Making It Work
When Baby Refuses a Bottle
From: NEW BEGINNINGS, Vol. 11 No. 5, September- October 1994, pp. 152-54
We provide articles from our publications from previous years for reference for our Leaders and members. Readers are cautioned to remember that research and medical information change over time.
"Making It Work" is a regular feature of the magazine NEW BEGINNINGS, published bimonthly by La Leche League International. In this column, suggestions are offered by readers of NEW BEGINNINGS to help mothers who wish to combine breastfeeding and working. Various points of view are presented. Not all of the information may be pertinent to your family's lifestyle. This information is general in nature, and not intended to be advice, medical or otherwise.
What tips can you offer to help a baby accept a bottle? I've tried every type of nipple and still my baby will not accept one—even from a stranger. I'm uncomfortable with the advice that "when she's hungry enough, she'll take the bottle." Please help.
Emily, born with her parents' stubbornness, steadfastly refused the bottle. I tried different nipples, countless feeding positions, quiet rooms, and rooms with music, all with the same result—Emily went on a seven-hour hunger strike every day while her mother was at work. She'd give me a look that said, "I don't know what that rubber thing is, but it's not my Mommy so get it out of my face!" Irene came home every afternoon to find both of us frazzled and grumpy.
To remedy the situation, we kept Emily in bed with us all night long so she would nurse as much as possible. This allowed her to do most of her feeding at night since she nursed for hours at a stretch. Just before leaving for work in the morning, Irene nursed Emily one last time. Irene often brought work home with her so she could get back a little earlier. Emily, of course, wanted to nurse the moment Irene walked in the door. This system wasn't ideal, but it got us through. Fortunately, a breakthrough came several weeks later.
I was drinking a glass of water with Emily on my lap. She started grabbing at the glass as if she wanted some. Most of the water ran down her shirt, but she seemed to enjoy the little bit that she drank. I then tried a two-handled "sipper" cup designed for infants. At first she just played with it, but after a few days she drank the water every time. After that, everything went fine, and she quickly started drinking breast milk from the cup as well.
The problem with the bottle and rubber nipple was that Emily was not about to settle for an imitation mother. She simply refused to eat until we came up with an entirely new method. Now that she's a year old, she happily drinks juice and eats enough "grown-up" food to eliminate the need for Irene to pump milk for her anymore. Things are so much easier than they were a few months ago, but Emily still waits eagerly for her mother to come home!
Phoenix, Arizona, USA
As a working mother of four small children and one on the way, I have faced this situation many times. I am also a lactation consultant and an OB nurse, so mothers often ask me this very same question.
Many babies will not accept a bottle, even when they are supposedly "hungry enough" to do so. I have had good luck introducing a bottle gradually. A few weeks before returning to work, add a bottle (plastic) to your baby's collection of rattles and other toys so he can become familiar with it. When he is awake, but not hungry, put an ounce or so of breast milk, water, or juice in it, depending on the age of the baby. Spend some time at your caregiver's house before you return to work, and ask her to play with the new baby and this special "toy." Gradually work one feeding with the bottle into baby's normal feeding schedule. The key is to be patient with yourself and your baby, allowing plenty of time to make this transition gently.
Moscow, Idaho, USA
I went back to work full-time when my son was three months old. Although he had taken a bottle each week since he was three weeks old, as my first weeks back at work progressed, he refused the bottles of breast milk more and more frequently. By the end of the first month, he refused them completely.
We tried many different things but only one thing worked. One day the caregiver picked him up while he was sleeping, held him in a nursing position, and fed him a bottle of breast milk.
She fed him in his sleep for about a month. One day when he was having trouble falling asleep, she gave him a bottle when he was awake. He happily sucked it down. He now takes the bottles when he's awake and everyone is a lot less stressed.
Columbus IN USA
I am a first-time breastfeeding mother. My biggest concern regarding going back to work was nipple confusion, rarely mentioned in most of the breastfeeding literature I read. Therefore I did not even try to introduce a bottle to my son until he was two months old. There was no confusion on his part. He knew the difference between my breast and a bottle and wanted nothing to do with the latter!
Refusing the bottle, too, was rarely mentioned in anything I read. When it is mentioned at all, it is treated quite casually. The stress of repeated refusals can change a mother's normal concern about leaving the baby in the care of another into complete paranoia. "If something happens to me, this baby will starve to death," is a common fear.
My baby is now four months old and he will take a bottle, although still reluctantly. I tried many different nipples, and had the most consistently positive results with Gerber's NUK orthodontic nipple which is newly designed to equalize pressure. A lactation consultant once suggested that I turn the nipple over so that the hole faces the tongue instead of the roof of my baby's mouth, but this did not seem to make a difference for us.
Temperature is important.
My baby liked his bottled milk slightly warmer than room temperature. Some babies prefer that the nipple be warmed slightly by holding it under warm running tap water.
Location can also make a difference. I avoid offering the bottle in places where I usually nurse. Since I always sit on the sofa, rocking chair, or lie in bed to nurse, I found that my son was more willing to take the bottle if I started off standing or walking with him.
I did, however, find it very difficult to be patient during this time. I felt it was important that my baby not sense my urgency or desperation. Sometimes it was necessary to stop a session because my baby was becoming angry, actively pushing the bottle away with his tongue and/or his hands. This particular problem led me to an important understanding about how much my baby needed me. I realized that I did not want to leave him in someone else's care, especially a stranger's, which was my only option since my husband is in the military, and we have no family or close friends nearby.
I explained to my employer that breastfeeding was very important to me and the pressure of worrying about my son when I was away was unbearable. Surprisingly, I was invited to work part-time at home, and that is working out well.
Mary Ann Hoppa
Virginia Beach VA USA
Please trust your mothering instincts and ignore the statement "when she's hungry enough, she'll take the bottle." Believing this will only result in a tremendous amount of stress for you, your caregiver, and especially your baby.
We tried everything we had ever heard of with my son. But no matter what we tried, he refused to take the bottle. I decided that I would have to be creative, as well as more flexible. I arranged my work schedule so I could nurse him before I left, on my lunch break, and again at 4:00 PM. My company has allowed me to work seven rather than eight-hour days while my son needs to nurse as often as he does.
If he does need to be fed when I'm away, the caregiver gives him warm breast milk via a large medicine dropper. This works out well and satisfies him until I return.
All this was tricky at first, but attitude has a lot to do with our success. Rather than look at my son's refusal to take the bottle as a problem, I viewed it as a challenge for which I had to find a solution. When I arrive at the daycare center to pick him up, my son's smile and outstretched arms make it all worth it. Please don't give up. You can be a wonderful role model for many others.
Fergus Falls MN USA
When I returned to work, my daughter, Tess, was almost six months old. I was determined that she continue to have nothing but breast milk while I was away eight hours each day. Pumping the milk was not a problem. Tess, however, refused the bottle from the sitter, her father, and everyone else. Luckily, our caregiver is very patient and was willing to keep trying. We tried every nipple available, but to no avail.
Tess was not coordinated enough for a sipper cup, so instead we tried a spoon, and this worked well for Tess. A deep plastic spoon worked best but some babies might prefer a rubber-coated "soft" spoon. Our caregiver fed Tess two or three ounces at a time, then when she wasn't quite so hungry, offered her the bottle. Within two weeks, Tess no longer needed to begin each feeding with the spoon. I am proud to say that Tess received strictly breast milk until she was a year old, when she finally became interested in solids.
Now, at fourteen months, Tess still takes two small bottles of breast milk each day, in addition to the growing amount of solids. I am pleased that this worked out so well, since it would have broken my heart to give up nursing. Of course, we never would have made it without such a supportive caregiver. Good luck.
Shepherdsville KY USA
I have been caring for my breastfed, six-month-old nephew, Jordan, since he was six weeks old. I also have a twenty-two-month-old daughter who is still nursing.
Initially, Jordan accepted the bottle, though never with much enthusiasm. But beginning at about three-and-a half months of age, he started to refuse to take it. The first thing that a caregiver must do is relax and listen to the baby. It seemed that the harder I tried to get Jordan to take the bottle, the more upset he became. Although it is stressful, it's important to trust the baby so that taking the bottle does not become a struggle between the child and the caregiver. Communication between parents and a caregiver is important, too, as this situation often leaves both feeling inadequate.
With Jordan, I tried different types of nipples, and it was the NUK brand which worked best. I also tried not to give Jordan the bottle until other comfort measures failed. I did not want him to think of me as "that lady who's always trying to stick that thing in my mouth." For a while as we worked through resolving this issue, Jordan didn't like me to look at him while he drank from the bottle. Also, sometimes standing, swaying, or walking while bottle-feeding helped him relax. Jordan also seems to prefer fresh, refrigerated breast milk rather than frozen milk that's been thawed.
Milwaukee WI USA