If you have a baby who won’t take a bottle, you know how frustrating the experience can be. Parents often find themselves in this situation when they’re gearing up to leave their baby with a caregiver and discover that the baby won’t take a bottle of their pumped milk or formula. This can be particularly stressful if you are planning to go back to work or need to be separated from your infant for a long period of time.
“In many cases, babies who refuse bottles have been exclusively breastfed for a significant period of time,” says Dr. Jessica Madden, a pediatrician, neonatologist, certified lactation consultant and the medical director of Aeroflow Breastpumps. Breastfeeding is a multi-sensory experience, says Madden, involving being snuggled up against the breastfeeding parents’ body and receiving milk straight from the tap. “The bottle feeding experience can ‘feel’ quite different from this, so some babies will not feed as avidly,” Madden says.
But there’s hope. If you have a baby refusing the bottle, there are steps you can take to make bottle feeding happen. Read on for expert insights on what’s causing your baby’s bottle refusal, tips for how to get a baby to take a bottle and when to seek outside help for bottle refusal.
Why won’t my baby take a bottle?
There are many reasons why a baby refuses a bottle. Usually it’s breastfed babies who have difficulty taking bottles, but formula fed babies can suddenly refuse bottles, too. Sometimes there are medical reasons for why a baby won’t take a bottle, Madden says. These may include prematurity, thrush (yeast infection), teething or a current illness.
Babies who are tongue tied (where the tongue is tethered too tightly to the floor of the mouth) may also have trouble sucking on a bottle and may be prone to bottle refusal, says Leigh Anne O’Connor, a certified lactation consultant in New York City. “Tongue-tied babies often have a high palate and the bottle does not make contact with the roof of the mouth,” says O’Connor. “Contact with the roof of the mouth elicits the suck reflex.”
Babies may also refuse the bottle if the flow of the milk is too fast or too slow, O’Connor says. If the position you’re holding the baby in is uncomfortable or different from their usual feeding position, this could also cause them to refuse a bottle, she adds.
One mystery that parents sometimes encounter is when a baby who previously took a bottle suddenly starts refusing it or starts to refuse it only with certain people. According to Madden, the most common reasons babies start to refuse a bottle seemingly out of nowhere is when they are sick, the temperature of the breastmilk or formula is too hot or too cold or if the bottle flow is too slow or too fast.
It’s actually quite common for babies who are breastfed to refuse bottles from people who aren’t their breastfeed parent, including other parents and caregivers. “This is because they associate their breastfed parent with direct breastfeeding and would prefer to nurse than bottle feed when they are with them,” Madden explains.
How to get a breastfed baby to take a bottle
When you’re dealing with a baby who won’t take a bottle, you want answers, and you want them as fast as possible. This is especially the case when you have an upcoming event where you’ll need to be separated from your little one or are faced with a major transition like going back to work.
Katie McCann, a mom of two from Cambridge who blogs at From Bump To Bubble, says she faced this challenge when she had a breastfed baby who was going to need surgery. Her son needed to bottle feed for a time during recovery, but he refused to take a bottle in the lead-up to the surgery. This caused McCann tons of anxiety. “It was a challenging time, filled with worry about my baby’s nutrition and my ability to feed him,” she says.
Thankfully, her son was able to bottle feed in the end. McCann says one thing that helped tremendously was getting her husband involved, as her son would often refuse the bottle if she fed it to him. “We found that he was more likely to accept the bottle from my husband, perhaps because he didn’t associate him with breastfeeding,” McCann explains.
McCann and O’Connor also have a few other tricks to add to your list when your baby is struggling to accept a bottle:
Pay close attention to the baby’s hunger cues
“I found that introducing the bottle when he was showing early signs of hunger but was not yet distressed was more successful,” McCann shares. “If I left it too long he would become hungry (or hangry!), and he would be more likely to refuse the bottle and demand the breast.”
Consider letting your baby “play” with the bottle nipple
You can use a bottle nipple (detached from the bottle) much like a pacifier, O’Connor suggests. You can even try dipping the bottle nipple in milk and letting the baby suck on it. Try this for a few days so that your baby feels comfortable with the bottle nipple, and then add it back to the bottle and try feeding your baby.
Try moving around while feeding your baby
Have the person who feeds the baby sit in a rocking chair or bounce on a yoga ball while offering the bottle. If other types of movement aren’t working, a baby carrier may do the trick. O’Connor says to try wearing the baby facing out in a carrier while swaying or dancing.
Tips to address bottle refusal with caregivers
Caring for a baby who refuses bottles isn’t just stressful for parents, but for anyone who’s caring for the baby, including nannies, babysitters and extended family. When you are responsible for a baby, keeping them well fed is essential. Here, experts share their top tips for helping caregivers who are dealing with a baby who won’t take a bottle.
1. Leave a memento from the breastfed parent behind
“If the baby refuses from a caregiver, the breastfeeding parent can leave a piece of their unwashed clothing that has their scent,” O’Connor suggests. This may help relax the baby and allow them to take the bottle, she says.
2. Help them get the timing and setting right
It’s best to feed the baby a bottle at a time when they aren’t ravenously hungry, Madden suggests, as they may be more fussy then. Additionally, offering the baby the bottle in a quiet and dimly lit room with no distractions can help, she adds.
3. Show them how to feed the bottle at the right angle
Pro tip: aiming the bottle nipple to the roof of the baby’s mouth can elicit the baby’s inborn sucking reflex, says O’Connor. “Once the baby accepts the bottle and begins to suck, the bottle can be repositioned so that the milk flows,” she advises.
4. Tell them to experiment with flow and body positioning
Making sure the bottle is the right temperature for the baby (usually warmed a bit, but not hot) and that the nipple flow is appropriate for the baby’s age can help, Madden says. Additionally, how a caregiver holds the baby can make a difference. “Some infants will also bottle feed more readily if they are held in a side lying position when they are bottle feeding, as this is similar to how they are held while breastfeeding,” she suggests.
What are the best bottles for breastfed babies?
O’Connor says that while some babies may prefer a faster or slower type of bottle nipple, there isn’t one type of bottle that is best to help a baby who’s refusing the bottle. “There is no one-size-fits-all,” she says. “I have seen so many variables that it is typically trial and error.”
Madden agrees with this sentiment, and says that in her practice as a physician and lactation consultant, she’s become less convinced over the years that certain brands or types of bottles are better than others. “Although there are many brands of bottles made to mimic breastfeeding, with a wide base and shorter nipple, the truth is that most infants take traditionally shaped bottles and nipples (which are usually less expensive) just fine,” says Madden. The only exception would be infants that have cleft palates, who may need to use special bottles, such as bottles with ultra slow flow nipples, Madden notes.
When to seek help for bottle refusal
Caring for an infant who refuses a bottle can be extremely challenging. The good news is that there are many options out there and things both you and your caregivers can try. Still, sometimes you might need a little outside help.
“I recommend getting help if your baby is unable to transition to a bottle, or back and forth from breast to bottle, after about a week,” Madden says. The key is to find a physician or lactation consultant who is well-versed and experienced in bottle refusal, she adds.
If your baby continues to refuse a bottle, you might also consider reaching out to an infant feeding specialist or an occupational therapist. Both of these types of healthcare providers can be helpful for babies who struggle to feed well with a bottle, according to Madden.
Whatever you do, don’t hesitate to reach out for support. Feeding babies can be difficult in so many situations, and you aren’t meant to do this alone.
