Help! My Baby Won’t Take a Bottle—What Should I Do?

Leana Thompson, RN, BSN, IBCLC

This blog was written in paid partnership with Dr. Brown's.

I hear this all the time: "I'm going back to work soon, and my baby won't take a bottle! What should I do?" If you're in this boat, take a deep breath—you're not alone, and this is something we can work through together. As an International Board Certified Lactation Consultant (IBCLC), I've seen this countless times, and while it can feel stressful, there are ways to make it easier for both you and your baby.

Why Does Bottle Refusal Happen?

Babies are born with a strong suck reflex—this is a survival mechanism that helps them feed. In the first few weeks, this reflex is involuntary, which is why newborns tend to take a bottle without much fuss. But around 8-12 weeks, the suck reflex integrates, meaning it fades away as your baby starts to gain control over their feeding skills. This change is often when bottle refusal kicks in for some babies.

Here's what could be happening:

• Physical differences: Your breast is soft, warm and expands in your baby's mouth, while a bottle is firm and doesn't change shape. Your baby might be thinking, "This doesn't feel the same at all!"
• High palate or gag reflex: Babies with a high palate or a sensitive gag reflex might find bottle nipples tricky to manage, leading to more refusal.
• No pacifier, no bottle: Babies who don't use a pacifier may also have trouble accepting a bottle since both require similar skills.
• Strong letdown: Some breastfeeding moms may have a strong letdown that helps transfer the milk into the baby's mouth without them having to do much work. When the let-down starts slowing down, we start seeing some babies start struggling.

Let's Bust Some Myths About Bottle Feeding

You've probably heard a lot of advice, and some of it might make bottle refusal worse! Let's clear up some common myths:

• Myth #1: "Wait until 3 months to give a bottle."
Many parents worry that introducing a bottle too soon will lead to nipple confusion or that the baby will prefer the bottle over the breast. But actually, introducing a bottle between 2-4 weeks can help your baby get used to it without interfering with breastfeeding. Waiting too long could increase the chance of refusal.
• Myth #2: "Wait until your baby is starving; then they'll take the bottle."
This is a big one, but it's also a recipe for frustration. A hungry baby is more likely to be upset, making it harder for them to try something new like a bottle. Instead, offer the bottle when your baby is calm and not too hungry.
• Myth #3: "Only a partner or dad should give the bottle."
It's a common belief that babies won't take a bottle from mom because they're used to breastfeeding. While it's great for other caregivers to help, mom can still be involved in bottle introduction. The key is a calm and consistent approach.

How to Avoid Bottle Refusal

The best way to avoid bottle refusal? Introduce a bottle early and keep practicing. Here's what I recommend:

• Start between 2-6 weeks of age: By introducing the bottle during this window, you help your baby get used to it while still keeping breastfeeding as the primary feeding method.
• Practice Consistently: Offer the bottle once a day or at least a few times a week. This helps keep it familiar and prevents refusal down the line, especially if you're going back to work.

What's Going on When Your Baby Feeds?

Feeding is more complex than just sucking milk. Babies need to have a wide latch and a perfect seal with their lips. When the bottle nipple tickles their palates, they need to be able to cup the nipple with their tongue and create suction to allow them to swallow. If any step goes wrong—like if they gag or can't make a good seal—they'll stop feeding. This can be incredibly stressful for both you and your baby. Your baby needs to learn what to do with the bottle so they can intentionally use it to eat, and this takes time and practice.

Tips for Introducing the Bottle

If your baby is refusing the bottle, here are some gentle ways to help them get used to it:

• Get familiar with the nipple: Let your baby explore the bottle nipple without any milk first. This low-pressure play helps them get used to the feeling without any stress.
• Try calm times of the day: Early morning or mid-afternoon can be good times to try offering the bottle when your baby is relaxed.
• Experiment with positions: Some babies respond better when lying flat, others when held upright or carried in a forward-facing carrier while you walk around. Try different positions to see what works best.
• Encourage sucking reflex: When offering the bottle, gently angle the nipple up towards the roof of your baby's mouth to stimulate their suck reflex.
• Keep it light and distract: Use soft music, a favorite toy or gentle rocking to create a calming environment when trying the bottle.

When to Reach Out for Help

If bottle refusal continues, don't hesitate to reach out to an IBCLC. They can help narrow down which bottle and flow rate would be best for your baby depending on the IBCLC's assessment. We can even provide personalized support, specific exercises and strategies that match your baby's unique needs. If you do not have a local IBCLC that specializes in bottle refusal, my practice does virtual bottle refusal consults around the world to get babies back to taking a bottle within two weeks.

Final Thoughts: You've Got This!

Introducing a bottle doesn't have to be a battle. Start early, keep practicing and stay patient. Every baby is different, but with consistency and a calm approach, you can help your little one learn to take a bottle. Remember, you're not alone in this journey—reach out if you need extra support.