Bottle feeding and bottle refusal - Evidence Based Babies
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Bottle feeding and bottle refusal

Bottle refusal

If you regularly have to leave your little one with someone else, or you’re going back to work, you’ll need to leave milk for baby. But your baby is refusing the bottle, so now what?

It’s completely normal for babies to not want to take a bottle. They know the real deal, they’re used to the real deal, so why would they want to take a bottle? They’re not familiar with bottles, it’s not natural to them like your breasts are.

But still, your baby needs to be fed when separated from you, especially for long periods of time.

So, let’s have a look at some tips, tricks and alternatives to get your baby feeding:

The right type of bottle nipples

Nipples that gradually change in shape from narrow at the tip to wider at the base is best and will encourage a wide latch.

Bottles with such teats include bottles such as Pigeon, Dr Browns, Evenflo, Lansinoh, Medala etc.

Slow flow teats are best

Having too fast of a flow could not only overwhelm and overfeed a baby, but it can cause flow preference, which is when a baby prefers the quick flow of the bottle over the slower, paced flow of the breast.

Always use the absolute smallest teat available.

Pace feeding

Feeding at the breast is a slow meal, the baby can pace the feed themselves and stop when they’re full. With a bottle they can’t, you are the one holding the bottle so you should be the one pacing the feed.

Not pacing a feed can cause flow preference, overfeeding, choking, and even an aversion to feeding.

Try different bottles

Some may say you should try different bottles where others might say you should stick to only one. Both are right. You should try with one for a good while to get your baby used to it, only after trying for quite some time with no success, should you then try another bottle.

Different temperatures of the milk

Some babies may prefer cold milk from the bottle where others may prefer room temperature or a bit warmer. It’s best to see which your individual baby prefers.

Latch baby onto the bottle as they would latch onto the breast

Softly rub the bottle’s teat on their cheeks and lips, waiting for them to open wide for a latch. Latch them onto the bottle. Remember they should have a deep latch on the bottle just like they would at the breast.

Never force a bottle into a baby’s mouth.

The timing of the feed

The timing of a feed is very important. The baby needs to be hungry enough to want a feed, but not too hungry for them to become fussy during the feeding.

Feed on demand

Feeding on demand rather than on a schedule is always best for any baby. It’s important to pace feed and not to overfeed a baby. Breastfed babies will usually drink about 30-40ml per hour away from mom. Smaller feedings feedings more frequently is best.

Have someone else give baby a bottle

Most babies will refuse to take a bottle from their mother as they know she has the real deal right there. More often than not, mom will even need to leave the room or house completely before the baby will accept the bottle from someone else.

Try different positions

Some babies may prefer facing forward while others may prefer to face the caregiver feeding them. Play around to see what works for that individual baby. Remember a baby should never lie down to bottle feed as pace feeding has to be done with the baby being more upright.

Movement

Movement is really soothing to babies. You can try different types of movement to help soothe the baby. Rocking, swaying, lightly bouncing, walking and so forth.

Distraction

Try to distract the baby by going outside or to another area or read a book while feeding them.

Less distraction

Some babies may not feed well distraction and may need you to feed them in a quiet room with little distraction.

A bit of mom

Keep a piece of moms clothing nearby so the baby can smell their mother. This may work for some babies by creating some familiarity for the baby.

Alternative feeding methods

If all else fails, it’s important to remember that there are alternative ways to feed your baby. You can feed baby by cup, spoon or syringe. It’s incredibly important to use the correct technique and pace the feed. If the baby is 4 months and older, an age-appropriate sippy cup may also be used.

Reverse cycling

Sometimes, no matter what method or technique you try, some babies just won’t feed if it’s not from mom directly.

After the first few weeks of life, babies may sleep for longer stretches at night, so when they reverse cycle, this basically means they turn their day and night somewhat around. They will drink just enough during the day and sleep more than usual, and when they’re reunited with their mother, they will make up for the missed feedings by feeding more frequently during the night.

It’s important to note that you should never force a baby to reverse cycle, you should always try and feed the baby using different methods and techniques, and only when all else fails, can it be seen as reverse cycling.

When a baby reverse cycles, it’s important to always offer liquid, even if they refuse it and to keep an eye on their hydration levels to ensure they don’t get dehydrated.

Reverse cycling is not safe for newborns.

How to check for dehydration:

  • Sunken fontanelle (soft spot)
  • Sunken eyes
  • Fewer tears when crying
  • Less than 5-6 wet diapers per 24 hours
  • Dark and smelly urine
  • Listlessness

Never force feed a baby, only offer frequently and keep an eye on them if they show any signs of serious dehydration.

Additional information and resources:

Paced feeding

Open cup feeding

How much expressed milk will my baby need?

UK mothers’ experiences of bottle refusal by their breastfed baby

Disclaimer

Please take note that all of the information provided on this website is for educational purposes only.

We take every effort to ensure that we stay up to date with the latest research and that we only provide you with the best possible evidence based information available.

Online information will never be a substitute for individual support by a qualified healthcare professional.

Evidence Based Babies is a supporter of the WHO International Code Of Marketing Of Breastmilk Substitutes (WHO code) and the WHO and UNICEF’S Baby Friendly Hospital Initiative.

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