Nightingale Night Nurses 2-2020-192

5 Top Bottle-Feeding Problems + Solutions

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Is your baby having bottle feeding problems? You’re not alone. Come feeding time, so many factors come into play that can affect how well your baby eats. If your baby refuses the bottle, falls asleep, drinks too quickly or too slowly, or spits up a lot, you’re in the right place. Let’s dive into top bottle feeding problems and their solutions. 

Refuses the Bottle 

There are several reasons why babies refuse their bottle. If your normally breastfed baby won’t take a bottle, there are a few strategies to try such as:

  • Different bottles
  • Different caregivers
  • Different positions
  • Different bottle temperature

First off, we recommend trying a different bottle like Dr. Brown’s Wide Mouth Glass Bottle or Comotomo, which more closely resemble the breast. Secondly, have a trusted caregiver offer the bottle when the baby is relaxed, mildly but not overly hungry, and when Mom is out of the house. Lastly, try mixing up different variables like feeding position, bottle temperature, or movement while feeding. Read our full post on tips for a breastfed baby who won’t take a bottle here.

If your normally bottle fed baby suddenly refuses to eat or becomes frustrated quickly after starting a bottle, there could be several factors at play:

  • Temperature: too hot or too cold 
  • Blocked bottle nipple hole
  • Bottle cap is too tight leading to lack of ventilation/
  • Bottle nipple too small/slow
  • Bottle aversion due to recent negative association with feeding, like choking on milk or being scared by a loud noise while feeding
  • Expressed breastmilk or formula is not fresh
  • Baby is ill, teething, or distracted
  • Simply not hungry

The solutions: First, always check that the breastmilk or formula is fresh and it’s at a good temperature. Turn the bottle upside down to make sure the bottle nipple hole isn’t clogged. 

Secondly, observe your baby closely. Are they running a fever or lethargic? Call your pediatrician. Are they very upset or frustrated? Try to soothe them first before trying again. Are they simply distracted? Try feeding in an outward-facing position so they can observe whatever is holding their interest, or alternatively try feeding in a dark room to limit distractions. 

If your baby seems well but won’t take a bottle and you know that they must be hungry, call your pediatrician. Some babies develop feeding aversions and need a specific plan to get them back on track. Never forcefully try to feed your baby, as this can make problems exponentially worse. 

Falling Asleep on the Bottle 

Does your baby fall asleep on the bottle? Sometimes exhausted babies get into a vicious cycle where they fall asleep during an unfinished feeding, then sleep poorly because their hunger isn’t satiated. This leads to many short feeds and frequent wake-ups. 

The solution: Get professional support to get your baby into a good feeding and sleeping rhythm. In general, babies should follow the “Eat, play, sleep” routine to avoid hunger and sleep overlap. When babies eat after waking, they have the energy to complete their feedings. After that, they can work out that energy during tummy time or another playtime activity, then they’ll be ready for a nice solid nap. 

Eating Too Quickly

Does your baby attempt to down their bottle in mere minutes? You may hear and see your baby swallowing rapidly as they drink. This can lead to spluttering, gagging, choking, or spitting up. Babies that manage to drink quickly can sometimes fool their caregivers into preparing another bottle, then they promptly take that bottle to satisfy their sucking needs and spit it back up. 

The solution: Encourage paced feeding. Paced bottle feeding allows the baby to be more in control of their intake. First off, make sure the bottle nipple size is right for your baby. There are no standard bottle nipple sizes across brands, but in general you want the smallest size that your baby tolerates well (no frustration, finishes feeding at a comfortable pace). Make sure you’re not angling the bottle down so that liquid comes out too quickly. Try sitting your baby in your lap and supporting the back of their head with your hand, and hold the bottle horizontally. The baby should have to exert some effort to get the breastmilk or formula to flow. Don’t forget to burp your baby and offer breaks!

Collapsing Bottle Nipple

You may be startled the first time a bottle nipple collapses while you’re feeding your baby. Your baby will be surprised as well, since they won’t be able to get any milk out! A collapsing bottle nipple means there’s a problem with venting. Thankfully, this is usually easy to fix:

  • Check that the the ring isn’t too tight
  • Check that the the nipple is sitting flat in the ring and isn’t squished or crooked
  • Check that the bottle nipple hole isn’t clogged
  • Check that you’re using the same brand/style of ring and bottle

If everything above checks out, and the bottle nipple keeps collapsing, it may be time to move onto a different brand with a firmer bottle nipple texture. 

Baby spits up a lot

All babies spit up to some extent. Some regurgitate quite frequently, but are no worse for wear – we call those babies “happy spitters.” If your baby doesn’t seem bothered by spitting up and they’re gaining weight well, there’s probably no need to change anything (except stock up on burp cloths!). Other babies are clearly quite uncomfortable after feedings. If your baby spits up a lot, the first step is to make sure they’re not overfed. Pace your feedings, and give lots of breaks and opportunities to burp. 

The next thing to try is to encourage your baby to remain upright (and as wiggle-free as possible) following a feeding. Hold them calmly against you and gently rub or pat their back. Laying a baby down with a full stomach can cause them to spit up quite a lot. 

If your baby is spitting up and is clearly uncomfortable, schedule a visit with your pediatrician to assess for reflux or allergies. GERD in babies can be treated with prescribed feeding changes and/or medication. 

Common Bottle Feeding Problems + Solutions

Common bottle feeding problems include refusing the bottle, falling asleep on the bottle, drinking too quickly, bottle nipple collapsing, and spitting up a lot after feedings. Thankfully, most of the time these problems can be resolved at home with simple adjustments. However, if your baby is unwell or is struggling with feeding, don’t hesitate to call your pediatrician. Some bottle feeding problems require medical support.