Certified Breastfeeding Counselors (CBC) often get a variety of questions. As you support different families, you may have a client with questions about a breastfed baby refusing a bottle. As a CBC, you can help them understand why this might occur, and aid in problem solving.

There are many potential reasons for a baby refusing a bottle. Here are a few reasons why a baby may refuse a bottle:

Outgrowing Suckling Reflex

In the early months, a baby has a suckling reflex. Babies will typically suck reflexively at the breast, on a pacifier, and on any bottle nipple. For many, this means an easy transition between breast and bottle.

It is important to note that this early reflex is why a baby guzzling a bottle after time at the breast does not indicate supply. They reflexively suck when something is in their mouth during the early days and weeks.

After two to three months, babies lose the natural reflex to just suck. They have a bit more control and will not always suckle on things they dislike. Many babies happily switch between breast, bottle, and pacifier. Others have strong preferences.

For some breastfed babies over three months, they may not associate a bottle with feeding and refuse it.

Baby Now Has More Body Control

A young infant has little control over bodily movements. The combination of a suckling reflex and inability to move well means nearly all newborns will take a bottle. Once they have more purposeful movement and control, they may bat away a bottle or pacifier they do not want.

They may desire the breast, or they may simply not want to eat. They can now control their body enough to refuse the bottle.

Bottle Feeding is Different Than Latching at The Breast

While both the breast and the bottle require a good latch and suck, they actual latching and milk removal is different. Except for a strong letdown, baby has control over flow at the breast. They can naturally pace their feeding at the breast. Pacing at the bottle often requires the adult to position the bottle well.

For a baby who has a well-established latch at the breast, latching on the bottle could be difficult or simply unfamiliar. The material, shape, and flow vary greatly with bottles, and all are different from the breast.

How To Overcome Bottle Refusal

While many babies easily switch between breast and bottle, for some it is more of a challenge. For caregivers, this can be stressing, As CBCs you can support your clients through education and problem solving. The following suggestions are for healthy babies who are physically able to latch.

For babies who are preterm, severe reflux, tongue ties, muscle tone issues, or other challenges, it would be outside our scope to help parents problem solve.

Here are 5 tips to help:

Have Someone Else Give Bottle – Ideally With Breastfeeding Parent Not Nearby

Consider this, Oreos are pretty good. If you are craving a quick treat, they are wonderful. However, if you happen to be at grandma’s and you smell her baking fresh cookies, will you still want the Oreos instead?

Breastfeeding infants can smell their breastfeeding parent. If they are smelling “fresh” milk, they may be less likely to accept the bottle.

Smells aside, baby associates their breastfeeding parent with breastfeeding. Sometimes, simply having the breastfeeding parent elsewhere is enough to end bottle refusal.

Try Different Feeding Positions

Just as baby may have preferred positions while breastfeeding, they may prefer a different position while bottle feeding. The way a bottle flows, it can be easier for some infants to be in a more upright position. Being upright gives them more control over the flow.

Offer The Bottle When Baby is Drowsy

When baby is already almost asleep, or baby is just waking, they may be more likely to accept the bottle. Most infants find suckling comforting, so if they are drowsy, they may naturally suck rather than refuse the bottle.

If baby tends to eat on a somewhat predictable routine or schedule, offer the bottle before baby wakes for a feed. Offering 10-15 minutes before the expected feed might mean a drowsy and not overly hungry baby. An overly hungry baby might be frustrated trying to figure out the bottle.

Consider a Cup or Sippy Cup

If baby is six months or older, they may be able to take a sippy cup. They might find it fun to explore and practice with.

If baby is younger, cup feeding might be something they will accept. It does not require latching. Simply place the small cup (often a medicine size) to their lips. You can search “infant cup feeding” or “newborn cup feeding” for video examples.

Mix Milk With Solids

If baby is already eating solids, consider mixing their milk with their solids. This can help them stay hydrated until they either accept a bottle or the breastfeeding parent returns.