Bottle Refusal

What do you do when your baby will not accept a bottle and you need to go back to work? You’ve seen the commercials on tv and photos on social media of babies happily sipping away on their bottles. You may not have been prepared for your baby to refuse one. But I’m here to tell you, bottle refusal is common and at times very hard to break in the breastfed baby.

If you plan to go back to work, I always recommend introducing a bottle to your breastfed baby at about 4-6 weeks old. That way, baby is in a routine and feeling comfortable at the breast but also young enough to accept a change in how they receive their milk. The bottle should be offered using the Paced Bottle Feeding method and under very low pressure conditions (not too hungry, no forcing, stop and try again later if baby gets upset).

So what happens if you missed that 4-6 week window and baby refuses the bottle? Here are a few tips I use to try and get baby to accept and drink from the bottle.

-Use a slow flow nipple. Pay attention to the shape. The shape of the nipple should be long with a gradual transition from base to tip. This is how your breast is shaped when the baby is latched and sucking. Ditch the wide based nipples.

-Allow the baby to take a few sucks of the bottle while tipping the milk back so they are just sucking air for the first few sucks and then allow the milk to flow in the nipple. This is similar to how they feed at the breast, suckling before the letdown.

-Mom should be in a different room or out of the house altogether. The caregiver should try feeding in the same room mom would feed in with a piece of her worn clothing near by. If this doesn’t work, you can try the complete opposite. Perhaps a room baby has never fed in with little to no smell of mom nearby. In both cases mom should not be present. If mom is nearby, baby is going to want their milk the typical way, from the breast.

-Offer the bottle in between feeding times where baby is not very hungry but could be interested in eating. A hungry baby has no patience to try a new feeding method.

-Try different positions and locations. I’ve had a lot of luck with the caregiver feeding the baby in a baby carrier while walking around the house or outdoors.

-Going along with the paced feeding method, let baby latch onto the bottle as opposed to putting the bottle in baby’s mouth. Touch the nipple to the lips and allow baby to open wide. Keep the bottle horizontal while feeding and give breaks often.

-Try to offer the milk at different temps. Try first with the milk warmed similar to the temp it would be coming from the breast. If that doesn’t work try room temp. Some babies will even prefer it cold especially when they may be teething.

-Try distracting baby while offering the bottle. Singing, walking around the room, telling a story, bouncing or swaying lightly.

-Taste the milk you plan to give baby. Does it taste and smell fresh? Does it have a strong soapy taste? If so, you may have high lipase and the baby could be refusing the milk due to its taste.

-Allow baby to play with an empty bottle. Let them get used to the feel of the nipple and remove the sense of stress or pressure around the bottle. This works for older babies who can grasp.

If all else fails, there are alternate feeding methods! Cup feeding is one of my favorite ways to feed a breastfed baby. Or if your babe is 6 months+, try straw cups.

Let a Lactation Professional help you get through bottle refusal. Don’t stress out, allow me to figure out what trick can make bottle feeding work for your baby!

Breastfeeding and Coffee

Are you a coffee lover like I am? I may be a gluten-free plant-based vegan, but you’re not going to convince me to take this hot cup of joy out of my hands in the morning! I can’t think of a time in my life when I needed coffee more than when I was breastfeeding my newborn babies. But is it safe?

Here are the facts. Mild to moderate consumption of caffeine is generally safe for a breastfeeding mama to consume (LLLI). Two to three cups of coffee or under 300mg of caffeine is unlikely to negatively effect your baby. However, younger babies (under 6 mo) may be more likely to show effects of caffeine such as irritability or wakefulness.

Here is what I recommend. If you’re breastfeeding and coffee is something you enjoy, drink up! You deserve it and let’s be real, you probably need it. If you notice baby is showing symptoms after you consume coffee and nurse, decrease the amount you’re drinking. If your baby is still showing symptoms, eliminate the caffeine for 2 weeks and see if baby is still exhibiting the same irritable behaviors. If you need to cut your cup of coffee out of your diet because you think your baby is showing undesirable symptoms, give it a break and try adding your coffee back in after your baby is 6+ months. If you’re baby is full term and seemingly unaffected by your caffeine consumption…CHEERS!

Keeping Baby Awake for Feedings

Newborns are notorious for dozing off during feedings. How do we keep baby actively suckling so we get a good feeding during each nursing session?

First, look for feeding cues. The best time to feed baby is when they are in the light sleep stage. You may see their eyes twitching underneath the eyelids, their hands creeping up to their mouth, the start of leg and arm movements. This is the best time to bring baby to the breast and get a good feeding.

If baby starts to doze off or stops actively suckling, try breast compressions while they are still latched. You can run your fingers gently down your breast toward the nipple or hold your breast in a C shape and gently compress milk into baby’s mouth.

If baby is still sleepy at the breast, you can massage their jaw from the side reminding them to keep suckling.

If all else fails, try undressing them, adding more light to the room you’re nursing in or patting them gently with a wet washcloth.

Is My Baby Getting Enough Milk?

As an LC, I’m often asked this important question. ‘How do I know if my baby is getting enough milk?’

The best way to determine if your baby is getting enough milk is by monitoring their weight gain. Your baby should gain about 4-7 ounces a week for the first 3 months of life. But how do you tell if baby is getting enough milk on a day to day basis without having to wait for a weigh in at the pedi or with a lactation specialist?

Here are 3 important things you can look for to reassure you that your baby is feeding well.

1. Diaper Output. Baby should have 1-2 wet diapers in their first 24 hours of life and at least 1 poop. On day 3 through 6 weeks of life, baby should have at least 6 wet diapers and at least 3 stools per day.

2. After 2-3 full days after birth you should notice your milk come in. You may observe milk leaking from your breasts or your breasts will feel full. You will see milk on baby’s lips or in their mouth after a feeding and hear baby swallowing at the breast. If you don’t notice the signs of your milk coming in, set up an appointment with an LC as soon as possible.

3. Your baby has a good healthy looking skin color and there are several times throughout the day when they are active and alert. Note: newborns are sleepy! However, there should be several times during the day and night when they are awake and alert.

It is so important to meet with a lactation professional after you bring baby home to make sure your baby is latching correctly and properly transferring milk. As an LC, I love answering all of mamas questions and showing her how to make breastfeeding comfortable for her and baby.

Let’s set up a lactation session. My prices are very affordable and the value you will get from the appointment will no doubt make you more confident and less concerned about the issues you’re experiencing! Studies show mamas who meet with lactation specialists are more successful at reaching their bf goals!

Christine Opre, MS; CLC®️

Switching Breasts When Nursing

Moms often ask when they should switch breasts while nursing. There really is no rule when it comes to switching sides and sometimes the baby just needs one breast to be satisfied. I like to remind my clients to follow their instincts and switch breasts when they feel it’s necessary.

Here are some situations that might suggest it’s a good time to switch breasts while nursing.

  • The number of sucks baby takes increases before you hear a swallow
  • Your breast feels “empty” and baby is still interested in feeding
  • Baby is getting fussy, popping on and off the breast after nursing comfortably
  • Baby nurses for a while then pops off the breast
  • Your other breast feels full and you’d like to relieve the discomfort

If your baby only takes one breast per feeding, remember to start on the opposite breast for the next nursing session (unless you are block feeding). I used to wear a bracelet and switch it to the side I needed to start with next feeding.

Baby-Friendly Hospitals

For prenatal mamas who choose to deliver at a hospital, I recommend finding a Baby-Friendly Hospital! Baby-friendly hospitals give mamas the information, confidence and skills needed to successfully initiate and continue exclusively breastfeeding their babies. The staff at a baby friendly hospital is specifically trained in breastfeeding education to ensure mamas have the experience and assistance they need to be successful with nursing. The Baby-Friendly Hospital Initiative (BFHI) implements the 10 steps to successful breastfeeding and gives mamas every opportunity to feel supported and confident feeding their little ones. Find out if the hospital where you plan to deliver is baby friendly by going to babyfriendlyusa.org. There are a few of them here in NC, close to home!

Society and Breastfeeding: Then and Now

This Facebook memory popped up and a flood of memories came rushing over me. My grandmother and I always had a very close relationship and I miss her dearly. We always talked a lot about her memories growing up and eventually starting a family. When I was nursing my first baby she told me about her experience. She had her first baby in the 50’s and her doctor told her she couldn’t breastfeed simply because she “can’t’.” No explanation was given and she said he was noticeably uncomfortable with her asking about it. He gave her medicine to dry up her milk and insisted she feed her baby (my dad) formula.

Back then breastfeeding was frowned upon especially in the middle and upper class societies. My grandmother told me people thought breastfeeding was gross and women only nursed if they were poor and couldn’t afford formula. I’m so happy our society has come so far since the 50’s and the fact that moms nowadays are more educated and encouraged to breastfeed their babies. Don’t get me wrong, there is a lot of work that needs to be done to take the perception of sex out of feeding our babies with our breasts. But I am so glad (and my grandmother was too) that I was able to breastfeed my babies without the added stress of society telling me I couldn’t.

And I feel even more blessed that my life’s work is to educate and help women do what we were give the gift to do…nourish our babies with our bodies.

Foods You Eat and Your Breast Milk

Did you know that your baby is exposed to the different tastes and flavors of the foods you eat through your breast milk? The foods we consume slightly change the taste of our milk, exposing our baby to the flavors they will someday consume directly. I find it fascinating that my girls LOVE their green juices in the morning. When I was nursing both times, green juices were a huge part of my morning breakfast routine. Could it be they were exposed to the leafy flavors early on when they were nursing and now they developed a preference for it? Well maybe but maybe not. Research suggests babies may react less negatively to the flavors they have been exposed to via breast milk. Whether they end up liking the food or not is subjective.

There is also research being conducted on breast milk and allergies. There is early evidence that may suggest when mom consumes a potential allergen and nurses baby, the baby has less of a likelihood of developing an allergy to that food. Very similar to desensitization therapy. Little exposures to certain foods may help develop a tolerance and possibly a preference for them.

Sources

Hausner, et al. 2010; Boston Children’s Hospital.