Baby refusing breastmilk (or formula)?

Call them nursing strikes, call them bottle refusal. If you’ve found your way to this post, you know what I’m talking about.

As a Registered Dietitian Nutritionist (who also dealt with a baby who completely refused bottles) I wrote this post to walk you through all my best tips and suggestions to manage any sort of refusal you’re dealing with!

While it is super stressful when your baby is refusing breastmilk or formula, it’s actually not uncommon or unexpected. I don’t know about you, but it brings me some comfort personally when I know something is normal. These “nursing strikes” or bottle refusals are pretty common for most babies between 7 to 12 months of age. 

Baby refusing breastmilk or formula 6 months or younger 

But for the first 6 months, breastmilk and/or formula is a baby’s main source of nutrition and hydration, as you know. So of course it’s worrisome when they all the sudden take in less than before or start refusing it altogether.

If you’re in this situation with your 0-6 month old baby, please talk to your child’s doctor if it goes on for any length of time. While it can be normal, you always want to get eyes on your baby to rule out any potential issues or signs of dehydration. Especially if baby is showing any other signs of illness.

In this post, I’m going to be talking mostly about older babies. Babies who are well-established on breastmilk/formula and already eating complementary foods. It becomes more common to see milk refusal as babies approach the age of weaning off of breastmilk/formula in favor of a more food-first diet. 

Why is baby refusing milk?

There are a number of reasons your baby may be refusing breastmilk or formula. 

It can be due to sickness or discomfort, teething, a fever, or maybe they’re just…not hungry. Some babies want to feed more during these circumstances, but some want to feed less! 

One of the trickiest parts of being a parent is knowing why something is happening! It can be so hard to pinpoint a reason for a baby’s behavior. Sometimes they just throw us for a loop even when nothing is seemingly wrong. 

If your baby is refusing breastmilk or formula, try to rule out what you can. Is he/she visibly sick? With a fever? Are teeth coming in? Do they flip out any time you try to give a bottle instead of the breast?

It never hurts to call your pediatrician’s office or nurse line and run it by them. They will have insight into each potential scenario and will screen for issues, plus give you some suggestions of what to do. 

Steps to manage breast refusal and maintain milk supply

1. Use a pump to maintain supply:

If your baby is refusing the breast, use a pump to keep your milk supply up. Try to pump as often as you would normally feed to maintain the supply and demand balance.

Even if you don’t get the desired number of ounces, it’s still beneficial to pump. Many women produce less milk when pumping compared to breastfeeding, so don’t worry about your supply diminishing.

2. Offer the breast first:

Always offer the breast before pumping, as you normally would. If the baby refuses, then use the pump.

3. Avoid skipping feeds:

Do not skip feeds altogether, if possible. You can even hand express if you don’t have a pump! This will help to maintain your milk supply and prevent mastitis, an infection caused by clogged ducts due to milk backup.

4. Manage distractions:

If you suspect your baby is refusing feeds due to distractions, try changing the location. Older babies can get distracted and fidgety during feeds. Relocate to a quiet room, turn off the TV, or get away from siblings for a few minutes.

5. Evaluate their overall feeding schedule:

Sometimes baby is ready to reduce their daily number of nursing sessions because they become more efficient at getting more milk, or because they are taking in more solids.

6. Consult your doctor for infants or sick babies:

If your baby is an infant or sick, contact your doctor.

7. Consult an IBCLC for older babies:

If the refusal is happening with an older baby and there are no apparent reasons, consult an International Board Certified Lactation Consultant (IBCLC) in addition to your doctor.

8. Collaborate with healthcare professionals:

Some pediatricians’ offices may have an IBCLC on staff. Work with your doctor and IBCLC to create a plan that includes weight checks and tracking feeds more closely, if needed. They may also recommend supplementing or fortifying breastmilk or formula.

What not to do if baby is refusing breastmilk

If your baby is refusing his/her breastmilk or formula, it can be really stressful! You’re probably in problem-solving mode, but there’s a few things not to do when this problem arises.

1. Don’t stop trying. Like I mentioned above, you can tank your milk supply if you don’t remove enough milk from your breasts. Plus, baby could decide one time that they change their mind, and poof! Your issues are solved! (They’re not the most predictable little things!)
   • HOWEVER! If it’s affecting your mental health or emotional well-being and their refusal leads to the end of your breastfeeding journey, it is not your fault. Your well-being is an important factor to consider and you should not sacrifice it. So if you are getting to that point, it is totally okay. (Even if it feels emotional or tough.)
2. Avoid offering other liquids to compensate. Babies under 12 months old shouldn’t have any other milk as a drink. They also shouldn’t have any other beverages besides a few sips of water with food (for those 6+ months). 

Baby refusing formula

If your baby is just starting formula and they’re refusing it, don’t get discouraged. Sometimes it takes time for babies to adjust to formula/a new formula.

Tips to manage the transition

If you’re transitioning from breastmilk to formula, there are a couple things you can try.

1. Gradual mixing: Offer your breastmilk mixed with formula at different concentrations until you reach 100% formula to help your baby adjust.
2. Alternate bottles: Or, instead of mixing, you can alternate bottles of breastmilk and formula to ease the transition.
3. Find the right formula: It may take some trial and error to find a formula that your baby tolerates well. For a deeper exploration into formula options, refer to this post. Know that the best formula is the one your baby tolerates well! It may not be the one you originally wanted to use. That’s not your fault.
4. Address GI issues: If your baby is experiencing what you believe are GI issues related to breastmilk or formula, they may benefit from a specialized formula. It is crucial to work with your child’s pediatrician to address these issues and not to troubleshoot on your own.

Baby refuses bottle

Sometimes the issue is not with the breastmilk or formula itself, but with a baby refusing the bottle! I somehow was 2/2 with babies that had a hard time taking a bottle.

This issue can be common in breastfed babies. They may prefer the breast and feel like they have to work too hard to get the milk out of a bottle. Nipple flow on a bottle doesn’t always mimic the breast, and sometimes these babies are just downright opinionated.

If your baby is refusing a bottle and you did a quick Google search, let me stop you before you spiral into the depths of mom guilt. It’s not the pacifier’s fault. You sometimes hear that using a pacifier leads to rejecting breast or bottle, but studies don’t confirm that.

What can you do if baby is refusing the bottle?

This one can also take a little trial and error. 

You can drive yourself crazy (and go broke on the way!) trying every different type of bottle. Sometimes that’s not the problem! I recommend trying one or two along the way to get your baby used to them and see what goes well, but there isn’t always a magic bottle that’s going to work every time. 

Other ideas for bottle refusal include: 

1. Play with the temperature: Of course you never want to make it too hot, but some babies like it cooler and some like it warmer.
2. Have mom leave (if possible): Some people have more success with bottle feeding when mom is out of sight.
3. Use a distraction: Okay, I know we don’t want our babies to be watching TV at this age, but sometimes giving them something else to focus on for a second can help distract them from the fact that they hate the bottle!
4. Feed sitting up instead of in nursing position: It can be difficult to take a bottle from a reclined position. It’s best to position baby in a semi-upright or seated position with a bottle.

I’m definitely not an IBCLC (they’re the ultimate experts), but I’ve seen lots of content out there about bottles and babies. Sometimes the cute trendy bottles are actually NOT the right shape for baby.  The ones trying to emulate breast shape SEEM like they would be good, but the nipple is often not big enough or long enough to simulate what would happen if a baby was on the breast and their little mouths can’t pull in enough. 

If breastfeeding is not an option for you, or if you’re going to be away from baby for an extended period of time and are worried about bottle refusal, please contact your pediatrician and IBCLC. Your team can help you come up with the best plan for feeding your baby! Infants can actually even learn to drink from a cup! We have options! 

What to do if baby refuses frozen breastmilk

If you’ve worked so hard to build up a little freezer stash, and you go to defrost some of that liquid gold AND YOUR BABY WON’T DRINK IT…I feel your pain. 

The truth is we don’t fully understand why a baby might refuse frozen milk. It is possible that it’s related to changes in taste and smell of the milk once it’s been stored and frozen. 

While milk that is frozen and defrosted may smell different (or bad!), it’s safe to use as long as you followed proper safe storage guidelines.

You may have heard that scalding milk before freezing can reduce change in taste, but the Academy of Breastfeeding Medicine recommends against scalding milk, as discussed in this article.

Here are some suggestions for when baby refuses frozen breastmilk:

1. Try combining some freshly expressed milk with the frozen milk, to see if they are more accepting of the taste when combined.
2. Freeze milk for as short of time as possible. The longer milk is frozen, the greater the potential for changes in smell or taste. 
3. Give yourself permission to use formula as needed. I completely understand the desire to give baby breastmilk 100% of the time. But if they won’t drink frozen milk no matter what you try, you CAN use some formula (without any guilt). Sometimes we just cannot be “perfect” and that is truly okay. Especially in this case, when formula will still give them all the most necessary nutrients and keep their belly full when you are away.

Don’t try these things at home for baby refusing breastmilk or formula

I want to reiterate a few things because we’re all about safety and nutrition here at Mama Knows. 

If your baby is refusing breastmilk or formula, don’t give them cow’s milk as a replacement. Excess cow’s milk can be hard on little kidneys, and it can displace other important nutrients they need to get through their main source of nutrition. 

Cow’s milk is fine as an ingredient in food once baby is starting solids, but we want to hold off on it as a drink until after age one. That can be a little confusing! But it’s really the amount that’s the distinguishing factor here. A little bit of cow’s milk here and there, should be totally fine. But putting cow’s milk in a bottle or serving it multiple times a day is not recommended for babies under one.

I wish I didn’t have to say this one but, please don’t try to make your own baby formula.

It’s not safe to make your own baby formula at home. There are many reasons why not, but from a nutrition standpoint, baby is NOT going to get all of the critical nutrients they need to develop properly. The FDA warns parents against homemade formula and mentioned reports of babies who were hospitalized due to low calcium intake.

Don’t think breastfeeding is the ONLY choice! There are so things that factor into how you choose to feed your baby. 

If you want to breastfeed, it also doesn’t have to be all or nothing. Many people embrace a hybrid approach using both formula and breastmilk depending on their desires, milk supply, work schedule, sleep, or child care situation. 

Getting started with solids?

The early days of solids are usually pretty messy with very little eating happening. But as the months go on, some babies start really preferring solids over breastmilk or formula.

We want to maximize the nutrition they’re getting from food as they start eating more solids and drinking fewer ounces of breastmilk or formula. And we want to prioritize some important nutrients that they’ll need to start getting more from their diet as they drink less breastmilk/formula. 

One of those nutrients of concern is iron. Some iron-rich foods I like to prioritize for babies and toddlers are meat (or meat-based baby food pouches like these from Serenity Kids), potatoes, chickpeas, spinach, and Cheerios (yes, I said Cheerios!). 

Give these baby-friendly banana oat pancakes a try, or offer something savory like this baby and toddler-approved meatloaf.

I have a few posts about starting solids with younger babies and older babies.

I also have a free guide called Simply Solids that will walk you through the stages in a more in depth way!

And finally, I created a two-week baby led weaning meal plan you can download complete with meal ideas, helpful tidbits, and all my favorite gear!