When your breastfed baby won’t take a bottle, it can be stressful and even a little scary. Babies are not always onboard when transitioning from breast to bottle. Whether you’re going back to work or want others to help feed your baby, you might start to wonder: “What if my baby never takes a bottle?”
Don’t panic. Usually when your baby won’t take a bottle, they’re just struggling with the learning curve. They’re new to the world so they have a lot to learn. Sometimes there may be some motor skill or medical condition making it more difficult. But no matter the reason, we’re here to help.
Keep reading to learn the most common reasons why your baby may be refusing a bottle, tips for helping them get used to a bottle, and what may be going on if bottle feeding doesn’t start to improve.
Common types of bottle-feeding problems
Not all bottle refusal looks the same. There can be a range of signs that your child is struggling to take a bottle, including:
- Turning away from the bottle
- Gagging or fussing as the bottle’s nipple nears their mouth
- Being unable to latch/compress the bottle’s nipple and express milk
- Chewing on the bottle’s nipple
- Sputtering or coughing while feeding
- Not being able to completely swallow their sip of milk, so that some drips from their mouth
Why do many babies have problems when switching to a bottle after breastfeeding?
There’s no one-size-fits-all answer to this question. In most cases, bottle feeding problems aren’t due to abnormal oral motor function, nor are they usually due to an underlying medical issue.
Actually, one of the most common reasons breastfed babies won’t take a bottle right away stems from not being introduced to one early enough in their growth. In fact, the number one mistake families make is offering a bottle too late.
Why timing is so important when introducing a bottle to a breastfed baby
Babies are born with an automatic sucking reflex. But at 2 to 3 months old that reflex becomes voluntary. In effect, that gives babies the ability to turn down a feeding if they’re not comfortable with it.
If a baby hits this stage in their growth and has only fed from their mother’s breast, they may have developed a “preference” for that method of milk delivery. Babies establish a suck-swallow-breathe pattern that works for them and lets them handle their mother’s milk flow.
When given a bottle, not only is the milk flow different, a baby has to adapt to a different nipple shape and texture. They also need to slightly adjust their posture from what they’re used to. For someone so new to the world, making these kinds of changes can be hard and overwhelming, leading to fussing, tears and why your breastfed baby won’t take a bottle.
When to introduce a bottle to a breastfed baby
There’s an ideal window of time for introducing a bottle to a breastfed baby. You want to avoid doing it too late, but you also don’t want to do it too early. It’s important to make sure your baby gets the hang of breastfeeding and is getting enough milk before introducing a bottle.
We usually recommend waiting about 2 to 4 weeks after your baby is born before trying to bottle feed. Unless they were born early, most babies are ready by then.
How to get a breastfed baby to take a bottle: 5 helpful tips
1. Switch back and forth between breastfeeding and bottle feeding
You give your baby the best chance at developing their feeding skills if you regularly switch between bottle and breast in the midst of feedings.
2. Try giving the bottle when your baby is waking up
No matter the time of day, babies are more likely to take a bottle when they’re just waking up. The instinct to eat takes over when babies are still a little sleepy. Don’t let your baby get overly hungry before feeding. That can result in fussiness and crying (a late feeding cue), and make it harder to initiate feeding either by bottle or breast.
3. Create a relaxing environment each time you offer the bottle
Play soft, calming music – like classical or folk. Sit down someplace where you can gently rock back and forth. And swaddle your baby with their hands near their face. Having a quiet, dark room with few distractions can help, too.
Doing these things will relax your infant – in part because they will also relax you. Children sense and feed off the energy of the adults around them. And it’s no different when you and your baby are adjusting to bottle feeding. If you can be at ease with the varied routine a bottle brings, your baby will be more content, too.
4. Have a family member other than mom offer the bottle whenever possible
Each person will hold your baby a little bit differently for feedings. When your little one can get used to these differences early, it helps them learn how to adjust their posture so it’s less likely to be an issue when their sucking reflex becomes voluntary.
5. Try giving your baby a different type of bottle or nipple
Sometimes, the solution to bottle feeding problems is as simple as finding the right bottle or nipple. While there are nipple levels associated with age, every baby has their own feeding style, which may not match their age or size. There are many different nipple and bottle types out there – trying to figure out the best choice can be an overwhelming process. Finding the right fit is something that your baby’s doctor or a lactation specialist can help you with.
6. Experiment with baby’s bottle-feeding position
Your baby may also prefer to eat while in a certain position, which typically differs from breastfeeding positions. Try different angles and placements to see if there is one they favor. For example:
- Cradling them in your arm at a 45-degree angle while keeping their head and neck aligned.
- Sitting upright so that their back is against your stomach.
- While sitting or lying down, bend your legs and position your baby so they face you with their head resting against your knees, their back against your thighs and their feet on your stomach.
No matter what position you use, remember to angle the bottle so that milk only comes out when your baby sucks, and never prop the bottle in their mouth. Also remember to never lay your baby completely flat while feeding.
What to do when an older baby is refusing to take a bottle
The breast to bottle transition is certainly easier if you introduce a bottle at the right age. But even if your baby is already 2 to 3 months old, it’s still possible. In addition to the tips above, you can help your baby practice with a pacifier.
A pacifier can help babies form and strengthen their sucking ability. Consistently offer a pacifier to help soothe your baby when they’re fussy, if you’re not already. This helps your baby learn to organize their mouth movement, which will calm them. Once that becomes routine, begin offering your baby a pacifier for 20 to 30 seconds when you go to make a bottle. Doing so will help them more calmly prepare for bottle feeding.
Gently pull on the pacifier as your baby sucks it. Make sure to do this at least 3 to 5 times a day, including when your baby is using the pacifier to prep for a bottle feeding. These slight tugs will help your baby learn how to resist releasing the seal they’ve formed on the pacifier’s nipple. And that can strengthen their latch on a bottle’s nipple, too.
When the above tips don’t work, there may be another reason your baby is refusing a bottle
If you’ve been trying at-home strategies for a few days and your baby doesn’t seem to be getting more comfortable taking a bottle, call your baby’s doctor. They can help determine whether a medical issue may be present or connect you with a specialist if needed. Other reasons why your baby is refusing a bottle can include:
Reflux issues can cause pain with eating
Babies can get heartburn, too! When a baby has reflux, food and stomach acid flow from the tummy back into the esophagus (the tube the carries food from the mouth into the stomach).
Reflux causes babies to feel discomfort or pain when eating, which understandably affects feeding. Symptoms that may point to reflux issues include:
- Arching or stiffening their back when feeding
- Crying, fussing and getting red or watery eyes while feeding
- Coughing regularly during feedings or right after them
- Refusing to drink or accepting only 1 ounce of milk or less
- Falling asleep while feeding
- Having poor sucking and breathing coordination
- Taking a long time to eat or drink
It’s important to know these actions can occur and not be related to reflux. It’s common for babies to have a fussy time of day or be more tired some days than others. If symptoms are ongoing, a baby can be evaluated and treated for reflux.
Facial or oral structural differences can make latching difficult
If reflux doesn’t appear to be the problem, your baby’s doctor may refer you to a rehab specialist like me.
I’ve been helping moms and families who struggle with the transition to bottles for almost a decade. It’s part of my work as a speech therapist at Park Nicollet. You might think, “My baby’s problem is with eating – not talking. What does speech therapy have to do with that?” The answer could be, a lot!
The shape or structure of a baby’s cheeks, mouth, tongue or jaw can impact their feedings. That’s because these body parts affect how they’re able to latch both to the bottle, as well as to the breast. For example:
- Thin cheeks with little to no fat pads make it hard for a baby to hold their tongue in place to feed
- A tongue-tie(where the tissue that attaches the tongue to the bottom of the mouth is too short) can limit a baby’s ability to move their tongue from side to side in their mouth or past their lower lip to feed
- A tongue-tie that’s been clipped requires a baby to relearn how and where to move their tongue to feed, and create new muscle memory
- A “vaulted” palate (where the roof of the mouth is higher and narrower than the typical flat U-shape) causes additional space in a baby’s mouth that can make it harder for their lips to form a tight seal
Weak oral muscle tone or lack of oral stimulation can make it hard to get enough milk during feeding
It’s possible that a baby just doesn’t have the strength to get what they need during a feeding. This could be the case even if they have very normal oral motor actions.
If your baby is refusing to take a bottle, we’re just a phone call away
Always feel empowered to call your baby’s doctor or make an appointment with them. They can connect you with different types of breastfeeding support, including drop-in breastfeeding support groups and lactation consultants who help with both bottle and breastfeeding issues. They can also refer you to a pediatric rehabilitation specialist.
Our incredible nursing staff is also here for you. HealthPartners patients can call 800-551-0859. Park Nicollet patients can call their clinic directly during regular business hours, or 952-993-4665 if it’s after hours. For questions and advice on new baby care, you can also call our 24/7 BabyLine at 612-333-2229.
Find a doctor who can help
Are you still looking for the right doctor for your new baby? We have hundreds of doctors and clinicians across the Twin Cities, central Minnesota and western Wisconsin, that can help you with all your questions.
While you may be wondering how to get them to take a bottle today, you’ll get it figured out. Then the question will be: How can I get my child to eat their vegetables?