How to get a breastfed baby to accept a bottle?

- Their mouth is wide open to latch onto the nipple and areola
- Their lips are "flanged", folded outwards
- Baby's tongue is forward and extends over their lower lip

- Baby's mouth is properly sealed
- The lips are flanged around the teat
- The tongue is at the back of the mouth and draws milk out of the bottle

The baby starts refusing the breast out of "laziness" because the flow from the bottle is faster, whereas at the breast they have to make an effort to suckle. A baby taking a bottle is also immediately rewarded by the flow of milk, whilst a baby at the breast has to wait for the let-down reflex to receive it.

The baby can no longer suckle effectively and extract milk from the breast. The baby will start to suckle less well and take in less milk. 

A growing number of experts suggest that this difficulty may be a sign of an underlying weakness in sucking, which prevents the baby from adapting when a teat is introduced. In that case, it is not so much the teat or the container that is at fault, but an underlying issue that prevents the baby from adapting.

The baby's mouth should be well filled, and the teat should reach far enough into the throat to touch the soft palate, just as during breastfeeding. If your baby tended to push the breast away with their tongue when experiencing reflux or nausea, they will do the same with the bottle. In that case, introduce the teat into their mouth gradually.

La Leche League recommends using standard teats rather than orthodontic teats, which better replicate sucking at the breast. The teat should be as soft as possible (opt for silicone over latex). A soft teat adapts to the baby's mouth and sucking action, not the other way around.

It is best to choose the slowest flow rate possible from the start. At the breast, your baby has to work to receive the milk.

You do not need to change teats as your baby grows (flow rate does not change at the breast over the months), but you can stay on a flow rate of 0 or 1, unless the flow is really too slow.

To check whether the teat flow rate is appropriate, you can use the feeding duration as a guide: if your baby finishes their bottle in 5 to 10 minutes, the flow rate is far too fast and you need to switch to a slower teat. If, on the other hand, your baby takes more than 30 minutes to finish a bottle, the flow rate is probably too slow and your baby risks tiring themselves out whilst feeding.

In the context of mixed feeding, it is particularly important to be mindful of the risk of nipple confusion. The main cause of nipple confusion is a preference for flow rate. The baby starts to refuse the breast out of "laziness", as the bottle flows more quickly, whereas at the breast they have to make an effort to feed. 

– Baby sits upright on your lap to take the bottle
– The bottle is held parallel to the floor, not vertically as is most commonly done. The milk should always be horizontal in the bottle. This way, the baby drinks only what they need, at their own pace, just as with breastfeeding
– Do not force the teat into the baby's mouth; instead, offer it near their mouth or nose, making small movements, and wait for them to take it. As with breastfeeding, they should never be forced.
– Then wait for the baby to take 2 or 3 sips, then lower the bottle so the teat empties
– Put the bottle back to horizontal when the baby is ready and asks again, and so on until the bottle is empty
– When the bottle is nearly empty, you can tilt the baby to 45 degrees so they don't swallow too much air

– Warm the milk well to 37 degrees to get as close as possible to the temperature of breast milk
– After warming the breast milk, you can soak the teat in the warm breast milk for 1 minute (or in warm water if it is infant formula)
– Do not wait until your baby is hungry before offering them a drink (especially very hungry, i.e. in tears), as this is likely to make things even harder — instead, offer it at the first signs of hunger
– Do some tests with your milk before freezing too much. Some mothers have breast milk with a high lipase concentration, which causes a change in smell (like soap) that some babies dislike. If this is your case, before freezing any more and risking your baby refusing it, heat your milk before freezing it. To find out more, see our article "How to store breast milk".
– If your baby refuses the milk, do not force them to drink

The soft cup is a spoon-bottle that can be a good alternative if your baby has difficulty latching. It can be used from birth, or when the mother returns to work.

Its tip allows milk to be taken gently and in a controlled way. Baby won't suckle but will lap the milk.

The babycup resembles a small graduated cup, adapted to little hands. It is dishwasher safe and is free from bisphenol A and phthalates.

It is a good option for giving milk to a breastfed baby who is in someone else's care. The milk should be placed against the baby's mouth so they can lap it at their own pace.

You can also use a simple teaspoon. Baby will then lap up the milk. A teaspoon holds around 5 ml of milk.

When you start weaning your baby, you can also make breast milk flans using agar agar.