When to switch nipple size: When To Switch Nipple Sizes On Baby’s Bottle

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When To Change Bottle Nipple Flow Size? (& Why You Should)

As a first time mom, I was awfully unprepared for all that breastfeeding has to throw at me. That is partly one of the reason why I started this blog, to save my fellow mom friends some frustration (that and as a mental outlet).

Don?t even ask me how I switched my son from breasts to taking a bottle. That was another whole episode of challenges. From choosing the right bottle that would please him to finding the right nipple flow size was very overwhelming than I ever imagined it to be.
If someone had told me that I have to try five different bottles before we could find the ?one,? I would have laughed. Unfortunately, that was the reality.
I didn?t even know that nipple size flow was a thing until I stood clueless in the bottle section of Toys R Us.

Preemie, Extra small, Anti Colic? Natural Flow? Y cut? What the heck is all this? And, how do I know which one to choose and when?

If you have been googling all day about which nipple flow size to choose or when to transition to the next flow size, relax and read this post. If you still have any more questions, feel free to comment below, and I will try my best to help you.

I am not going to promise you that at the end of this post, you will know which nipple size will work for your baby. If I did, I would be lying. Honestly, It is more of guesswork, but what you will know is how to make an educated guess (and hopefully not be frustrated by the whole process).

Table of Contents

What is Nipple Flow Size & Why Is It A Big Deal?

If you take a close look at the tip of the bottle nipple, you can see that there are tiny holes through which your baby sucks the milk out of the bottle.

The number of holes in the nipple (or the shape of it) will determine the flow size of the nipple. There is a reason why there are a variety of nipple flow sizes and designs in the market, that’s because no one baby is the same and what works for one may not work for another.

How and When to Switch Nipple Flow Size?

There are so many factors that determine which nipple flow will best suit your baby. What works for your baby in the newborn stage may not work when they are older. Also, breastfed and formula fed babies have different needs that would require different nipple sizes.

Nipple Size and Baby Age:

Mostly all the brands have different nipple flow sizes based on the babies age. Most have them start with the slowest flow for 0-3 months, and the flow size increases every three months. Some brands even offer a Y cut nipple flow for babies older than nine months to drink thicker liquids like smoothie or milk mixed with cereal.
If you think that you will pick the right nipple size according to the age of your baby, then I’m sorry to say that it’s not as easy as it sounds.
The age of the baby is NOT the only thing that matters. As I said earlier, breastfed babies have different needs than formula fed babies, which I will discuss below.

Nipple Flow Size for Breastfed Babies:

Breastfed babies are very picky when it comes to choosing a bottle and a nipple. Consider yourself lucky if your baby took a bottle without a fight.
If your baby has been exclusively breastfed and you are introducing a bottle for the first time, then be careful to choose a bottle ( and a nipple) that will avoid any nipple confusion.

A baby has to work to get the milk out of the breasts. Bottle feeding is easy for breastfed babies; they might get so accustomed to a bottle that they might even reject your boob.

My two cents while choosing the nipple for your baby is to get one that is designed for breastfed babies. We went with this, and it was the only one that my son took.

When it comes to choosing the right nipple flow size, start with the slowest flow and work your way up. Breastmilk is thinner than formula, and will easily flow through the ‘slow’ nipple size. Many moms never transition to the next nipple flow size, because the baby was happy with the slow flow.

Here are some of the best Slow-Flow nipple size that might work for breastfed babies:
1. Avent Natural

Nipple Flow Size for Formula Fed Babies:

If you are planning to formula feed exclusively, right from birth, then start with the slowest nipple flow size. Many formula fed babies tend to get gassy, so it is better to choose a bottle that is anti-colic. This is the best anti-colic bottle and moms swear by it.

If you are introducing formula to an older baby, then look at the nipple flow chart to start with the size that is recommended for the age.

Signs to Switch Nipple Flow Size:

Now that we know which size nipple to choose for breastfed and formula fed babies, but how do you know when you got the wrong nipple size. Don’t worry; your baby will tell you.

When the nipple size you currently use is too small, the baby will fuss about it. Your baby might be frustrated that they are not able to eat more. They might suck in vain, give up and be cranky.

If your baby is doing any of the things below, it might be a good idea to go up a size.

  • Sucking too hard
  • Flattening the nipple
  • Getting frustrated by squirming, pushing the bottle away, or kicking
  • Hitting the bottle
  • Taking more than thirty minutes or an hour to feed
  • Eating less than normal at feeding time and then being hungry again soon after

On the other hand, you might be using a flow that is too big for your baby. It is better to have a slower flow rather have a faster one. Especially for newborns and smaller babies, there is more risk in using a faster slow (they have less sucking power and might choke on too much milk). If you notice that your baby is very gassy ( and fussy) after the feed, then it might be because they took in air while feeding.

Always be cautious when you are switching to the next flow size and watch for these signs:

  • Baby Choking on milk
  • Gagging on milk
  • Milk dribbling out of the mouth
  • Struggling to keep up with the milk flow
  • Gassy after the feeding session
  • Finishing a bottle way too soon ( within 5 minutes)

Switch back to a smaller size flow if you notice these problems with your baby.

Let’s Wrap Up:

Who would have thought choosing the right nipple flow size would be such a daunting task. Phew! Hopefully, after reading through the post, you? have an idea on how to figure out the best nipple flow for your baby. If your baby is happy with the nipple size you are using, don’t bother changing the size. On the other hand, if your baby is frustrated or you see any of the signs above, then move on to the next size.

If you have any questions , feel free to post them below.




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When To Change Nipple Size—3 Clear Indicators To Watch Out For 2023

Bottle feeding presents its own unique set of challenges. 

Bottle nipple size is one of the biggest bottle-feeding challenges to conquer for parents. 

Your baby’s mouth needs the right nipple size to feed comfortably, and knowing when to change nipple size or nipple flow – from a slow flow nipple to a medium flow nipple – is a challenge that can take some trial and error.

In this article, we’ll talk all about bottle nipples. 

From the differences in brands and the bottle nipple sizes they use to the signs that it’s time to change nipple flows to a faster flow nipple, to frequently asked questions about baby bottles, breastfed babies and nipple size, and more.

When to change nipple size

Bottle feeding is often made out to be a lot easier than nursing. 

And some things make the process of bottle feeding a baby a bit simpler than breastfeeding. 

However, bottle feeding presents unique challenges, such as finding the right bottle brand for your baby and the right bottle nipple size for your little one.

Breastfed babies and bottle nipples

If your baby consumes breast milk and sometimes nurses directly from the breast, you may want to hold onto that slow-flow nipple you used on those first bottles you bought.

Breast milk flow is often a bit slower when nursing. You have to wait for the letdown to occur, and then your baby typically has to use quite a bit of suction to get the breast milk flow going.

Due to this, most pediatricians and almost any lactation consultant will advise you not to switch from a slow-flow bottle nipple size until you have to if you also nurse.

This avoids nipple confusion, which can happen easily and is most common in young babies. Nipple confusion is when your baby refuses to latch onto your breast for breast milk because it is easier to get milk from the bottle nipple.

To avoid this, experts say you should try to continue using a slow-flow bottle nipple for as long as you can, as a slow-flow nipple makes your baby work harder to get the milk flow going, and it is similar to the work baby has to put into getting human milk from the breast.

How to know when to change nipple size

If you look closely at the packaging on bottle nipples in the store, you will see that they usually have age ranges listed. For example, a slow-flow nipple size is often listed as a newborn-size nipple, and so forth.

However, it’s not always so simple as going by age. Sometimes your baby’s mouth is a bit small, a little bit larger, or your baby grows quickly due to a growth spurt, and they’re ready to move up a little faster.

You can look for signs your baby will start to display to let you know that it may be time to go up in nipple size. 

The following are some of the most common signs, also known as readiness cues.

1. It takes over 20 minutes to finish a bottle feeding

The nipple size on your baby bottles may be too slow, and it may be ready for a faster-flow baby bottle if it takes more than 20 minutes for your little one to finish the whole bottle.

This can also mean that your baby gets worn out or bored sucking fiercely at the baby bottle nipple and simply decides to fall asleep instead. 

If this is regularly occurring or with increasing regularity, then it may be time to switch bottle nipple sizes to a medium flow or even fast flow bottle nipple.

2. Sucking fiercely on the baby bottle

When the suction created on the baby bottle gets so intense that the bottle starts to collapse on itself, your baby is ready for a medium-flow or fast-flow nipple.  

Nipple flow is too slow when the suction your baby is employing to get milk flow going changes the shape of the baby bottle.

Even a breastfed baby may need to change bottle nipple size if the slow-flow nipples are causing them to suck so hard that they are collapsing or denting bottles.

3. Baby gets irritated with the slower flow rate

It may be time to select a faster-flow nipple, like medium flow, if your slower flow rate is causing your little one to start crying or fussing after just a few minutes with a bottle.

When presented to a hungry baby, most baby bottles mean relief is on the way. When the nipple flow is too slow, however, it can spell disaster, as your baby quickly becomes frustrated with the nipple flow rate.


There are many good questions surrounding not only nipple flow rates but also bottle feeding in general. 

Too often, parents don’t ask these questions. 

Remember that we aren’t meant to inherently know everything as parents. We learn by asking questions, which makes us better prepared to give our little ones the things they need to grow and succeed.

The following are some frequently asked questions about bottle feeding:

1. What is paced bottle feeding?

Paced bottle feeding is a method in which bottle feeds are more calculated to make a bottle or breastfed baby take their time with the bottle.

It is said to help with acid reflux and indigestion and to keep a baby from puking or spitting up frequently due to being fed too fast.

This method involves using slow-flow nipples, or the slowest flow your baby will tolerate, and holding the bottle parallel to the floor when you feed your baby.

2. Can I size down if the nipple size is too fast?

Most babies will let you know if you switch the nipple of your baby’s bottles and they are not ready for it. A bottle-fed baby will often choke, make a huge mess of the milk, spit up a lot more or have gas issues due to too much air, or start to fight to get away from the faster flow rate.

The good news is that you can size down if needed. 

For example, you can go back to medium flow nipples if you try fast flow nipples and notice that the milk is dripping from the mouth, refusing to accept the bottle becomes the new norm, or your baby seems to be choking or struggling to keep up with the fast flow.

If you notice your baby struggling, switch back to a slower milk flow, but hold onto the fast flow rate nipple for later.

3. Do I have to switch the nipple level?

The short answer is: nope! It’s not entirely uncommon for older babies to stick with slow flow rates until these babies grow out of the need for bottle feeds. 

Many babies are fine with the same flow rates during their bottle-feeding journey.

Brands and their nipple levels and sizes

You’ll notice when you start looking at nipples that different brands use different terminology and age ranges on their packages. 

This can make the whole process confusing, and you may not know when to switch nipple sizes.

The following are some of the most popular brands and the sizes of nipples they offer. 

If you are still confused, consult with the medical professionals who regularly treat your baby and family or with your lactation consultant.

1. Dr. Brown nipple levels

Dr. Brown nipples come in six sizes the company calls “levels.” They are as follows:

  • Premature
  • Level 1: For newborns to three months
  • Level 2: For three to six months
  • Level 3: For six to nine months
  • Level 4: For nine months and up
  • Y-cut: For nine months and up

2. Avent nipple sizes

Phillips Avent is a trusted brand that makes several different sizes of nipples. Great for babies who are formula-fed or breastfeeding, the following are the ways the brand categorizes their nipples:

  • First Flow Nipples: For premature babies and newborns
  • Newborn Nipples: For zero to three months
  • Slow Flow Nipples: For one to three months
  • Medium Flow Nipples: For three to six months
  • Variable Flow: For three months and up
  • Fast Flow Nipples: For six months and up

3. Comotomo nipple sizes

Comotomo brand offers four different-sized nipples and suggests the ages given these nipples correspond with the following:

  • Slow Flow: For birth to three months
  • Medium flow nipple: For three to six months
  • Fast flow: For six months and up
  • Variable Flow: For six months and up, for thicker liquids as well

4. MAM nipple sizes

MAM is a brand often used for babies breastfeeding alongside bottle feeding or supplementing while breastfeeding.

The nipples are shaped like a breast to mimic breastfeeding, making the transition nearly seamless for many little ones.

The following are the nipple sizes offered by this brand:

  • Slow Flow: For newborn to three months
  • Medium Flow: For three to six months
  • Fast flow: For six to twelve months

5. Nuk nipple sizes

Nuk brand nipples simplify things and are loved for their simplicity in nipple sizes. The following are their two options for nipple levels:

  • Size 1: For babies zero to six months
  • Size 2: For six to eighteen months


It can be overwhelming figuring out when to change out nipple sizes. 

However, it is something that you can try and then go back on if you need to. 

Don’t rush the switch, but look for readiness cues from your little one, and don’t be afraid to ask for help or try different brands.

Hopefully, this article has helped you feel confident that you’ll be ready when the time comes to switch to a faster flow.

Nippleplasty — size reduction surgery

Anesthesia: local Duration of procedure: 0.5-1 hour Hospital stay: days (if required)

Discomfort: 1-2 days Primary result: 2-4 weeks

Quite often, patients who turn to a plastic surgeon for breast correction, at the same time want to change the size or shape of the areola. Some women are embarrassed by the large size of the areolas by nature. In others, with a congenital anomaly in the structure of the mammary glands, there are asymmetries or irregular shapes of the nipples and areolas.

When is nipple areola reduction recommended? It is possible to correct the areola and the shape of the nipples not only after pregnancy and breastfeeding, but also in the following cases:

  • congenital asymmetry in size, location or shape;
  • acquired asymmetry — as a result of surgery;
  • areola size too large for a woman, causing complexes and discomfort.
  • You must have a consultation with the surgeon before the operation. He will examine the breast, assess the condition of the tissues, and select the optimal method of correction.

    How to prepare for surgery

    To prepare for plastic surgery, you need to undergo an examination:

    • Ultrasound of the mammary glands;
    • Ultrasound of the vessels of the lower extremities;
    • routine blood and urine tests for hospitalization;
    • ECG with interpretation.

    You should also consult an anesthesiologist before plastic surgery. He will select the most optimal drug for you.

    How a nipple correction surgery works

    Nipple-areola correction is performed under local or general anesthesia. The type of anesthesia depends on the complexity of the operation: if the surgeon reduces the areola at the same time as lifting, breast augmentation or reduction, general anesthesia is performed. If only the areola needs to be corrected, local anesthesia is sufficient.

    To reduce the areola and improve its shape, the surgeon makes an incision along the border of the pigmented area and the skin of the breast. Then it cuts out the pigmented area, removing excess tissue and creating a beautiful symmetrical shape of the areolas. If there is asymmetry, the surgeon can reposition the nipple-areolar complex for an aesthetically pleasing result.

    After the correction, external cosmetic sutures and special dressings are applied. Due to the fact that the incision is made in the transition area, surgical sutures are almost invisible. After the rehabilitation period, they will become invisible.

    What you need to know about the rehabilitation period

    The rehabilitation time depends on the complexity of the surgical intervention. If the plastic is performed under general anesthesia, you will need to spend a day in the clinic under the supervision of a doctor. You can check out the next day and go home.

    Primary discomfort: pain, swelling, slight fever — disappears in 1-3 days. The first 7-10 days after plastic surgery, you can not take a shower or bath. Your doctor may recommend special underwear for you. He will schedule the dates for removing the sutures and follow-up examinations.

    How much does nipple and areola reduction cost?

    The cost of the operation is calculated individually and depends on the complexity of the procedure. Most often, the operation is performed in combination with other operations. The doctor will inform you at the preliminary consultation. The final price includes not only correction, but also consumables, surgical supervision, hospital stay and food (if the procedure is performed under general anesthesia), anesthesia.

    Popular questions

    Can I have a nipple and areola reduction if I am going to have a baby in the future?

    Reducing the size of the areola does not affect future lactation. With nipple reduction surgery, future lactation is also preserved in most cases, and nipple augmentation surgery is associated with the intersection of the main ducts. Philip Nikolayevich is an opponent of the intersection of the ducts of the mammary gland.

    Is it possible to reduce nipples if they are too large and stick out?

    Possible. The operation consists in circular excision of the nipple and its subsequent flattening.

    How long do I need to stay in the hospital if the anesthesia is local?

    Patients are observed within an hour after surgery under local anesthesia.

    Cost of correcting the shape of the nipples and the size of the areola

    Correction of the shape and size of the areola and the nipple

    from 90 000

    Mistakopoulo Philip Nikolaevich

    About the doctor

    I strive to find an individual approach to each patient and provide an opportunity to choose the ideal method of breast and body correction. I go into detail about all the features and benefits.

    Make an appointment More about Dr.

    All my life I have experienced difficulties because of my breasts with a difference of almost 1.5 sizes (3 and about 4.5) and asymmetry. It seemed to me that my breasts were from two different women. An incredibly difficult task, which I suffered all my life, was the selection of underwear. Few places could…

    Olga, 34g, Moscow

    Read review

    Someone boasts of tummy tuck, someone — breast augmentation. And I want to talk about my operation and boast of both))) These 2 operations were carried out for me at a time, moreover, from a very unusual access))) After the phrase “unusual access”, anything can come to mind . ..

    Valentina P.

    Read review

    I made my breast by Philip Nikolayevich Mistakopoulo and I am delighted with the results. The operation was performed by a surgeon with a name, with tremendous experience (more than 4,500 operations !!!) in breast plastic surgery, a plastic surgeon, an oncologist, a mammologist. He is one of those specialists who all his life …

    Mila T.

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    Areola: what operations can change the shape, size, color?

    The skin of the areolas is structured and has slight irregularities. Beneath it are Montgomery’s glands and a small amount of milky currents. This keeps the areola and nipple soft for lactation. During feeding, the baby easily captures the breast and gains access to mother’s milk.

    Normal areola appearance

    There is no typical normal as they come in different colors, sizes and shapes. Both round and elongated shapes are considered the norm. Diameter — 3-12 cm. The right and left areolas are not identical to each other. There are no «twin» breasts. All women have differences between the right and left mammary glands. All this is normal.

    The presence of lumps in the chest, pain when pressed is not the norm. In the presence of such signs, immediately consult a doctor.


    As the breasts enlarge, so do the areolas. Due to hormonal changes, they darken.

    Breast enlargement occurs during pregnancy and lactation and during weight gain. In the first case, the gland itself increases, in the second — adipose tissue.

    After pregnancy, the bust is restored, and as a result of a sharp weight loss, the skin sags. Areoles remain wide and stretched.

    Recovery directly depends on the condition of the skin and its elasticity. At a young age, weight loss can be tolerated without damage to the skin. In the older one, stretched areolas remain after losing weight.

    Areola reduction: Methods

    It is worth emphasizing that there are no simple methods. Creams or folk methods will not help in this case. If the advertisement of the remedy says that it will reduce the areola and make the breast more elastic, beware of experimenting with such a drug. The best reduction method is surgery.

    As a rule, manipulation is performed in combination with a breast lift or breast reduction. Often large areolas suggest the presence of a corresponding breast. But not everyone likes this state of affairs.

    People who want to correct their breast volume turn to a plastic surgeon. Doctor Igor Butko has been successfully performing facial and figure correction surgeries for more than 20 years. She uses modern techniques, equipment and safe anesthesia in her work. All manipulations are carried out under conditions of absolute sterility. Patients are guaranteed confidentiality of treatment.

    During the operation, the surgeon makes a donut-shaped incision along the edge of the areola, removing excess tissue in a circle. The remaining areola is fused to the surrounding skin.

    Laser lift available. The work uses a laser aimed at lifting, but not affecting the pigment. In this case, the areola also decreases in size. But the question of choosing a doctor and a place for laser correction should be approached carefully. Not all specialists guarantee the desired result. An experienced plastic surgeon will determine the contraindications to the procedure and inform the patient about this.

    Areola augmentation: Methods

    In this case, surgery is the best option. Some patients resort to tattooing. Doctors do not recommend applying a tattoo to such a sensitive area of ​​\u200b\u200bthe body. In addition, the body may reject the injected pigment. After tattooing, a strong reaction of the body can develop, which will lead to the need for surgical intervention for medical reasons. Pigmentation may vary in color. Even a perfectly matched tone will be noticeable when viewed. Over time, the pigment is removed from the body and the tattoo site brightens.

    A plastic surgeon enlarges the areola during breast augmentation surgery. When volume is added, the skin is stretched. As a result, the size of the areolas increases.

    The second method involves excising the surrounding skin in the form of a doughnut. The skin strip is removed. The areola is stitched to the edges of the skin. Gradually pigmentation increases. The duration of the process depends on skin elasticity and the degree of sagging of the breast. This method will not lead to cardinal changes, however, it will visually increase the size of the areola.

    How to find a good areola correction specialist?

    Do not trust yourself to the first plastic surgeon you come across. It is worth studying the information about the doctor, getting acquainted with the results of his operations, studying the reviews of previous patients.

    Many years of practical experience, the availability of author’s methods, work for the result — the criteria for a good specialist. As a rule, you can find real responses on the clinic’s website and independent forums.

    By alexxlab

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