Breastfed baby refusing a bottle? Read these tips and tricks!
If your breastfed baby is refusing to take a bottle, you are not alone. This is actually a very common issue. There are many reasons why a mother might be introducing the bottle to her baby. Whatever the reason, it can be quite alarming when your baby refuses a bottle time after time. Try not to panic (easier said than done, I know!). As frustrating as it may be, a wise woman once told me: “Only a smart baby would prefer the warmth and comfort of mom’s nipple over a bottle. A healthy baby will not starve themselves”.
I took great comfort in that little phrase as I struggled with this issue. It was over a month of no success before my baby finally took to a bottle. I visited with lactation consultants and spent countless hours scouring the internet for tips and tricks on how to get a breastfed baby to take a bottle. In an effort to save you some researching time, here is a list of everything I learned. Many of them didn’t work for me, but they have worked for other parents and caregivers. If you are having trouble getting your baby to take a bottle, you might consider trying some of the items on this list.
Different nipple shapes.
There are tons of nipple shapes out there. Some claim to be more like a mother’s breast, which in theory may make the transition from breast to bottle a little easier. In our experience, my daughter had the best latch with a round (not orthodontic-shaped) nipple that gradually widened to a large base. But, each baby is different. This is a list of bottles/nipples that either claim to be transition-friendly or that were recommended to me by other moms.
- Evenflo (best latch for my daughter)
- Dr. Browns
- Munchkin Latch
- Laytex NaturaLatch
- Tommy Tippee
The motor skills needed for a baby to drink from a bottle nipple are somewhat different than those needed to drink from the breast. It may take a little time for your baby to adjust to each nipple type that you try.
It’s important to observe your baby’s latch on a particular nipple. Look for similar latch characteristics that you do for breastfeeding: flanged, relaxed lips (like fish lips) that rest on the base of the bottle (not just pinching the nipple teat). Your baby should have a solid seal with no milk spillage from the corners of their mouth.
It is expensive to buy a bunch of different bottles, and especially frustrating when your baby won’t accept any of them. If it’s an option for you, borrow a bottle from a friend to try it out before purchasing it.
Different nipple flow rates.
Bottle nipples come in different flow rates. The higher the number on the nipple, the faster the flow rate. To start, I think it’s best to try a slow-flow nipple. Depending on the baby and the bottle brand, you might look for nipples labeled as: preemie flow, extra-slow flow, slow-flow, 0+m, 1+m, or size/level/stage 1. Keep in mind that not all brands are created equal, and “slow flow” rates can vary from one bottle to the next. Once your baby takes to a bottle and demonstrates a good latch, you can watch his/her signs to see if a different flow rate is indicated.
Signs the flow rate is too fast: gulping without taking breaks, unable to catch breath while sucking, wide-eyed, spilling milk down the chin, coughing/choking (could also be nipple shape/length), looking worried, splayed fingers or toes, tense muscles, turning head away from nipple, pushing the bottle away, having wet throat sounds/clearing throat, or finishing a feed to quickly (<10 minutes).
Signs the flow is too slow: baby is sucking more than 2 times before swallowing, sucking a few times and then pulling off the nipple, sucking hard, crying, biting/tugging on the nipple, appearing board or angry/frustrated, taking >30 minutes per feed, showing hunger signs shortly after an unfinished bottle feed, or not meeting weight gain expectations.
There are few more things to consider in regards to flow rates. First, a baby may refuse a bottle if the flow rate is too fast or too slow. Second, your baby may prefer a bottle flow rate that is similar to your let down flow rate. Consider what your let-down is like when breastfeeding – does your baby show signs of a fast or slow flow? Moreover, look at the age recommendation for each nipple. Remember, though, that this is only a recommendation, and it might not be appropriate for your baby. It’s important to observe and follow your baby’s signs and cues.
Amy Peterson, IBCLC, has a lot of helpful information on nipple flow. She recommends offering the bottle in an upright fashion, such that it cannot drip while being introduced. According to Amy, a dripping bottle may cause a baby to refuse the bottle.
You can also incorporate pacing strategies to mimic breastfeeding – see this post.
Some babies want to receive a bottle in an environment that is similar to the one they breastfeed in. Other babies prefer a totally contrasting environment. Try both to see which works better for your baby.
Offer the bottle in different rooms of the house.
- Try feeding your baby in the bedroom, entryway, kitchen, porch, or backyard.
- Try the rocking chair that mom uses to breastfeed. Or, try the sofa, or a lawn chair. Maybe he will prefer you holding him while you’re standing?
- Some babies won’t eat if they are too distracted to concentrate on feeding. Try feeding these babies in a dark, quiet room.
- For other babies, distractions can be quite helpful. My baby was more likely to entertain the bottle when she was looking at the ceiling fan, watching the cars drive by, or staring at one of her toys.
Try wearing your baby in front carrier (facing out), going for a walk outside, and offering a bottle. This technique actually came up multiple times in my search – worth a try! Some people say that patting your baby on the bum or belly is helpful. The goal is to get your baby’s natural sucking reflex kick in. I found the Baby Bjorn to be a perfect carrier for this approach. Be cautious, however, because you can’t see your baby’s face if she does start sucking. You want to make sure your baby is drinking safely.
Some babies like to take a bottle in a breastfeeding position. But, other babies prefer something different. Try facing your baby outward on your lap, or place him in the car seat. When our little one finally took a bottle, she would only accept it while she was sitting in the Rock n Play, facing her caregiver. Whatever position you use, try to keep your baby upright.
Some babies never take a bottle from mom, because mom is associated with the breast. Why would a baby drink from the bottle when he knows mom’s got the real deal? Have other caregivers (partner, friend, grandparents, etc) try offering your baby the bottle.
Leave the house.
Babies are smart, and they often know if you are hiding around the corner or down the hall. Physically leaving the house while another caregiver offers your baby a bottle can be helpful. Get some exercise, run some errands, or meet a friend for lunch. This was especially hard for me because I hated that our little girl would be crying and hungry while I was out. On the other hand, it was nice to go for my first bike ride of the year! I was very winded and out of shape, but I’ve never been so motivated to pedal hard and make it back home!
Most babies like to drink milk that is heated to body temperature (98.6F, or lukewarm). However, milk does not have to be reheated before offering it to your baby, and I know of some babies that actually prefer colder milk. You can try offering a variety of temperatures, so long as the milk does not exceed body temperature. Aside from burning your baby’s mouth, overheating your breast milk can damage its beneficial properties.
You can also try heating the bottle nipple with lukewarm water.
Extra info – Here are the guidelines for heating your milk:
- Warm your bag/bottle of breast milk in lukewarm water. You can either place the stored milk in a container of water, or run water over your bottle. Heat the milk until it is about body temperature (98.6F), which is lukewarm, not hot.
- Avoid using a stove, microwave, or even hot tap water to heat your baby’s milk before serving.
- Try the drop-of-milk-on-your-wrist method to test the temperature. Your wrist is a sensitive site and should give you an idea of your milks temperature.
- Read more about milk storage and reheating here: CDC site, KellyMom, Baby gear lab
Use freshly pumped milk
Does your stored milk smell or taste soapy or sour? If you are following safe milk handling and storage procedures (see links just above), an unpleasant odor may be due to an excess amount of lipase in your milk.
Lipase is an enzyme that is naturally present in all milk. It breaks down fats to supply helpful nutrients to your baby. Some mothers have more lipase in their milk than others. The smelly milk is safe to drink, but many babies refuse it.
The amount of lipase you have affects the amount of time before your pumped milk starts to smell/taste sour.
Here is more information on this topic. These links include steps you can take to improve baby acceptance, and what you can do with your already frozen stash: San Diego Breastfeeding Center, KellyMom, Pumpables
Pull the ol’ Bait and Switch
Start out breastfeeding your baby, and have a warmed and ready bottle at your side. Then, try swapping the breast for the bottle, and see if your baby will keep drinking! This technique may work best in a dark room, when your baby is getting sleepy.
Similarly, some parents report success swapping between a pacifier (or even the tip of their finger) and a bottle. With each scenario, the goal is to initiate the sucking reflex before introducing the bottle.
- Try not to get frustrated. Stay calm and be persistent. Babies can sense frustration. If your baby is adamantly refusing, don’t continue to force it. It’s probably best to put the bottle down and try again later. In our experience, forcing the bottle on our baby while she fought it was always a losing battle.
- Try offering the bottle when your baby is happy, relaxed, and calm. Maybe during playtime or after a good nap.
- Try offering the bottle when your baby is sleepy.
- Offer the bottle at the first signs of hunger, before your baby gets overly hungry. Once overly hungry, a baby can be more difficult to feed.
- Early cues: licking lips, smacking lips, making sucking sounds, opening mouth, sucking on hands/toys.
- Progression to overly hungry: rooting around on caregivers chest, fidgeting/fussing, repeatedly hitting your chest or arm, rapid breathing, crying.
- Consider trying a baby-led approach. Instead of shoving the nipple into your baby’s mouth, offer the bottle by swiping the nipple gently across your baby’s lips, waiting for a rooting response (opening wide), and allowing your baby to “accept” the nipple.
If all else fails, there are other ways to feed a baby besides the bottle. Talk to your doctor or lactation consultant about the following options:
- Medicine dropper, eye dropper, or syringe (to avoid choking, a lactation consultant recommended having my baby suck on my finger while I slowly released milk through one of these devices)
- Sippy cup (sometimes babies can skip a bottle and go straight to a cup; this is typically recommended for babies 4+ months of age)
Sometimes babies will refuse to eat while mom is away, but then make up for it with extra feeding time once mom returns. This is great because it means your baby is finding a way to get enough food. Unfortunately, however, the extra feedings usually occur at night, meaning less sleep for both of you. Hopefully these night time feedings are a short-term solution. Keep track of your baby’s weight and growth to ensure she is getting enough nutrition.
In the first few weeks of my daughter’s life, I used a bottle to supplement after each breastfeeding session due to nutritional concerns associated with tongue tie. She didn’t have much difficulty drinking from a bottle in these early days. Over the first month, she became more efficient at the breast and no longer required supplementation. My husband and I continued to give a bottle occasionally, but not consistently.
When our daughter was about 6 weeks old, we went on a long road trip to visit family. During this time, we went almost 2 weeks without giving our baby a bottle. We were quite surprised when she wanted nothing to do with the bottle when we returned home. She continued to refuse the bottle every day for the next 5 ½ weeks! My husband and I tried all of the above methods, but nothing worked. Occasionally, she would chew on the nipple, but she never started sucking.
During that 5 ½ weeks, I pumped every morning. Whatever milk I generated (usually 3-5 ounces) was divided into bottles, and I then offered these bottles throughout the day in various ways. While I hated pouring all that precious milk down the drain after my daughter refused to drink it, this “pumping and dumping” really helped increase my milk supply! Hey – a plus side to all of this!
The time came for me to return to work. I was panicked and afraid that my daughter would starve while I was away. Desperate to find a way to get at least some milk into my baby, I tried each of the above alternative methods (medicine dropper, syringe, and sippy cup). Of these options, the sippy cup worked the best, although it was very slow going and quite messy. We used a soft-tip sippy cup, which would release milk only when she chewed on it. This was the most successful way for my husband to feed our daughter during my first few days of work (she consumed no more than 2 ounces during my 10 hour shifts, but at least it was something).
At the end of my third shift, our daughter took her first 2 ounces from a bottle! It wasn’t until half-way through the second week that she really took to the bottle and gobbled down a whole 14 ounces in one day! It continued to be a battle for my first shift or two every week, but after the first month or so the battling stopped. I guess my baby needed an extreme version of the “leaving the house” technique.
My daughter’s weight remained on track throughout my return to work, which comforted me. Once she finally took to a bottle, we adjusted the nipple type and flow rate until we found the best/safest fit. Like I mentioned above, she has the best latch with the Evenflo bottles. My daughter preferred the slow flow (0+m) nipple until she was at least 6 months old.