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 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.
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, and you want to slowly touch the nipple tip to their lips so they’ll open their mouth, and then to the roof of their mouth right behind the gumline, 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.
There are a decent number of IBCLCs (International Board Certified Lactation Consultants) like me who do a lot of bottle refusal consults. They can help you.
Find a local IBCLC who specializes in bottle refusals below (currently this list is USA only)… For more info about this list or to be added, please read this note.
Carly Marks, San Diego
Evonne Smith, Los Angeles
Ellen Schwerin, San Francisco
Heather Shabestari, San Diego
Chrisie Rosenthal, Los Angeles
Rachelle Markham, San Diego
Molly Brannigan, San Francisco Bay
Michelle Kunschke, Sacramento
Jewel Mohr, Sacramento
Debra Bender, Silicon Valley
Tali Ganir, San Francisco Bay www.taliganir.com
Katie Howser, San Francisco
Rachel O’Brien (that’s me, the one who wrote this article) MetroWest/Worcester to Waltham: see my services here
Shelly Taft, Central MA
Michelle Stolow, Maynard
Maire MacLean, Boston’s North Shore
Heather Bingham, Arlington
Melanie Venuti, Boston
Kira Kim, Boston’s North Shore
Please note: This list was last updated 1/2019 and contains names, locations and websites of IBCLCs who say they specialize in bottle refusal consults. Names are in no particular order (except for in Massachusetts where I put myself first because it’s my blog post and I can do what I want) and are provided merely as a courtesy for my readers.
If you are an IBCLC in the USA and would like to be added to this list, please make sure you are:
- experienced with bottle refusal consults
- confident about your skill and ability in this area
- in private practice with a standalone website (not a Facebook page)
If these all apply to you, please contact me with your name, town/area and state, and your website. I will add names to this list at my leisure, and I have final say on who is on this list.
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