Help! My baby won’t take a bottle!
Is your breastfed baby refusing bottles? Don’t panic! Dive into some reasons a nursing baby rejects the bottle and some tips to remedy bottle-feeding aversion.
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.
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Bottle Feeding the Breastfed Baby FAQs
Bottlefeeding a breastfed baby can feel completely overwhelming. But with our lactation consultant tips, it doesn’t have to be! Explore all our bottle-feeding advice.
Did you know that lactation consultants not only help with breastfeeding, but can also help with bottle feeding? It’s true! We are here to offer guidance with all aspects of feeding (introducing solids, as well!) and know a ton about bottles and how to balance them with breastfeeding.
Questions about bottle feeding come up in many of our private consults, as well as in our private Facebook Group (for those who purchased our online course: Breastfeeding for the Working Family.) So, we figured we would write a blog article answering some of the most frequently asked questions. So, here you go…..
When is the best time to introduce a bottle?
Ideally, the best time to introduce a bottle is after your baby has mastered the art of breastfeeding. There is a window of opportunity when your baby is between 3-6 weeks old where he/she still has an innate sucking reflex and is more willing to try a bottle. Once babies reach 10-12 weeks, that innate sucking reflex goes away (or is integrated) which can make introducing a bottle more difficult at this time.
Sometimes bottles are introduced earlier than 3 weeks, due to baby not breastfeeding well or baby not gaining weight well. This DOES NOT mean your breastfeeding journey has been sabotaged! It might make breastfeeding a bit more challenging, as bottles are much easier to feed from than the breast, but you probably introduced the bottle earlier than 3 weeks BECAUSE you were having breastfeeding challenges, right? So, definitely meet with an IBCLC to remedy those breastfeeding challenges, but please know that not all breastfeeding-hope is lost just because you offered a bottle to your infant before 3 weeks.
How should I choose a bottle and bottle nipple?
Many bottles out there say that they are ‘similar to the breast.’ Don’t be fooled by their marketing. Truthfully, there are no bottle that are similar to the breast. If you haven’t noticed, our human nipples are all different shapes and sizes and no bottle nipple is stretchy like a woman’s areola and expands like a woman’s nipple when breastfeeding. So start with choosing a bottle that helps your baby achieve a wide latch and choose the slow flow nipple of that brand.
Are all slow-flow nipples the same?
Nope! Each bottle brand has its own slow flow nipple, but some ‘slow flow’ nipples flow really slow and some flow really fast. You will want to see how your baby reacts to the flow to determine if it is the right flow for your baby. PS. Those bottle nipples given out in the NICU or postpartum floor ARE NOT slow flowing, even though they say they are. They flow really fast, which is why your 3 day old is able to suck down 2oz in 5 minutes, which is way too much and way too fast.
How will I know if the bottle flow is too fast or too slow for my baby?
If the bottle flow is too fast for your baby, he/she will look panicked! Eye bugging out. Hands splayed. He/she might choke or spill milk out of the sides of her/his mouth. He/she might be really gassy after finishing the bottle. If this happens, you will definitely want to either try a slower flow nipple for that bottle brand or try a completely different bottle brand.
If the bottle nipple is too slow, your baby might get really frustrated when bottle feeding and it might take over 30 minutes to finish the bottle….way too long!
Bottle feeding should take about 15-20 minutes for the first few weeks to months. Once breastfeeding is established and going well, then bottle feeding might speed up to faster than 15 minutes.
What is paced bottle feeding and why it is important?
Paced bottle feeding, or baby-led bottle feeding, is a feeding method that allows your baby to be in charge of his/her feeding. This means, when your baby sucks, he/she gets food. When he/she pauses, no food is released from the bottle. Your baby is seated in an upright position and the bottle is held horizontally. This is super important in those first few weeks of bottle feeding because we want the pace of the bottle to mimic the pace of milk at the breast. We don’t want bottle feeding to be so much easier than breastfeeding that your baby starts to prefer the bottle over your breast. Also, baby-led bottle feeding also keeps your baby from overeating. This is important for all caregivers to know, which is why we created a YouTube video all about Paced (Baby-Led) Bottle feeding. Share with everyone who bottle feeds your baby!
If I am breastfeeding, am I able to offer a bottle, as well?
Yes! If you have a partner or spouse who can offer the bottle while you pump, take advantage of this! It’s just one less thing you have to do! But if you are in charge of all of your baby’s feeding sessions, then feel free to offer a bottle in place of a breastfeeding session to help him/her practice bottle feeding.
When do I need to change the bottle nipple to the next size up?
Probably never! Really! Sure, you might want to replace the bottle nipple with a fresh, new one every few months, but as long as your baby is happy with the flow and taking the bottle in a normal amount of time (remember…. Somewhere between 10-20 minutes, depending on his/her age), then there is no reason to go up a level. You could stick with the 0-3 month bottle nipple the entire first year. Essentially, if your baby is happy with the flow, stick with it!
How much milk should I put in each bottle?
One way to figure this out is to go to a breastfeeding support group and weigh your baby before and after a breastfeeding session. That’s a great amount to leave in the bottle. Otherwise, most babies in the first 3-6 weeks take about 2-3oz per bottle. Babies above 10lbs need about an ounce an hour, in general. This increases slightly as your baby continues to gain weight. Babies above 13lbs need about 30-32oz per 24 hours, so divide that by the number of feedings per day and there is your answer for how much your baby needs per bottle.
If I am returning to work, how often should I practice the bottle with my baby?
Ideally, you would introduce the bottle by the time your baby is 6 weeks old. Then, offer the bottle a few times a week, just to keep practicing, so that when you return to work your baby is familiar with this additional way of getting food.
What if my baby won’t take a bottle?
First, check out our article: Help! My Baby Won’t Take a Bottle. Give these tricks about 1 week ONLY! If your baby rejects the bottle for a full week, then is it time to meet with an IBCLC to figure out why your sweet babe is refusing the bottle. Bottle refusal can happen for many reasons: baby doesn’t like a particular bottle, baby has a high palate, baby has a tongue tie, etc. Stop struggling and let us help you figure this out!
So what additional questions do you have about bottle feeding? Share them here and we will add them to this article!
If I Give My Newborn Baby a Bottle, Will She Refuse the Breast?
Will giving your newborn baby a bottle hurt breastfeeding or cause nipple confusion? Explore this common question with our team of lactation consultants in San Diego.
Originally published on February 11, 2014; Revised August 27, 2024
Author: Robin Kaplan, M.Ed, IBCLC, FNC
The short answer is “we don’t know”. There is so much information out there about nipple confusion. Some will tell you that if anything other than a breast *touches* your baby’s mouth, he’ll never want to breastfeed again. Others will regale you with stories about how their exclusively breastfed baby had bottles! cups! pacifiers! in the first few hours of life and had no problem switching back to breast. Each baby and situation is different. It’s never a given that your baby will, or will not, develop nipple confusion if he/she has a bottle before breastfeeding has been successfully established.
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!
What is Nipple Confusion?
Bottle nipples and breast nipples have a very different feel to the baby, so sometimes when babies are used to one and they are introduced the other, it can seem confusing. You can help to prevent this by choosing a bottle nipple with a sloped, wide base rather than a small, thin, long nipple. This will help the baby to continue to open his/her mouth widely while feeding, which is what we want him/her to do while at the chest/breast. However - it is often a “flow preference”, rather than nipple confusion, that can cause a baby to have a difficult time switching from bottle to chest/breast. Even the “slow flow” bottles the nurses use in the hospital flow much faster than the breast, especially during those first few days when milk volume is low. Plus, even with those “slow flow” bottles, the baby doesn’t have to work very hard to get the milk to flow into his/her mouth. When the bottle is tipped, the milk often just pours into his/her mouth. At the chest/breast, the baby has to suck for a while to elicit the “letdown” of milk, and then throughout the feeding is only rewarded when he/she sucks at the breast. With a bottle, the milk pours into his/her mouth whether he/she’s sucking or not. These babies are smart! They learn very quickly that with one form of feeding, they don’t have to work as hard.
How Can I Avoid Flow Preference?
The easiest way to avoid flow preference is to only feed your baby at chest/breast until breastfeeding has been established, baby is back to his/her birth weight, and has gone through his/her first growth spurt that occurs around 2-3 weeks of life. However, there are many different situations when it may be necessary or appropriate for a baby to fed in an alternative way during those first few weeks of life. Some of these situations may include: premature babies who haven’t developed the suck, swallow, breath pattern yet; birth complications that force parent and baby to be separated for some period of time; anatomical challenges that prevent the baby from being able to latch on properly (tongue/lip ties); or sometimes parent’s preference - damaged nipples, etc. If you do feed your baby another way, there are things you can do to avoid the possibility of your baby developing a flow preference, or preferring an alternative feeding method. If your baby is able to latch comfortably, one option is to supplement at the chest/breast using a tube and syringe, and to either deliver the supplement very slowly and only when baby is actively sucking, or allow the baby to pull the supplement on his/her own. This helps the baby to continue to associate the breast with food, as well as ensuring baby has to work for the flow. If you do bottle feed, you can pace the bottle feeding so that it simulates a feeding at the breast - I’ll discuss this in greater detail in the next paragraph.
What if I Need/Want to Give my Brand New Baby a Bottle?
If a baby does receive a bottle, there are some things you can do to help prevent a flow preference from developing. The most important thing to realize is that there really isn’t a truly “slow flow” nipple, and that most bottles are the same, even the ones that claim to be designed for a nursing baby. It’s not so much the bottle you choose, but the method you use to feed the baby. Baby should be fed in a paced manner, so that the length and pace of the feeding mimics a breastfeeding session. The amazing online breastfeeding resource, KellyMom, has a great article on how to properly bottlefeed a breastfed baby - http://kellymom.com/bf/pumpingmoms/feeding-tools/bottle-feeding/. Another great resource regarding bottle/breastfeeding is www.breastandbottlefeeding.com. Both sites contain a great amount of information on “nipple confusion” and flow preference and how to avoid them.
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Ashley’s Success Story
As an IBCLC, I work with a lot of moms trying to get their babies back to breast after being fed via bottle. I’m always excited to share my own story to give them some hope and let them know that it is possible to transition a baby who is exclusively bottle fed to a baby who exclusively breastfeeds! My first child was born in New York City, in the fall of 2007. The hospital I delivered at had two lactation consultants on staff, but the one who was scheduled to work the day my daughter was born was in a car accident and not able to come in. So I fed my baby with an incorrect latch for a day and a half. By the time the lactation consultant arrived on the day we were being discharged, my nipples were cracked and bleeding. I was in extreme pain and every feeding brought bouts of panic and anxiety with it. Looking back, I realize that she had a lip tie and that may have been causing the painful latch. I chose to pump for a few days to allow my nipples to heal, and found that pumping and bottle feeding caused much less stress. So I exclusively pumped for my daughter for 4 months.
Exclusive pumping is hard work! You’re basically doing double feedings - by feeding the pump, then feeding your baby. Plus with the constant washing of pump parts, I felt like I was chained to the house every three hours so that I could pump to maintain my supply. On the flip side, there were benefits to it as well. My husband could feed the baby and I was able to get out of the house early on to do things like laundry. :) However, I always felt like I was missing out on a HUGE piece of those early months with my baby. I’d always assumed I’d breastfeed exclusively, and felt like a failure that I wasn’t. I kept trying periodically, but my baby would often cry at the breast and I would get frustrated easily and give up, assuming it would never happen. But I kept trying, and finally, at 4.5 months, she was latching regularly and I was able to put away the pump! She nursed until 14 months old, and I’d never felt such pride or accomplishment about anything before. I use this story to encourage moms that just because their babies aren’t latching RIGHT NOW, that doesn’t mean that they won’t later.
If your baby is struggling with bottle feeding or breastfeeding, we are just a consult away!
Don’t let bottle feeding or breastfeeding struggles cause stress for you or your baby! Our consultants can help identify the root cause(s) of why your baby is struggling going between breast and bottle and can offer suggestions for ways to overcome these challenges! Book a one-on-one postpartum 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.
Top 10 Ways to Stop Caregivers from Overfeeding Your Breastfed Baby
How can a lactating parent ensure that her baby’s caregiver isn’t overfeeding, or unnecessarily throwing away, that precious liquid gold she spent time to pump out?
I hear it all the time.
Mom and partner get home from a much-needed date night to find out that grandma gave their 4-month old two 6oz bottles in 4 hours.
Mom picks up her baby from daycare to find out that her 6-month old took three 5oz bottles, plus the backup 5oz bottle in the freezer, in 8 hours. She pumped 12oz at work and thought that would be plenty for the next day. (which it is!)
Mom comes home from getting a haircut to find that her partner gave their 3-month old a 5oz bottle. The baby only ate 3oz, so her partner threw the extra 2oz away.
Who ever said there’s no crying over spilled (or wasted) milk never pumped breastmilk for her baby!
It’s hard work to pump… who has extra time when taking care of a newborn to pop on some plastic milk-extracting contraption and just sit for 15 minutes? Um… no one! So when a caregiver over feeds a baby, or throws away breast milk that could have been used at another time, it can be very frustrating and defeating for a mom. And as that extra freezer stash starts to dwindle because of misuse and over feeding, moms might feel their stress levels spike to an uncomfortable high.
So how can a mom ensure that her baby’s caregiver isn’t overfeeding, or unnecessarily throwing away, that precious liquid gold she spent time to pump out?
Top 10 Ways to Stop Caregivers from Overfeeding Your Breastfed Baby
Keep bottles in small increments (2-4oz, depending on the weight and age of your baby) and tell the caregiver to wait in between bottles to assess the baby’s mood (to see if he/she is really hungry) – Haley
Use the slowest flow nipple you can find and use the 1oz per hour rule (offer 1oz per hour that you are away from your baby) – Miranda
Pre-make bottles in small increments. For example, leave two 3oz bottles so caregivers don’t have to divide a 6oz bag into two separate bottles. – Shelly
Go over Kellymom’s article with your baby’s caregiver, How to bottlefeeding the breastfed baby, which talks about paced bottlefeeding – Tova and Megan
After baby has taken the bottle, try other soothing techniques (i.e. rocking, singing, swaying, take on a walk) rather than offering more breastmilk in an extra bottle.
Keep a few extra 1oz bags of breastmilk in the freezer or fridge. That way, if your baby’s caregiver really needs to offer your baby a little bit more, it is a small amount and won’t go to waste.
Talk to your baby’s caregiver about reusing breastmilk. While there are no definitive studies that state the exact amount of time that breastmilk must be used within (once the bottle has been fed from), most lactation consultants believe that if a bottle of breastmilk isn’t completely finished, it is safe to place it back in the fridge and the remainder used within 4 hours. (Kellymom.com article - Reusing Expressed Breastmilk)
Use the milk calculator to figure out how much your baby will need per bottle. Keep in mind, this is only accurate until your baby weighs 14lbs. After that, your baby’s breastmilk need plateaus at about 28-35oz per day. It won’t go up beyond that, so those 6-8oz bottles are really unnecessary.
Have a heart to heart discussion with your baby’s caregiver. Let him/her know how important it is to you that your baby isn’t overfed while away from you. Show empathy and explain that you understand how challenging it is to read your baby’s cues and that things are easier for you because you can always soothe your baby with your breast, which is something the caregiver cannot do. Explain how much milk your baby truly needs in a bottle and during the time you are gone. Anything over that is too much for your baby and makes it difficult for you to keep up. Come up with unique ways for him/her to bond with and soothe your baby, rather than just relying on giving more breastmilk in a bottle.
This advice came from a nanny, which was written so well I didn’t want to paraphrase it. ‘I nannies a breastfed baby for about a year and communication with the mom was very important. I also stuck to a schedule. If it was getting close to time for another bottle and I expected her home soon, I would text or call her to see if she wanted me to wait if she was on her way. Also, we would talk in the morning and she would let me know if she planned on coming home for lunch so I knew not to make a bottle. When I noticed that her son’s appetite was increasing, I would let her know that he was acting more hungry increased his bottles 1oz at a time. We also worked on adjusting his schedule so instead of 4oz every 2 hours, we found that 5oz every 3 hours kept him happy. That way he only needed 2 bottles while she was gone (10oz) instead of 3-4 bottles (12-16oz). A big help was her freezer milk in a variety of ounces. I was able to defrost what I needed to give her son without wasting any. As a breastfeeding mom myself, I did my best to respect the hard work she put into building a stash of milk for her son. – Catie.
Is your breastfed baby refusing bottles? Don’t panic! Dive into some reasons a nursing baby rejects the bottle and some tips to remedy bottle-feeding aversion.