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Ugh - My Baby Won't take a Bottle! The Challenge of Bottle Refusal

Bottle refusal can be stressful for parents, especially for those returning to work and not being to be breastfeed as regularly as before. There is no magical trick - like all things, it boils down to patience and repeated tries but here are some tips that can help:

Introduce the bottle early

We usually encourage parents not to introduce the bottle until the baby is well established in latching and nursing properly and is gaining weight steadily. This typically occurs around age 2 weeks for most babies. The bottle feeding is a lot easier for the baby than breastfeeding in the beginning. If babies are given the bottle too often in the beginning, some may decide that the effort required to master breastfeeding may be too much and may start to reject the breast. However, if you baby is having a difficult time gaining weight due to struggles with nursing or low maternal milk supply or frequent nursing is taking a significant toll on your health, your pediatrician may recommend temporary bottle feeding even before then.

During the 2 week visit, we encourage parents to start offering a bottle of pumped breast milk or formula (if your milk supply is lower) at least once a day. You are welcome to do it more often if you prefer. Maintaining at least one bottle a day will provide your baby with steady practice of going back and forth between the breast and bottle. This will also allow other family members (partners, grandparents, older siblings) to participate in caring for the baby. Pumping is additional work for already fatigued mothers but don't grow lax in offering the bottle. Babies are more likely to reject the bottle if they start to lose practice!

Be mindful of the timing of the bottle feed

If your baby resists the bottle, try to offer a bottle of pumped breast milk about 1 hour AFTER nursing. Logic would have it that if he is hungry, he would be more willing to take a bottle (since he may be more willing to take it however it's given) but it's actually the opposite. If he's ravenous and you offer him a bottle, he may be too frantic and impatient to give it a go and may become even more resistant. You want to offer it when he is hungry but not overly so. Offer but don't force it on him - if he's crying and pushing it away, take a break and try again a little later. Once your baby has become accustomed to taking pumped breast milk from a bottle, you can try transitioning to formula if your milk supply is low.

Find the right position

Do not hold him the same way that you do when nursing - that may set up the expectation that the breast is coming. Hold him sitting up in your lap, looking out from you. It may be helpful to have him face a bright window or even the TV to help distract him while feeding. This will be a temporary measure to use until he becomes more adept at bottle feeding at which point, off goes the TV!

Get mama out of the room!

It's helpful to have someone other than the mom offer the bottle since it might be too enticing to have mommy with the "real thing" (boobs) sitting near by. Moms - take this time to take a shower, squeeze in a quick nap, or cuddle with your other children.

Try out a new bottle or nipple

As a last resort, you can try switching to a latex nipple (softer, brown rubber) from a silicone (harder, clear) one. The softer, squishier texture may resemble the mother's nipple better. Switching bottles to wider ones that "mimic" the breast shape may also help but before switching to a whole new set of bottles, try switching just the nipples instead if you have the option.

If all fails...

Some babies stubbornly hold out no matter what you try. If that is your situation, nurse your baby as often as you can before and after work. If you are able to swing by home to nurse during the day, do so but don't make drastic changes in your schedule or work to make this happen. Don't feel guilty about having to go back to work - your baby will be fine! We have yet to lose a single baby of a working mother to starvation! Most of these "long resisters" eventually come around when they realize they truly have no other options and non-mother caretakers often succeed in getting the babies to take the bottle. Have your caretaker offer the bottle more frequently to "make up the difference" if your baby is taking only small volumes each time.

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