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Move up a size when your baby shows you the flow is too slow, not because they've reached the age on the box. Feeds that drag on, a baby who fusses or falls asleep halfway through, or a nipple that collapses while they suck are the usual signs. If your baby gulps, coughs or has milk running out of the corners of their mouth, the flow is probably too fast, so stay where you are or go back a size. Each brand names its sizes differently, so use the chart below to match them.
Nipple sizes by brand
| Starting age | Hegen | Pigeon | Dr. Brown's |
|---|---|---|---|
| Newborn | Extra Slow (0) | SS (0M+) | Preemie or Level 1 (0M+) |
| 1 month | Slow (1), 1 to 3 months | S (1M+) | Level 1 |
| 3 months | Medium (2), 3 to 6 months | M (3M+) | Level 2 (3M+) |
| 6 months | Fast (3), 6 months+ | L (6M+) | Level 3 (6M+) |
| 9 months | Fast (3) | LL (9M+) | Level 4 (9M+) |
| Thicker liquids | Thick Feed (Y-cut) | Y-Cut (9M+) |
The ages come from each brand. Hegen calls its ranges approximate and says your baby's development and comfort come first. Dr. Brown's says there's no right time to change levels. The ages tell you where to start, and your baby tells you when to change.
Nipples only fit their own brand's bottles. Hegen teats are made for Hegen bottles. Dr. Brown's wide-neck nipples fit its Options+ wide-neck bottles, and its narrow nipples fit the narrow and Original bottles. Check the bottle you have before you buy.
Signs the flow is too slow
- Feeds take noticeably longer than they used to. Hegen gives more than 20 minutes as a sign.
- Your baby gets fussy or frustrated partway through.
- The nipple flattens or collapses while they suck.
- They fall asleep before finishing.
One slow feed doesn't mean much. Look for a pattern over a few days before you change.
Signs the flow is too fast
- Gulping or loud, hard swallowing
- Coughing, gagging or choking during the feed
- Milk dribbling out of the corners of the mouth
- Pulling away or refusing the bottle
If you see these after moving up, go back to the previous size and try again later.
How to try a new size
- Change one thing at a time. If you're also switching bottles or formula, wait before changing the nipple.
- Try the new size at a calm feed, not the middle-of-the-night one.
- Hold your baby close and upright, and let them rest when they need to, as the Eastern Ontario Health Unit suggests.
- Watch for the signs above over the next few feeds.
- Stop when your baby shows they're full, whatever is left in the bottle.
If feeds still seem hard after trying a different size, talk to your doctor, nurse practitioner or public health nurse.
What about Y-cut and thick feed nipples?
Y-cut nipples are made for thicker liquids. Dr. Brown's says its Y-Cut is used when a pediatrician recommends thickened milk. Don't thicken a bottle on your own: the Eastern Ontario Health Unit says not to add baby cereal to thicken infant formula.
When to replace nipples
Nipples wear out even if the size is still right. Pigeon suggests replacing them every 2 months and rotating two or more, Hegen every 2 to 3 months, and the Eastern Ontario Health Unit every 3 months. Replace one straight away if it's cracked, sticky, thinner, discoloured, out of shape or has bite marks. Check before each use, especially once your baby is teething. Our guide to bottle brushes covers cleaning nipples and vents, and the Hegen bottle brush and teat cleaner ($13.99) is made for bottles and teats.
Shop nipples by brand
- Hegen teats, 2-pack, $15.99
- Pigeon silicone nipples, 3-pack of one size, $26.99
- Dr. Brown's Options+ wide-neck nipples, 2-pack, $7.99
Prices are in CAD and were current when we wrote this. Still choosing a bottle? Our comparison of Hegen, Pigeon and Dr. Brown's covers shape, venting and cleaning, our anti-colic vent guide explains the extra parts, and our guide to Pigeon's glass, silicone-coated glass and PPSU bottles compares the three materials. You can also call our Richmond, Burnaby or Ottawa store ahead to check which sizes we have.
