Bottle refusal is exactly what it says on the tin – a breastfed baby refusing a bottle. As you can imagine, gently putting an end to bottle refusal is not always an easy task. Of course, in a perfect world, we wouldn’t ever have to worry about trying to persuade our breastfed babies to take a bottle (mostly because we worry about damaging the nursing relationship) but unfortunately, many mothers are forced to return to work a short while after giving birth. When a baby refuses bottle, it can be an absolute nightmare to deal with, adding more stress to a time that may already be upsetting.
I have lots of personal experience in dealing with babies not taking the bottle. Although Monkey, as a baby, was happy to switch between breast, bottle and binky without any difficulty at all, our youngest is a completely different kettle of fish. Squish was given a binky at the age of 5 weeks, and just two days of light use gave us a nasty case of nipple confusion causing him to refuse the breast. Once we dealt with that, we refrained from introducing any kind of teat until he was much older, missing the supposed Magic Window for bottle introduction. I didn’t have to return to work until much later, and our breastfeeding relationship was more important to me than getting him to accept a bottle. It wasn’t worth the risk.
Whilst we were trying to convince him to take a bottle, we literally tried everything. Aside one or two exceptions, I have not come across a tip or suggestion that we didn’t try. Here I will share everything I learnt while we were attempting to deal with a baby refusing a bottle, in the hope of providing a concise, step-by-step guide.
An important note: introducing bottles to a breastfed baby carries a risk of causing nipple confusion, lazy nursing or complete breast refusal. Please, please think carefully before introducing a bottle if your breastfeeding relationship is important to you. There are many other ways to get milk into a baby, so if you can avoid using a bottle it is wise to do so. However, I am fully aware that sometimes it can’t be avoided, and in that case please be aware of the problems that can arise and how to up your chances of avoiding them.
(For the record, we never succeeded in beating the bottle refusal. Some babies just never take to it, and that’s the way the cookie crumbles. As a compromise, we postponed my return to work for three months and I hope that, by the time I must return, we will be making headway with the sippy cup.)
Step One: Choosing a Bottle
A more accurate title for this section would be ‘Choosing a Teat’. After all, that’s the part that your baby will be in contact with and the part that will either attract or repel them.
The most obvious starting choice would be a breast-like bottle. There are plenty on the market, all promising to be just like mum. We tried the following:
We had more success with these than we did with any of the others we tried, but the success was limited. The BreastFlow was his favourite; he would take about an ounce from that one in comparison to drops from the others.
The other bottles we tried were varied and many, including MAM, NUK, Avent, the Medela one that came with my breast pump and plenty of different generic brands. He laughed in the face of all of them. Of course, he would (and still will) glug cooled boiled water from any of them, but try putting breastmilk in and he gives you that look that says “hang on a minute, mum. This isn’t supposed to come from here. Pull the other one.”
It really is true that different bottles work for different babies. I joke that exclusively breastfed Squish owns more bottles than your average bottlefed baby! If something doesn’t work out, try something else. And then something else. Breast-like bottles are the obvious choice, but some babies (especially older ones) seem to get on better with something that is nothing like a breast at all. I have also heard great things about the Playtex Drop-Ins – apparently, because the teats are made of latex rather than silicone, they are softer and more breast-like in texture, and because the milk goes into a disposable, inner bag there is much less air in the bottle. We always steered clear of them because I didn’t feel comfortable using them – because of the small health risk from latex – but we are willing to give them a go at some point if we have no other option.
Step Two: Timing Is Everything
It is really important to pick the right time to practice with bottles. You want to be gently and positively encouraging without being forceful or stressing the baby out. After all, the goal is to get them to take milk from a bottle happily – any aggravation is only going to make that harder, and upset both of you.
Pick a time when baby is not too hungry or full, and not tired or grumpy. 30-60 minutes after a breastfeed is a good time, or perhaps a short while after a meal if your baby is eating solid foods. If baby becomes stressed, stop immediately and try again another time. Nothing encourages bottle refusal more than pushing the issue.
If your baby happily chews on the teat, allow them to do so. They may start sucking. Once they are comfortable with the bottle, you can try offering it at a time when you know they will be hungry to see if they will drink properly from it.
The amount you practice with bottles really depends on how desperate you are for baby to take them (and of course, how comfortable your baby is with it). If your return to work is imminent and you simply must get your baby accepting a bottle very soon, then you’ll want to practice often. Start practicing as soon as you can so you can take your time a little with it. The key is to get the baby familiar enough with a bottle so that they happily accept it as an alternate food source.
Step Three: Mum or Dad?
You may well find that if you try to offer the bottle, you will get nowhere. Bottle refusal often magically fixes itself if dad, or another caregiver, gives the baby the bottle. Remember too that your baby can smell you from quite a long distance, so you may have to leave the house altogether in order for them to accept that they can’t get the num-num’s straight from the tap.
In our case, the bottle refusal was actually worse when I left the house. He would chew on the bottles whilst I was there, but leaving the house caused him to go on hunger strike. It’s boob or nothing with this kid!
Step Four: Pick Your Position
Holding your baby in the traditional reclining position to give them a bottle may not work out for a breastfed baby. If mum is the one giving the bottle, it will almost certainly be too close to the real deal for them to willingly accept milk from a secondary source. If somebody else is feeding your child, the position may be too similar to a breastfeeding position. Again, try absolutely everything you can think of until you find something that works! Here are the positions we tried:
· Traditional reclining position
· Sitting up and having them hold the bottle if they are able – we had more luck with this but ultimately no dice
· Having daddy/caregiver hold them in a breastfeeding position with the bottle tucked under their armpit
· Sitting baby in an infant seat of some description
· Giving the bottle in the bath/in the garden/whilst walking around the house
Step Five: Relax!
Dealing with your baby refusing bottle can be really frustrating, especially since you will probably be working to a deadline. Trust me when I say that getting stressed about it will not help. Stay upbeat and positive about the whole process, because your baby will pick up on your frustration and upset very easily.
- Try very warm milk, cold milk and everything in between – it’s surprising how fussy babies can be about their milk.
- Warm the teat under the hot tap before offering it to your baby.
- Although silicone is safer, latex teats are more skin-like in texture and are worth trying if you have no luck with anything else.
- Some babies don’t like breastmilk that has been previously frozen. Try pumping and offering it to your baby immediately, then working up to previously refrigerated milk before starting to use your freezer stash.
- Some peoples’ breastmilk has an excess of lipase in it, which can, over time, make it taste bad. The lipase doesn’t affect the milk when it’s fresh, only when it has been stored (usually for a day or more, although some women report the milk to start tasting funky after just a few hours). If your frozen breastmilk has a rancid smell when thawed, you likely have an excess of lipase. The way to deal with this is to scald the breastmilk before freezing it. Heat the breastmilk in a pan on the hob to the point that small bubbles are forming at the edge, but not so that it reaches a proper boil. Once it has reached that point, quickly cool it and freeze it immediately. Heating the milk on the stovetop will not affect the breastmilk’s nutrients and antibodies, but microwaving it will, so avoid that if at all possible. Sadly enough, even breastmilk with some of the live aspects killed off via microwaving is still better for a baby’s stomach than formula.
OK, I’ve tried everything and nothing’s worked. What now?
You may find, like we have, that none of the above bears any fruit and that your baby is one of those babies that will never accept a bottle instead of the breast. If this is the case, please try not to worry as there are plenty of other ways to get your milk into your child. Yes, they’ll take some getting used to, but it’s possible.
- Cup feeding – even very young babies can become accustomed to drinking from a cup. Use a proper cup to bring the liquid to the baby’s lips, and gently tip a few drops in. It will be messy to begin with but they will soon get the hang of it, and you will avoid any risk of nipple confusion. A Doidy Cup is a great choice – they are UNICEF baby-friendly and are highly recommended for breastfed babies. You can also try some of the various sippy cups on the market (you can find them on Amazon)
- Syringe feeding – use an inexpensive syringe purchased from the chemist/drugstore to deposit the milk into baby’s mouth.
- Finger feeding – A Supplemental Nursing System (SNS) is a tube attached to a bottle that is usually taped to the breast so that the baby can get milk from the tube whilst nursing. Instead, attach the tube to a finger and let the baby suck on your finger to get the milk. I once read a story online of a father who would actually let the baby suckle at his nipple with an SNS attached while the mother was working, because the baby would not accept milk any other way. Honestly, that’s a little too strange for me. Neither my husband nor I would be at all comfortable with that. But hey, each to their own, right?
- Reverse cycling – most babies will simply learn to wait for their milk and make up for lost time by reverse cycling – drinking more through the night. This is obviously dependent on the age of the baby, but if they are eating solid foods and are happy to drink water from other sources, they will likely learn to just wait for mama’s boobs. If you are worried that they aren’t getting enough of your milk, you can sneak extra in by preparing some foods with expressed milk and maybe even making breast milk ice cubes/ice lollies for your baby to snack on – great for teething babies!
What are your top tips for dealing with bottle refusal? Did your baby refuse a bottle? If so, how did you cope?