My baby won’t take a bottle

I just returned to work part-time. Our baby Nicholas is four months old. On the days that I work, my husband is home with him.  They have a great relationship, but there’s one big problem. Nicky is breastfeeding and refuses to take a bottle of expressed milk when I'm gone. (He took a bottle when he was younger but we stopped giving it to him while we were on vacation and he’s been refusing for two weeks now) For the past few days Nicky is spending a lot of time crying and his dad and I are stressed out. As soon as  I get home, he nurses and is fine. What can we do?

You're not the first parents to discover that an older baby is often more set in his ways than a younger one. A determined four-month-old baby who enjoys breast feeding can be very resistant to any other method of drinking milk. You were wise to introduce Nicky to the bottle when he was younger, but you didn’t know how important it was to keep offering every day so that he continued his enthusiasm.

The trick to persuading an older baby to take a bottle is to take your time and to not give up.  Don't expect Nicky to change his mind overnight!  He won’t starve, but he may wind up wanting to nurse a lot when you get home and at night to make up for what he’s missed.  In fact, if you are only away from him a few days a week and nurse him all the rest of the time, he may be able to get by without nursing while you're gone. Of course, it will certainly be easier on everyone if you can get him to accept a bottle.

It’s important to offer Nicky a bottle a few times a day, every day, whether or not it is a work day for you.  If Dad is only trying to bottle feed on the days that you work. Nicky won’t be getting enough consistent practice. The first step is to help Nicky get used to the feel of an artificial nipple in his mouth  A rubber nipple, of course, has a different feel than the warm, soft, mother-scented one he's telling you he prefers! Don't worry if he’s reluctant to take any liquid from the bottle at first.   You can help make the bottle feeding more appealing during practice sessions by offering him sugar water, made by mixing four ounces of water with one teaspoon of sugar.  This water mixture is less sweet than breast milk and because it is different, it doesn’t remind the baby so much of what he’s missing by not having the breast.  

If at all possible, the person who offers the practice bottles should be someone other than Mom.   The scent of his mother, or even her presence in the room, will often confuse a baby and anger him about the new source of milk.  Besides, it's very hard for most mothers to resist baby's protests.  With Mom hovering, the person giving the bottle tenses up and the baby feels the tension.  

Here are more suggestions to follow as you're looking for a strategy with Nicky.  Try each idea for a few days.  If after the fourth day a method isn't working, try something else.

• Try different types of nipples.  Make sure that Nicky can get milk with a minimum of work.  There are hundreds of different shapes—try a couple, but don’t keep trying, since consistency is important, too!

•Try to hold your baby in different positions, such as away from your body, facing you, or in an infant seat.  After a baby is used to a bottle you can go back to holding him close while he feeds.

•Offer the bottle when your baby is hungry, half full, or when he doesn't seem hungry at all.  Babies are different in the times when they will be receptive to a new way of feeding.  Some babies will take a bottle in the evening after breastfeeding, when a   mother's milk supply is naturally low.

• Offer the bottle when Nicky is awake and alert.  If that doesn’t work, wait until he's sleepy.  It's hard to predict  in which state your baby is likely to be less resistant, so try both.  Most babies, however, will not calm down and take a bottle once they are furious.  It's better to stop, soothe your baby, and try again a little later.  If repeated tries are unsuccessful, end your attempts for the day and try again the next day.  Don’t battle Nicky—that will make him angry and more resistant.

If you find that despite all of your daily efforts Nicky is still refusing the bottle, you have a couple of choices.  You can offer him breast milk from an eyedropper or a spoon to get him used to taking milk in a different way.  You can start offering him easy-to-digest "soupy" solids such as rice cereal with lots of milk, or jarred fruits or vegetables that are high in water (Read the label:  "water" will be listed as the first ingredient.)  You don’t have to give him big quantities of these foods.  He only needs enough to get him through the day,

It’s hard enough to leave a baby to go back to work without worrying about his feeding.  Fortunately, time is on your side.  You may have to do more nursing in the evening and at night than you had planned, but if you keep presenting Nicky with a bottle day after day he will eventually figure out that there is more than one way to get his mom’s milk.