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Making It Work

Refusing a Bottle

From: NEW BEGINNINGS, Vol. 19 No. 6, November-December 2002, pp. 218

"Making It Work" is a regular feature of the magazine NEW BEGINNINGS, published bimonthly by La Leche League International. In this column, suggestions are offered by readers of NEW BEGINNINGS to help mothers who wish to combine breastfeeding and working. Various points of view are presented. Not all of the information may be pertinent to your family's life-style. This information is general in nature, and not intended to be advice, medical or otherwise.

Situation

I am returning to work part-time next month. My 10-week-old baby refuses to take a bottle of expressed milk. We've tried everything: my husband giving him a bottle when I'm out of the room or me giving it to him in the breastfeeding position. Nothing works, my son just screams and refuses the bottle. My husband or mother will be watching the baby while I am at work four nights a week for my six-hour shift. My employer is very positive about pumping, but what good will that do if my baby won't take the pumped milk. How have other mothers handled this situation?

Response

Our second daughter wouldn't take a bottle of expressed milk after my wife returned to work (I'm a stay-at-home dad). She screamed and refused any attempt to feed her with a bottle. We spent a small fortune on every type of bottle known to man! I even tried wearing one of my wife's shirts (so I'd smell like mother). We also bought a couple of soft cup feeders. Our daughter didn't like the soft cup feeder, but I was able to get her to drink some of the milk, much to her displeasure. It was a very stressful situation for all of us.

Throughout this ordeal, I sought the advice of the lactation consultant at our hospital. She told me that my daughter wasn't going to starve herself, and that sometimes babies just won't take a bottle. But it was difficult for me to accept the fact that she might not eat anything for an entire eight-hour day. I felt absolutely horrible about the situation. It was stressful for all of us so I quit forcing the issue, as our lactation consultant had advised. If my daughter wouldn't eat, I wouldn't insist. I did try at regular intervals to feed her but she never would take the bottle-she just wanted her mother.

Our pediatrician once asked of my daughter, "How many times a day does she breastfeed?" I told him, "Once. From the time her mother gets home until the time she leaves again."

Andy Fullerton
Fayetteville AR USA

Response

I have been in this same situation not once, but twice. I also started back to work when each of my children was about 10 to 11 weeks of age. Both refused many different bottles, but luckily, their home daycare is less than five minutes from work and my shift is only from 1 pm to 5 pm. This came in handy, especially in those early weeks of establishing our nursing relationship. I breastfed right before I went to work and once during my shift (the daycare provider always called me to let me know when my children were hungry). This schedule lasted for about four weeks with both of my children.

Currently, my nine-month-old son nurses around noon, before I leave for work, and then waits until after I get home at 5:30 pm to nurse again. He still holds out for me-refusing to eat hardly any solids. This also means he makes up for it by nursing at night. His now two-and-a-half-year-old sister did virtually the same thing. Neither one of my children ever really took a bottle.

Fortunately I am in a career quite supportive of breastfeeding-I am a pediatrician. The owner of my practice and staff are understanding and helpful and many of my patients seem to understand when I have to run out for 20 minutes. With my job, I have to juggle nursing and being on call for the hospital. If my son needs to be fed before I can return home, my husband brings him to me to nurse.

If you are working six-hour shifts, you could nurse before and after work and have your husband or mother bring your baby for a mid-shift nursing break. If you are close enough and have enough time, you could go home.

If your employer is positive about pumping, I assume that he or she would be equally happy to provide a place for you to nurse your infant at work. Along with the various reasons that human milk is the best for your baby (and your employer), you could point out that nursing would be faster than pumping. You do not need an electrical outlet, refrigeration, or to clean up! It is also probably better to help maintain your milk supply. You eventually might be able to just nurse before and after work. After all, babies who sleep through the night go eight to 10 hours or longer without eating.

It was difficult those first couple of months back to work, but worth all the effort and stress to see such happy children. Good luck.

Dana Simmang, MD
Georgetown TX USA

Response

My husband and I were recently in the same predicament as you! Our second child, Simone, learned to nurse easily, but she refused the bottle from its introduction at four weeks of age until my wife, Melanie, returned to work at 11 weeks. Our local LLL Leader, the hospital's lactation consultant, and our friends and family were very helpful and supportive, yet Simone still would not take a bottle. We had trouble finding information about our problem in breastfeeding and parenting books, and even on the Internet. We also tried cup and syringe feeding with little success. Simone seemed to have a problem with many artificial nipples because of a strong gag reflex: the long nipple ends would choke her. When we finally tried a wide silicone bottle nipple with a short end, she was able to latch on, but was still uncooperative. For a time everyone in the family even walked around the house with a bottle to show Simone how much fun it was!

When Melanie returned to work about two weeks ago it was trial by fire. Our worst fears were realized when Simone refused almost all breast milk from a bottle. My instinct from being the stay-at-home parent with our first child, Ian, told me to persevere, be patient, and remain calm and comforting. I brought Simone to Melanie's workplace the first day so she could nurse. I watched for signs of dehydration (be sure your baby has wet diapers with clear urine), but thankfully that was not a problem. At night Simone would nurse a lot more than usual to make up for her not eating during the day-be prepared for that possibility.

After a couple of days, Simone seemed to accept the fact that the bottle or ongoing hunger were her only options and began to take a few ounces per day. Within a week, she was eating a normal amount from the bottle and continues to do very well. Melanie pumps at work, and we also use milk that she stockpiled in the freezer while on leave.

I know our "solution" may not sound like the ideal one, but in our case it paid to be flexible and just move ahead. Support from others was crucial, because our situation seemed hopeless for a time. Seek encouragement from your friends at LLL and elsewhere, and hang in there!

Jonathan Rootellis
Spencer WI USA

Response

This situation sounds just like what my husband and I had to deal with when I was going back to work. Our daughter, Jessica, was four months old at the time and refused to take a bottle. We tried having me out of the house during feeding time, him walking around while feeding her, me trying to feed her, every type of nipple possible, all to no avail.

My husband ended up having to put her in a sling and inserting his pinky finger in her mouth for her to suck on while using a medicine dropper to put milk in her mouth with the other hand. As you might imagine, it was rather awkward for him with his arms twisted in weird ways.

Luckily, my mother-in-law, who was an LLL Leader for 30 years and a lactation consultant, told us about a finger-feeder made by Medela; it's called the HazelBaker FingerFeeder™. It's a soft bottle that you place in your hand. There's a very thin, flexible tube connected to the bottle. You wrap the tube around the base of your finger and run it to the tip (it comes with tape to secure it). Then you stick your finger in the baby's mouth and she sucks both your finger and the tube. You can either let her suck the milk or gently squeeze the bottle to get more milk into her mouth. It made my husband's job a lot easier! I can go to work without worrying about Jessica getting enough milk, she gets the satisfaction of being able to suck on skin rather than rubber or plastic. It was a lifesaver for all of us!

Janet Cushing
Jacksonville FL USA

Response

My advice is to relax! Six hours will seem long but if your baby is as determined as mine, she will wait for you to come home. Can you see her on your break? I was lucky because my husband brought her to my office every day for lunch. He was very creative in finding ways to keep her happy without feeding her. I think he was even relieved when he didn't have the added pressure of feedings. He just hung out and enjoyed playing with her. She went five hours during the day without nursing and made up for it by cluster feeding in the evenings and during the night while we co-slept. She gained weight on target and is very healthy. Don't be tempted to try solids too early either to replace your milk-we tried at about five months but our daughter wouldn't touch them until she was ready at seven months old.

Those months seemed stressful at the time, but looking back, it wasn't worth the amount of energy I spent fretting over it.

Tracey Waller
Bellbrook OH USA

Response

Your situation sounds very similar to mine when I returned to work. I went back to work three days a week and my husband and mother-in-law took turns watching my son, who was 12 weeks old. He was not fond of taking a bottle, even after trying several types of nipples. We ended up using a sippy cup with a soft rubber spout designed for babies three months and older. The cup can be adjusted to non-spill or free flow. My son seemed to do much better with the cup, particularly if it was on free flow. This allowed him to take a little of my expressed milk, although much of it would soak his shirt.

My employer was supportive of my need to pump, so I had an abundant supply of my milk in the freezer. I was grateful to be able to pump to keep my milk supply up and avoid plugged ducts and other problems.

The main thing that helped us through was having my husband or mother-in-law bring my son to nurse on my lunch break.

My son is now 16 months old and I work one day a week. I'm happy to say he still visits me at lunch so he can nurse and have some mommy time. Getting to see my son and my husband at lunch is the highlight of my workday.

Laurie Nickell
Madeson IN USA

Response

I faced the same situation when I had to return to work and my baby, Krista, absolutely refused the bottle. I had to go back when Krista was 12 weeks old, so a few weeks beforehand we started giving her "practice" bottles of expressed milk. She refused to take a bottle from me, my husband (with me out of the house), and even her grandma. She seemed offended by the very notion of an artificial nipple.

On a routine visit to the pediatrician, I mentioned the situation. Her response surprised me: "Don't bother with any more practice bottles." She explained, "No baby will willfully starve herself. Once she realizes there are no other options, she'll take the bottle at daycare." I was concerned, but trusted Krista would figure out what she had to do. Soon, she was taking about six ounces each day. I was working only six-hour days, and I would nurse when I dropped her off and immediately upon arrival to pick her up at the day care center.

Krista never conceded to take more than eight ounces during the day. She also nursed more frequently during the night than she otherwise might have. I figured we were both doing our part: she was willing to take some breast milk from a bottle, and I was willing to sleep with her and nurse during the night. I'm glad we did, because at 18 months, Krista is still happily nursing.

Dawn Bucholtz
Terre Haute IN USA

Response

I know exactly how you feel! We had the same problem with our daughter. It was a week before I was scheduled to return to work and she was still refusing the bottle. I was a wreck. I know you said that you have tried everything, but I want to share what has worked for me.

  1. Leave the house, don't just leave the room. Have your husband or mother try when you are not home. Go for a walk or to the store. I am convinced the baby knows when you are there.
  2. Try different nipples. We went through six kinds before one worked for us. It was a rubber, orthodontic nipple that she finally accepted.
  3. Try slipping the nipple in her mouth when she is half-asleep. She may start sucking automatically before she realizes that it is not you. Our daughter did.
  4. Don't give up. Try every day.
  5. If she still will not take it, have your husband or mother bring her to your work so that you can nurse her during your break.

Manya Paul
Scottsdale AZ USA

Response

I suggest trying a wide range of bottles and nipples until you find one he'll take. Also, you may find it helpful if someone else offers the bottle, and if you can bear it, if you leave the house entirely. My husband was better able to offer the bottle if he carried our son in a nursing position while walking around the house.

I have to say, I did feel some jealousy at first, but it was positive in the long run. I have the best of all possible worlds-I am able to be a mother 24 hours a day by co-sleeping with my baby and being on call to nurse. I also run my own business and have help from the best nanny in the world. My husband totally supports my choice to let Isaac lead the way with weaning and sharing the bed, and he has become the most outspoken proponent of breastfeeding I know!

Betsy Hoffmeister
Seattle WA USA

Response

When my baby was nine or 10 weeks, he was a good bottle drinker, so I had no problems going back to work part-time and leaving him with his nanny or his dad. By four months, however, he was getting pickier and soon refused to take the bottle altogether. He just cried and screamed and pushed it away. We tried everything with no success, including a bottle advertised to look and feel like a real breast. His nanny could get him to drink some milk (usually half an ounce or less) using a dropper. My husband coped by putting him in the stroller and walking him to sleep. Occasionally, I was able to come home for lunch and breastfeed.

This went on for about a month or two. (By the way, a lot of parents confided to me that their children never took the bottle either.) He eventually learned to drink a little from a no-spill sippy cup. We flipped the rubber piece on the inside that makes it spill proof so that the liquid would drip out the spout for him. It was messy, but the frustration from not knowing how to suck was gone, and now he could drink as much as he wanted.

Of course, this was a very stressful period for all of us. I felt extremely guilty for working. His caregivers spent many a difficult day with a crying baby. But what kept us going was the knowledge that this phase was temporary.

I pumped the entire time and stored my milk in the freezer. I guarantee that you will need all that milk you're stocking up-as soon as he starts drinking again you'll go through your supply in no time. Good luck.

Maggie Stenz
Brooklyn NY USA

Last updated Thursday, October 19, 2006 by njb.
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