How Long Do Babies Use Preemie Nipples?

If you’re wondering how long do babies use preemie nipples, the short answer is that there isn’t one age when every baby needs to move up to the next nipple size. One month? Two months? When they reach their due date if they were born prematurely?

After using preemie nipples with both of my babies for completely different reasons, my biggest takeaway is that I would not focus too much on age. I paid much more attention to how my baby was actually feeding.

My first baby was full term and started with a preemie nipple because my doula recommended the slower flow while I was also planning to breastfeed. My second baby was born prematurely at 33 weeks and started with an Ultra Preemie nipple in the NICU while she was still learning the suck, swallow, breathe coordination needed to bottle feed.

Their feeding journeys were very different, but in both cases, I moved up nipple sizes when they seemed ready rather than because they had reached a certain age. If you're figuring out bottles and feeding from scratch, I also put together my newborn feeding essentials based on what I actually used with both babies.

How Long Can a Baby Use a Preemie Nipple?

There is not one age when every baby needs to stop using a preemie nipple. Some babies may only use one for the first few weeks, while others may need a slower flow for much longer.

With my full term baby, we used a Dr. Brown’s Preemie nipple from birth until around one month old. At that point, I moved him directly to a Size 1 nipple. I actually had no idea at the time that Dr. Brown’s made a Transition nipple that falls between Preemie and Size 1.

With my premature baby, we took things much more gradually. She started with an Ultra Preemie nipple in the NICU, moved to a Preemie nipple at around one month old, and then moved to a Transition nipple at around two months old.

The important thing was that I wasn't looking at the calendar and deciding it was time to switch. I was watching how she was eating.

Our Preemie Nipple Timeline With a Premature Baby

Because my second baby was born at 33 weeks, feeding was one of the things she had to learn in the NICU before coming home. She started with Dr. Brown’s Ultra Preemie nipples because she was still working on coordinating sucking, swallowing, and breathing.

She stayed on the Ultra Preemie nipple for approximately her first month. Around one month old, we transitioned her to the Preemie nipple.

By around two months old, feeds were starting to take a long time. I was fortunate to have a night nurse at the time, and she suggested trying the Dr. Brown’s Transition nipple because my baby seemed frustrated with the slower flow.

That was actually how I learned that the Transition nipple existed. I hadn't known about it with my first baby and had gone straight from Preemie to Size 1.

She used the Transition nipple for approximately another month before moving to Size 1. By around five months old, we started trying Size 2. When we first moved up, however, I noticed that she seemed to spit up more, so I went back and forth between Size 1 and Size 2 for a while rather than forcing the switch.

That experience reinforced something I had already learned: moving up a nipple size does not have to be permanent. If the faster flow doesn't seem to be working for your baby, you can slow things back down.

Signs a Preemie Nipple May Be Too Slow

For me, one of the biggest signs that it was time to consider moving up was how long bottles were taking.

Once a bottle was consistently taking 30 minutes or longer, I started paying closer attention. My baby also seemed frustrated with the bottle, which was another clue that the Preemie nipple might not be giving her milk quickly enough anymore. I share more of the signs I watched for in When Should You Change Bottle Nipple Flow?

A long bottle doesn't automatically mean you need to change nipple sizes, especially for a premature baby or a baby with feeding challenges. But if your baby previously fed comfortably and suddenly seems to be working extremely hard for the milk, getting frustrated, sucking quickly without getting much milk, or taking much longer to finish a bottle, it may be worth considering whether the nipple flow could be part of the problem.

Signs You Moved Up a Nipple Size Too Soon

There is another side to this. A faster nipple isn't necessarily better.

When I moved my second baby from Size 1 to Size 2, I noticed that she seemed to spit up more. Instead of assuming she had to stay on Size 2 because we had already made the switch, I went back and forth between the two sizes.

Other signs that a nipple flow may be too fast can include coughing, gulping, milk spilling from the mouth, pulling away from the bottle, or seeming overwhelmed during the feed.

That is why I wouldn't move up solely because the nipple packaging associates a particular flow with a certain age. Your baby's behavior during the bottle can tell you much more.

Preemie vs. Ultra Preemie vs. Transition Nipples

Before having a premature baby, I didn't even know Ultra Preemie nipples existed. And despite already having one bottle fed baby, I also hadn't known about the Transition nipple when he was a newborn.

The Ultra Preemie nipple is an even slower flow than the Preemie nipple. In our case, it was what the NICU used while my premature baby was learning to bottle feed.

The Preemie nipple was the next step for us. It was also the nipple I had used from birth with my full term baby when I was planning to breastfeed and my doula recommended starting with a slower bottle flow.

The Transition nipple was our bridge between Preemie and Size 1. I found this especially helpful with my premature baby because jumping directly from Preemie to Size 1 wasn't necessary. We had another option in between.

You Don't Have to Follow Nipple Size by Age

This is probably the biggest thing I would tell another mom standing in her kitchen wondering whether her three month old should still be using a Preemie nipple.

You don't have to change nipple sizes simply because your baby reached a certain age.

One thing my pediatrician pointed out that really stuck with me was that breastfeeding doesn't work this way. Your breast doesn't suddenly become a "Size 2 nipple" because your baby reaches a particular month.

That doesn't mean bottle nipple flow never needs to change. Both of my babies eventually needed faster flows. But I found it much more helpful to think about nipple sizes as options based on feeding ability rather than milestones my babies needed to reach on a schedule.

What I Would Do If My Baby Was Still Using a Preemie Nipple

If my baby was happily drinking bottles with a Preemie nipple, finishing feeds comfortably, and growing appropriately, I personally wouldn't rush to change it just because of age.

I would start thinking about trying the next flow if bottles were consistently taking 30 minutes or longer, my baby seemed frustrated, or I noticed that she was working much harder to get milk than she had previously.

I would also buy the next nipple size before I desperately needed it. That way, when I started wondering whether my baby was ready, I could try it for a bottle and see what happened. If the flow seemed too fast, I could simply go back to the slower nipple and try again later. I also keep enough nipples on hand to have one for each bottle, which I explain in How Many Bottle Nipples Do You Need?

And if you're using Dr. Brown’s bottles, I would specifically look at the Transition nipple before automatically jumping from Preemie to Size 1. I wish I had known it existed the first time around. Nipple flow isn't the only bottle change that happens quickly in the first few months. I also shared when I switched from 4 oz to 8 oz bottles with both of my babies.

Frequently Asked Questions

How long should a baby stay on a preemie nipple?

There isn't one age that works for every baby. My full term baby used a Preemie nipple for about one month, while my premature baby progressed from Ultra Preemie to Preemie and then Transition more gradually. I would pay attention to how comfortably and efficiently your baby is feeding rather than changing nipple sizes based solely on age.

Can a full term baby use a preemie nipple?

Mine did. My doula recommended starting my full term baby on a Preemie nipple because I was planning to breastfeed and wanted to use a slower bottle flow. He used it for approximately his first month before moving to Size 1.

When should I move from a preemie nipple to Size 1?

I would look for changes in the way your baby feeds. For us, bottles taking 30 minutes or longer and frustration with the slower flow were signs that it might be time to try something faster.

You also don't necessarily have to move directly from Preemie to Size 1. Dr. Brown’s makes a Transition nipple that falls between the two, which we used with my second baby.

What is a Transition nipple?

Dr. Brown’s has a Transition nipple that provides an option between its Preemie and Size 1 nipples. I didn't know it existed with my first baby, but we used it with my second baby after Preemie and before Size 1. It was a really helpful middle step for us.

What if I move up a nipple size and the flow seems too fast?

You can go back. When we started moving from Size 1 to Size 2, I noticed more spit up, so I went back and forth between the two flows for a while. Moving up doesn't have to be a permanent decision the first time you try it.

Is it okay for a three month old to still use a preemie nipple?

Age alone wouldn't make me change nipple sizes. If your baby is feeding comfortably and efficiently and your pediatrician is happy with their growth, I wouldn't personally see reaching three months as a reason by itself to move up.

If feeds are becoming very long or your baby seems frustrated, however, it may be worth trying the next flow or discussing it with your pediatrician.

The Bottom Line

After using Preemie nipples with a full term baby and Ultra Preemie and Preemie nipples with a premature baby, I don't think there is a magic age when you are supposed to move up.

Watch your baby instead of the number on the nipple package. If feeds are comfortable and going well, there may be no reason to change something that is working. If bottles start taking much longer, your baby seems frustrated, or feeding suddenly feels like a lot of work, it may be time to experiment with the next flow.

And if you try the faster nipple and it seems too fast, you can always go back. I did.

This article is based on my personal experience feeding my two babies and is not medical advice. If your baby was born prematurely, has difficulty feeding, is coughing or choking during feeds, isn't gaining weight as expected, or you have concerns about feeding, talk with your pediatrician or feeding specialist.