If you find yourself wondering why your baby prefers the bottle over the breast, you’re not alone. It happens to many moms. It could be that your baby tried to nurse when they were first born, but now they fall asleep or cry at the breast. Or maybe they used to love breastfeeding but lately started to get fussy and push away from your breast. Regardless of the circumstance, breast refusal doesn’t feel good. It’s easy to take it personally. Don’t.
Here’s a simple guide to help you understand why breast refusal happens so you can take steps to encourage your baby back onto the breast.
Why Your Baby Chooses the Bottle Over You
Babies are born wanting to breastfeed from you. They are hard-wired with reflexes that cause them to open their mouths wide and gape when they smell your nipples. They have other reflexes too, that make them suck when your breast fills the roof of their mouth, or hard palate. If they choose the bottle over you, it’s usually because they learned it is harder to get milk out of you than the bottle.
There are several reasons why this happens:
Latching Challenges
A common reason babies refuse the breast is that they can’t get a deep enough latch. If they can’t latch deeply, they can’t efficiently pull milk out of your breast. For your baby, this can feel as fruitless as trying to suck milk out of a straw with a hole in it. A shallow latch can happen for several reasons:
Gape restriction is when your baby is born with particular anatomy that makes it hard for them to gape normally. Instead of unhinging at the jaw to create a wide open gape, they hinge at the jaw and slide off the breast when they try to nurse.
Nipple Shape: Your baby’s mouth has to fit onto your nipple shape. If you have flat or inverted nipples, it can be more challenging for your baby to fit their mouth over your nipples.
Breast size and shape: Your baby’s mouth also has to fit onto your breast. If you are engorged or have very round breasts, it may be harder for your baby to form a seal when they try to latch on.
Tongue tie is when tissue under your baby’s tongue doesn’t dissolve in the womb so they have a hard time moving their tongue normally to breastfeed.
Poor positioning: Positioning is a skill that has to be learned. If you are not supporting your breast or your baby’s head enough, especially early on, they can have a hard time staying latched on deeply.
Nipple Confusion
Babies are hardwired to want you. But if they nurse repeatedly and can't get milk, and then you follow it with a bottle, they’ll learn to choose the bottle over you. Bottle nipples are made of silicone or latex, which feels different than the breast. Babies who can’t transfer milk from the breast will choose the bottle because it is easier. Put simply, babies want to eat. If they can't get their food from your breast, they’ll look for the next best thing.
Flow Control
Bottles deliver milk in a fast, steady flow, whereas breastfeeding involves a balance between the baby's sucking rhythm and your letdown. If your baby is used to the easy flow of a bottle, they may become impatient if you have a slow flow of milk or overwhelmed if you have a fast flow and/or strong let down.
Low Milk Supply
When your baby is born, your milk supply usually takes around two weeks to fully come in. During this time, your baby may need more milk than you have. If your baby is older and you haven’t been emptying your breasts regularly and fully, your supply may dwindle. Rarely, some moms aren’t able to produce a full supply.
Sleepy Baby
If your baby is premature or very young, they tend to be sleepier. This is due to higher circulating levels of a hormone called cholecystokinin. If they are too sleepy and won’t wake up to nurse, a bottle may be the easiest way to get them to eat at first.
Tips to Help Your Baby Choose Your Breasts
If your baby refuses your breast, here are some suggestions to encourage them to breastfeed.
Promote Your Milk Supply
Make sure to empty your breasts regularly and fully and then give them time to fill up again. On average, this means nursing and/or pumping for 10 to 15 minutes on each breast and then allowing 2 to 3 hours for your breasts to fill up again. Try to make sure your breasts are fully emptied, because empty breasts make more milk than full ones.
Practice Skin-to-Skin Contact
Skin-to-skin contact is important both during and between feeding times. That’s because touching, smelling and even hearing your baby cry makes your brain release the hormones oxytocin and prolactin. Oxytocin helps you bond with your baby and triggers your milk letdown. Prolactin helps lay the foundation of your milk supply. Help your hormones help your supply by stroking your baby's cheek, holding them close, and speaking to them during breastfeeding.
Practice Responsive Feeding
Don’t wait until your baby is starving to offer the breast. Note when your baby first shows signs of hunger, like rooting and putting their hands in their mouth. Try to breastfeed when your baby's hunger is less urgent and so they will be less frustrated at the breast. Once your baby associates your breast with milk, they will be happy to stay there.
Ensure a Deep Latch
A proper latch is crucial for successful breastfeeding. A deep latch is when your baby is able to get most, if not all, of your nipple and areola inside their mouth and form a seal. The latch should not be painful. If you suspect an anatomic issue such as gape restriction or tongue tie, speak to your doctor.
Try Nipple Shaping Accessories
If you have flat or inverted nipples, try using breast shields or nipple formers before feeding. These devices can help shape the breast and make it easier for your baby to latch.
Soften Full Breasts
If your breasts are engorged or very full, hand express or pump before nursing to soften them. Softer breasts are easier for your baby to latch onto. If you have an oversupply, pumping for a few minutes can also slow a fast flow.
Limit Bottle Use
Gradually reduce the number of bottles you offer your baby. This can encourage your baby to rely more on breastfeeding for milk.
Pace Bottle Feeding
If you need to supplement with bottles, practice paced bottle feeding. This technique slows the amount of milk your baby gets from the bottle so they won’t associate the bottle with fast milk flow. You can also use a slow-flow bottle nipple.
Be Patient and Persistent
Transitioning from bottle to breast takes time. Be patient and persistent, and celebrate even small successes. Sometimes working with a calm lactation consultant helps.
Frequently Asked Questions
How do I get my baby back to breastfeeding after a bottle?
To transition your baby back to breastfeeding, focus on making sure you have a good supply, skin-to-skin contact, and your baby has a deep latch. Gradually reduce bottle use and while making sure your baby is able to transfer milk from your breast.
Why is my baby fussy at the breast but takes bottles?
Babies might get fussy at the breast due to latching issues, a low milk supply, or a strong flow. Bottles may give your baby more control over the flow and don't require a deep latch. Offering a calm and quiet environment for breastfeeding, adjusting nursing positions, and ensuring a deep latch can encourage your baby back onto your breasts.
What do I do when my baby rejects my breast?
If your baby rejects your breast, don’t take it personally. Look for underlying causes, like low supply, latching problems, or nipple confusion. Seek guidance from your doctor or a lactation consultant and try different techniques to make sure your baby has a positive association with your breasts.
Can a baby reject the breast after bottle feeding?
Yes, a baby can reject the breast after bottle feeding, but this usually happens if they are not able to get milk from the breast. This can be due to a low milk supply, slow milk flow, a poor fit between your baby and your nipple or breast shape, or your baby’s anatomy, such as gape restriction or tongue tie. Addressing these issues can help your baby choose breastfeeding again.
Conclusion
If your baby refuses to breastfeed but chooses a bottle, it is most likely due to one of the reasons listed above. With time and patience, and sometimes some outside help, most moms can eventually wean their baby off the bottle and back onto the breast.
Reviewed by Linda Dahl, MD