Bottle aversion is an extremely common theme amongst parents and caregivers. It rears it's challenging head in clinic on such a high basis; if you are going through it, you most certainly are not alone!
Bottle aversion is completely draining on primary carers. It is all encompassing and makes it difficult to see a way forward. Why? Because a hungry baby is restless, overstimulated, frustrated, tired and upset. All things that can feel like a physical, primal pain that does not shift and does not let up. Throw in the extra sleep deprivation on top and parents and caregivers can feel like the weight of it all is too much.
There is even research out there that highlights an increase in parental stress, anxiety and even post-natal depression for parents who have children or babies with feeding difficulties (Jones, 2013). Helping your child overcome these issues, can help you!
In a lot of my posts, I talk about 'fed is best'. This is such an important message because 1. it's true and 2. it can really help release some of the unnecessary guilt that society and some healthcare providers might have you feeling if you choose not to breastfed. Again, parents who can't start breastfeeding or for whatever reason have to stop sooner than they would like to can also be a catalyst for mental health difficulties which can't be good for anyone!
So the breastfeeding can't start, or has to stop and then what? Bottle feeding. But you start it and your baby won't accept it. You keep offering and if anything your baby refuses even harder. Your whole world flips because if you can do anything as a parent it's feed your baby and right now you can't even do that. Let me tell you something, it's not you.
What causes bottle aversion?
How long is a piece of string?! There are so many triggers for bottle aversion some that are identifiable but some that exist under the radar, i.e. we can't be sure but we know the outcome is bottle aversion.
Often it's an anatomical or physiological issue making it difficult for a baby to latch.
Tongue-tie & posterior tongue-tie are common causes because the tongue cannot function effectively enough to create the right pressure on the teat.
Cleft lip and/ palate are also common causes for bottle aversion. In this instance babies born with cleft lip and/ palate have to under go a lot of corrective surgery in the first few years of their life so they experience lots of negative feelings in their mouth from a early age. The result, refusing anything in their mouth at all.
The big one we see a lot is gastroesophageal reflux or other vomiting conditions. If your baby spends a lot of time bringing milk back up, they will stop wanting to put it there in the first place. We all know vomiting is a really unpleasant experience but we can rationalise the isolated incidence. A baby isn't quite able to do that yet so is more likely to avoid at all costs, just in case.
Dysphagia. If your baby has swallowing difficulties they will not want to take a bottle. Sometimes the flow rate from the teat can impact heavily on your baby and put them off feeding. Their refusal is their communication to say something isn't right here. Listen to that instead of feeling you have to plough on.
Respiratory/cardiac issues. Acute or chronic. If your baby has a horrid cold and they're all stuffed up they will be finding it hard to breathe. Milk feeding puts enormous strain on your baby's respiratory system as your baby has to close off their airway over and over again when they swallow. If they are finding it more difficult to breathe they will find it more difficult to close off their airway and some of that milk could go down the wrong way or just be an overall unpleasant experience. Even if they're over their illness the memory of that experience can continue to be impactful to their feeding.
If your baby has an underlying respiratory or cardiac condition or is susceptible to infant respiratory illnesses this also puts repeated, ongoing strain on their ability to feed effectively. They won't want to keep doing that and no amount of coaxing will help until you seek some advice to put the correct strategies in place.
The other major issues causing bottle aversion are psychological.
Babies who are born sick or who become unwell and require an extensive period of tube feeding and being nil-by-mouth. Their lack of experience and practice with putting anything in the mouth prevents them from wanting to try, in some cases. I once worked with a toddler who had sadly never had the opportunity to put anything in her mouth for the first 2 years of her life and by age 3 she was so avoidant it took extensive therapy to even get her to a point of touching food.
Pressure. Whether we intend to or not, when our baby doesn't feed we all default to the wrong response - pleading, trying and in some cases (although I would fervently advise you do not do this) force feeding. I get it, the anguish that comes with a baby not feeding leads us down some unpleasant paths but this can be and is the biggest cause of aversion. Initial milder versions of aversion quickly become extreme and entrenched because the pressure following it can be so immense the baby cannot accept the bottle anymore.
The big question on everyone's lips is... how can I resolve this?!
Let me just through out a disclaimer, whilst most can make very good progress at a quick rate, others may not resolve completely or at all. Sorry to be disheartening, be assured that this is unlikely to be your baby because it's uncommon that no progress can be made.
Take a breather. Step back, look at the situation as a whole. Is my baby well? Is my baby gaining weight along their centile? Is my baby growing well? Do they have plenty wet and dirty nappies? Then they are likely getting what they need even if it doesn't feel that way. This gives you permission to approach each feed calmly and with the mindset of letting your baby take the lead. When they've had enough and are putting the bottle away, respect that. Allow them to finish when they want to. When they feel the positivity in that experience they will likely feel confident to try for a bit longer each time.
Rule out underlying causes. If there is a vomiting condition making each feed extremely unpleasant for your baby or a tongue-tie preventing a good latch then speak to a healthcare provider to try and rule some of these things out OR get the appropriate treatment. Until these issues are resolved or managed there will unlikely be any change to your baby's aversion. I will say here though, that in my experience a frenulotomy or tongue-tie division, isn't always a quick fix or neccessary. I've worked with babies who have a tie but don't have it snipped and made progress. My baby has quite a significant tie and doesn't have bottle aversion. Also, sometimes the longer it's left the less impact on functionality and the greater trauma (due to increased awareness) can actually be detrimental.
Seek advice. You don't have to go it alone. You also don't need to keep buying different brands of bottle teat until you could set up your own shop of bottle teats. It's not always about the teat so that is a thankless (and expensive) task. Ask a Feeding Therapist for some advice. They will likely need to see what your baby is doing either face-to-face or via video recording. Usually the latter is more beneficial because you capture a true example of what happens. The amount of times a baby has slept through my clinic has proved that. This also goes for the formula you offer too by the way!
Know that time is a healer. I know that sounds cliched, but it can be. Some babies with bottle aversion wean well so it's not a doomed future with feeding. At some point in your babies early years, they won't have a bottle at all anymore. They will learn to drink through a different cup so can take their milk in different ways. They will also be getting the majority of their calories from food which takes the strain off. That being said, I really do know how long those early days can feel with a newborn, focusing on every detail and feeling tired, worn out, confused and alone. I promise, it gets better.
Ignore unsolicited advice. Hands up if the older generation in your life make comments and give 'advice' that actually makes you feel like a failure or worse about the situation 'we never used to have this, just keep trying' 'they'll take it if they're hungry'. Stop listening to that and start seeking science-backed guidance like this to help.
Please don't sit with this on your own! Not seeking help can be detrimental to you and you baby! Take good care of yourself when you can, it's wild out there!
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