bottle refusal

bottle refusal is behavioral solvable

Most of the advice out there about bottle refusal is a myth- leaving parents feeling anxious, misunderstood, and like they need to battle with their baby. Families are gaslit into thinking they’re just not allowing baby to get hungry enough, and that they caused this problem. 

The truth about bottle refusal is that it’s an oral function issue, not a behavioral one. Babies under 8 months old don’t understand cause & effect, and they don’t refuse to take a bottle just to manipulate you.  Babies are hard wired to eat- and if they won’t eat, there’s a reason.

Yes, even babies who fed from the bottle just fine in their early days and weeks can suddenly have trouble bottle feeding and “refuse” bottles altogether.  This is not a problem that you caused, but it IS a problem that you and your baby can solve together!

Once you learn what’s causing the bottle refusal for YOUR baby, you can work as a family to fix it.  After our meeting you’ll be equipped with individualized daily oral exercises and respectful bottle practice guidelines.  Most babies I work with learn to feed from a bottle in 2 weeks or less

What exactly is bottle refusal?

Bottle refusal is when a baby who is mostly or exclusively nursing/feeding at the breast/chest will not eat from a bottle. Many times the baby actually did take a bottle, sometimes even once a day, for their first few days or weeks. This makes it appear like baby is intentionally choosing not to feed from the bottle or “refusing” to bottle feed, thus the term bottle refusal was born.

  • If baby is also getting upset when they see the bottle and not allowing it in their mouth at all, they are also experiencing bottle aversion
  • When you put the bottle nipple in baby’s mouth they will typically kick it around in their mouth, thrust it out with their tongue, or bite on it; they usually won’t suck.
  • Baby will usually become upset and begin to cry if you keep pushing it. 
  • Bottle refusal typically begins around 8-12 weeks. Some babies slowly start to refuse bottles- other babies will seemingly change overnight. 
  • Bottle refusal is not caused by high lipase, milk/formula that’s too cold, or because baby isn’t hungry enough. If these things fix the problem, it’s not bottle refusal! 
  • Typical bottle feeding advice for breastfed/nursing babies (paced feeds, sitting upright, slowest flow nipple possible) doesn’t fix the problem either. 

Bottle refusal can be incredibly hard for parents to deal with because it’s not a problem that’s widely understood. This means that when parents seek help they are faced with a lot of disbelief because of course your baby can take a bottle, they did it before- you’re just not making them hungry enough.

The families I work with are often dealing with massive amounts of anxiety and guilt over the issue. It’s a very isolating issue- because so many people don’t understand it, you feel alone. Often the nursing parent is blamed for causing the problem or giving in to the baby too much or not “allowing” other people to feed the baby.

Parents dealing with bottle refusal may not be able to return to work or seek the medical care they need because they can’t be away from baby for more than a couple of hours.

Here’s the thing- bottle refusal in babies under 6 months is always an oral function issue. Even if baby “has always breastfed fine” and is gaining weight like a champ. 

The key to breaking through bottle refusal is identifying why your baby is having trouble feeding from the bottle, then tacking them, step by step,  exactly what they need to do to feed from the bottle. 

That’s where I come in.

FAQs about working with Rachel on bottle refusal

I do bottle refusal consults for babies under six months.  Babies six months and older are usually better off learning to drink from a soft straw sippy cup rather than working on using the bottle.

I do occasionally work with babies six months and up on a case-by-case basis- please contact my office directly with info about your baby/situation before booking.

Absolutely! I have met virtually with families for bottle refusal in almost every state in the USA as well as internationally. You don’t need to come to my office for our visit (although of course, if you’re local to Boston, office visits are a great idea).

Maybe. As long as the insurance subscriber is lactating (making milk) this visit can be coded as a lactation visit, which is covered by many insurance plans. I am in network with Aetna and Meritian as well as Unicare/GIC.  For all other insurances you pay out of pocket and I’ll provide you with an itemized receipt/superbill to submit to your insurance carrier for reimbursement.

If baby is fully formula or donor milk fed and the insurance subscriber is not lactating, the visit is not considered rio 

You can see my current prices here on my booking page. All cash pay visits include 2 weeks of follow up messaging via my secure messaging app or email.  In-network insurance visits do not include follow-up.

Nope! I know it can be tricky to make plans around nap time, so baby sleeping for part of our appointment is not an issue. Much of our appointment will be us talking, and I have even done bottle refusal consults when the baby wasn’t present at all. It’s not ideal but we can make it work! 

I always want to do bottle refusal visits by meeting with the parent who is doing most/all of the current feeds (typically the parent who is nursing the baby). For virtuals, anyone else in the family or care team can be in the room and join in the conversation! 

For office visits, if you would like to have more than two adults (or more children than just the baby) with you, please contact me so we can make sure we have the space.

It happens… but not most of the time! Let’s be real, people don’t hire me because their baby’s bottle refusal problem is easily fixable. It’s not like you’re putting the bottle nipple in your baby’s nose, after all.

Most of the time our meeting is an evaluation to see what is causing your baby to “refuse” the bottle, where they are with their current bottle skills, and then discussing the step-by-step plan to fix the issue.

For the vast majority of families I work with, the babies are able to eat at least 2 oz (60 mL) of milk at a time within two weeks of our appointment.

Honestly? Probably not. And anyone who promises you that they can get your baby over bottle refusal in 24 hours is not someone who you should trust! 

We CAN still work on the problem and discuss what you or baby’s caretaker can do in the meantime if you must be apart from them.

It’s just very important for you to have realistic expectations. Oral function issues are not caused overnight and they’re not solved overnight either!

Please bring/have ready at least 2 oz of pumped milk or formula, the bottles you have been using (or trying to use…) and any other feeding tool you’ve been working with (cups, syringes, etc). 

If we are meeting virtually we may also need a place you can lay baby that you can cover with a towel, burp cloth, etc in case things get messy.

Your baby should be willing to eat during our time together. They don’t need to be hungry but please don’t feed them within 30 minutes of our starting time. 

Howvver, if baby is hungry during the visit I will absolutely have you nurse/feed them the way they are used to eating! Hunger is NOT a good motivator for most babies refusing bottles.