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Resources for Feeding, Eating, Drinking, Speech, and Mouth/Airway Function


Hot Topic Blog - Feeding, Eating, & Drinking


April 2016


The following is an interview with Diane Bahr, MS, CCC-SLP, CIMI (Published Author and International Presenter on Feeding, Motor Speech, and Mouth Development) by Cintia Saporito (Journalist in Argentina). This interview was conducted in July, 2015.

Questions from Cintia Saporito (CS)

Answers from Diane Bahr (DB)

CS: Are there any circumstances in which it would be best for a new mom to change the baby to formula?

DB: This is a decision that should be made by the parents and the baby’s pediatrician. Pediatricians sometimes suggest that parents supplement breastfeeding babies with formula if the baby is not gaining weight and growing appropriately. There are also babies with special medical conditions where formula and bottle feeding are recommended. Bottle feeding (while convenient in our Westernized world) is actually a medicalized way of feeding a baby.

CS: How should formula be introduced to a baby? 

DB: Formula is usually introduced to a baby in a bottle with an appropriate nipple. I have bottle feeding guidelines in my parent-professional book Nobody Ever Told Me (or My Mother) That! Everything from Bottles and Breathing to Healthy Speech Development (Chapter 2). I specifically discuss how a parent can choose an appropriate bottle nipple for the baby. As a therapist, I personally like rounded bottle nipples to encourage tongue cupping. If the bottle nipple moves in and out of the baby’s mouth, I teach parents carefully applied cheek support. If the bottle nipple still moves in and out of the baby’s mouth with carefully applied cheek support, then I usually recommend a shorter bottle nipple. Orthodontic type bottle nipples also work well for some babies; however, they don’t seem to encourage tongue cupping (a movement needed for feeding and swallowing throughout life).

CS: Which is the best formula to buy? What things should parents consider when choosing it at the market?

DB: This is an important discussion for parents to have with the baby’s pediatrician. There are formulas on the market that are reported to be more easily digestible. This may be particularly important if the baby is from a family with allergies and/or sensitivities. The other thing I have found, as a feeding therapist, is babies having difficulties with particular formulas after a couple of weeks. In this case, the pediatrician may recommend that the parents rotate formulas within the baby’s diet. We, as feeding therapists, think this problem may occur because babies are getting the same food over and over with formula. Whereas, with breastmilk the baby gets whatever mom is eating (i.e., a more varied diet with different tastes and nutrients).

CS: How can a mom know formula is working for the baby? 

DB: Formula is working for the baby, if the baby is gaining weight and growing appropriately. However, if the baby has excessive gastroesophageal reflux, suspected belly pain, excessive gas, rashes, chronic congestion, and/or other allergy or sensitivity symptoms, the parent must speak with the pediatrician about changing the formula. I have a discussion of infant allergy/sensitivity symptoms in Chapter 3 of my book Nobody Ever Told Me (or My Mother) That! Everything from Bottles and Breathing to Healthy Speech Development.

CS: How should bottles be kept hygienic? 

DB: There are bottle sterilizers, and there are bottles with disposable bags.

CS: Once formula is prepared, how should it be kept? 

DB: The parents should read the instructions on the formula for refrigeration or other guidelines.

Some powdered infant formulas have caused illness in some infants. See the World Health Organization Guidelines for preparing powdered formula:,

CS: Are there any changes moms should expect in the baby when he/she begins with formula? 

DB: The parents should look for any signs of digestive problems or allergy/sensitivity symptoms and speak with the pediatrician if these occur. See other questions above. Here are some signs of allergies and sensitivities (excessive reflux, chronic diarrhea or constipation, chronic nose/chest congestion, excessive drooling or perspiration, frequent ear infections, chronic bronchiolitis and/or coughing, asthma, itchy rashes, eczema, bright red buttocks/cheeks/ear lobes, fast pulse, extreme restlessness or activity, sleeping problems, dark circles under the eyes, and the list goes on in my book).

About the Interviewer

Cintia Saporito is a Journalist and Sociologist from Buenos Aires, Argentina. She has contributed as a writer to different media and editorials in her country, as well as collaborated in the writing process of books specializing in subaltern movements and economic history. Cintia is also a Human Studies and Communications Middle School Teacher and is now in the process of getting her degree in Psychology.

Here is the article written by Cintia as a result of her interview with Diane Bahr:

- Saporito, C. (2015, July). Tips to Switch from Breast Feeding to Formula (Text in Spanish).

About Diane Bahr

Diane Bahr, MS, CCC-SLP, CIMI is a certified speech-language pathologist and infant massage instructor. She has practiced speech-language pathology since 1980 and has been a feeding therapist since 1983. Her experiences include teaching graduate, undergraduate, and continuing education courses; working with children and adults who exhibit a variety of speech, language, feeding, and swallowing disorders; and publishing/presenting information on oral sensory-motor function, assessment, and treatment. She is the author of the textbook Oral Motor Assessment and Treatment: Ages and Stages (Allyn & Bacon, 2001). She has also written a book for parents entitled Nobody Ever Told Me (or My Mother) That! Everything from Bottles and Breathing to Healthy Speech Development (Sensory World, 2010).