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Our Lactation Consultant and Feeding Specialists came together to give all the tips and tricks!

Do you feel like you have tried every bottle and nipple shape you could find in the store, but your baby STILL will not take a bottle?! I’m sure panic mode has set in (especially if this is in conjunction with baby starting daycare or you going back to work - I get that stress!), but take a deep breath and read on! I’ve got you covered! As a feeding specialist and mom of a babe who refused the bottle, I have some tips to share that can help your little one and you during this process!

Why is My Baby Refusing Bottles?

I wish there was a simple answer to this question, but every baby is different. There can even be some differences between breastfed and formula fed babies as to why they are refusing a bottle. For a breastfed baby, it’s important to remember they are not confused between the breast and bottle. But, they are likely to gravitate towards whatever is easiest to get milk! This is called “nipple preference,” and is often the main culprit of bottle refusal. But, other factors can play a part such as comfort, which caregiver is feeding, etc.

It’s also important to keep suck reflex integration in mind. Baby’s suck reflex will start to integrate into voluntary sucking between 2-4 months of age. This means it is important to start offering a bottle to your breastfed baby before this integration starts. This is especially important if you are planning on returning to work. Begin offering a bottle consistently (that means daily or at least 5x a week) once you and your baby have established breastfeeding and once baby is about 3-4 weeks of age. This blog post is great for learning how to bottle feed baby!

One piece of (bad) advice that parents seem to hear often when their baby is refusing a bottle is, “if your baby is hungry, they WILL take the bottle. Just wait until they are hungry enough”. Well let me break it to you…that is just NOT the case! There are a variety of reasons a baby might be refusing a bottle, but not being hungry enough isn’t one of them. This type of advice can be harmful to both the baby and parent, and cause WAY more frustration than anything.

How can I get baby to accept the bottle?

Remember earlier when I said I had some tips and tricks? Here they are! Let’s discuss…

Try a new position! Typically when a baby is offered a bottle, the instinct of the feeder is to hold the baby in the crook of their elbow with the baby's body facing up. This might be a comfortable position for you as the feeder, but for your baby, especially for a breastfed baby, it isn’t the most optimal. Being in this position, your baby doesn’t have the ability to regulate the flow of milk, as gravity is forcing the milk into the nipple even if baby doesn’t want to suck. TRY positioning your baby across your legs on their side slightly elevated. Elevated side-lying allows your baby to regulate the flow of the milk and pace the feeding on their own.

Elevated side-lying can occur on a pillow on propped legs, like this baby here!

Don’t offer the bottle when your baby is hungry. Yup, you read that right! Think about when you are super hungry and just ready to eat. You don’t want to be offered food in a way that you don’t know how to eat from or that you don’t prefer - that’s frustrating! Your main focus is to get food in your stomach, not learn a new skill. That’s how your baby feels when you offer them a bottle (and they don’t know how to drink from it, or don’t want to!) when they are super hungry and expecting to eat immediately. TRY offering the bottle as practice at a non-feeding time first!

Change the nipple flow rate! This could be changing it to a slower flow OR faster flow. If your baby was taking the bottle and suddenly stopped and you noticed frustration, this could be a sign they need a faster flow! Or maybe you offered your baby a flow that was too fast and they didn’t like that. Try a slower flow!
Let your little one take charge! When you present the bottle, don’t immediately shove the nipple into your little one’s mouth. Allow them to take their time coming to the bottle and latching on!
Remove the nipple from the bottle and try. Yep, take the nipple off/out of the bottle and use the nipple (kind of) like a pacifier. Pop a little breastmilk or formula in the tip of the nipple (only a few drops) and let your little one explore it with their mouth. Hold it up to their mouth for them. Slowly increase how much is in the nipple as you do this across a few days, and work your way up to introducing a bottle once again. Start small (1 ounce is success!) and work your way up to a full feed.

Bottle Refusing Baby Going to Daycare

It’s stressful in itself when your baby won’t take a bottle, but then adding in the factor of your baby not taking said bottle while at daycare can send you over the edge.

One of the most beneficial things you can do is communicate with your daycare provider! I recommend going over the tips I provided above with them, especially if you are noticing success with these tips at home! It’s important that everyone who is feeding your baby is keeping things consistent.

One thing to be prepared for is the pressure of offering solids before your baby is ready. Your daycare providers might suggest they can offer baby cereal or purées instead of fighting with a bottle.

It is highly discouraged to start offering solids before a baby is developmentally ready. The Academy of American Pediatrics (AAP) does not recommend starting solids before ~6 months of age, or before baby has shown all signs of readiness.

But, speaking of spoons… you can offer formula or breastmilk!

Sometimes offering formula or breastmilk via spoon can help baby “warm up” to a bottle down the line. Sit baby upright and supported (perhaps with their back to your chest on your lap) and offer small spoonfuls. Usually around 4-5 months of age baby is ready to sit up with support in this position and you can try spoonfuls of breastmilk or formula.

There are other options for your daycare provider (or you) to offer formula or breastmilk to your baby besides the bottle! Did you know your baby can use a straw or open cup? You can introduce a straw or open cup anytime to your baby. Usually ~4 months is the sweet spot for using a straw to help with breastmilk or formula intake.

How to Introduce a Straw or Open Cup

Now I know some of you reading this might be wondering “Jordyn, if my baby is refusing a bottle, how are they going to take an open cup or straw?” Well, drinking from open cups and straws are actually different oral motor patterns than the breast or bottle. This is a great way to offer breastmilk or formula if baby is refusing that bottle!

Several cups have a squeezing mechanism on them to help push the liquid up the straw. This helps baby learn that if they suck, the liquid will come up! This one is my favorite and can be used as a regular straw, too!

I help Penelope, 6 months, take sips from a small open cup. Helping your little one get the hang of open cup drinking and straw drinking is normal!

Using a small open cup (like this one) is a great way to offer sips of breastmilk or formula to baby. You bring it to their lips and let them figure out the rest!

For more information on what cups I recommend as a feeding specialist and how to use them, check out The Cups and Straws Guide!

Is it Refusal or Oral Motor Dysfunction?

I discussed some possible reasons and different scenarios as to why your baby might be experiencing bottle refusal, but sometimes it’s a little more than “bottle refusal.” If your baby is refusing a bottle, it is important to figure out if it is due to any kind of oral motor dysfunction. If you’ve tried all the tricks in the book and something still isn’t sitting right, it’s likely time to talk to a professional! A feeding specialist and/or IBCLC will be able to evaluate if the oral dysfunction is impacting your baby’s ability to eat efficiently. You can speak with a professional on the Eat Play Say Team here and get the help you need!