Help! My baby won’t take a bottle!
Originally published on June 24, 2019; Revised August 27, 2024
Author: Robin Kaplan, M.Ed, IBCLC, FNC
Photo by Brytny.com on Unsplash
So your breastfed baby is refusing bottles. Isn’t the typical concern that a breastfeeding/chestfeeding baby may prefer bottles over nursing and not the other way around? While breastfeeding refusal can happen as well, any type of feeding rejection is your baby’s way of communicating that something is feeling challenging. So let’s dive into some of the reasons why a nursing baby rejects the bottle and some tips to remedy a bottle feeding aversion.
ABOUT SDBFC
The San Diego Breastfeeding Center was established in 2009 by Robin Kaplan, International Board Certified Lactation Consultant, Functional Nutritionist, and parent. Her vision was to create a judgment-free, inclusive support system for families navigating infant feeding challenges.
SDBFC offers a wide range of one-on-one breastfeeding, infant feeding, and nutrition consultations - as well as classes, support groups, online articles, and social media - making it your one-stop-shop for all things infant feeding!
Why do babies refuse to take bottles?
your Baby lost their innate sucking reflex
All babies are born with an innate sucking reflex. This is the reflex that causes them to start suckling as soon as something (nipple, finger, bottle, pacifier) is placed in their mouth. Well, that innate sucking reflex at some point becomes integrated, usually between 8-12 weeks old, making it such that the baby now decides whether he/she wants to suck, rather than relying on the reflex. And if your baby hasn’t practiced bottle feeding before the reflex is integrated, they might have no interest in trying out this new feeding skill.
Tips to overcome bottle rejection with an older baby:
Try offering when your baby is sleepy - this is when the innate sucking reflex comes back temporarily!
Change the temperature - maybe warming the milk will be more enticing
Try some distraction techniques - face your baby away from you, try lying your baby on their side, bounce on a yoga ball, go outside for a distraction, have an older sibling show the baby a toy or book
Offer your baby just the bottle nipple (no milk in the bottle), after nursing. Think of this as playful practice, which removes the stress and keeps this low pressure. Once you find a bottle nipple that your baby is willing to suck on without milk, then offer the bottle with milk the next time around.
Your baby doesn’t like that particular bottle nipple or flow
Bottle nipples come in many different shapes, sizes, and flow rates. Don’t fall for the marketing hype when the bottle packaging says that it is ‘just like the breast.’ If your baby is struggling with the flow of milk coming out or cannot form a good seal around the bottle nipple, that is going to feel very frustrating to him/her and could cause bottle refusal of that particular bottle(s)
Tips to overcome bottle rejection when your baby doesn’t like the bottle nipple or flow:
Focus on what your baby does when you put the bottle into his/her mouth.
If his/her lips don’t form a great seal around the bottle nipple (milk spilling out of the sides of her/his mouth, lips curled under, etc), choose a different shaped nipple/bottle.
If he/she looks overwhelmed by the milk flow (eyes bugging out, hands splaying, etc), go with a slower flowing nipple or switch to a completely different bottle brand. And practice paced bottle feeding
If your baby is struggling to get milk out of the bottle, move up to a higher nipple size to see if that helps.
Pumped milk has excess lipase in it
Does your pumped milk smell soapy, metallic, or sour? Was your baby willing to take freshly pumped milk before he/she started rejecting the bottle? It’s possible that your milk might have excess lipase. Lipase is a natural enzyme that breaks down fats in pumped milk, making it easier for babies to digest. However, when lipase levels are too high, it can cause the fats in milk to break down faster, especially when stored in cool temperatures. This can change the taste and smell of the milk, making it less appealing to babies.
Tips for overcoming bottle rejection due to excess lipase:
First, you’ll want to figure out when your milk starts to become sour.
Next, you can scald your milk to deactivate the lipase, stopping it from souring your milk.
Then, you will want to practice with the bottle nipple (like in the recommendations above) to demonstrate to your baby that bottle nipple doesn’t equal sour milk flavor.
Once your baby is willing to practice with the bottle nipple (without milk in it) then offer a bottle with non-sour milk.
Your baby has a tongue tie, upper lip tie, or high palate
Variations in oral anatomy can sometimes make bottle feeding challenging. Some tongue ties restrict the way a baby extends or wraps his/her tongue around a firm bottle nipple, making it more difficult to extract milk from the bottle. Some upper lip ties restrict the way a baby’s upper lip flanges, making it more difficult to form a good seal around a bottle nipple. Some high palates are very sensitive, causing a baby to gag when a long bottle nipple touches that particular spot at the roof of the mouth.
Tips for overcoming bottle rejection due to a tongue tie, upper lip tie, or high palate:
Work with a lactation consultant to identify which bottle might be most comfortable and effective for your baby, based on his/her oral anatomy, while protecting your nursing relationship.
Work with a lactation consultant to evaluate whether a tongue and/or upper lip tie release would be helpful for bottle feeding (as well as continued breastfeeding and solid food feeding).
Work with an Occupational Therapist or SLP who specializes in alternative bottle feeding methods for babies
If you’ve tried a few of these tricks and your baby is still refusing the bottle, STOP! It’s important to not force the issue or it could become very difficult to resolve. Your baby is trying to communicate that it is time to bring in a lactation consultant who has extra training in bottle refusal (like all of the lactation consultants at SDBFC!)
If your baby is refusing a bottle, we are just a consult away!
Don’t let bottle feeding struggles cause stress for you or your baby! Our consultants can help identify the root cause(s) of why your baby isn’t taking a bottle and can offer suggestions for ways to overcome these challenges! At each bottle feeding appointment, our lactation consultants complete a full oral assessment, try a variety of bottle nipples, and offer strategies for helping your baby build bottle feeding skills. Book a one-on-one bottle feeding consultation today
SDBFC is committed to providing high-quality lactation and functional nutrition consultations to parents in San Diego and beyond. Explore our postpartum, prenatal, and functional nutrition consultations, take a breastfeeding class or attend a workshop.
About the Author
Robin Kaplan has been an IBCLC since 2009, the same year that she opened up the San Diego Breastfeeding Center. Robin was the founding host of the Boob Group podcast and published her first book, Latch: a Handbook for Breastfeeding with Confidence at Every Stage in 2018. Melding her passions for supporting lactating parents and holistic health, Robin finished her Functional Nutrition Certification in 2023. In her free time, she enjoys hanging out with her two teenage boys, hiking, traveling, weaving, cooking, and searching for the best chai latte.