Planning for a return to work can be anxiety producing to say the least. Fortunately, things often go better than expected, especially if you are able to plan carefully in advance. However, on occasion, our sweet little friends decide to complicate the process by refusing to take a bottle! Have no fear…eventually things work out if you hang in there.
Here is a list of some things to consider if you are being challenged:
Bottle Giver – If your baby will not take a bottle from you (which is often the case), see if your partner or other caregiver has some success. Baby may sense your presence in the room, so you might want to disappear for a while.
Nipple Types – These days there are so many different choices! Buy only one of two or three types of bottles with slow flowing nipples. If your breastfeeding baby is introduced to a bottle with a fast flow nipple, he may choke and release the nipple quickly with overwhelm. Conversely, if he is older or if you have a rapid and forceful milk ejection reflex, he may prefer a fast flow nipple. So you might enlarge the nipple hole just a bit if he takes the bottle initially but seems frustrated with a slow flow.
Degree of Hunger – Try offering the bottle before your baby exhibits signs of hunger. If that doesn’t work, try waiting until hunger signs are becoming evident (fussing and rooting).
Taste – I recommend teaching a breastfed infant how to take a bottle using fresh breast milk in the bottle. If you are using previously frozen milk, and your baby is persistently refusing the bottle, I would suggest you perform a taste test: defrosted vs. freshly expressed milk. In about 1 out of every 500 cases, previously frozen breast milk takes on a different (often soapy) flavor. This has to do with changes in the lipid fraction of the milk during the freezing process (more on that later, but call the lactation office if you find this is in fact the case).
Temperature - Is the nipple and milk warm (body temperature)? While most babies enjoy their milk at room temperature or even cold, some have a “gourmet” palate that demands perfection. A warm nipple is the expectation of your breastfed baby as milk is delivered directly from your soft and warm breast. Something cold and firm may not be acceptable to your baby.
Sense of Smell – Babies are very sensitive and acutely aware of their own mothers scent. Try rubbing the bottle nipple on the skin of your breast so that it smells more like you. You might also have your caregiver place something that you have worn (yes, I mean your well worn, smelly tee shirt!) near baby’s face while the bottle is being offered.
Motion - Rocking, swaying, or riding in a car seat might mesmerize your baby enough to accept a bottle.
Trickery - Try slipping the bottle into baby’s mouth while she is sleeping in care giver’s arms (not flat on her back in bed). She may awaken to discover that drinking her mama's warm, sweet milk from a different container isn’t so bad after all!
In any case, please don’t give up. If all else fails, there are alternate ways to feed your baby (including by cup if necessary). Some babies may opt for smaller indirect (bottle or cup) feedings during your work hours followed by frequent requests to feed directly from your breasts when you are at home. As long as he gets an adequate 24 hour intake, he'll be fine. You’ll see. Things eventually work out and you will be proud of yourself for hanging in there!
