Monday, March 11, 2013

MiM Mail: Refusing the bottle!

Returning to work from an 8 week maternity leave has proven more stressful than I thought but for a reason I didn't anticipate!

I'm currently a second year internal medicine resident and welcomed my first child into our hectic world 8 weeks ago. I was all set to return to work (but more time is always be better) ready with my pumping gear and planning out a loose schedule to hopefully make pumping work. I missed the chaos of inpatient medicine but thankfully, I've been eased into my return with an outpatient block but will have to cover a few random overnight calls in the next 2 weeks. As I'm sitting in my office pumping and texting back and forth with my stay-at-home full-time husband, we realize that our LO is refusing her bottle!! We did trial runs prior to this day and she happily took the bottle from her daddy but now she either plays with the bottle (even with her hunger cues) or flat out spits it out and then cries. He has tried many different tactics (different room, walking, holding her different positions, not waiting until too hungry, having something close to remind LO of her mommy or taking it away, etc), and we've discussed our situation with a lactation consultant who offered some additional tips. LO finally took a bottle once while relaxed in her swing after a short nap but struggled with the next feeding. She used to make wet diapers early AM/late night when I was home to breastfeed overnight but this has dropped off during the day. So far (it's only been a couple of days) she's still happy and playful in between her naps. Of course I nurse as often as she wants when I'm home but this makes me nervous as my days can be 14-16 hours long when I'm not on overnight call. This of course brings up the times when I'll be at the hospital 28+ hours. What will happen if she's still refusing the bottle? I know some people will say if she's hungry she'll eat from the bottle, but I don't completely buy that line of thought and she can't make up a whole day's worth of not eating in a couple of feeding sessions. She's not breastfeeding anymore than usual when I return home right now. I'm hoping she'll take to the bottle again, but I wonder if anyone else ran into this challenge.

Thanks for any words of wisdom and support.

13 comments:

  1. Same thing happened to me with my youngest. Mine wouldn't take the bottle AT ALL. Don't worry, they get over it. When she doesn't have a choice (i.e. you're not there and she's hungry), she'll eventually take it, I promise you.

    ReplyDelete
  2. She's picking up on your stress ?

    ReplyDelete
  3. Listen to Fizzy, it will be alright. Of course she's having a little bit of a hard time, it is a pretty big transition. BUT! She's loved, safe and well cared for by her father. They will figure out a rhythm together. Consider this to be just like the first few days of life when she & you were figuring out breastfeeding - she and her father are figuring out their own feeding relationship. It sounds like he's working hard to meet her needs and getting lots of the right kinds of support. Tell him he sounds like an excellent Dad! And be kind to yourself!

    ReplyDelete
  4. You both can do this!! My youngest didn't like the bottle either - would take 1/4 oz at a time or something pitiful to just wet her lips til I was available. She did make up for it in the evening - nurse as soon as I was available and a bunch overnight. As for how to make your o/n calls work -> my husband (also a SAHD) would bring my oldest (born when I was a 2nd yr res) to the hospital - he'd bring a diaper bag and a book and I'd do one or two feedings in the call room as pages/admissions allowed. It was pretty boring for him (he'd stay a few hours!) but it meant we sometimes got to eat together on call nights, I could pass off the first 12+hrs of pumping to him to bring home, feed my baby in person and generally brighten my call. I was able to nurse her until >1yo this way. You guys can do it! :-)

    ReplyDelete
  5. Have you tried some sort of cup feeding for her? My daughter refused to take a bottle so I think she was about 3 months when we occasionally used a small medicine cup (the type that comes on top of cough syrup or similar) to hold at her lips and gently give her a bit of milk - more effort required than a bottle but at least she was getting something when I had to go out. Then by about 4 months old she would accept milk from a Take 'n Toss sippy cup - tiny holes in the spout so a slow flow of milk and she didn't have to actually suck at it as she would a bottle (it seemed as if she never quite figured out that she should such a bottle nipple to get milk or that she just plain didn't want to). I didn't have to go back to work until 8 months postpartum so it wasn't quite as much an issue for us as I wasn't needing her to take as much EBM from someone else when she was only a few months old.

    Dr. Jack Newman's site (http://www.breastfeedinginc.ca/content.php?pagename=doc-WFBW) has the following (the most relevant part for your situation): " Some Myths:
    Babies must learn to take a bottle so that they can be fed when the mother is not there. Not true. Why not an open cup? It is true that some exclusively breastfed babies will not take a bottle by 2 or 3 months of age...If your baby is refusing to take a bottle, do not try to force him; you and he may become very frustrated and there is just no need to go through all this...If he is even 3 or 4 months, he does not need to take a bottle. He can be fed liquids or solids off a spoon and by 6 months of age he can be taking enough so that he will not be hungry during the day. Furthermore, he can start learning to drink from a cup even by 1 day of age. The cup can be an open cup and is best not to have a spout (a “sippy” cup is, essentially, a bottle). If, however, he has not got the hang of the cup by the time you must leave him, do not worry, he can take fluids off a spoon..."

    ReplyDelete
  6. They totally have radar for stressful events, don't they? I don't have any advice, but I think what people are saying about sounds good. Good luck!

    ReplyDelete
  7. We had intermittent issues with taking the bottle - it was very stressful. We discovered that a big factor was speed of milk delivery - using a nipple with too slow of a flow caused our kids to protest and refuse the bottle, until we realized it was time to move up a size. If it's a lot harder than breastfeeding to get a meal, some kids don't think it's worth it. I always found those age guides for the sizes to be off. Maybe that's worth a try?

    ReplyDelete
  8. My second one refused a bottle for 2 weeks after I went back to work. She would give hunger cues, Daddy (also a SAHD) would warm up the milk, she'd fuss at him, and then she'd go back to sleep. Repeat x all day long. My little darling was 10 or 11 weeks old at the time, and already chunking up quite heartily, so I didn't worry about her nutrition. Eventually she did figure out that this is how we eat during the day. It sounds like your tyke has the best possible love and encouragement - she'll get there, don't worry.

    ReplyDelete
  9. I second the cup feeding. Also, dad doing skin on skin when feeding can help too. That's what she's used to with you. I had a dad who would take off his shirt, tuck the bottle under his armpit so the nipple stuck out and feed a bottle refusing baby that way...

    ReplyDelete
  10. The fact that I do not remember stress around this issue either speaks ill of me (maybe I blocked it?) or portends well for you.

    Both my kids took bottle well from nanny. How lucky for you that it is dad.

    Lots of good advice above. Good luck!

    ReplyDelete
  11. I agree with Fizzy and others. Took our Zo 7 days of an expressed milk strike to realize he and the bottle had to make their peace. Prior to my starting work he never had issues with an occasional bottle. We made breast milk smoothies (milk and banana, milk and peaches, milk and yogurt, etc . . . .). Your baby will get what he/she needs. Keep pumping and try your best to make the best milk :-)

    ReplyDelete
  12. I was all set to return to work (but more time Blood Pressure Medication is always be better) ready with my pumping gear and planning out a loose schedule to hopefully make pumping work.

    ReplyDelete
  13. Thanks for the great advice and support! My LO got over her bottle strike with some clever tricks by my hubby whom I remind every day is doing a fabulous job. She doesn't eat as much as if I were around but she's not anymore fussy than usual and pretty happy and making enough diapers. I'll of course keep the additional suggestion in my back pocket for when/if LO decides to hold out again.

    I kept trying to write this earlier but was somehow pulled away by my hubby, LO or patients!! Hahaha. Thanks again, everyone. I love this site and it's been a godsend.

    ReplyDelete

Comments on posts older than 14 days are moderated as a spam precaution. There may be a delay between submitting your comment and its publishing. Thanks for commenting!