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Ask Dr. Sears: Bottle Drinking

Q. I've been exclusively breastfeeding my baby for four months. I want to start pumping, but my baby will not accept the bottle. What should I do?

A.
Babies are creatures of habit. Once they get used to a way of feeding that they enjoy, they are reluctant to change (like ordering from a familiar menu at your favorite restaurant). I congratulate you on wanting to continue giving your baby your milk. Getting babies to go from breast to bottle and from breast milk to formula (which has a more bland and less sweet taste) is a double whammy and is likely to meet with more protest. The fact that she is getting your milk -- even if it is from a different container -- is a real plus. Here are some ways to get her to accept the occasional bottle.

First, realize that your baby is less likely to take a bottle from you and more likely to accept it from another caregiver. She expects to be breastfed by you, not bottle-fed, so when you try to give her a bottle, she naturally thinks "what's wrong with this picture?" Also, if you are in the same room or she knows you are nearby, she is unlikely to accept a bottle from a substitute.

If you can, choose a caregiver who's a veteran bottle-feeder and ask her to experiment with various feeding positions. Some babies will more readily accept a bottle when held in the position they have become accustomed to during breastfeeding. Other babies are baffled by being held in the breastfeeding position during bottle-feeding and prefer to be held at a different angle. Still others will more readily take a bottle when being carried in a [XREF {/parenting/experts/sears/index081601.html} {sling. Also, show Dad how to feed his baby as both will enjoy this special feeding time.

Choose a nipple that resembles the shape of your own areola and nipple, with a wide base that gradually tapers down to the tip of the nipple, much like the natural shape your breast takes in your baby's mouth. To entice your discerning little feeder, warm the nipple to make it more supple. Teach your baby to latch on to the artificial nipple in the same way she latches on to your breast: mouth open wide and lips turned out.

If your baby learns lazy latch-on habits on the silicon substitute, she may latch on to your nipple the same way, resulting in insufficient milk delivery and sore nipples. Show your caregiver how to let your baby suck on her finger between feedings. Using a finger as a pacifier sometimes teaches babies to more readily accept sucking on an artificial nipple.

Instruct your caregiver to interact with your baby during bottle-feeding by enjoying eye-to-eye contact, caressing her, and even wearing a short-sleeved blouse to promote skin-to-skin contact. Remember feeding is a social interaction, not just delivery of milk.

One of the newest ways of giving babies pumped breast milk -- especially if your baby refuses a bottle -- is to let your baby lap up the milk from a cup, like a little kitten. Use a tiny, flexible plastic cup that holds one or two ounces. You can use a disposable cup or purchase ones especially made for infant feeding (available from catalogs that sell breastfeeding supplies). Cups made of flexible plastic can be bent into a spout shape. Allow your baby to lap up the milk and swallow at her own pace. Don't pour the milk into your baby's mouth.

As your baby grows she is more likely to accept an occasional bottle. In the meantime, compliment yourself on the fact that you have a very discerning baby who loves you and enjoys being fed by you.

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