Bottle aversion or refusal in babies

A bottle aversion or refusal is often unintentionally developed during periods when your baby is not drinking spontaneously enough (possibly due to illness) and requires assistance to receive adequate nutrition. Your baby may associate negative experiences with feeding times, leading to delays and restless feeding sessions. A baby with an aversion may ignore their hunger and satiety cues out of fear of being forced to feed.

Once other medical causes have been ruled out and it is confirmed that your baby has the proper sucking technique to drink efficiently and comfortably, a plan can be developed to overcome this aversion. The key focus during the first two weeks is to create a calm and positive feeding atmosphere, allowing your baby to decide when to start and stop feeding.

The first two weeks are both the most challenging and the most crucial. As a parent, it requires letting go and trusting your child. During this period, it is best for only one person to handle the feedings (if necessary, a second person, such as a partner, can be involved). Once your baby is feeding well again, others can begin offering the bottle.

During these weeks, it is normal for your baby to initially lose some weight. However, this should be monitored by a healthcare professional (midwife, lactation consultant, doctor) to ensure it remains within safe limits. Keeping a written record of feedings, as well as diaper output, can be helpful during this time.

Important Considerations

Whenever possible, wait for your baby to show hunger cues before offering a feeding. If your baby does not request a feed after many hours (depending on their previous feeding pattern), you may offer the bottle, but the choice to drink should remain with the baby. It is essential to ensure that your baby does not feel pressured to drink. Feedings should take place in a calm, relaxed environment—if necessary, in a separate room away from household distractions.

Common Hunger Cues:

- Smacking lips or tongue

- Sucking on hands

- Turning the head or opening the mouth when stroking the cheek from the ear to the mouth corner

- In a later stage: restlessness or crying

How Your Baby May Show They Want to Drink:

- Looking at the bottle and opening their mouth when the nipple is presented

- Becoming excited when seeing the bottle and possibly reaching for it

- Continuing to suck and drink from the bottle

- Holding the nipple in their mouth during a sucking pause instead of letting it go

How Your Baby May Indicate They Do Not Want to Drink (or Have Had Enough):

- Keeping their mouth closed

- Pushing the nipple out with their tongue

- Sharply turning their head away

- Becoming restless or arching their back

Forms of Pressure to Avoid During Feeding:

- Restricting your baby’s arm or head movements

- Inserting the nipple into their mouth against their will

- Preventing your baby from pushing the nipple out

- Applying pressure to their chin or cheeks to encourage sucking

- Wiggling or rotating the bottle in their mouth

- Passively dripping milk into your baby's mouth

- Using tricks such as starting with a pacifier and swapping it for the bottle

- Creating distractions during feeding with external entertainment

- Repeatedly offering the bottle after your baby has indicated they do not want to drink

This approach should always be discussed with your healthcare provider beforehand and may not be suitable for all babies. Do not implement this plan without seeking professional advice.

If you would like to read more about bottle aversion, I highly recommend the book *Your Baby’s Bottle-Feeding Aversion: Reasons and Solutions* by Rowena Bennett.

If you have any questions or concerns, do not hesitate to reach out to me or one of your other healthcare providers, such as your midwife or doctor. Would you like guidance on this issue? Click the button below to schedule an appointment.

Best of luck, dear parent—you've got this!