18 answers

When to Switch from Slow-flow to Fast Flow Nipples and What About Cereal?

I feel pretty dumb asking this question, seems like I should just know. When do I switch my 4 month old from the slow flow nipples to fast flow? I am somewhat reluctant to just "try it" as we had so many problems getting the right formula for him (finally ended up with Nutramigen ready-to-feed), the right bottle (Playtex drop-ins), etc. to end his painful gas and constipation.

Also, I am receiving conflicting info on cereal from WIC vs. the pediatrician. WIC says we should wait until he's 6 months old since he was a preemie (5 weeks early) and that waiting will be better for his eczema and preventing allergies. The pediatrician laughed at that and told me to "buy the poor kid a box of rice cereal and start feeding it to him". She said there's no proven reason not to.

Additionally, if I do give him cereal now, do I use a bottle or a spoon? WIC says if he can't eat it from a spoon, he isn't ready. The doctor says give it to him any way he can eat it.

Thanks in advance,

What can I do next?

Featured Answers

Hi K.,
My son is almost 7 mo old and still using the size 2 nipple. It has a slow to medium flow. I don't plan to move him to another size at all. My ped. told me that as long as he's not frusterated when drinking, then he doesn't need to switch.

As far as cereal goes, we started right at 4 mo, but it took until around 5 mo. for him to eat more than one or two baby spoonfuls. I was told by my pediatrician to always feed cereal from a spoon because you're really just teaching them to eat and swollow in a different way. The cereal is really not nutrition for them right now. Since you use a specialized formula, you might try mixing the cereal with water in the beginning because most of it will be wasted.

Good luck!

Honestly, I started all 3 of kids on a small amount of rice cereal at 3-5 weeks old. I would make it very watery and spoon feed. They slept thru the night. It's mostly trial and error, but you'll get it.

More Answers

There are no dumb questions, so relax.
First off - your pediatrician *laughed* at your question? Seems like she's on a bit of an ego trip, and egos don't keep babies healthy.
Bit of experience here - My baby sister's doctor recommended adding rice cereal to her formula at 6 months of age to limit her spitting up - the next day she had a fecal ball so huge that it ripped her anus open. Where was Dr. Ego then? Not with a glob of petroleum jelly on his finger with a screaming infant in his lap. Listen to WIC - they are in the business of feeding babies, and doctors may, at best, take a semester course on child nutrition. Formula (as well as breastmilk, of course) is completely adequate for nutrition during the first year of life. Please don't put your baby at risk for excema and allergies. As a lifelong excema, asthma, food allergy, and allergic rhinitis sufferer, I'll tell you that he will thank you for your efforts, even if they don't work out (I was breastfed, but started solids at ONE month of age, at, you guessed it, the doctor's recommendation).
As for the nipple, I used a 3-month rated nipple (I used avent for my breastmilk while working) starting when my now 4 year old was 6 weeks old, because she was so frustrated and hungry trying to get enough flow from the newborn nipple to fill her belly fast enough). Best thing I can say is try to go by your baby's preference and his gestational age, to give his tiny digestive system a little wiggle room to catch up. Try a faster flow, he might like it, or he'll let you know. But that 'just add some rice already' recommendation from your oh-so-jolly doctor gives me the shivers.
Good luck, K., and please do come back with more questions, that's why we moms and read and respond - we want to help you!

1 mom found this helpful

Just my opinion, but it sounds like you need a new pediatrician. The sooner you feed babies solids (rice cereal, etc) the higher the chance of allergies- and if your son already has eczema then I would definitely hold off. Babies don't "need" food in their first year- breastfeeding or formula should be their primary source of nutrition- food is just for experimentation. Also, do not put the cereal in a bottle- it can be a choking hazard. Mix it up thinly and spoon feed him. He may reject it a few times until he becomes accustomed to this new consistency. Lots of luck to you, and trust your mommy instinct!

Hi K.,

I just switched my 3 month old to level 2. I knew she was ready because she looked like she was sucking so hard and not getting anything. It was also taking her a while to eat (like an hour). I did check the label on the level 2 nipples and it said 3-6 months (I use Dr. Brown bottles, check the label on the bottle nipples you use). Also, my pediatrician does not want my daughter to start cereal until at least 6 months old and that is if she is ready.

S. B

This isn't answering your question and I'm sure you've figured it out by now since you posted years ago haha.... I searched when to switch from slow flow nipples and came across your post. The more of it I read, the more it could have been me writing it! My baby was 6 weeks early, on Nutramigen ready to feed (after much experimentation), using Playtex Drop-ins and has eczema. Coincidence!!! I'd love to hear how your little one is doing now!!!

The lactation consultants I have talked to had a really good point about these fast flow nipples. They pointed out that when you're breastfeeding, you're nipples don't change and become fast flow, so why should you change a bottle's nipples. It's just a marketing ploy. So called "slow flow" bottle nipples are still faster than nursing, so there's no need to make access any easier than it already is.

As for the cereal, we started both our kids at around 5 months, from a spoon. I'm pretty sure that most sources tell you not to give cereal through a bottle, but I don't remember exactly why.

I hope this helps. Good luck!

my ped says wic are idiots, they tried to tell me my oldest had low uron but they were going on an adult scale, as for the cereal my daughter has had many feeding problems and is now at six months gaining weight first we switched her to nutramigan and by what the ped and a ped gi specialist said to add on tsp of rice cereal per 1 oz of formula to thicken and add carlories. wic does not have dr they have nutrintist just pay them no mind to get the formula and listen to your dr..if your baby isnt having a problem with the nipple you are y=using then don't change it, as for eczema my middle daughter has that,asthma and is autistic she did't have real food until 6 months (i waited because she did't seem ready to me) i always parent on my gut instict


Your confusion is warranted. I'm so sorry that your child's Dr was so rude. Until a baby is able to sit on their own, and shows interest in solid foods no baby should be fed solids of any kind. When a baby requires cereal to keep their food down, there's something wrong with what they're eating, or physically wrong with the baby, not a need for solids. A baby's digestive system is not mature enough to properly digest anything other than breast milk (or formula) until they are at least 6 months old. Waiting until 6 months or more is recommended, and in the case of your little one and the eczema you mentioned, he would do far better to wait until at least 6 months if not closer to 8, and at that point you will probably be able to skip cereal altogether. Foregoing the juice is another good option as well.

For the nipple question, if baby is fussing when taking the bottle, it might be time to move to maybe a medium flow nipple. This flow is typically recommended for babies over 3 months. The Fast flow nipple is generally suggested for when babies reach 6 months. What nipple system are you using? Perhaps their website might provide some insight.

I hope this helped, even just a little.

Blessings to you and your little one,
Wife, Mother, Friend

Hey may be a little young for the faster flow nipple, but you won't know until you try it. Buy a pack of them and see. I tried it with my son and I knew he wasn't ready because he was choking a little bit and a lot of it he would drool out. As for the cereal, I don't know about him being a premie, but once again you can just try it. I kind of agree with your pediatrician, what's the harm? He may not be ready for the spoon, but you can just give a try and see what happens. Maybe because he's developmentally younger he'll push out with his tongue a little longer. Good luck!

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