My Baby Won’t Take a Bottle. What Should I Do?

Baby Won't Take Bottle

Question: My breastfeeding baby won’t take a bottle. What should I do?

Answer by Dr. Pierrette Mimi Poinsett MD:

This is a common challenge for many babies.

The mechanism of bottle feeding is different from breastfeeding. Bottle feeding primarily works by gravity. And depending on the type of nipple, has a more rapid flow than breastfeeding.

On the other hand, breastfeeding requires a different kind of sucking mechanism and also involves milk letdown.

Before we get started, please note that it is important to wait until baby is 3-4 weeks old before presenting a bottle to minimize nipple confusion.

Here are some tips for successful bottle feeding:

  1. Use a nipple that resembles a breast.Use silicone nipples that do not have an additional flavor compared to latex nipples. You may need to try several different bottle nipples with different sized holes and shapes before finding the one your baby likes the best.
  2. Choose a time when baby is hungry to present the bottle.However don’t wait until baby is so hungry that baby is frustrated.
  3. Try using a pacifier or your finger to initiate your baby’s suck before presenting baby with a bottle.
  4. Have another caregiver present the bottle instead of mother.
  5. If another caregiver is not available, feed baby sitting in mother’s lapfacing away from mother. You can also try bouncing the baby or walking around with baby and bottle to distract baby from the breast.
  6. Use expressed breastmilk instead of formula for initial bottle feedings as some infants do not like the taste of formula. This will enable baby to first get used to bottlefeeding without having to also get used to being fed formula.
  7. If baby is 6 months of age or older- a cup may be easier to try than bottle feeding. Try first with a two handed sippy cup meant for older infants. If a sippy cup is not working well, you can try using a small cup or shot glass to feed baby. Do not try to pour the liquid into baby’s mouth. Instead allow baby to lap up the liquid. The advantage of cup feedings is that baby will not have to be weaned from bottle at a later time.

There is a group of babies that despite trying everything, refuse to bottle feed.An alternative is to increase night and evening feeds.This is also known as reverse cycle breastfeeding.This pattern of feeding compensates for not taking day time feeds. Also, when leaving baby with another caregiver, make sure baby is breastfed just before leaving and right away upon returning to baby.

References:

Huggins K., The Nursing Mother‘s Companion 7th edition, Harvard
Common Press, 2017.

Pryor, G, Nursing Mother, Working Mother, Revised: The Essential Guide to Breastfeeding Your Baby Before and After Your Return to Work, Harvard Common Press, 2007.

Summary
About the author

Dr. Pierrette Mimi Poinsett M.D.

Dr. Poinsett is a board certified general pediatrician with over 25 years' experience. She is California based. She has a special interest in health care advocacy and health care social media.

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