Choosing the Right Bottles & Pacifiers: A Lactation, OT, and PT Perspective
When families ask which bottle or pacifier is “best,” the answer is almost never about the brand — it’s about the shapeand how it supports your baby’s feeding skills, comfort, and oral motor development.
As an RN & IBCLC Candidate working collaboratively with a pediatric Occupational Therapist and Physical Therapist, I spend a lot of time helping families understand why nipple and pacifier shape matters so much.
If you want a quick visual guide, I’ve created a simple carousel on Instagram that shows ideal shapes vs. shapes to avoid. You can view it here: Bottles and Pacifiers
Why Shape Matters More Than Brand
Feeding is one of the most complex things a newborn does. It involves breathing, sucking, swallowing, posture, sensory processing, and oral motor coordination — all happening at once.
The shape of a bottle nipple or pacifier can either support those skills or make things harder.
When we simplify a baby’s feeding tools, we reduce compensations and create opportunities for more coordinated, comfortable feeding.
A Lactation (IBCLC) Perspective: Supporting the Latch
From a lactation standpoint, we look for bottle nipples and pacifiers that support:
A deep, comfortable latch
Midline tongue movement
Effective suction patterns
Jaw stability
Reduced compression at the nipple
Certain shapes can encourage shallow latch patterns, extra jaw gripping, or tongue retraction — which may contribute to feeding fatigue, clicking, or discomfort at the breast or bottle.
Cylindrical shapes and gradual tapers typically support more natural tongue elevation and a more breast-like oral pattern, especially for babies who are moving between breast and bottle.
An Occupational Therapy (OT) Perspective: Sensory & Oral Motor Development
Occupational Therapists look at the sensory and functional components of feeding.
Pacifier and nipple shapes can influence:
Sensory input to the tongue and palate
How well baby maintains midline
Rhythmic, coordinated suck patterns
Oral awareness and motor planning
Flattened or bulbous shapes often change how the tongue elevates or moves side to side.
OTs tend to recommend cylindrical, consistent-width designs because they promote more organized oral motor patterns and support healthy sensory development.
For OT insights on feeding, check out my colleague at @foodisfunletseat — she brings so much warmth and clarity to this topic.
A Physical Therapy (PT) Perspective: Posture, Alignment & Stability
Feeding is a whole-body task, and PTs look closely at how a baby’s posture affects their ability to suck, swallow, and breathe.
Bottle and pacifier shapes can influence:
Jaw and neck stability
Tongue posture
Breathing coordination
Muscle tension and oral compensations
Wide or uneven shapes may lead to increased jaw clenching, tongue retraction, or difficulty maintaining midline.
Cylindrical shapes typically support better oral alignment and reduce unnecessary muscle tension.
For more PT-focused feeding information, my colleague at @movingmunchkins is a wonderful resource.
The Right Tools Support Better Feeding
The goal is always the same: make feeding more coordinated, more comfortable, and more developmentally supportive.
For babies in feeding therapy — or those showing early challenges — using the right nipple or pacifier shape can make a meaningful difference in:
Tongue function
Comfort at the breast or bottle
Oral motor skills
Long-term feeding success
You can see visual examples of ideal vs. less supportive shapes directly in my Instagram post. These images can help you compare what you already have at home and guide you toward tools that align with your baby’s developmental needs.
Need Personalized Support? We’re Here to Help.
If you’re unsure what bottle or pacifier is right for your baby, or if feeding feels stressful or confusing, know that you don’t have to figure it out alone.
Our collaborative team — lactation, OT, and PT — offers individualized feeding assessments to help your baby feed comfortably and thrive.
Reach out anytime to schedule an appointment. We’d love to support your feeding journey.