"I assumed all babies would willingly take a bottle..."
When you learn about breastfeeding during pregnancy, you hear terms like “supply and demand” and are taught how important a good latch is for successful milk transfer. However, very few people talk about the fact that many breastfed babies refuse to take bottles of breast milk, something many moms don’t expect. We see images of baby bottles everywhere and assume that all babies will drink from them.
Interestingly, the bottle is easier for a breastfed baby to drink out of since it’s a static process. Some babies can drink milk much faster from a bottle than a breast. For this reason, many moms are advised to not introduce a bottle until at least 4-6 weeks, or when breastfeeding is well established. What many moms don’t expect is that not all babies will take a bottle when it’s eventually introduced.
While bottle refusal is OK for some families, many moms need to go back to work or would like more flexibility in feeding. It can be extremely frustrating and isolating for a mom who wants or needs to be away from their baby longer than two hours but cannot due to feeding schedules. Furthermore, bottle refusal can be difficult for care providers and can discourage loved ones from wanting to care for the baby.
It is a blessing to successfully breastfeed, but when baby can’t take a bottle, sometimes mom feels trapped. Perhaps she’s distracted at work because she worries about how much milk her baby is drinking at daycare. These are very valid, real feelings. Fortunately, this situation is temporary.
Both of Megan’s babies refused bottles, as have many of our clients’ babies, so we are fully aware of the emotional toll this can take on a family. We wanted to share some practical tips and alternatives to bottles that can help you survive this temporary phase.
Before you read this article, please know these four things:
Oh, and one day your bottle refuser will be a toddler who sees a baby bottle and tries to drink from it. Little stinker.
Let’s talk about how to navigate bottle refusal.
All images used in this blog post were submitted by members of our Feeding Littles Clients Only Facebook Group and are used with permission.
First, an important safety caveat.
This article assumes that your baby is getting enough milk to support adequate growth and development via breastfeeding. If your baby isn’t transferring milk well, is refusing to breastfeed, is away from breastfeeding mom for a prolonged period and isn’t taking milk, or is refusing their formula please work with your health care provider ASAP. Dehydration in infants can be very dangerous and must be addressed immediately. Additionally, it’s important to make sure that your child does not have any medical issues that would prevent them from taking a bottle. For example, babies born prematurely and those with neuromuscular impairments maybe more susceptible to feeding preferences, and these specific concerns should be discussed with your child’s pediatrician, lactation and feeding specialists.
Why do babies refuse bottles?
Unfortunately, we never know which babies will refuse bottles. Many babies have no difficulty transitioning back and forth between breast and bottle, while other babies will fight a bottle and refuse to accept it.
Let’s briefly discuss the mechanics of breast and bottle feeding so we can better understand what your baby is experiencing.
Breastfeeding is dynamic – as breasts fill and empty, a baby’s mouth constantly adjusts to accommodate these changes. Breastmilk changes in consistency and nutrient quality from the beginning of the feed to the end. It starts off more watery and higher in protein, which can help baby quench their thirst and provides amino acids for physiologic processes, and becomes higher in fat and creamier in texture as the feed proceeds. The milk consistency and changes throughout the day, as does the taste of breastmilk depending on mom's diet. Even the color of breastmilk can change from day to day!
What’s more, breastfeeding is a dynamic bonding experience between mom and baby. Babies are used to mom’s voice, her smell, her body and the little routines they have established together while feeding. Of course, you don’t have to breastfeed to bond with your baby, but from a nursing baby’s perspective, feeding time equals time with mom.
That’s why when you try to bottle feed some breastfed babies, they refuse to drink the milk. The bottle is not dynamic like a breast, and the nipple itself is very different than mom’s nipple. Babies know the difference – they’re smart little creatures! What’s more, when mom tries to give baby a bottle, baby might not understand why they can’t have what they’re used to – the breast.
Think about it from your baby’s perspective: all they know is cuddling with mom (warm, comfortable, familiar) and getting their milk from her breast. They have done it only this way for potentially 500-2,000 feeds, depending on when you start to offer a bottle. Suddenly you are asking them to do something extraordinarily different than what they’ve practiced their entire life. It makes sense that many of them refuse the bottle.
Stress can affect this process, big time.
Before we talk about specific strategies (we promise to get there!), we want to emphasize how much stress can affect how well a breastfed baby will take a bottle. When babies refuse bottles, it can understandably be extremely stressful and anxiety-driven. Breastfeeding moms may feel desperate, “trapped” at home or angry that their baby isn’t figuring it out. Similarly, the adult attempting to feed the baby with a bottle may be frustrated or fearful because it hasn’t been going well. They might not be willing to continue to try.
Your baby can pick up on this stress. They sense not only their mom’s anxiety, but also the stress of the person giving them the bottle. Stress in a breastfeeding mom may affect their breast milk production.
Of course…hearing that you need to stress less or “calm down” when faced with an emotionally-charged topic only stresses you out even more. Rather, we (Judy and Megan) just want to highlight how important it is to be emotionally calm and steady when trying to offer the bottle. It’s equally as important for the person doing the bottle feeding to try to remain calm, patient and positive during this process. Notice how your body tenses or how the bottle feeder responds to the baby if your baby is turning their head, spitting out the bottle nipple or crying. If the bottle feeder or the baby begin to get noticeably stressed, take a break and try again. Explain to the bottle feeder that this is a process that might take time.
How can I (hopefully) prevent my baby from refusing bottles?
If you are planning to return to work, many lactation professionals recommend offering the bottle every few days starting at 2-4 weeks of age. Of course, if breastfeeding is still a major struggle, work with your lactation consultant first. Be consistent – it can take time for your baby to become accustomed to the feel and the rhythm of a bottle. Ideally, have someone other than the breastfeeding mom do the bottle feeds. This can be a great bonding experience for your partner or another family member.
If possible, start by putting an ounce or two of expressed breastmilk in a bottle with a slow-flow or preemie nipple. Judy recommends Dr. Brown’s bottles because they are known for their venting system. This helps keep air out of the milk, which prevents gas and makes the feeding go more smoothly. If we don’t need to burp the baby as often, then less latching on and off may occur. Many babies get frustrated and somewhat lost the more frequent on/off latching with the bottles when they're used to breastfeeding.
You don’t need to offer a full feed; the goal is to get your baby used to the sucking pattern and nipple feel of a bottle. If you’re consistent with offering a bottle every few days, your baby will be more likely to continue to accept it.
My baby won't take the bottle - what do I do?
Below are some specific tips and multiple things to rule out if your baby refuses a bottle. You don't have to try all of these things! We are simply offering multiple techniques that may help.
Don't forget to read your baby’s cues. We don’t want to force a baby to drink from the bottle by holding it in their mouth when they’re refusing to swallow or if they’re crying without suckling. It can become a safety hazard if milk is in their mouth but they’re not swallowing effectively, and they can develop a negative association with bottles and feeding time. Above all else, don’t force this process.
My baby still won't drink from the bottle despite trying everything above. Now what do I do?
First off, it’s important to remember that there’s nothing wrong with you or your baby if they don’t take a bottle. It’s not a required developmental step. Breastfeeding does great things to develop your child's oral-motor skills, so don’t worry that they are “missing out” developmentally if they don’t take a bottle.
However, that doesn’t make bottle refusal easy. Here are some ways to work around bottle refusal:
Alternative Feeding Devices
NIf your baby will not take a bottle and you need to give them milk in another manner, sometimes additional tools may help. Before using any of these techniques, please consult a feeding specialist or lactation specialist, especially if your baby has any breathing or swallowing issues. The biggest concern with this type of feeding is a risk for aspiration if your baby isn’t actively drinking the milk.
We are simply offering these techniques to help you safely use these tools and be aware that they exist. This does not replace medical advice or care. Talk with your provider about which specific products and techniques will work best for your baby.
Dropper or syringe:
Open cup, bowl or spoon
We generally recommend introducing an open cup to babies around 6 months when they start solids as discussed in our Ultimate Guide to Cup Drinking. However, if your breastfed baby is refusing bottles, you can try an open cup, bowl or spoon as early as 4 months, or when your baby has good head and neck control.
Note: sometimes spoon feeding colostrum or breast milk is a technique used much earlier than 4 months - lactation specialists often utilize it in the hospital before a baby has figured out how to breastfeed. These are general guidelines to help families whose babies consistently refuse bottles and can't receive milk when mom is away, but every baby and situation will be different. Work with your provider.
Can you continue to breastfeed into toddlerhood if your baby refuses bottles as an infant?
Yes! Many moms decide to breastfeed into toddlerhood (12+ months). At this point, breastfeeding a bottle-refusing baby can be less stressful since they don’t need to breastfeed as much as they did in infancy. Many moms gradually stop pumping at work and only breastfeed when they’re with their toddler. While at daycare (or while mom travels), baby drinks an alternative milk from a cup or gets their nutrition through food and water until mom comes home.
We know that bottle refusal can be really stressful, but we hope these strategies help you discover some solutions for your family. Soon your baby will be drinking from a cup and eating food like a pro – this is so temporary!
Flying with kids? We have one word for you: SNACKS.
Here are our minimums in the snack department when we fly as a family - longer trips may require even more snack options!
We always bring reusable water bottles that we can fill once past security. Lately we’ve been digging the Hydroflask kids straw bottles and we always label them in case they get left behind. Check out our Amazon shop for a complete list of our favorite straw cups! The labels shown are from Mabels Labels.
We also bring one type of fruit or veggie, either fresh or freeze dried. These freeze dried strawberries from Trader Joe's are crunchy and aren’t as concentrated in fruit sugar or as sticky as regular dried fruit (although we dig dried too - just be consistent with teeth brushing!). Freeze dried is great for kids who love a little crunch. They’re also shelf stable so they’re perfect for travel. Babies can have them if they’re soft and easily dissolvable/chewable - the strawberries are probably the safest.
We always bring a beige crunchy “interesting” food that will keep their attention for a bit, like Annie's Homegrown bunnies, veggie straws or crackers. We don’t serve these foods every day - but we do serve them sometimes - and to our kids they’re a little unique!
Lastly, something filling! We actually brought a Larabar on this trip for the kids and I tried these Enjoy Life Protein Bites - we wanted to test them out and show them here for those of you dealing with top 8 allergies! Holy moly, they're delicious! They’re kind of like a chocolate dessert with a nice protein boost, and for families who need a quick, portable option that doesn’t include top allergens they’re awesome!
Other protein/fat combo options good for young eaters on planes include string cheese or Babybel cheese, sunflower butter sandwich or homemade energy balls.
Many parents don't realize that It is recommended to avoid or modify choking hazards until your child is 4 - that’s about the age when most kids have adequate oral-motor strength to properly handle these foods. Choking hazard foods are either very hard so difficult to chew, or they're round and juicy like grapes, cherries and cherry tomatoes, which more easily slide to the back of the mouth.
Even if your baby is eating anything and everything well, it's still need to avoid choking hazards. Of course, you as the parent have to decide which foods are best for your child - we just share the info so you are aware of the potential risks.
The most uncommonly known choking hazards are raw carrots and raw apples. We recommend cooking or shredding them with a cheese grater to make them safer.
A short list of choking hazards is below. A complete list with thorough safety explanations and precautions can be found in both of our online courses in a handy dandy printable.
Did you know that the first cup Judy recommends babies learn to drink from is an open cup at around 6 months?
This Tiny Cup from ezpz (not sponsored) is one of our favorite new open cups, but you could also use a shot glass or a cup found in our Amazon store. Open cup usage helps babies learn to take a small amount of liquid in their mouth and successfully swallow. This is especially helpful for straw and other cup drinking, as sometimes babies don’t know what to do when the liquid hits their mouth. Judy finds that if her clients drink from an open cup first they’re more likely to master a straw cup. Plus, learning an open cup is a skill your child will use for life.
We have an entire guide to teaching your baby open cup and straw cup drinking on our blog, plus find our favorite cup recommendations there! It’s actually one of our most frequently asked questions. We also talk about why teaching a cup in infancy is important and why it’s OK to give a little bit of water to babies 6+ months. (No, they don’t need it for hydration - it’s more to help them learn cup drinking, prevent constipation, and start to appreciate the flavor of water.)
Struggling with getting your kiddo to drink water or milk in toddlerhood, and wondering what to do about weaning from the breast or bottle when you’re ready? Perhaps you want to breastfeed into toddlerhood and aren’t quite sure how to make it work for you? Check out our Milk and Weaning eBook, which is also included in Step 4 of our Infant Course and Step 16 of our Toddler Course if you’re already a client. It will help you make the best decision for your family and includes info for breastfeeding/pumping families, formula-feeding families, those who want to switch to cows milk or another alternative milk, and those who don’t want to use milk in toddlerhood. It’s balanced and non-judgmental - just the facts from your favorite feeding pros.
Did you know that all of these “protein” foods are appropriate for 6 month olds who show readiness signs to eat?
Many protein foods like beef, poultry and fish are very high in heme (absorbable) iron and are recommended as a first food by the World Health Organization, American Academy of Pediatrics and Health Canada. Yes, babies without teeth can chew softly cooked meats - the trick is to use moisture while cooking! The Instant Pot and crockpot will be your friend - try cooking with low-sodium broth to keep the meat soft.
Yes, babies can digest meats despite some saying that they can’t. In fact, most current digestive health protocols for adults like the GAPS diet and AIP recommend meat as a first food. There’s a reason it’s recommended for babies too! Of course, not everyone eats meat - see vegetarian notes below.
Eggs aren’t high in absorbable iron but are a highly nutritive food that happens to be an allergen. Early, frequent exposure to allergens like eggs, shellfish and finned fish is critical for allergy prevention according to current recommendations. If your child has a higher risk for allergies due to family history, eczema or breast milk/formula tolerance issues, talk to your pediatrician or allergist first.
Vegetarian/vegan? Many non-animal foods like beans, lentils, whole grains and leafy greens are good sources of iron too. You’ll have to decide if you want to introduce seafood, eggs and dairy - all allergens - due to the importance of early and frequent exposure.
Are you lost on what to feed your baby? Are you interested in BLW, or infant self-feeding? Join the thousands of families worldwide who have taken our infant feeding course, which provides expert help from two feeding professionals who have a combined 45+ years of experience. We offer practical, non-judgmental, non-rigid tips that can help this work for you. Plus, we teach you how to set your baby up for competent eating for life (with elements of eating disorder prevention)! As a client you will gain access to our private Facebook group, and your course doesn’t expire as long as we are selling it! Use it for your next baby too!
Have you heard of coconut butter, also known as coconut cream? It is made from pureed coconut and is similar to coconut milk - but it’s thicker and higher in calories! Coconut cream is made from 4 parts coconut and 1 part water, whereas coconut milk is 1 part coconut, 1 part water.
One tablespoon has 100 calories, so it’s an energy-dense food that’s great for babies, toddlers and kids, especially if they are struggling in the growth department and their pediatrician has recommended more high-calorie foods. This is the only time you’ll see us mention calories - simply just for comparison when talking about adding more calories to your child’s diet if needed for growth or medical issues. We do not recommend counting your child’s calories unless specifically indicated by your doctor or dietitian.
Coconut cream is a great way to add calories - and flavor - to your tot's diet:
Coconut is a great source of lauric acid, which has anti-inflammatory compounds, and it’s a delicious, satisfying option for those with dairy, nut, or soy allergies. I got this Nutiva brand at Sprouts, but there are many different brands you can try.
Fork and Beans has a delicious vegan fudge using coconut butter that’s awesome for those who can’t tolerate dairy:
In a heavy saucepan over low heat, melt chips with coconut cream, non-dairy milk, and salt. Remove from heat. Stir in nuts if desired and vanilla.
Spread evenly into wax paper-lined small square pan. Place more chopped nuts on top if desired. If using nut/seed butter, drizzle it over the fudge.
Chill 2 hours or until firm. Turn fudge onto cutting board, peel off paper and cut into squares. Store covered in fridge.
Breakfast burritos are amazing for adults and kids alike because you can modify them to your tastes and dietary needs (see below for allergy/diet modifications), plus they’re super easy and delicious!
Sometimes babies, toddlers and kids are overwhelmed by burritos in their whole form and do better with deconstructed options, so above is one way you could present breakfast burrito ingredients to your tot - using an ice cube tray! (This is a silicone tray from Target purchased this past summer.) Shown here are tortilla, eggs, cheese, beans, guacamole and salsa (2 flavors). Yes, babies and kids can eat spicy foods - just start slowly! Some of these foods contain salt, so if you serve these to babies under 12 months just go easy on salty foods the rest of the day.
Since breakfast burritos from restaurants can be so filling, we’ve shown half of a burrito here. The most important thing is not rigid “portion control,” but rather eating until your body is comfortably full and satisfied.
The ice cube tray spaces are really small - the image isn’t to scale next to the full burrito so you can see it better. Each section has about 1 tablespoon of food. Keep offerings small for kids so they’re not overwhelmed - they can always have more than what you serve, and if they don't eat it you waste less food.
Here are some of our favorite breakfast burrito ingredients:
Need to modify your burrito for allergies or dietary concerns?
Teething almost always affects mealtime in some way. A sudden change of eating patterns usually means something’s up - and teeth are a very likely culprit (even before you can see them poking through the gums).
When it comes to teething and mealtime, here's some things to keep in mind:
Food ideas to help with the pain:
Remember, stay consistent with regular food at regular mealtime - you never know when they’ll pick it back up again, and we don’t want their eating to digress in the long-run!
Oh, the things we learn when we become parents, right? As feeding professionals who have worked with thousands of families - and moms ourselves - we have both learned a lot more about food than we ever learned in school. Fortunately, there is still so much more to learn and more ways to grow in our understanding...but here are some things we know to be true right now"
Need more help? Our online courses are here to help you navigate feeding your kids under age 7! The infant course is appropriate for new eaters and babies who haven’t learned to self-feed; our toddler course is best for kids 10 months - 6 years.
We love squash, especially during the fall months! These fall favorites are super high in vitamins and minerals and have a hearty texture that helps bulk up a meal so you’re satisfied when finished and have more leftover! They’re a great first food for baby because they’re soft enough for strong gums and are usually well liked by new eaters.
These delicious beauties are shown here cut as wedges - technically some of them are half moons because of the round shape of the squash. All that matters is that baby can pick them up using a palmar grasp and can bring them to their mouth.
A few things to note:
These are simple preparations - you can change it up as much as you'd like to meet your family's needs and favorite tastes.
Need help encouraging your baby to feed themself real foods? Check out our online Infant Feeding Course to get professional nutrition and feeding help from the comfort of your home!
Megan and Judy, co-owners of Feeding Littles, bring you helpful info on food, nutrition, picky eating, and feeding young children. Megan McNamee MPH, RDN is a Registered Dietitian Nutritionist based in Scottsdale, Arizona. Judy Delaware, OTR/L is an Occupational Therapist specializing in feeding therapy with children 3 and under in Boulder, Colorado. Megan and Judy are both moms of two and love helping families develop a healthy appetite for all foods!