Recently I heard from two mothers who have returned to work and their babies go all day without taking a bottle of expressed breast milk from the childcare provider! There is no funny smell or taste, so Lipase does not seen to be the problem. Baby seems happy without eating, but both mama and day care provider feel terrible about it!
You may discover that your little one reverse cycles, nursing often in the evening and through the night, then sleeping more and eating less when away from you.
The best time to introduce a bottle is when baby is 4-6 weeks old. Starting earlier may interfere with successful breastfeeding and waiting too long may result in the baby refusing the bottle. What if you have now returned to work and your baby refuses a bottle all day long?
Sometimes breastfed babies refuse to take a bottle from Mama because they know she has something better to offer. Ask a family member or close friend to take over bottle feedings until the phase passes. In all likelihood, you will have to leave the house (or at least leave the room) during these times. Some babies will not accept a bottle in the chair where mama usually nurses them – try sitting in another room.
If your baby has been accepting bottles, and is now refusing, the best thing to do is continue with the regular feeding routine, including offering your baby a bottle at the normal times. He may resist, but try to not become frustrated (babies feel our feelings!) When it is time for a feeding, have the helper offer baby the bottle by letting a few drops of milk fall onto his lips and into his mouth so he recognizes the breast milk. Next, stroke his lips with the nipple until he opens his mouth well, as if to latch on. Don’t try to force the nipple in – keep feeding time happy and playful.
Experiment with feeding the baby in different positions:
- Cuddle close in the breastfeeding position
- Propped in your lap with his back to you
- Propped on your thighs with baby facing you.
Babies are naturally curious, and love to put things in their mouth. Use this to your advantage. If your little one will touch, grasp, lick, mouth the bottle, consider this a win! One of these play sessions he might get a little milk in his mouth, find it is a nice surprise, and decide to suck. Ask your child care provider to include the bottle in play times several times, rather than limiting bottles to designated feeding times. Perhaps he will accept a bottle just as he is falling asleep.
No particular bottle or bottle nipple has been shown to be best. If your baby rejects the type you have after a few attempts, try another. The average new born, will probably be comfortable with a medium base, long shank nipple with a slow flow and gentle slope from tip to base. An older or larger baby might prefer a wide base nipple with a slow flow and may respond to the novelty of a bottle nipple that is least like breastfeeding.
A baby should be able to go back and forth from breast to bottle more easily when the bottle nipple is used properly and the feeding is paced to match the flow of milk from the breast and the time the baby usually takes to feed at the breast. Remember, to get the baby’s mouth over the base of the medium or wide base nipple. This is similar to the positioning on the nipple and areola. Pace the feeding to replicate the flow of milk from the breast.
Another option is to skip the bottle and go directly to a cup. Try a small cup, medicine cup, shot glass, spoon or something similar. You can find specially made feeders on the internet and follow the manufacturer’s directions.
Cup feeding an infant takes a little time and perfecting. When offering cups to infants, allow the baby to pace the feeding. Try not to pour milk into the baby’s mouth. Place the cup on the baby’s lower lip, tipped just enough to bring the fluid to the rim of the cup. Your baby’s tongue will come forward and sip or lap the milk, just like a kitten. If your baby is older, a ‘spill proof’ cup may be a good option.
Finally, if your baby is old enough and ready for complementary foods one strategy can be to offer those feedings while mama and baby are apart, and breastfeeding before and after work hours.
One thing is for certain; you will get through this, and on to the next challenge of parenting. Good luck!
Resources:
KellyMom.com
LactationEducationResources.com
Carolina Lactation Consultants, LLC 