about it sooner! It didn’t really come on my radar until about one year into caring for newborns, and even then I wasn’t sure how applicable it would be for babies who weren’t preemies- who this feeding position was most recommended for from my initial understanding. Some babies I’ve cared for struggled with upright paced feeding that couldn’t be resolved by changing bottles, nipple flow, nipple shape, or through other ways, but as soon as I implemented side lying feeding, the benefits were clearly evident!

Side Lying Benefit: Calmer Eating

In general, all babies were calmer eaters. This looked (and sounded) like less gulping, as well as appearing less overwhelmed, especially if upright feeding was too fast (e.g., coughing or gagging on milk).

It made a huge difference for babies who had these difficulties:

1-week-old with reflux⁵ and laryngomalacia⁶, who was also recovering from a viral infection
1-month-old exclusively breastfed, who, with first bottle attempt, found the nipple flow to be too fast and upright feeding to be awkward (side lying appeared much more comfortable, as that’s what she was used to with breastfeeding)
1-month-old with viral-induced bronchiolitis⁷
A couple of 3- and 4-month-olds who at times refused the bottle and became increasingly distractible (aka more interested in looking at and giving their attention to other things!)

Additional Benefit: Calmer Feeding Sessions for the Parent or Caregiver

Sometimes feeding with a bottle can be a lot! Figuring out flow, latch, and other baby feeding aspects as a parent or caregiver can be difficult when baby is also having a difficult time, so the side lying position can be extremely helpful in slowing things down. Also, if you wanted to just start with this position from the get-go rather than the upright position, go for it!

And always make sure that you’re able to settle into a comfortable position while feeding, burping, and holding baby! For elevated side lying, you can sit with your legs on the couch, with knees up, and baby resting on their side on top of your thighs. For slightly elevated side lying, you can sit in a chair with a stool under your feet and have baby resting on a pillow on their side. I frequently use a pillow (with a burp cloth or muslin blanket over it, just in case of milk spillage or spit ups), but a thick, folded blanket could work in a pinch.

More pictures demonstrating side lying feeding can be found at Feed Eat Speak’s blog post, “Elevated side lying bottle feeding”², and I highly recommend checking that out since it’s the link I text to parents the most!