Baby Can't Manage the Bottle

Parent Q&A

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  • Bottle Feeding Consultant?

    Sep 15, 2021

    Is there such thing as a feeding consultant to help with bottle feeding only? I know lactation consultants will sometimes help with bottle feeding when ultimately trying to get baby to breastfeed more, but my son is exclusively bottle fed at this point. Does anyone have any recommendations? Or know of a lactation consultant open to helping with a baby who only takes the bottle? Thanks!

    I don't have a specific person to recommend, but when our daughter was slow to gain weight, we spoke to a lactation consultant who recommended an occupational therapist to help with bottle feeding.  I'll add that if you're getting pressured by your pediatrician because your baby is not staying on his weight growth curve, you might want to consider getting a second opinion.  Our daughter has been slow to gain weight but (knock on wood) seems to be healthy and hitting her milestones.  Our old pediatrician gave us a hard time about our daughter's weight and referred us to a GI specialist who stressed us out even more, and then we switched to a new pediatrician at Berkeley Pediatrics who thinks our baby is doing well and doesn't need medical intervention.  (Anecdotally, I dropped from the 95th weight percentile at birth to the 3rd percentile at 8 months and there was nothing wrong with me, I just wasn't a big eater.)  Good luck!

    A few months ago I felt like my baby was struggling with both breastfeeding and bottles, and the lactation consultants weren't helping me with my concerns about issues with the bottle.  My pediatrician suggested seeing an occupational therapist at Children's Hospital Oakland (UCSF BCHO); she said they're very experienced with bottle feeding stuff.  I didn't end up making an appointment because the problems we were having got better on their own right around the time the doctor put in the referral.  So I can't actually vouch for this, but it SOUNDS like it it could be what you're looking for!  Oh and she said there are also occupational therapists who work with babies at Alta Bates or Herrick Hospital (I think it was Herrick - anyway it was Sutter), but she strongly recommended Children's Hospital as the best option.  Hang in there!

    Ask you doctor for a referral to an Occupational or Speech Therapist who specializes in feeding!

    You don't mention what the issue is, or how old your baby is, but there are definitely lactation consultants (as well as occupational and speech therapists) who can help with any kind of infant feeding challenges.  Lactation consultants often help get breastfeeding babies to bottle-feed when parents go back to work, so they aren't only familiar with bottle-feeding help when the goal is "getting back to breast."  Call and explain your issue, and they will certainly let you know if they have the skills to help.

    I talked to the lactation support available through Kaiser when my kid wasn't drinking bottles while I was at work all day (but breastfed fine). They were super supportive of helping to figure out different bottle solution.

    Lactation consultants will often have some expertise in bottle feeding.  I'd reach out to a few and ask.  You didn't mention the issue you are facing, but our premature and underweight daughter had may problems drinking from a bottle (starting in the NICU). We were pressured by the NICU medical staff and later our pediatrician to make sure she was getting "enough" formula, which led to her developing a bottle aversion.  If you think your baby might have a bottle aversion (crying at the bottle, refusing to take bottle, turning head away from bottle, not drinking "enough"), then I highly recommend Rowena Bennett's book on the subject (and she lays out a very specific plan to overcome bottle aversion).  

    I recently asked for advice about this (my baby stopped taking a bottle about 6 weeks ago, and it's very annoying).  Friends recommended Serena Meyer: https://www.bayareabreastfeedingsupport.com/  I also got an appointment with a Kaiser LC to discuss it, and I'll know more about how that goes after tomorrow.  Friends also recommend an occupational therapist or speech language pathologist -- I'd see what you can get covered by insurance since it's $$.  

  • Baby doesn't latch on bottle

    Oct 30, 2019

    We've been trying daily for a month to get our 8 week old baby to take a bottle. The issue isn't that she refuses, in fact she seems interested in the bottle. However, she can't seem to figure out how to latch onto it. She has only done it successfully about five out of thirty tries. She latches fine at the breast. We've tried three types of bottles/nipples (Dr. Brown's, Avent, Como Tomo). She seems to have a strong gag reflex so hasn't taken a pacifier, either. (Trying the pacifier made her gag and throw up on 3-4 different attempts with two different brands.) I called Alta Bates Lactation Consultation and the woman I spoke with didn't have any advice.

    There's one month left before I go back to work and my husband will need to feed her. Anyone have tips to get her to latch onto the bottle?

    We had the exact same experience with my second. I'm so sorry. We tried EVERYTHING. We knew she could sometimes take a bottle, but usually wouldn't and would end up crying for hours when my husband tried. We were also successful breastfeeding. She also wouldn't take a pacifier. We tried 10 bottle and pacifier types but didn't find a difference. We tried different lactation consultants, different settings, different people offering the bottle. We also had her evaluated for tongue tie, which she didn't have. I would first recommend you get her checked for that. If she isn't (and she probably isn't since she nurses well), I would recommend just keep trying new people and new settings offering her the bottle. We felt so tired and stressed about it because I was going back to work in two weeks. I even bought a feeding dropper just in case a bottle would never work. Then magically one day we asked the person who was going to watch her (who has been a caregiver for 30 years) if my husband could come to her house and bring the baby and bottle and have her try. I kid you not, the baby took the bottle immediately from her like magic. Then my husband did it there. Then she always took it, even from me. I don't know if she was just ready, or the vibe was right, or what, but it worked. So don't give up, and just keep trying!! And if it doesn't work, you can do droppers and cups, and it will be okay too!

    The great news is that she's interested in the bottle! That's the hard part. I would start by getting her used to sucking on something other than the breast, like your pinky. It's harder and shaped more like a bottle nipple, and you can control how far you let your pinky go back so as not to trigger her gag reflex. You can gradually desensitize her that way. I got my (bottle- resistant) son to suck happily on my pinky and then transition directly onto a bottle that way. Also, you could ask her pediatrician to check for a tongue-tie, though that's less likely if she's successfully breastfeeding. Good luck! You got this! 

    Hi!  You should join and post this question on the Facebook group: Main Street Mamas : East Bay (CA)  People respond super quickly and lots of good advice!

    No bottle latching tips but my daughter hardly took the bottle at all when she was an infant and experimented with cup feeding with some success and she took a sippy cup as early as 4 months with some success as well. I’m sorry I don’t have specific links to videos but I know there are YouTube videos on cup feeding. I know how stressful this is feel free to reach out if you’d like support from another mama who knows this struggle! 

    Both my sons had these issues. My firstborn - we were able to 'train' with the help of my mom. Apparently he preferred a female caregiver giving him the bottle. After my mom visited for a few days and got him to take the bottle from her, we were able to transfer bottle giving to my husband. Our secondborn, he never shed his clear preference for breastfeeding. His nanny managed to get him to take the bottle, at first 1-2 oz per session and then finally 3-4 oz per session. His nanny said that it helped when they were outside - she could get him to take the bottle in the stroller, facing out, distracted. Our secondborn had the best luck with Como Tomo. 

    It is definitely stressful when they don't take the bottle and you have to go back to work. My secondborn at best had 4-5 oz of bottle during the day when I worked. And we would just make up the calories through his breastfeeding at all other times. Also, with the dream feed, my husband would sometimes get him to take 1-2 oz (when baby was sleepy and more willing to go along with the bottle feed). I think the key is consistency. Even if baby only takes 0.5 oz at a time, if your husband does it every day, she may eventually work her way up to more.

    We had a similar issue with our kiddo when they were a baby. Sometimes even nursing it would happen, and we figured out (for us) that it had to do with the milk flow (like if I was full or if the hole in the nipple of the bottle was too big). We ended up using the joovy bottles with the newborn nipple where there was slower airflow. He took it fine after that without gagging or throwing up. Some pacifiers that were too long also made him gag more and he seemed to like the Phillips avent one that is attached to the little stuffed animals. He used it more for teething though...

    The very first thing that came to my mind is to have her checked for lip tie and/or tongue tie. Even if your little one was able to latch on to breast, it doesn't preclude the possibility of lip and/or tongue ties being a factor if she is still having trouble with latching onto a bottle. And, unfortunately, this is not something that the majority of doctors, and even well-meaning nurses and lactation consultants, always know how to properly assess and diagnose. They just don't have the knowledge. For us, it was a midwife who diagnosed it for our son. Perhaps you could take a look at her frenulums and compare to some pictures online? Surprisingly it's a lot more common than most doctors think! Call Dr. Yazdi in Castro Valley-- 15105382098 , www.dryazdi.com. He is AMAZING, and seems to be the Bay area expert on these issues. He can assess for you as well, I'm pretty sure he is still doing free consultations. Our son needed both lip and tongue tie frenectomies, and Dr. Yazdi's laser surgery was fast, recovery was fast, just overall a life-changing experience-- And afterwards, it was like a switch had been flipped, our son's ability to latch to both bottle and breast improved immediately and I kid you not it had me crying with relief. After weeks of struggling, and a failed "snip frenectomy" performed by an ENT specialist at Kaiser who was very nice and well-meaning but, we found out later, did not recognize the extent that our son's lip tie needed more than just a "snip." And again, I know this might sound scary, but it's really not, so please don't worry. This is actually a very common issue for newborns that is unfortunately severely under-diagnosed and it can be such an easy fix if you get somebody knowledgeable to help you! I can't be sure this is the problem, of course, but it's a hunch based upon your description, and I think it could be worthwhile for you to at least check out. Best of luck. Feel free to reach out if you would like to chat. I am happy to share more about our experience.

    Have you tried different nipple sizes?  Sometimes the first nipple is the slow flow one, but there are preemie sizes and extremely low flow 1 hole nipples that tend to be shorter in size.  That might help.  The regular nipples were too long for my small baby.

    Other tips I got from a lactation consultant:

    1) spray some milk on her lips before she starts to suck

    2) point the tip of the nipple towards the roof of her mouth and tickle

    This sounds like a tie... and many of the LCs unfortunately miss these, especially if the baby can nurse "well enough" or has made modifications to nurse.  I'd HIGHLY recommend you go see a pediatric dentist who can evaluate - the evals are typically totally free.  It's $750 without insurance to have ties (lip or tongue) revised, and if you have Delta Dental it costs almost nothing (it was free for us).  My son ended up having a severe tie that was missed by 4 different LCs and pediatricians.  We had the opposite problem where as soon as he had a bottle at daycare he never nursed again and we couldn't figure it out until he couldn't latch onto a straw cup at 11 mo and we brought him in for an eval to find he had a grade 4 (severe) lip tie.  He literally started nursing again that same day - I needlessly exclusively pumped for almost 9 months - it was crazy!  Worth your time & energy to see someone.  The best in the East Bay is Dr. Yazdi in Castro Valley - almost everyone makes that 30 min pilgrimage as he's the only one over here certified by the tongue/lip tie network.  There are folks who do it with Alta Bates but they do it surgically vs. with a laser which is not advised, especially once baby is past a week or two old.  Good luck!

    My son was 7 months when i had to go back to work and he never took the bottle either.   We just gave him the milk in Munchkin 360 cup and had dad, first, then the daycare feed him with it.  He definitely was unhappy about it but when he was hungry enough he did drink from it.  Just keep trying they will finally accept something esp when mom isn’t around and they are hungry 

    Don’t stress to much. If you want, keep trying different brands but if by the time you go back to work just pick the one baby did the best, stick w it, and let babe figure it out. I’ve done both. I tried many brands w my first babe, many of which were popular fancy brands, but in the end it was the “cheap,” playtex drop-ins that she took to. With my other babe, I decided not to use the money w bottle experiments and just went again with the playtex bottles. It took a little while for him to figure it out but eventually did...after a week or so. The plus about the drop-ins, you can compress the bag a little when needed and a lil milk will squirt into their mouth and they can drink that way too. A friend of mine also had challenges w bottle training, and tried many more bottles than I did, and her babe finally like the Comotomo bottle. You can find them on Amazon.

    Does your babe spit up much in general? Maybe they have a lil reflux. Just a thought.

    Good luck!

    Hi, my son was like this! We fed him under a mobile with lights and music so he was distracted and then he would eat. 

    Or she may just have to learn you’re gone and it could take a few weeks to adjust and for her to get the bottle is the food source. Stressful I know! In this similar situation with my 3rd!

    If baby's latch at the breast is good, forget the bottles (which can mess with that!) and use a cup, a spoon, or a syringe for feeding.  A small "training" cup (not a no-spill sippy but one with a soft spout that doesn't have to be sucked on) or even an open-top cup (with careful handling by the adult) can work really well.  Some babies also do better with a sippy straw than with a bottle nipple. 

    Not sure if the same strategy works with the bottle, but my tiny baby also gagged on the pacifier until the lactation consultant told me to aim it in toward the roof of her mouth, so she could then kind of clamp down like she does on a nipple. Hopefully that very simple advice helps? I’m so sorry—this sounds really hard and stressful. :(

    We had the same problem.  Most bottles were too narrow, the nipples cylindrical, and the flow too fast.  To feel natural, we found the bottle needed to be wide, the nipple shaped more naturally, and also slow flow.  The only one that worked for us was Nuk with a slow-flow nipple.  I'd recommend you try Nuk and try both slow-flow and regular, and see if one of those works. 

    Hi! My daughter and precious grandson live with me and they faced a similar situation.  The baby was delivered 3 weeks early due to my daughter's age and vulnerability.  As a result the baby did not have a latch reflex at all to the point that he was unable to breastfeed.  The only bottle we've ever been able to use is the Dr. Brown with a number one nipple.  Then limit the feedings to 2 oz at a time, feeding more frequently.  He's eight months old now and eating a few little solids, but the gagging was SO strong with anything bigger than a number one nipple that he ended up at Children's Hospital from constant projectile vomiting.  He even gags himself sucking his tiny fingers or coughing hard.  The doctors at Children's just said go all the way back to number one nipples and 2 oz at a time.  We did that and he's up to 6 oz at a time now with no more vomiting.  Avanti bottles literally drowned him in fast flow and none of the others worked out except Dr. Brown.  Target in Albany has a good selection, I just picked up a few more number ones.  BTW Our little guy weighs 22lbs, up from 5 at birth, so he's not malnourished.  But the projectile vomiting was a constant huge mess and the daycare was very worried even though they are super fabulous.  This is a real problem, I totally understand and hope that I have been of some help.  Also, to tempt Baby to latch, drip a few drops first on her lips to alert her and make sure a few drops are already on the nipple.

    Had exactly the same problem and our baby doctor told us it was nipple confusion.  I had to stop breastfeeding except at bedtime, and used only Advent Bottles.  Stick to one type of bottle, I liked Advent the best and I pumped like a madwoman.  My daughter did not use the pacifier until she was about six months old.    Hope this helps.

    Hi,

    Have you confirmed with your ped that she isn't tongue tied? Our little boy couldn't take a paci and gagged, and we tried at least 6 different brands. Although I thought we were having a fine time nursing, it was one thousand times better after he had a frenectomy (at about 6 weeks I think?) He was nursing with his lower lip, but then after a little retraining he nursed with his tongue on the bottom and transfers that skill to the bottle without problem. 

    How frustrating, though! Good luck.

Archived Q&A and Reviews


Questions

4 week old can't get milk out of bottle

March 2007

My baby is one month and I am trying to introduce a bottle with breast milk in it. She happily sucks on the bottle but she is unable to get any milk out. I am using Avent bottles with the 1 month nipple on it. Any suggestions? new mom


Maybe the hole in the nipple needs to be made bigger. I've had to do that in the past with the baby I helped raised. It was taking her too long to get just a couple of ounces into her. The bigger hole made a wonderful difference. Start by making the hole a little bigger and go from there. Randy Jane Reitzes, LVN, CMT, CCHH


I had a similar problem with my baby... try a variety of bottles, it may take sometime (weeks or more) before your baby gets the hang of it. The breastflow bottle from The First Years company (sold at Babys R Us) worked well for me. (email me if you want mine, i no longer need them) margaret


My adopted son was bottle fed from birth. The silicone in Avent nipples was too thick or stiff or something, and he never could get the milk to flow easily. We've had good luck with the Playtex ''drop-in'' silicone nipples and bottle, so maybe try those. You can always decant the milk from the Avent bottles if that's the kind of pump you have. bottle-feeding mama


Get the Avent nipples with more holes. Your baby is less likely to take a bottle if it's a chore. If at 4-weeks she's a good nurser, chances are that she won't suddenly prefer a bottle to you, even it if is easier to get milk out. anon


my lactation consultant only recommends Playtex Premium nurser drop-ins for young EBF babies. I just bought one today so can't tell you how it will work with my 6 week old yet! my LC is an old hippie, was mid wife, now LC, and just knows everything...OK, not everything, but she is wise, experienced, and thoughtful. swear by my LC 


Tongue-tied baby having trouble with bottle

June 2005

Hello, My daughter is almost 2 months olds and refuses to take the bottle. We first introduced the bottle when she was 3 weeks old. After a few minor battles, she actually drank from it quite well for about 2-3 weeks. Now, however, she is absolutely fighting us. It's very stressful because I will be returning to work in about 2months. I also need to mention that she is tongue-tied. The skin that attaches the tongue to the bottom of her mouth is elongated. I've been told that this may inhibit her from comfortably sucking on a nipple. My oldest is also tongue-tied and he didn't have a problem with our bottles of choice. It just baffles me that she once took it willingly but now screams in our faces. We are currently using Advent bottles? I would appreciate any suggestions regarding what to do. Thanks in advance! dna30


My daughter was the same way - exactly! The bad news is that she NEVER took to a bottle again. The good news is that she started drinking from a sippy cup at 5 months old. She still hasn't perfected it at 9 months but she can do it and get fluids. We tried every single bottle, every single position, every single time, every single liquid, every single temperature, every single person and nothing worked. She just would not go fo rit. But, in the end, I think it made life easier because now we won't have to wean from the bottle, which took a long time with our older girl. Good luck. anon


I am a lactation consultant who is also a mother of baby born tongue tied.

I would urge you to look into having your baby's freunulum cut. The procedure is simple and easy while your baby is young, though pediatricians are often under educated about how they can effect feeding.

We took my son to an oral surgeon. Once she established the tongue tie, she gave him a pacifier dipped in sugar water, grabbed his tongue with a some gauze, injected just a bit of lidocaine, then snipped it. After holding someone gauze on the cut for a moment, she was done.

My son was nursing in 1 minute after we were done. We saw improvement in his weight that very week.

The benefit to doing it now, as opposed to waiting is that waiting can cause health issues- as baby may not be able to adequating drain a breast or bottle, there can be speech issues, and it's a more complicated procedure to do once the child gets older- often times involving general anesthesia.

As far as bottles go, I have 2 suggestions, go with a plastic bottle such as gerber that you can sort of squeeze to help the flow. Or make sure that you use a nipple with a larger hole to allow the milk/formula to come out easier. Rae

 


6-month-old soaked in milk from bottle

March 2003

My 6 month old gets bottles of pumped breastmilk, and some formula mixed with breastmilk, when I am at work. Although she rejected the bottle at first, she now eagerly reaches for it. However, when she drinks from the bottle a lot of the milk runs down her chin, soaking through her bib and clothes. The milk seems to run out the corners of her mouth while she is sucking and swallowing. She doesn't mind in the slightest, but it makes feeding her, particularly when we're out, difficult. I thought she'd outgrow it, but it's been about two months and there hasn't been any change. I have tried all different shapes of nipples, and nothing seems to make a difference. I'd love a suggestion about what to do. Rebecca


Maybe she needs a nipple that doesn't flow so fast. If you haven't already, try the kind for newborns that have smaller/fewer holes. VM


My son did that too. He's now 17 months old and is much neater when he nurses/drinks from a bottle. It's eating solid food that is very messy now! Your daughter should grow out of this. Just keep a bib on her. Amanda