Why is my breastfed baby refusing bottle feeding?

Both of my babies were breastfed and completely refused to take a bottle. That was before the days of the internet when I could have just googled what to do. 

Instead, I had to take trips to the library to read tattered mothering books, which to be honest were less than helpful, and none of the advice worked.

Nowadays, lactation consultants are on hand to help and of course you can access all of this information with a couple of clicks of a mouse.

I wanted to write this blog to support those breastfeeding mums who, like me, just needed someone else to help with the feeding now and again, so I could have a break – like getting 6 hours uninterrupted sleep…that would have been bliss!

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Why is my breastfed baby is refusing bottle feeding? by Sarah Almond Bushell - The Children's Nutritionist

Why won’t my baby take a bottle? 

Your breastfed baby refusing a bottle is unfortunately very common, and can cause extreme frustration, stress and anxiety for us mums. 

Why you might want to introduce a bottle

Your baby doesn’t need to learn to drink from a bottle, but you might want them to.

If you plan to introduce a bottle, La Leche League recommends waiting until your baby is at least 4 weeks old, so they get used to breastfeeding first. Sometimes, mums worry that their baby will refuse to accept a bottle if it’s left for too long, however this isn’t always the case (1)

If your baby doesn’t need a bottle until they are much older, for example if you are going back to work when they are 6 months old, there is no need to introduce the bottle earlier. Babies are pretty good at learning new skills.

What are the reasons they won’t take a bottle?

Why is my breastfed baby is refusing bottle feeding? by Sarah Almond Bushell - The Children's Nutritionist

There are lots of different reasons why your baby is refusing the bottle. 

It could be your baby being too full and so does not have the appetite or incentive to take more milk. If there is lots going on when you offer the bottle, your baby could be distracted by the change or new environment.  And if they are feeling unwell, they’ll be seeking comfort from something familiar like the breast and are unlikely to take a bottle. 

However, the three main reasons for why your breastfed baby is refusing a bottle that I see in my feeding clinic are:

Your baby isn’t used to the teat of the bottle.

This is a very common reason. If the baby isn’t used to the artificial teat used on the bottle, they are less likely to take it. It feels unnatural to them compared to your nipple (2)
.

Your baby wants to be close to you!

Your baby refusing a bottle could simply be that they want to be close to you just like breastfeeding. There are many benefits to skin to skin contact and it can be confusing for babies to accept a bottle when they are used to skin to skin contact and being fed from you (3)
.

Negative bottle experiences

This is also a big reason for refusing bottles. If your baby has had a negative experience in the past, they may be less willing to take a bottle in the future. For example, if your baby was taking it fine but then became unwell they may associate the bottle with feeling poorly which was a negative experience i.e. reflux, gagging, vomiting. 

How to help your breastfed baby take a bottle

Let’s start with getting the basics right:

Why is my breastfed baby refusing bottle feeding? by Sarah Almond Bushell - The Children's Nutritionist

  1. Firstly, make sure that you have a quiet space with no distractions. This will make a big difference when introducing a bottle.

    Babies can get very distracted, therefore a peaceful space where both you and your baby are relaxed, will allow your baby to focus on learning this new skill. 

  2. Secondly, make sure you get the position right. This step is really important for ensuring that you and your baby are comfortable. It is best not to have your baby completely flat on their back when feeding as the milk may flow too quickly (1)
    .

    When learning a new skill babies need something to push their feet against. When you’re holding your baby in your arms in a reclined position use the arm of the sofa for their feet to push against.

    A slight bend in the knee can be helpful. This helps your baby co-ordinate the fine motor movement of the lips, tongue and jaw. Bringing your baby’s arms to midline will also help.

  3. Place the teat of the bottle firmly but gently down the central tongue groove as this allows the tongue to cup around the teat and promote proactive suckling. 

  4. Try pace feeding, which mimics breastfeeding, strengthening the bond between you and your baby.

    This bottle-feeding technique is great as it prevents overfeeding and gives your baby control. Find out more about it on my blog ‘Why you should practice pace feeding when bottle feeding your baby’.

  5. You then may want to try asking someone else to feed your baby as your baby may simply just associate you with the breast. Daddy or grandma could be a better option.

    Make sure it’s someone who knows your baby well enough, and limit to just 2-3 different people involved in feeding your baby (1)
    .

  6. Lastly, an important step is to feed your baby at a time when they are most alert. Dream feeds or bedtime is not a good time for learning. Also choose a time when they have an appetite (1)
    .

    Don’t attempt to bottle feed your baby when they’ve just had a breastfeed, or else they will more than likely refuse the bottle. They need to have an incentive after all. However, if they are too hungry, they may get frustrated which also results in an unsuccessful bottle feeding attempt.

    Go for somewhere in between. This may take some practice, but you will soon find the right time for feeding. 

The amount your baby takes will be very small initially as they learn the new skill, but that’s OK you can gradually increase with daily practice.

Think of the milk in the cup/bottle as an activity rather than a feed while you are practicing and take it away at the first sign that your baby is getting fed up or frustrated so there are no negative associations.

Why is my breastfed baby is refusing bottle feeding? by Sarah Almond Bushell - The Children's Nutritionist

Experiment with different flow teats

Babies can notice the difference between different teats. Some prefer softer or firmer teats, while some prefer shorter or longer teat lengths. Different teats create a different flow, meaning that the milk comes out faster or slower. Essentially the hole in the top is bigger as the teat number goes up and a bigger hole means a faster flow. Do experiment to see what your baby prefers (2)
.

What not to do

There are a few things to avoid when it comes to bottle feeding and which may be causing your breastfed baby to refuse the bottle. 

  1. Don’t ever leave your baby alone when feeding, your baby may choke on the milk from the bottle. 

  2. Don’t have air in the teat. You want to have a full teat, so your baby is only taking in milk and not air.

  3. Don’t rush into bottle feeding too quickly! Avoid offering a bottle feed when you have other things going on, take your time, start just once a day, keep things calm and don’t rush (1)

  4. Check the temperature. The average temperature of breastmilk is around 37 degrees celsius (7)
    , ensure formula or reheated expressed breast milk is similar. Any hotter and you risk burning your baby’s mouth but also experiencing something different to what they expect, may lead to bottle rejection. Never warm milk in the microwave, as milk can get very hot in different spots, leading to burns.

Could a lactation consultant help or are they just for breastfeeding?

Lactation consultants can definitely help with bottle feeding, they specialise in breastfeeding but can offer great advice and help when it comes to bottle feeding. They are a really good resource for women who are struggling with any kind of feeding. 

If you are looking for a lactation consultant, you can find one near you on ‘Lactation Consultant of Great Britain’ website
. In addition, the La Leche League has some further suggestions which you can read about here
.

Why is my breastfed baby is refusing bottle feeding? by Sarah Almond Bushell - The Children's Nutritionist

Is there a better bottle for breastfed babies?

Sometimes trying to look for the perfect bottle can be overwhelming. There are so many different types, brands, and claims. 

To save you some time, I’ve compiled a review of the best bottles for breastfed babies which you can read here. 

What about a cup for milk feeds?

Still refusing? You could try an open cup. You’d be surprised how well babies manage cup drinking and most breastfed babies avoid the bottle entirely, going straight to the cup. Even premature babies can drink from an open cup.

To do this correctly you should firstly sit your little one upright with their neck and head supported. The rim of the cup should then be put on their lower lip. They will then begin to explore what’s inside and discover the milk, this will probably take time, and a few goes so don’t worry if they don’t manage it right away!

A smaller cup might also be useful to try at first, I like the Baby Cup
which is small enough for a baby’s mouth and is made from a warm, soft material so it’s comfortable even for very young babies. 

Don’t try to pour the milk into your babies’ mouth, instead let them sip or lap it up (1)
.

Why is my baby suddenly refusing the bottle?

Sometimes babies have been taking the bottle well for ages and then suddenly start refusing it. This is known as bottle aversion. It often happens when they associate feeding with something negative. It’s a conditioned response to avoid the thing they didn’t like.

It could be as simple as being overly encouraged to finish a bottle. To a young baby this is force feeding and they don’t like it. To us mums we are just trying to ensure our babies get enough nutrition, so it often comes from a good place.

Discomfort is another reason; it could be something as simple as taking in too much air during a feed which has led to tummy ache or the pain from regurgitation or reflux.

In rare cases where there is an allergy (8)
or digestive issue, refusal of the bottle (or breast) can be a tell-tale sign. This was how I discovered my daughter Maisie had an egg allergy, she was always fussy at the breast and developed an aversion to breastfeeds at around 8 months. Turns out she was getting egg via my breastmilk and it made her feel poorly. 

Whatever the reason, identifying the cause and eliminating it is key so that feeding can get back to normal. If you need professional support ask your GP for a referral to a dietitian.

Sarah Almond Bushell MPhil, BSc (Hons) RD MBDA - Registered Dietitian & Children’s Nutritionist

Sarah Almond Bushell MPhil, BSc (Hons) RD MBDA – Registered Dietitian & Children’s Nutritionist

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