First published 1/13/2019; updated 5/5/2023 & 2/24/2024
Ah, bottle refusal. Or as it’s also known- “my baby won’t take a bottle and I am losing my ever-loving mind.”
You’d think that once you got over the hurdle of those early fiddly tender confusing frustrating breastfeeding days, a bottle would be a piece of cake… but if you’re reading this blog post there’s a good chance your baby refuses to take a bottle.
Try not to panic- hopefully you’ve got at least a week or two until whatever event or life change is coming up that the bottles are required for. This often FEELS like an emergency, but you have time!
If someone tells you to just send baby to the sitter with a bottle and “if he/she is hungry enough, he/she will figure it out” or “daycare workers are really good at bottles so don’t bother trying at home first”, give that person your sternest angry eyes and walk away from them.
(Now, if your baby really does need to eat from something other than you RIGHT NOW and won’t take a bottle, I suggest you put some pumped milk in a medicine cup or shot glass as shown in this video. It can be a bit messy, but baby will be fed and give you a back-up plan until you get this whole bottle SNAFU figured out. Sometimes a sippy cup with a flexible straw works, too.)
The goal here is to make slow and steady progress while keeping bottle feeding HAPPY and CALM. Screaming, crying babies aren’t going to eat no matter how many brands of bottles you try.
I’m here to help!
We'll start with a dry, clean, empty bottle.
1 Let your baby play with/suck/chew on the bottle nipple with NO food in it first. That’s right, just the nipple and the bottle collar. If your baby is old enough to put things in their mouth, hand them the nipple and let them explore it. If baby isn’t quite that old then try gently introducing the nipple to their mouth like a pacifier. We want this to be non-threatening and low pressure.
2 Once your baby is comfortable with the nipple being in their mouth you’ll want to try dipping the nipple in expressed milk and letting them suck on it; again, this is WITHOUT it being full of milk. We’re just making friends with the nipple, not eating.
3 If your baby won’t suck on the nipple no matter what you do, get them to play tug-of-war while sucking your clean finger or a pacifier (if they’ll take one). They will need to cup your finger with their tongue, extend it over their gums, and keep it there while they suck. When they’re sucking you’ll tug your finger/pacifier a bit to encourage them to suck it back in.
4 If you can’t get your baby to suck on a bottle nipple, pacifier, OR your finger and you’ve tried this over and over for at least 3 days, you need one-on-one help with a skilled IBCLC to figure out what’s going on. There’s always a reason babies aren’t sucking, and the reason is never “because he wants to make my life harder.”
5 Once you’ve got baby used to sucking on the bottle nipple, hand them an empty bottle to play with/get used to. Again, keep it low pressure and fun.
Headed back to work?
You're ready to move on to a bottle with something IN it!
Once they’re convinced that the bottle isn’t going to do them grave bodily harm you can fill it with about one ounce of pumped milk. Warm? Cold? Doesn’t really matter. Try one, try both. Most babies don’t have any problem drinking cold breastmilk straight from the fridge.
You’ll want to start with baby sitting up or semi reclined- make sure baby’s arms and legs are supported and they’re not flailing or tipsy.
You’ll want to gently lay the bottle nipple vertically against baby’s lips so they open their mouth. You then gently move the bottle nipple into their mouth, angling UP towards the roof of their mouth, allowing them to suck it in.
Once you get your baby to allow the bottle nipple into their mouth, you may need to trick them into sucking on it and drinking. There are lots of ways of doing this.
I’m going to give you a boatload of ideas- but it’s very important that you DO NOT TRY THEM ALL AT ONCE. Try a few of these in one session if your baby is calm and happy. If your baby gets upset, STOP!
If you DO get baby to suck and swallow, even once or twice, be super sweet and happy about it in a calming way. They have to learn that this is okay and not threatening and that sometimes even when we’re loudly celebrating, it confuses them.
Keep it happy and soothing! And if they only do one or two sucks and swallows and then stop, don’t force it. Count it as a win and try again later.
Because here’s the thing I’ve found in every single bottle refusal (and also, breast refusal) consult I’ve done- if baby isn’t taking the bottle (or breast) THERE IS A REASON. Babies don’t refuse bottles just to be jerks and show us who’s boss.
You’ve got a couple of choices here!
- You can book a virtual or office visit for bottle refusal help with me, and we can work together, or
- Find a local IBCLC who specializes in bottle refusals- you can ask them if they have completed my course, Guiding Bottle Breakthroughs, OR ask them what their approach is with bottle refusing babies. If they tell you that “the mom” can’t give the bottle, you know that perhaps they don’t have specific training in bottle refusal.
Parents, please note: This post used to contain a list of private practice IBCLCs who told me that they were skilled in helping babies with bottle refusal. It was provided merely as a courtesy for my readers. I removed this list as of 2/2024 and I will be replacing it with a list of lactation professionals who have completed my bottle refusal course so that I am referring to people who I am confident are trained and equipped to help families with bottle refusal.
LACTATION PROFESSIONALS, please note:
More info on Guiding Bottle Breakthroughs:
- 11 CERPs (6 L-CERPs, 4 R-CERPs, 1 E-CERP)
- This is a self-paced course that you complete in your own time
- Hours of video instruction, professional & client handouts
- Charting form & care plan included
- Video resource library
- Feedback from yours truly 💁♀️ on your final assignment
- Exclusive footage of actual bottle refusal consultations
If you are a lactation professional with a current lactation certification I would love to have you join us in the course! Feel free to contact me with any questions.
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