Breastfeeding is not just a way of feeding a baby calories. Breastfeeding provides comfort between feeds, a way to fall asleep, and a regular connection and cuddle with mum every couple of hours (or more!). Consequently, while some babies are happy to switch between bottle and breast, some babies won’t take a bottle at all because they prefer to breastfeed. This poses a problem if a mother needs to be away from her nursling for any length of time. This article looks at twelve ideas to encourage a reluctant breastfed baby to accept a bottle whether for occasional feeds or on a more regular basis and explores alternative ways to feed a baby.
Twelve tips to help baby take a bottle
1. Smile and relax, be patient
It can be natural to start to feel concerned, tense and anxious if the baby in your care is not eating whether you’re a parent, grandparent or child minder. If baby starts to cry because they want the breast and won’t take a bottle this can add to your feelings of helplessness or frustration. Try to comfort baby and stay calm while you work through some ideas on this list. A baby can sense if a carer is stressed and this may hinder successful bottle feeding. Singing or talking gently to baby about what is happening can help comfort her. Try not to add to the stressful situation by forcing a bottle teat into a baby’s mouth, wait until they open their mouth and take the teat themselves.
2. Try different bottle teats
It can be helpful to choose the kind of teat that encourages a similar “latch” (the way baby attaches to the breast) to breastfeeding. This will also help reduce the possibility that introducing a bottle interferes with breastfeeding. You may need to try a few different brands to find one that your baby likes; often a medium length teat with a medium wide base and a slow flowing teat. Some babies may prefer a softer or firmer teat. For much more information on choosing a teat shape see Best Bottle for a Breastfed Baby.
3. Copy breastfeeding
Some babies may be persuaded to take a bottle teat if they are cuddled and snuggled into the breast and held in a breastfeeding position perhaps even with skin-to-skin contact. There are several ways to make a bottle feed more like a breastfeed and these are discussed in Tips to Bottle Feed A Breastfed Baby.
4. Avoid breastfeeding positions
In contrast to #3 above, some babies will be expecting the actual breast in their mouth when they are held in a position that mimics breastfeeding and will not be fooled into taking an artificial teat. For these babies it may help to try bottle feeding in very different positions to breastfeeding:
- Baby facing outwards from the caregiver’s lap (looking into the room)
- Baby sitting facing the carer supported against their thighs (carer’s legs slanted and bent at the knee)
- Baby sitting bolt upright
- Offering a bottle in a different chair or room to usual—be creative… the garden or even the bath tub might work!
5. Not too hungry, not too full
It can help to offer a bottle feed before a baby is too hungry. Look for early feeding cues such as baby sucking fingers or fists or moving their head side-to-side with an open mouth. Learning a new skill is always harder if you’re very hungry.
6. Different temperatures of milk or teat
Some babies will have a preference whether their milk or the bottle teat is warm or cold. Try different temperatures to see if this helps baby to take a bottle.
7. Mother out of sight?
If a breastfed baby’s mother is the one offering a bottle, or in the room while another parent, carer or relative is trying to feed a bottle, a baby is more likely to just want the breast as usual. They won’t understand why they are being offered this new thing instead of the breast and may feel frustrated. Conversely some babies might be happiest having their first bottle experience with their mother.
8. Music and movement
Some babies who won’t take a bottle teat can be persuaded by introducing movement while offering a feed. This might include rocking baby in your arms or a rocking chair, walking around, or swivelling gently on an office chair. If movement isn’t helpful you might try playing music or, if the setting is already noisy, experiment with offering a bottle in a quiet room.
9. Find an experienced bottle feeder
An experienced bottle feeder can often have more success with getting a reluctant breastfed baby to have a bottle. Call in the expert whether grandma, mother-in-law or a friendly neighbour or child minder and watch their techniques. Try not to view this as defeat if you are unable to persuade the baby in your care to take a bottle but somebody else can. The most important thing is to get baby fed and contented.
10. Try offering a bottle when baby sleeps
A baby can breastfeed or bottle feed while they are in light sleep. As such, some carers have had success with baby accepting a bottle when they lift a sleeping baby, hold them in a breastfeeding position and brush the teat against their lips. A sleeping baby will often open their mouth and suckle.
11. Disguise the bottle
If a baby won’t take a bottle, and is becoming anxious even at the sight of one, it may help to disguise it in some way. Try putting the bottle itself inside a brightly coloured sock or wrap it in some clothing that smells of his mother. A different shaped bottle, colourful beaker or sippy cup (see below) that might be mistaken for a toy can break the negative association, especially if you can let baby discover the new toy at his own pace.
12. Let baby copy you
Babies, especially older babies, enjoy copying older siblings and adults. Try having a second bottle or colourful sippy cup for yourself and show your baby how you casually drink from, or pretend to drink from it. An older sibling might like to help with this game. Remember not to get the two bottles/cups confused for hygiene reasons!
Alternatives to a bottle
A bottle teat is not the only way to offer a baby their milk feeds even with a very young baby. If a baby won’t take a bottle—or you would prefer not to introduce one—alternatives to try include:
An open cup
Even a very young baby can lap milk from a little cup. It’s important that baby is alert and awake and that milk is never poured into their mouth. See Cup Feeding a Newborn Baby for much more information about cup feeding pros and cons and how to do it.
A sippy cup
A sippy cup or baby beaker is a hard or soft spouted spill resistant cup with holes in the spout. An older baby can often manage a sippy cup—some cups are suitable from 4-6 months of age. A brightly coloured sippy cup looks more like a toy or something to chew and can capture a baby’s interest. Let them discover on their own that there is something to drink inside. As with an open cup, it is important not to leave a baby unattended as if the flow is too fast they could choke. Sit baby in your lap and guide the sippy cup so that it isn’t tipped up too far or too fast. If the cup has handles and your baby wants to hold the cup, guide them so that the flow is not too fast. First Steps Nutrition advocates using a cup or beaker from six months of age instead of a bottle:
From 6 months of age, infants should be introduced to drinking from a cup or beaker, and from the age of 12 months they should be discouraged from drinking from a bottle. It is best to use cups that are open-topped or which have a spout that is free-running, so that there is no need to ‘suck’. Sucking drinks from a bottle teat or spout means the drink spends more time in contact with the teeth and this can lead to dental problems. Baby cups can be useful for introducing drinking from a cup as they can be held easily and offer a small volume of liquid. Water given to children under 6 months should be boiled and cooled first, but tap water is fine for all infants over 6 months of age. There is no need for drinks other than milk or water in the first year.
Cleaning caution. Bear in mind that feeding cups with valves, spouts or straws are very difficult to clean properly and black mould can build up inside over time if you can’t get into the mechanism.
Finger feeding
If baby is happy to suck on a finger then a finger feed is a possible alternative for occasional feeds for a young baby. This involves a very narrow feeding tube taped to your finger with one end in baby’s milk. Milk is sucked up the tube much like a straw. Finger feeding is explained in more detail in What is Finger Feeding?
Syringe or spoon
Although a spoon or syringe (such as a blunt ended medicine syringe) can only deliver small amounts of milk, if a baby is happy to sip from a spoon or for the syringe to drip milk into the corner of their mouth this could be a possible means to keep them hydrated.
Creative solutions
In some circumstances it may be possible to be creative with working or studying arrangements if a baby refuses to eat when they are away from the breastfeeding parent. Ideas to consider include:
Reverse cycling
Some babies who refuse to feed from a bottle while they are away from their mother tend to breastfeed all evening, and continue to feed frequently through the night once they are back together. This is sometimes called reverse cycling (switching days with nights). Bear in mind that some older babies who sleep through the night may go 8-10 hours without a feed. So although not ideal, and frustrating for the carer, some babies will be able to safely make up their calories by reverse cycling when back with their mother. Finding safe sleep solutions such as having baby close at night can help with this, see Bed-Sharing with Baby. Continuing to offer small regular feeds in a bottle or cup will give a baby who is reverse cycling the opportunity to have a drink if they will. Always watch for signs of dehydration such as strong coloured urine, hardly any wet nappies, and dry mouth and lips1. Note that this strategy is not appropriate for very young babies who need to feed every few hours around the clock.
Bring baby to mother
Depending on the circumstances it may be possible for the carer to bring baby to his mother for a breastfeed during her lunch break. Or for the mother to visit her baby in a creche or nursery to breastfeed him during a pumping break or lunch break. Breastfeeding directly will often be quicker than pumping and won’t require any equipment or storage facilities.
Shorter work day
Arrangements such as shorter working hours, or working from home may be possible for some families. Choosing childcare that is close to the mother’s place of work will avoid the additional separation of a long commute so that baby could have his last breastfeed at child care instead of at home.
Delay work/college
Breastfeeding happens for a comparatively short time in an infant’s life. Some families are able to delay returning to work or study or find work with shorter shifts until their little one is less dependent on his mother.
Frequently asked questions
When should I introduce a bottle?
There tend to be two basic opinions about when to introduce a bottle to a breastfed baby and there are pros and cons for both options:
1. Introduce a bottle between four to six weeks of age
Rationale: Introducing a bottle too early can interfere with breastfeeding e.g. it could cause nipple preference (where a baby begins to prefer the bottle) or nipple confusion (where a bottle teat interferes with a baby’s latch). Breastfeeding is often established by four to six weeks of age and a baby of this age is often more open to a bottle teat than an older baby. A regular bottle from this age is said to familiarise a baby with bottle feeding so that they don’t forget and begin to refuse it.
Downside: It isn’t possible to generalise at what point breastfeeding is going smoothly for an individual baby or which baby might be negatively affected by introducing a bottle teat when they are only a few weeks old. Sometimes it doesn’t seem to make a difference that a baby was used to occasional bottles from an early age. Once their mother is out of the house for long periods—a baby may miss their mother so much that they refuse to feed until she is home.
2. Introduce a bottle a week or two before separation starts
Rationale: Delaying introducing a bottle ensures that the breastfeeding relationship is not negatively affected i.e. by interfering with milk supply (the mechanics of supply and demand) or nipple confusion/preference. An experienced care giver can often persuade a baby to take a bottle once they are away from their mother.
Downside: There is not much time to figure out alternatives if a baby refuses to take a bottle and mother is going to be separated for long periods due to work or study.
My baby was having bottles fine but now she is refusing them. Why?
Possible reasons to refuse a bottle include:
- Change in taste of milk. Over time the fat digesting enzymes in stored breast milk can change the taste of milk. While some babies don’t mind this change, others refuse to drink the milk which may sometimes be described as tainted or soapy. For much more information about what to do in this situation see My Breast Milk Smells Soapy or Sour.
- Unpleasant experience. A negative experience with bottle feeding can cause bottle refusal. Possibilities include a carer forcing the bottle teat into a baby’s mouth. Or a very fast milk flow causing a scary choking episode.
- Poorly baby. If your baby is not feeling well this may be the reason he is refusing to eat.
- Missing mum. Breastfeeding is a baby’s whole world at first: providing comfort between feeds, a way to fall asleep, and a regular connection with mother. Even though a baby has had occasional bottles previously without a hitch, being away from his mother can unsettle a baby so that they refuse to feed until mum returns.
Is it true that a baby won’t starve themselves?
It is often said that a baby won’t starve themselves and will take a bottle when they are hungry enough. Although this may be true for some healthy older babies, it doesn’t seem very helpful advice as a general rule for the following reasons:
- A young baby could get dehydrated if they are not feeding often (be aware of the signs of dehydration)
- It is very upsetting for both baby, mother and carer when a baby is refusing to eat
- A poorly baby may refuse to feed so waiting until baby is “hungry enough” could cause a health issue to be missed
- Some babies continue to refuse to eat until their mother returns from work in the evening for several weeks
- A baby could get used to not taking much milk which could reduce their appetite generally (keep an eye on weight gain)
- Very underweight babies often appear quite contented and may sleep well despite needing more calories, see Baby Not Gaining Weight for further information
How much milk will my baby need per feed?
The volume a breastfed baby may need when they are away from their mother can vary.
- Breast milk. Between the ages of one month and six months of age this might be 90-150ml (3-5oz) breast milk per feed or a total of 750-1035ml per day (25-35oz) 2. There is more information in How Often Should a Newborn Feed? under the section headed How much milk do newborn babies need?
- Formula. For guidance on volumes of formula needed see How much milk do babies need, and how often should I offer milk feeds? on page 16 of First Steps Nutrition Trust’s Infant milks: A simple guide to infant formula, follow-on formula and other infant milks 2019.
Once a baby has started having substantial amounts of solid food the volume of breast milk or formula needed per day will begin to decrease (note, breast milk continues to be nutritious at all ages).
How often will I need to pump?
Exactly how many times you will need to express your milk when you are away from your baby will depend on how many hours you are separated, how often you normally breastfeed and the storage capacity of your breasts (how much milk the breasts can hold). If you normally feed every two to three hours you will probably find you need to pump every two to three hours at first to stay comfortable. See Exclusively Pumping Breast Milk for more guidance about pumping and pumping intervals and How Long Does Breast Milk Last? for storage information.
Summary
Some breastfed babies are very reluctant to drink from a bottle and teat. Some babies will refuse to eat until they can breastfeed again. This can be very stressful for parents, carers and babies when a breastfeeding mother has to leave her baby for many hours due to to work, college or university. There are several ideas that can help to persuade a baby to take a bottle and there are also various other alternatives and work around solutions. Given time and patience families can find a solution that works for them to meet everyone’s needs.