Breastfeeding experts and advocates will always warn you about nipple confusion/preference. The advice is not to feed your baby with a bottle or give your baby a pacifier because your baby will grow to prefer the bottle teat and reject your breasts. Or they will get ‘confused’. (I personally think that they are too smart to be confused. They are just exhibiting their preference.) Seldom do you see bottle rejection mentioned. More often than not, they scare mothers into not giving a bottle until it is too late. It is as if there is this conspiracy to get mothers to breastfeed their babies and not warn them about bottle rejection so that once they are stuck, they are stuck!
In fact, about the only time I see any discussion or information on bottle rejection is on mother/parenting forums where desperate mothers ask for help to get their babies to take a bottle. Bottle rejection seems to be something that one only get to learn through experience in real life, and often times, too late.
To save you the trouble of going around asking for help, I have consolidated a list of strategies that have been tried by mothers who have been there done that. Judging by the variety of strategies (some rather crazy-sounding), you know bottle rejection is no laughing matter and parents do get really desperate.
1. Try different kinds of teat
Not just small teats vs big teat, latex vs silicon. Try different flows – slow, fast, variable, etc. Try different brands even if they look the same. In recent years, more and more teats and bottles of special design has been introduced to the market, eg. Breastflow from The First Years, which I found recently. Don’t complain about the cost of buying all the teats available in the market. If you can find one that the little one takes too, you will be considered very lucky for your ordeal stops right here.
2. Try different bottles
If teats strategy failed, try using different bottles. Thankfully, there are not so many varieties, and you probably would have tried at least a wide neck bottle and a standard neck bottle when you tried the big teat and small teat. I even tried one of those bottles with a spoon attached instead of a teat.
3. Try different feeding places
Different room, different couch, different bed, etc. This sounds weird but it is true. Some babies are THAT picky. To some babies, the commandment is : Thou shalt not defile the place where breastfeeding usually takes place.
4. Try getting someone else to do the feeding
The idea is that if you do the feeding yourself, your baby can smell you and is smart enough to know that the real McCoy is present and will not take a substitute.
5. Try feeding the baby yourself
Yes, yes, this is a direct contradiction of Point Number 4. But some babies may just prefer to have mommy give the bottle because mommy is the favourite person after all.
6. Feed when the baby is hungry
The idea is that when you are desperate, you will not be so picky and will take whatever is given.
7. Feed when the baby is not frantically hungry
Yes, yes, another direct contradiction of the above point. The idea for this strategy is that when the baby is frantically hungry, he will not be receptive to anything new. So it will be a bad time to introduce the bottle.
8. Try keeping the milk warm
The idea is that the temperature of the milk should be close to your body temperature, which is what your baby is used to.
9. Feed when the baby is sleepy
Hopefully, he will be too sleepy to discern a difference in the feeding equipment.
10. Do not be in the same room when someone else is feeding the baby
Your baby may still be able to smell you and know the real McCoy is around. Some people actually have to leave their houses!
11. Try using ebm that has not been frozen
Some people claim that their babies can discern a difference in taste between ebm that has been frozen before and ebm that has not been frozen. You may just want to try your luck.
12. When all else failed, try feeding with a small cup or a spoon.
It is painfully slow and your baby may still scream murder. But it may just be the thing to get some milk in.
13. Try different feeding positions.
E.g. close to your bossom, hopefully your baby will be ‘fooled’ to take the bottle. Or simply because that’s the position most familiar to him instead of the lie-down-face-up position for bottle feeding.
14. Try breastfeeding halfway and sneak in the bottle
Breastfeed your baby and halfway, try to unlatch and sneak in the bottle. Try as much as you can to do it ‘seamlessly’.
Some ‘real’ advice :
1. Do not delay the introduction of the bottle for too long.
As soon as your baby is feeding well from the breasts, start giving him a bottle a day. My #3 rejects the bottle from 5 weeks.
2. Consistently give the bottle everyday
Do not make the mistake we made with our firstborn. We gave him a bottle at 5 weeks and he took to it well. We didn’t give him another bottle until a week or two later and all hell broke loose.
If your baby is already rejecting the bottle and you are trying the strategies listed above without much success, continue to consistently give him the bottle even if he does not take anything. Hopefully, things will improve bit by bit because your baby may need time to learn how to suckle from the bottle teat. This is provided you are desperate to have him take the bottle. Otherwise, it is perfectly ok to give up.
3. Reverse Cycle Nursing
Some babies do not take the bottle during the day but will nurse like mad through the night. If you are able to handle this reverse cycle nursing, your baby will still be able to get his nutrition.
4. Give one bottle a day at first for consistency but not too much to mess up breastfeeding efforts.
As the time for you to return to work approaches, gradually increase the number of bottle feeds.
5. Try to be gentle and not just shove the teat in
Remember babies have tongue thrust reflex. Notice how they will use their tongue to push out anything you try to put in their mouth? It is nature’s way of protecting the baby from ingesting solids before his time and choking on it. It may also be the baby trying to figure out what to do with this new thing in his mouth! Try to gently coax the baby to take the teat. If you find your baby pushing the teat out with his tongue, try aiming the teat up at the roof of his mouth instead of just thrusting the teat straight in. By aiming the teat towards the roof of his mouth, you avoid ‘direct confrontation’ with his tongue.
Notwithstanding all the advice given, realise that all babies are different. Yes, some babies do develop nipple preference and I have heard of a story about how giving a pacifier once supposedly messed up the mother’s whole breastfeeding effort. Yet, there are also a lot of other babies who feed well on the breasts even though they were given pacifiers. Similarly, for some babies, breasts and bottles co-exist in perfect harmony right from the beginning. Some babies will never take a bottle no matter how early you introduce it to him. Some are easy to persuade to take a bottle while others will never agree to have a bottle. Some babies, like my #1, are ok with anything else given in a bottle as long as it is not breastmilk.
My point is : don’t beat yourself up if your baby does not take the bottle no matter what you do. Chances are, it has got nothing to do with what you did or what you didn’t do. It is just your baby’s preference and his personality.
When everything else fails, remember you only need to endure this inconvenience for about 6 months. When your baby starts taking solids, it is time you start introducing the sippy cup and other fluids, e.g. water and juice. Most babies are ok with sippy cup although they still need to take a bit of time learning how to use it. And even if they are fussy about bottles and stuff, with the introduction of solids and other fluids, your baby will no longer be 100% dependent on your breastmilk, so that takes away quite a bit of your stress. Your baby won’t starve without you.