What is Baby Bottle Refusal? The science behind this common phenomenon and some tips to avoid it.

Is your baby refusing the bottle? If your little one is having a hard time taking a bottle, or perhaps is struggling to latch on or nurse on the breast after introducing one, it might be due to nipple confusion. For mothers, baby bottle refusal can be an incredibly upsetting and stressful experience.

Perhaps as a nursing mum, you intended to introduce a bottle to share the bonding experience of feeding with your loved ones, to return to work, or simply just have a much-needed break (even if it's just to have a walk or a rest!). For parents whose breastfed baby is hungry but refuses the bottle, it can cause deep anxiety for everyone concerned.

With all this in mind, what can breastfeeding parents do if your baby is suddenly refusing the bottle? We’ll be providing you with tips on what to do when your breastfed baby won’t take the bottle. We’ll also be providing advice to help families on how to fix nipple confusion, as well as the best bottles to avoid nipple confusion too. Don’t worry new parents – we promise you, there is hope!



Baby crying because of baby bottle refusal
Baby bottle refusal can be very frustrating

What Does Baby Bottle Refusal Mean?


Baby bottle refusal is related to a breastfed baby refusing the bottle. Some babies will simply not suck on the bottle (containing expressed breast milk or baby formula) when they are introduced to one. This might occur when they are first introduced to a bottle, but for others, they will never take to a bottle, and will only latch onto the breast. Other breastfeeding mums might experience their little one having trouble with latching onto the breast after being bottle-fed, leading to nipple confusion, or they may develop a preference for one over the other.


The Context of Baby Bottle Refusal

As we mentioned earlier, parents may have many different reasons for introducing a bottle – but a recent case study involving 841 UK mums who experienced their breastfed babies refusing the bottle, did so just on an occasional basis. For example:

● 59% wanted their partner or family to be able to feed the baby

● 35% stated some independence/more social life

● 15.3% said spending time with other children

● 14.4% stated work reasons

● 13.3% cited other (reasons included maternal illness)


Is Nipple Confusion Legitimate?

Yes, nipple confusion is unfortunately real, as many parents can attest to! Although there still remains a very limited number of literature and studies on the topic, which can add to the confusion and stress of parents experiencing nipple confusion.

Unfortunately, the many thousands of parents posting threads about the problem of their baby refusing a bottle on popular parenting forums such as Mumsnet and across social media suggests it is a fairly common issue.

In fact, it might be a much bigger problem than we think. The last comprehensive UK Infant Feeding Survey (IFS) of 2010 shows that 80% of UK mothers have fed their baby with a bottle by 4–10 weeks of age.


What Causes Nipple Confusion?

The exact causes of baby bottle refusal remain unclear. For example, the link between bottle feeding and nipple confusion hasn’t been proven, according to a leading study, but nevertheless, the World Health Organisation’s “Ten Steps to Successful Breastfeeding” advises that mums should be made aware of “the use and risks of feeding bottles, teats and pacifiers”. What can parents believe?

In any case, its possible causes have been widely discussed, including by La Leche League. On this note, let’s briefly chat about the main factors that can likely cause nipple confusion.

One possible cause could be that your baby is having difficulties changing between the bottle and breast before a breastfeeding routine has been fully established. She may be struggling with sucking on the bottle, as the technique for latching from the breast vs the bottle is quite different. Whilst it doesn’t always cause problems for little ones, there is unfortunately no way of knowing beforehand if your baby is likely to experience nipple confusion or not.

At the same time, some leading breastfeeding experts disagree as to the extent babies are refusing the bottle or teat due to the baby’s difficulty with technique, or whether it is simply due to mum and baby having troubles with a good breastfeeding pattern.

For example, a leading scientific study listed a range of possible infant and maternal risk factors that could lead to nipple confusion. These included nipple variation, low milk supply, abnormal breasts and maternal illness, or the baby being premature and born at low birth weight.


Happy breastfeeding baby
Breastfeeding is the most natural way to feed your baby

When to Introduce a Bottle to Avoid Nipple Confusion

There is a lot of conflicting information about when bottles should be introduced, adding to the confusion and pressure for many new mums and their loved ones. Some breastfeeding experts argue a bottle should be introduced only when the baby is settled with her breastfeeding routine, and interestingly, the majority of mothers who took part in the UK study we mentioned earlier in the article, gave another insight. These mums said starting earlier with a bottle was the best way to prevent bottle refusal in the first place, having a considerable impact on their experience and the overall breastfeeding duration. It's however important to notice that it's paramount to be cautious and avoid introducing the bottle too early, especially if you are not sure the breastfeeding routine is properly established.


What to Do if the Baby is Refusing the Bottle?

If your baby is hungry but refusing the bottle, don’t fear! In the earlier study involving UK mums and their breastfed babies refusing the bottle, 39% reported eventual acceptance.

If baby bottle refusal continues, there are a number of other feasible options too. Many families find that alternatives such as finger feeding, spoon-feeding and syringe feeding) were helpful ways to get their baby back on track with feeds.



Best Teat to Avoid Nipple Confusion


If you are looking for the best teat and best bottles to avoid nipple confusion, The Teatle, our groundbreaking bottle, was crafted with the intention of overcoming the difficulties associated with common baby bottles, including nipple confusion, by creating a product that is remarkably close to breastfeeding itself. With a wonderfully soft, pliable texture and shape, (built using the unique REALATCH technology) it’s just like a natural breast. We truly want to help parents avoid or overcome the anxiety and pain that can be caused when your little one refuses the bottle. And we are confident our breastfeeding bottle can do just that!






Sources:

https://www.researchgate.net/publication/280091118_Clarifying_nipple_confusion


https://onlinelibrary.wiley.com/doi/full/10.1111/mcn.13047


https://www.llli.org/breastfeeding-info/nipple-confusion/


https://webarchive.nationalarchives.gov.uk/20130315211757/http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_4096999.pdf


https://www.bpas.org/get-involved/campaigns/briefings/breastfeeding-and-formula-feeding/