Bottle nipple:Bottle refusal really should get a rebrand!! Bottle learning is really what is happening if you have been nursing, and this paradigm shift takes the judgment off both mom and baby. Nursing is a different skill set and often comes with a period of acclimation. So when it comes to introducing the bottle, it is crucial to contextualize this is the first time you are trying to "teach" your baby something new. Patience, my friend, will be required.

Solution:Try offering the nipple (no bottle attached) to the baby’s mouth getting baby used to the feeling and texture of the nipple. Encourage them to suck on the nipple without the bottle. Then, add some milk into the nipple, then into the bottle and look for satiety cues.

Personal preferences:Babies can have their own preferences on taste and temperature. If a bottle is too hot, too cold, or if the formula tastes different (each one can have a distinct taste), babies can refuse on the basis that they simply don’t like it.

Solution:If using formula, consider switching to a different one to see if it’s a taste preference. If on breastmilk, try switching up the temperature to see if they prefer warm or cold.

Colic:Babies who experience persistent, extreme fussiness are often more difficult to feed. They can turn down offers for bottles during colicky stages.

Solution:Experiment with timing. If baby shows a predictable “witching hour,” try feeding them before this time of day.

Tummy troubles:Babies struggling with moderate reflux or gastrointestinal upset may associate feeding with not feeling well. Tummy troubles can be behind seemingly abrupt bottle refusals.

Solution:Adjust the feeding position. Revisit paced feeding best practices to minimize swallowing air that leads to reflux pains. If you suspect your baby is struggling with persistent tummy pains, consult your pediatrician.

Stuffy nose:Babies have tiny airways and frequently experience congestion, making the feeding process uncomfortable. This could be the culprit if your baby has a stuffy nose and refuses their bottle.

Solution:Address the congestion before feedings. Try running a cool-mist humidifier and saline drops, followed by nasal suction. You can also create steam in your bathroom by running a hot shower and taking baby in to breathe in the steam. This can loosen and break up congestion before offering a bottle.

Oral motor dysfunction:If your baby is struggling with sucking from bottles and is gagging and choking on the milk or formula, there could be an underlying medical issue with oral motor function.

Solution:Get evaluated by a provider trained in functional assessment, like an IBCLC with advanced training in oral motor function. Additional referrals may be warranted.