Everything you need to know about introducing a bottle.
I get calls like this from parents fairly often: “My 5 month old won’t take a bottle and I’m going back to work in a few weeks…can you help?” These parents are often pretty panicked and desperate. I get it. This feels very scary.
Often these parents tell me that when their baby was a fresh, little newborn, they took a few bottles with no problem. They sucked it right down. But now their baby doesn’t seem to “get” bottle feeding, and at best they’ve managed to take about 1 ounce over the course of 40 minutes.
Very common, and all of it is very explainable.
The Suck Reflex and Why it Matters
When our babies are born, they have a reflex that causes them to suck anytime something goes in their mouth. Sucking is critical to survival for babies, so we’re born with this reflex. Our babies really have no choice but to suck.
This is why when your baby was around a week old and you gave them a few bottles to help them with weight gain, or some other issue, they had no problem taking that bottle.
Then, as breastfeeding became easier and you were told by everyone to “allow breastfeeding to become well established for a few months”, you stopped offering bottles.
Fast forward to somewhere between 3-6 months, and you try the bottle again, because the end of maternity leave is looming. This time, the same baby that drank so well from a bottle at 1 week old, cannot seem to figure out how to drink from it now. They may even be getting pretty upset about it. Likely you are too. What the #&*@ is happening?!
What’s making bottles harder:
➡️ The suck reflex, which was present at birth as a reflex, is now gone. Yup, the suck reflex “integrates” at 2-3 months, and now, your baby will only suck when they want to.
➡️ Your baby has gotten bigger. When your baby was a newborn, the bottle nipple fit pretty snuggly in their small mouth. Since there wasn’t any extra space in their mouth, creating suction and cupping their tongue around the nipple was pretty straightforward. Your baby’s mouth is now bigger and the nipple is not filling the oral cavity the way it used to.
➡️ Your baby is really comfortable with breastfeeding. They’ve built a positive association between getting their needs met and breastfeeding. The association with the bottle will need to be built. Remember, they choose whether to suck now.
This is NOT why this is happening:
❌ Your child is being stubborn or manipulative. Babies do not have the ability to manipulate. They simply have needs and they need you to help them meet those needs.
❌ Your baby is not hungry enough. Waiting until your baby is starving is not going to magically make bottle feeding work. This is about skills needing to be taught, not a lack of motivation.
❌ You “spoiled” them by doing so much breastfeeding. Nope, just nope. You have worked hard to make breastfeeding work and you’ve done a brilliant job. Now, you and your baby will work on a new skill which is bottle feeding.
So, what do we do to fix this? OK, I need you to stop googling and ordering more bottles and let’s talk about this.
Building Bottle Skills
One day you’ll probably teach your child how to ride a bike, and you might offer training wheels or hold onto the bike for them while they learn how to balance. You probably won’t just plant your kid on the bike and expect them to figure it out without any help.
You know how some kids take quickly to riding a bike and others need more practice? Same with bottles. If your baby is struggling with a bottle, the solution is usually practice and more of a step by step approach.
The Steps to Bottle Feeding
Step 1: Choose an appropriate bottle and nipple.
This one is a doozy, cuz the bottle market is C.R.A.Z.Y. Let me make it easier by suggesting a few bottles that work well for many babies.
These nipples have an appropriate flow and a shape that encourages a wide latch, similar to what babies do at the breast. Not all babies do well with these, so be flexible and shift to something else if these are not working for your baby.
Step 2: Practice with the nipple only.
Have your baby practice sucking on an empty nipple, not attached to the bottle. Offer the nipple to your baby when they’re in a good mood. This step is about learning how to suck on it.
Step 3: Start dipping the nipple in milk.
Once your baby is getting pretty good at sucking on the nipple, it’s time to start dipping the nipple into some milk or formula and letting your baby suck. This allows your baby to slowly start learning how to coordinate sucking and swallowing with the nipple.
Step 4: It’s go time!
Now that your baby is intrigued and hopefully getting pretty excited about this nipple as a source of milk, it’s time to start with a bottle of milk.
Choose a time when your baby is in a good mood. Many parents try bottles at the end of the day, when their partner gets home from work. This is unlikely to go well as most babies are a bit more fussy at the end of the day.
Put a small amount of milk or formula in the bottle (1-2oz) and warm that up. Get yourself and your baby into a comfortable position where you both feel stable. This is super important!
Stabilize the bottle by holding it like a pencil and resting your hand on your baby’s chest. If the bottle is moving around, it will make it even harder for your baby to figure out how to use it.
If your baby starts to get upset, stop trying and settle them down. We DO NOT want to inadvertently cause a bottle aversion, which is when your baby has a negative emotional response to the bottle.
Once your baby is calm and content, try again. If it isn’t going well, stop for now. Try again later on or tomorrow. You may need to go back to step 2 or 3 to work on sucking for a bit longer.
Once your baby is starting to figure out how to drink from the bottle, you’ll want to watch how they’re doing and respond accordingly. For example, if milk is leaking out of their mouth, they may need you to slow down the flow by tilting the angle of the bottle down. This is known as responsive or paced bottle feeding.
Congratulations!!! 🎉 You’ve taught your baby bottle skills!
Is there an ideal time to introduce bottles?
Yes! I recommend starting a daily bottle practice at around 3-4 weeks. This gives you some time to work on breastfeeding, then build in bottle feeding while your baby still has the suck reflex. Giving your baby a bottle about once a day will allow them to build bottle skills while being primarily breastfed, if that’s what you choose.
For more information about bottle feeding, see my article on bottle refusal.
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