If you’re bottle-feeding, you have to prepare the bottles, burp your baby afterward, change their diaper, and clean their bottles. Doing all of these things on top of being sleep-deprived and having other responsibilities can seem like a lot. It’s no wonder that many parents look for shortcuts when it comes to baby care and feeding. One such shortcut is “bottle propping” where you use a pillow or another device to hold your baby’s bottle in their mouth so that you can feed them “hands-free." There are even products sold in stores and online that aid in bottle propping. Bottle propping is never safe, even though it is tempting. Both the Centers for Disease Control and Prevention (CDC) and the Academy Of American Pediatrics (AAP) strongly advise against it. We connected with two pediatricians to give us the low-down on bottle propping. Here’s why it is considered dangerous, how to bottle-feed safely, and what alternatives are out there for exhausted parents.
What Is Bottle Propping?
Bottle propping is a way to feed your baby without holding the bottle. Parents often prop the bottle against something else like a rolled-up blanket or a car seat before the baby is developmentally able to hold a bottle by themself, explains Megan Shimkaveg, MD, a pediatrician at the University of Maryland St. Joseph Medical Center. In these cases, the bottle is not held by the parent, nor is the baby held by the parent. Bottle propping occurs anytime a parent positions their baby’s bottle so that the baby is being fed “hands-free.”
Risks of Bottle Propping
Bottle propping may have appeal, especially to tired parents. But it’s one of those baby practices that should be avoided unequivocally, without exceptions. The most serious danger of bottle propping is that your baby could aspirate or choke on the milk in the bottle. Babies do not yet have the head control to pull away, so they could choke on the milk as it flows out of the bottle, explains Sara Huberman Carbone, MD, pediatric medical director for One Medical, based in Orange County, California. On the other hand, when you are present, holding the bottle for your baby, and watching for their reaction, you are able to see if they are becoming distressed by the flow of the milk. You also are able to regulate the flow by changing the angle of the bottle, and you can remove the bottle when they appear satiated or full. The consequences of bottle propping can be serious, says Dr. Shimkaveg. Aside from the risk of overfeeding, choking and gagging on milk can put your child at risk of pneumonia and even death. “If a parent props the bottle and leaves—which is often the case—no one is there to help when they show signs of distress," she explains. “[This puts] the infant at risk of suffocating, or, in essence, drowning on its own formula.” Besides the risk of choking, pneumonia, and death, bottle propping can have other detrimental effects on your child’s health. The CDC notes that bottle propping can increase your baby’s chances of ear infections, tooth decay (from the milk pooling for long periods around the teeth), and overeating. If a baby is lying flat while the bottle is propped, milk can easily travel up the eustachian tube—the tiny pathway that connects the middle ear with the nasal passages—and can lead to chronic infections, hearing issues, surgery, and an overuse of antibiotics, says Dr. Shimkaveg. Some might also think that bottle propping becomes safer at a certain age, maybe when a baby has better head or neck control. Unfortunately, the answer is still no. “Bottle propping is never safe, period,” says Dr. Shimkaveg. “If a child can’t safely hold and remove a bottle at will, he or she needs to be fed by an adult,” Dr. Shimkaveg says.
What About Manufactured Bottle Propping Devices?
Just do a quick online search and you will see a lot of devices that allow you to feed your baby “hands-free.” Some of these devices look like pillows or foam wedges that prop your baby up for feeding. Others connect to car seats, baby seats, or cribs. Some devices even provide long tubes that connect the bottle nipple to the bottle itself so that your baby can suck on the bottle nipple alone, similar to a pacifier. None of these devices are safe or recommended, explains Dr. Huberman Carbone. In essence, any device that purports to feed your baby without your supervision is not recommended. “These devices have the potential to cause the same risks as bottle propping due to the unrestricted flow of milk,” she says.
When Can A Baby Safely Self-Feed From A Bottle?
There is some light at the end of the tunnel for parents who want a break when it comes to feeding, though. Eventually, your child will be old enough to self-feed with a bottle. The age at which this occurs varies from one child to another and has to do with their developmental maturity. Dr. Huberman Carbone says that her criteria for when it’s safe for your baby to self-feed from a bottle is when they can sit upright and unsupported for 10 minutes and when they can hold the bottle themselves, with their own two hands. This milestone is usually reached at 7 to 10 months, she says. “I still recommend supervision during this time for safety reasons,” says Dr. Huberman Carbone. “The flow of milk can still be quite fast and babies are still developing coordination. Feeding is also a wonderful time for parents to interact with their baby and encourage social development.”
Alternatives to Bottle Propping
The truth is, there are no safe ways to feed your baby without adult supervision. Your baby requires a watchful eye at all times while eating —even when they start eating solid foods. That being said, parents of babies need and deserve breaks. If you are able to have someone help you with baby feeding and care, do it. Take people up on their offers. Don’t try to be a martyr because it is not helpful for anyone. If you are parenting multiples, baby feeding can be especially draining. Look for ways to find outside help. If possible, hire a night nurse or someone to assist you. Or, have family members stay with you while you adjust. Any help you can find is invaluable. In addition to employing a set of extra arms, Dr. Shimkaveg suggests feeding your baby in a bouncy chair if you have more than one infant to feed. And, if you need to set your baby down because you need a moment of rest or you have to feed two babies, use a pacifier to soothe them. “Pacifiers can safely soothe babies who are waiting to be fed,” Dr. Shimkaveg offers.
Tips for Safe Bottle Feeding
Besides never using bottle propping while feeding your baby, there are a few other safety tips you should keep in mind when it comes to bottle-feeding. Begin by holding your baby in a semi-upright position, which would be about a 45-degree angle, says Dr. Huberman Carbone. Hold the bottle at an angle, too; this will allow you to control the pace of the milk flow. While feeding, pay attention to your baby. Give them breaks when they seem distressed, full, or need to burp. You also should not ever leave your baby alone with a bottle, and you shouldn’t let them sleep with a bottle, says Dr. Huberman Carbone. Other bottle-feeding safety tips include thoroughly washing your baby’s bottle with soap and water after use and testing the temperature of your baby’s milk by squeezing out a few drops of your wrist. You should never feed your baby milk that is too hot.
A Word from Verywell
Often, the parents who consider using bottle propping are the same parents who have reached a breaking point and are desperate for a break. Although bottle propping is never a good or safe idea, that doesn’t mean that you should not address the fact that you feel overwhelmed. If people have offered to help out, don’t hesitate to put them to work. If not, consider asking for help from trusted family members and friends. Most people are willing to help when asked. You could even look into hiring help if your budget allows. And, if you are feeling depressed or anxious and are finding it hard to care for yourself or your baby, contact your healthcare provider. Your mental health is important, and help is out there for you.