Expert: Sally Wendkos Olds - 4/2/2009

Question
My son is 9 months and I have been breastfeeding since birth.  The problem is that I can’t get him to switch to something else.  I’ve tried giving him a bottle for a whole week.  I’ve also tried giving him a sippy, but they are only toys to him.  How can I get him to stop nursing and switch to something else so that I can return to work?

Answer
Dear Amy,

First, congratulations for giving your son the best start in life by breastfeeding him! As for the current situation, I consulted a wise and experienced lactation consultant, and between us we have a few different thoughts for you:

* You will still be giving your son formula until he is one year old. At that time he can switch to plain cow's milk.

* I assume that he's eating some solid foods, so you can give him formula in cereal or pudding.

* You may be feeling pressured to wean him completely so you can go to work, but complete weaning isn't necessary.

* Many women who go back to work after having a baby combine nursing and bottle/cup feeding. They nurse morning and night, and have a caregiver offer milk in bottle or cup when they're not home. Maybe he would take water or juice from the cup and just get the “real stuff” directly from you.

* He may get enough nutrition from his solid foods while you're at work, then he can just nurse when you're with him and won't need to take formula at all.

* Try giving him a little juice in a sippy cup or a cup with a fun curly straw attached. Show him how to sip from the straw or cup and if he likes the juice, he might then be willing to try drinking milk from the same cup.

* Offer him formula in a cup or bottle shortly after he has nursed, when he's not so hungry. As he's playing with it he may discover that there's something good in there.

* Go out for a short time around his usual feeding time, and have someone else give him a bottle or cup, while you're not home. It may take a few tries. Then at the time of his next usual feeding, nurse him.

* I am attaching an excerpt from my book about helping babies who refuse a bottle.

I hope one or more of these ideas will help.

Good luck!

Sally
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Sally Wendkos Olds
Author, THE COMPLETE BOOK OF BREASTFEEDING: Eiger & Olds, 3rd edition 1999, published by Workman Publishing & Bantam Books, and available in most public libraries, bookstores & La Leche League chapters. Now in revision for a fourth edition, with pediatrician Laura M. Marks, M.D.
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FROM NOT YET PUBLISHED 4th EDITION OF THE COMPLETE BOOK OF BREASTFEEDING:

What If Your Baby Refuses the Bottle?
Your baby may absolutely refuse to take any nourishment from a bottle. Some go on “hunger strikes” if they can’t have the breast; no matter how ravenous they get or how piteously they cry, they won’t give in. Families cope with this in a number of different ways. One of the following may work for you:
• Nurse as much as possible while you’re home, so even if your baby won’t take a bottle while you’re gone, she’ll still be getting a good supply of milk.
• Brush your baby’s mouth with the nipple and let him grasp it himself instead of pushing it forcefully into his mouth.
• Warm the bottle nipple and the milk to body temperature by running warm water over the nipple and the bottle. Never warm milk in a microwave -- you can get hot spots, which can burn your baby's mouth.
• Ask someone else to pick up your baby while she’s sleeping, but almost ready to wake, and feed her milk in a bottle. Do this for a while, and then try it when she’s awake.
• If your baby absolutely will not take a bottle, try offering milk from a cup. You don’t need a special cup. Any cup will do, although the infant “sippy” cups with two handles and a lid are the least messy. You may want to use a bib with a plastic or rubber backing: While preemies are very neat about cup feeding, term babies usually are not!
• Or you can start by feeding milk through a large medicine dropper or a spoon, either rubber-coated or plastic. Sometimes, once the baby has received a couple of ounces of milk this way and is not so desperately hungry, he’ll be willing to tolerate the bottle for the rest of the feeding.
• Experiment with different kinds of milk. One mother discovered that her baby preferred fresh, refrigerated breast milk over thawed frozen milk. If you’re feeding formula, try another brand, after consulting with your baby’s doctor. Or try different proportions of breast milk-formula mixture to get your baby used to the taste of formula. You can start with three-quarters breast milk, one-fourth formula and gradually increase the amount of formula.
• Experiment with different feeding positions. Have your caregiver try propping your baby against her raised legs, or holding him facing out, so he can’t see her. (We don’t know why this works, but some babies feed better this way.)  Doing this in front of the television sometimes helps. We’ve also heard of a dad putting on his wife’s bathrobe and tucking the bottle under his armpit, with good results.