How to Help Your Baby Overcome a Bottle Aversion
Parents respond with nourishment when their babies cry and fuss because of an empty belly. Once their tiny tummies are nice and full, they turn their head away from the bottle or purse their lips closed. At least, that's the feeding experience parents hope for and expect to have!
What does it mean when a baby refuses a bottle even though they're hungry?
A bottle aversion can be confusing and upsetting to parents, but if you’re one of them, you're not alone.
Approximately 20% - 30% of infants and toddlers have feeding-related problems.
A baby or young child's feeding problem can lead to nutrient deficiencies and malnourishment, ultimately affecting their growth and development.
Some babies can resolve it on their own with time. Still, many need support from parents and/or a team of professionals that includes pediatricians, pediatric dietitians, and speech-language pathologists.
Keep reading to find out what a bottle feeding aversion is, what to do about it and when to call the pediatrician.
What is a Feeding Aversion?
Childhood feeding problems range from picky eating to a refusal to eat.
Can a baby really be a picky eater?
Picky eating and bottle aversions both fall under the umbrella of childhood feeding disorders. A feeding disorder is an inability or refusal to eat and drink enough food to meet nutritional needs.
Feeding difficulties tend to fit within three general categories that may be very familiar to some parents: limited intake, selective intake, and the fear of feeding. However, most children have mild feeding problems that don't affect their weight and health, despite being very challenging for parents.
What Causes a Bottle-Feeding Aversion?
As an experienced parent, you probably expect some degree of pickiness with your child. But a baby’s refusal to eat might be unexpected and confusing.
Here are some of the most common reasons a young child refuses to eat even though they might be hungry.
Sensory aversions and developmental disorders
Feeding problems affect 70%-89% of children with developmental disabilities. For example, children with Autism Spectrum Disorders commonly have sensory food aversions and refuse to eat because of a food's texture, color, appearance, or smell.
Premature infants
Premature babies have a high risk of aspiration while feeding. It's common for preterm infants to have oral feeding difficulties. As a matter of fact, difficulty eating is a huge factor in what delays a baby's discharge from the neonatal intensive care unit (NICU).
Swallowing difficulties
The first step in digestion is the physical processing of food by the mouth, throat, and tongue. Underdeveloped muscles or tongue-tie affect the baby's ability to move food around their mouth, swallow and suck. A frustrated and uncomfortable baby will reject a bottle if they have difficulty sucking.
Pain and discomfort
Babies may develop a learned feeding aversion if they associate pain with eating. A milk protein allergy, choking, or acid reflux are common reasons a bottle-fed baby might experience pain during eating. And, don't forget about ear infections. This common childhood illness makes swallowing very painful.
What About Bottle Aversion in Breastfed Babies?
Pumping keeps a mom's milk supply up and allows a baby to continue breastfeeding even when life gets busy. Using a bottle for breast milk can also give moms a much-needed break during overnight feedings and a chance for others to bond with the baby during feedings.
But, bottle feeding is a different sensory experience than breastfeeding, and babies may prefer one over the other.
Breastfed babies can develop a bottle aversion. Breastfed babies may not like the change in feeding position, the temperature of milk, lack of skin-to-skin contact, and fast flow rate even though the milk tastes the same.
The opposite can also happen.
Bottles allow babies to drink faster and more steadily than breastfeeding. And the difference in the rate and flow of milk can cause nipple confusion. In addition, some babies may take to the faster pace of bottle drinking and reject the breast.
The tips below work for formula-fed or breastfed babies who use a bottle.
What to Do if Your Baby Refuses to Eat From a Bottle
It’s important to individualize treatment for a baby's bottle aversion. Every baby is different, and what works for one child may not be the answer for another. The most effective strategies depend on what is causing the feeding aversion, how old your infant is, and your baby's preferences.
As a result, the best way to use these tips is to apply them one at a time. Then, reassess after a few days before applying a new strategy. (You don't want to overwhelm your baby with too many changes at the same time, and if you try too many strategies at once, you won't know which one worked!)
Keep in mind also that some babies end up showing improvement on their own.
And let your pediatrician know immediately if there are any changes in your baby's weight, growth, or energy level.
1. Don’t force your baby to eat
Nudging a bottle into a baby’s mouth isn’t recommended. As a parent, I understand the temptation to get a child to eat, especially a very young infant that you’re concerned about. But forcing a baby to eat can make a childhood feeding disorder worse. It’s also dangerous. A baby trying to refuse a bottle can choke if they’re forced to drink.
2. Find out why your baby is refusing the bottle
A pediatrician can determine whether there's a medical reason for your baby's bottle aversion. If so, a speech-language pathologist can assess your baby's ability to swallow and suck. Then they'll recommend treatments such as swallow exercises. If your baby has a tongue or lip tie that affects their eating ability, a pediatrician may recommend surgery to correct it.
3. Use paced bottle-feeding techniques
Paced bottle-feeding techniques mimic breastfeeding and allow your baby to drink at a slower rate than traditional bottle feeding.
Responsive feeding can teach you how to recognize and respond to your baby's hunger and fullness signals. Then, when you pick up on your baby's cues, you can respond warmly and promptly with food.
Common signs a baby is hungry include:
Making sucking sounds
Chewing and sucking on fingers
Crying - the key is to learn to differentiate hungry crying from the crying of a sleepy or uncomfortable baby
Fussing
If your baby shows signs they've had enough, parents should let the baby stop eating. Signs a baby is full include:
Turning their head away
Gagging
Spitting up
Slowing down or stopping
Falling asleep
Starting and stopping
4. Change up the bottle
The type of bottle and/or size of the nipple hole can affect the flow rate. If you practice responsive feeding, you'll recognize when the pace and flow of the milk are working well for the baby.
Every baby eats at a different pace and may need a faster or slower bottle nipple. Babies that are both breast and bottle-fed would do better with a slower pace nipple since that's closer to the pace of breastfeeding.
Generally, babies born around their due date can use a newborn flow rate. In addition, there are special nipples for babies with colic. And there are even bottles designed to give your baby the ability to drink at their own pace. For example, the Infant Self-Pacing (ISP) Feeding Bottle allows your baby to control the flow of formula.
5. Change the feeding position or routine
Change the routine with fun and relaxing activities before it's time for a bottle. For example, a few minutes of playtime together on the mat or a walk can diffuse the anxiety around feeding time for you and your baby! Even changing the order of your baby's daily routine might help break up a pattern of feeding difficulties.
Or your baby's usual position might be uncomfortable. Adjust the feeding position or highchair until your baby is comfortable and content. Babies should be held in a semi-upright position with their heads supported while bottle feeding.
6. Change the formula
Not all formulas taste the same, and your baby may enjoy another brand better. Also, some babies prefer different formula temperatures, so you can experiment with warming the bottle vs. not warming the bottle.
If your baby shows signs of a milk protein allergy or dairy intolerance, talk to your healthcare provider about trying another type of formula.
7. Be patient
Understandably, you might be stressed and frustrated when your baby refuses to eat from a bottle. But, babies can pick up on the tension and stress, which only worsens feeding fears and anxiety. Try to engage in positive food parenting practices that provide structure and encourage autonomy. Patience and a positive feeding experience are important for you and your baby!
Last Thoughts on Bottle Aversion
Aversions to food textures and certain foods' appearances are common in children.
A temporary aversion to certain foods isn't usually a medical concern as long as your child is growing and doesn't fall off their percentile on the growth chart.
But a bottle-feeding aversion isn't picky eating, and your baby may need the help of a team to move through it.
Talk to your pediatrician if you notice that your baby is losing weight. Even a few ounces of body weight is a lot for a tiny baby to lose. Speech-language pathologists and pediatric dietitians are other specialists that can help guide you through your baby's bottle aversion.
If you’re getting ready to start your baby on solids, download my FREE Baby-Led Feeding Essential Checklist to make sure you have everything you need to get started. You might also want to check out my online course for parents, based on my best-selling book which will walk you through the whole process of starting solids using a baby-led approach.
Alternatively, if your baby is almost ready to start solids and you’re looking for someone you trust to map out the entire first 12 weeks of your baby’s solid food feeding journey, check out my new Safe & Simple 12 Week Meal Plan! Over 30 recipes, weekly shopping lists, tons of balanced baby meals, a complete plan for top allergen introduction, & lots of guidance (with photos) on how to safely serve each food.
And if you're looking for personalized nutrition support for yourself, your babies and/or your kids, I am currently accepting new clients in my virtual private practice. Looking forward to meeting you online…
