Transcript: Help! My Baby Won’t Take a Bottle!

View Episode

The Boob Group“Help! My Baby Won’t Take A Bottle!

Please be advised, this transcription was performed from a company independent of New Mommy Media, LLC. As such, translation was required which may alter the accuracy of the transcription.

[00:00:00]

Veronica Tingzon: Once the baby reaches about 3-­‐5 weeks of age, breastfeeding parents might consider offering their babies a bottle of expressed breast milk here and there. Every once in a while though, the infant has different intentions and may refuse to take the bottle. What’s a parent to do? I’m Veronica Tingzon, an international board-certified lactation consultant and the owner of The Original Comfort Food in San Diego, California. Today, we’re discussing what to do when your breastfed baby refuses to take a bottle. This is The Boob Group, Episode number 9.

[Theme Song/Intro]

Robin Kaplan: Welcome to The Boob Group, broadcasting from the Birth Education Centre of San Diego. I’m your host Robin Kaplan. I’m also a certified lactation consultant and owner of the San Diego Breastfeeding Centre. At The Boob Group, we are online support group for all things related to breastfeeding. Wondering how you can become involved with our show? Visit our website at http://www.newmommymedia.com where you can send us comments or suggestions through the contact link. Join our conversation on our Facebook page. You can even call the boob group hotline at 619-­866­‐4775. The Boob Group is also looking for listeners to join our blogging team. If you’d like to share your current or past experiences about breastfeeding, be sure to send us an email. Today, we’re joined by three fabulous panelists in the studio. Ladies, will you introduce yourselves please?

Keegan Sheridan: Hi, I’m Keegan Sheridan. I’m 35 years old. I’m a naturopathic doctor and also a natural food and lifestyle expert for major cereal company. I have two children. The oldest is 23 months and the youngest is almost 6 months.

Val Velasquez: I’m Velasquez. I’m 26 years old and currently a stay-­‐at-­‐home mom. I have two small children, Olivia and Mila. Olivia is 2 1/2 and Mila is almost 11 months.

Christina Williams: I’m Christina Williams. I’m 33 years old. I’m in medical education. I have one daughter. She is just about 5 months.

Robin Kaplan: Well, thanks for joining us ladies.

[Theme Music]
[Featured Segment: Breastfeeding Tips For The Working Mom]

Robin Kaplan: Before we get started with today’s topic here’s Wendy Wright talking about breastfeeding tips for the working mom.

Wendy Wright: Hi, Boob Group listeners. I’m Wendy Wright, an internationally board certified lactation consultant and the owner of Lactation Navigation in Palo Alto, California. I’m here to answer some of your most common questions about returning to work as a breastfeeding mother. One of the questions we get all the time is what should I do to plan for my first day back at work? This is a huge step. The very first day and in fact, the first week can be extremely stressful for new moms. We’re sleep deprived.

Everything is new to us and we’re missing our infant terribly. Some of the things to do before your first day back, may be you could take a practice day. A day which you’re not obligated to go to work but you could actually pretend to be at work. Drop your baby at day care or have your nanny come over. Pump during the day, run some errands and actually get out of the house, practice getting dressed and being places on time. Just a practice day should make you feel much more comfortable that first day you do need to return to the job. Also, you want to put together a pumping check list which you can have near your front door that you can check in the evening or in the morning on your way out to work.

Contain items like breast pump, shield, tooting, all your valves and membranes, collection bottles and extra storage. Everything that you potentially need to take with you in order to make your pumping day successful by reviewing your check list routinely every morning or evening, you will avoid forgetting things that will really inhibit your ability to feel comfortable during the day. Another idea to plan for your first day and first week would be to start with a short week. If at all possible, start back to work on Wednesday or Thursday, that way you have a couple of days at work and then you have two days on the weekend to regroup, fix anything that didn’t go well the first couple of days, get some sleep and then start again on Monday morning with the five day stretch. And then when you found that it could be very, very successful and also helps you ease back into the new routine. The other thing I’d like to recommend is think about your pumping schedule before returning to work. What is it going to look like and make sure to satisfy time on your calendar. For example, a pumping day may look like this. Wake up around 6 am, nurse your baby, shower dress, have a healthy breakfast and then pump one time before you leave the home. 7:30 or so, leave for work with your baby, 8:00, for example, you might drop off at day care.

Check through your care provider about your baby’s needs and then nurse your infant before you leave the day care provider. Once you arrive at work, clear messages, get organized and take your first pumping break around 10 am. Pump the second time during your lunch hour and a third pumping break sometime around 3 in the afternoon doing your very best to spread the pumping breaks evenly throughout the day. Leave work at 5:00, pick up your baby and nurse while you’re discussing your baby’s day with your child provider. Come home, eat dinner and then just work on getting the baby the closeness and togetherness of your family for the rest of the evening, nursing as necessary, once baby goes to sleep, clean pump parts, get ready for the next day and go to bed as early as possible so you’re ready to face the world. Thanks so much for listening today and please visit http://www.lactationnav.com for more great information about my business, Lactation Navigation. And be sure to listen to The Boob Group for fantastic conversations about breastfeeding and breastfeeding support.

[00:06:15]
[Theme Music]

Robin Kaplan: Today, on the Boob Group, we’re discussing the optimal time to introduce a bottle to our breastfed babies as well as what to do if that baby has refused to take a bottle. Our expert Veronica Tingzon is an international board-certified lactation consultant and owner of The Original Comfort Food in San Diego, California. Veronica, welcome to the show and thanks for joining us.

Veronica Tingzon: Thank you for having me Robin.

Robin Kaplan: Veronica, let’s start with the basics of bottle feeding the breastfed baby. For a breastfeeding mom who wants her baby to take up both the breast and the bottle, when is the best time to introduce that first bottle?

Veronica Tingzon: Well, there is kind of a time window where you really kind of want to introduce the bottle if you’re going to be needing to do so. I mean, not every mother has to but, the ones that are going to introduce it, you want to wait till the breastfeeding has established and usually that’s somewhere about 3 weeks all the way until about 8 weeks. But, what happens is a lot of moms hear the word 3 weeks and they’re tired and they go, “Okay, 3 weeks and I’m gonna introduce the bottle” and they introduce it sooner than they need to. So, make sure breastfeeding has established and the soonest you want to do is about 3 weeks.

Robin Kaplan: Okay, terrific and do you have any recommendations for techniques on how to help the baby go back and forth between the breast and bottle?

Veronica Tingzon: Well, once again first of all, making sure that the breastfeeding is fully well established and what I mean by that is that the baby has the mechanics of the latch to the mom down path. I kind of compare it to being able to use a fork versus being able to use chop sticks. Once you’ve learnt how to use chop sticks, you can go back and forth between the fork and the chop sticks just fine. But, if you try using the fork first and not using the chop sticks, then it’s kind of like “Oh, I don’t wanna learn how to do the chop sticks.” So, learn how to breastfeed properly first, then the whole method of going back and forth between breast and bottle is just keeping the skill alive. “Okay, now I’ve got breastfeeding down, now I’m gonna try to do bottle feeding once a day ‘cause it’s really not that hard of a task.” But, sometimes they don’t want to go back and forth so you still have to keep it up at least may be once a day or once
every other day so that the baby can still be familiar with going to the bottle and then, it’s a skill that they never loose.

Robin Kaplan: Yeah, ‘cause I find that sometimes, like, I’ll get phone calls from moms that are going back to work at about 3 months and the baby took the bottle great for those first couple weeks that they had, after they had introduced it and then also the baby decides they don’t want to want that bottle and so it becomes quite a challenge and a battle of wills almost. Do you find that happens as well with you?

Veronica Tingzon: Oh absolutely, I mean, I get these panic phone calls or in support groups, moms like, “Oh my gosh, can you try to see if you can do it?” you know, and once again that baby is just like, “ah, ah, no way, I want it straight from the tap. I want the real thing. There’s no way I’m going to go to that plastic artificial thing”. And eventually, they do start to take it or start to take a breast substitute. But, it can be a challenge especially if you have somebody who’s not very patient watching your child. So, if it’s a day care center versus, you know, grandma or daddy, so if you can line up somebody that, you know, is very familiar with the child and is going to be patient enough to really kind of, coax their way through to that other form of, you know, breastfeeding substitute, you know, then they’re gonna have more success than the, you know, sterile day care center that’s like forget this, that’s it I’m not even trying.

[00:09:56]
Robin Kaplan: And how should a breastfeeding mom choose a bottle for her baby because I know a lot of them are very concerned and I was as well that this whole concept of nipple confusion and so how to make it so that, would you say there’s a recommendation for how to choose which one’s best for your baby or just kind of try it out?

Veronica Tingzon: It’s kind of the one that the kid chooses. I always laugh when moms get these like, multi packs of one specific bottle and then the mom goes to use it, the kid hates it. You know, I’m like, “don’t do that”, you know, get one of the whole bunch of different kinds and figure out the one that the kid likes. You know, my kid, of course, gravitated, my first child gravitated to the one that was the $7 one that you can only purchase in Japan that my sister sent to me. And of course, that was the $7 nipple that I can find anywhere. And it was that’s just the one he liked and so of course you know, I’m ordering online, you know, $7/ nipple. Whatever, it was the one he liked and it was the one that I was able to go back to work and make sure that he liked.

Robin Kaplan: So ladies, how was that first bottle introduced to your breastfed baby?

Keegan Sheridan: Well, in both cases I think we were around 4 or 5 weeks old when we did it and the first time my husband introduced and second time it was our nanny because we had a nanny already at that, by the time we had our second son. And I just kind of, wasn’t around so, it’s almost, I don’t really, I think it was okay because I intentionally wasn’t there. I’d been told not to be there that it would be hard for the baby to take a bottle if I was around and if he could sense that I was there. So, but I think in both cases that it went actually pretty well.

Val Velasquez: Well, with my first, I supplemented in the beginning, well, I supplemented the whole time so she liked the bottle. The bottle and her were great friends. [Laughs] My boob was not her friends. So, with her, there were no problems. But, with my second, she still doesn’t love the bottle.

Robin Kaplan: And how old is she again?

Val Velasquez: She’s almost 11 months. So, now then, I didn’t even try until she was, gosh, I don’t know, may be 4 weeks old. My husband tried to give her a bottle and she screamed bloody murderer. It was almost like she was offended by it. [Laughs] She was like literally offended and I think eventually what happened is that she just kind of, fell asleep. Yes, she gave up and didn’t not take it. And then you know, and immediately my mom who is like a saint, gave it to her. You know, I’m sure she fussed and was offended by that as well. But, my mom just kind of kept it there and then when she realized that it was my milk inside the bottle, that made her happy so she took it grudgingly but she took it and now still, I mean, it depends like, even right now, like, I hope she’s taking the bottle. She just knows that it’s not the real thing so….

Christina Williams: My daughter is almost 5 months and she’s still refusing. We did get her to take about an ounce a few times but, today we haven’t been very lucky.

Robin Kaplan: And how often do you work because there is definitely a need for her to have some sort of nutrition when you’re away from her.

Christina Williams: I work almost full time so, she spends her days, I do come home during lunch and feed her but she has made up for it by nursing all night.

Keegan Sheridan: And I actually have a very similar situation with my second son. It was almost the same thing.

Veronica Tingzon: I have been going to school for lactation at that time and my husband would watch the boys on the weekend while I was going to school and he just would not take the bottle and he would scream and cry for those 8 hours to, you know the weekend days. So for 16 hours he just screamed and screamed and screamed until he was 4 months old and we, I think at last count we counted 42 different bottles and nipples that we went through to try to placate him and he hated every single one we, tried fast flow, slow flow, medium flow, hard textured nipples, soft textured nipples, flat ones, round ones, long ones, short ones and it was like a doctor seers book. [Laughs] I mean it was awful. I thought well, “ what the heck? May be I’ll try to sippy cup”. So, I tried the soft stout sippy cups. It was okay with that and then somebody said, “why don’t you try one of those little flip top straw cups?” I was like, “He’s only 4 months. He can’t do that.” She said, “He can suck it out of the breasts, he can suck it out of a straw cup.” So, I thought okay, well, lets see about that and we had a little flip top straw cup and he started drinking out of that and problem was solved. So, what we’re looking at as like the convention of okay, my baby is X months old. He’s got to have a bottle as a substitute for the breasts. No he doesn’t.

Val Velasquez: I was just gonna ask, I wonder why they do that whole, ok, I’m going to take an ounce and then get mad? She does that too, what Christina said, it’s just silly, you know, you just took it, you know that, you know, the good stuff so why you’re gonna cry afterwards.

Veronica Tingzon: Part of it I think is A, there is all the air that they’re getting and so when they’re getting it, they’re uncomfortable and they’re like, you know, “it’s not as comfortable as mom, weaaa” and then the other thing is that the suck sensation, you know, okay, it came down way too fast and not still hugging and sucking and comforting and there is that part of suck sensation that’s not fulfilling them so, they’re just kind of, restating their opposition towards what they’re doing at this moment. They’re like, “okay, I need to eat so I’ll take it. But, I want you to know I’m not liking it.” And so they’re just stating their opinion.

Robin Kaplan: Veronica, should a mother be worried about the milk supply she gives a bottle on a regular basis?

Veronica Tingzon: Yes, depending on how she’s giving the bottle, there are some moms who elect not to pump and so if they’re putting in a breast milk substitute into the bottle and they’re not stimulating the breasts, well, goodbye milk. You know, it’s just, that’s just the way it works, you don’t stimulate, you don’t get the milk. But, if they’re pumping the milk out and putting their expressed breast milk into a bottle then there shouldn’t be a worry.

However, there are moms who don’t respond to the pump as well as they do to their own baby so, there are milk ejection, they are let down whatever you want to call it is not quite as strong with the pump and so then they don’t get emptied as well and then a partial signal is going to their brains so, a lot of moms ask me when should I start pumping or I shouldn’t start pumping until 3 or 4 weeks because I’m not gonna offer a bottle. I always tell them get familiar with the pump as soon as you’re getting familiar with the baby so your brain can be tricked into accepting both forms of milking.

Robin Kaplan: That’s a great bit of advice. I’ve never heard anyone recommend that but, I mean, it makes complete sense.

Veronica Tingzon: Absolutely.

Robin Kaplan: So and then in that way, because I’ve have had many friends who they cannot let down for the pump and they have to go back to work and it is devastating because they, even with hand expression, they can get a little bit out but it’s just that they’re not emptying as well as the baby is and so
it’s just the huge stress or so. I think that, I think I’m gonna start recommending that.

Veronica Tingzon: It’s a good one. If you look at moms whose babies go to the NICU, they start letting down to the pump just fine and it’s because it was the first thing that they started doing.

Robin Kaplan: That’s terrific. Ladies, were you able to keep up your supply or have you been able to keep up your supply while your baby is taking a bottle and if you have, how so?

Keegan Sheridan: I noticed that if I have to travel which I had to start doing recently for work where I’m pumping, repetitively and not nursing that I do gradually like, the pump definitely isn’t as great as nursing and so I will loose my, start to loose supply. So, I just make sure that when I am at home, I’m really not, I’m taking every opportunity that I can to nurse and it comes back up and sometimes I have to do some other things too like, switch to just having oatmeal every morning for breakfast and may be take some botanicals or something like that but, I can get it back. So, I noticed that it’s not as, it’s not as great like a kind of means over time.

Val Velasquez: Well, I’m not working so I don’t have to take the, I don’t have to pump much. If I pump it’s just because my husband and I wanna, you know, still a night out or something like that or you know, if I’m gonna go work out or something like that. However, I’ve noticed the contrary since I am nursing her so much, when I do pump, I make more milk because my body is thinking that there is this extra nursing session or something like that. It stimulates my supply so, like, if I pump one day, then I notice that the next day I have super full breasts. So then I keep pumping and it’s sort of like this and I’m just like okay, you know…

Veronica Tingzon: But, I think conversely as opposed to what she is going through, what you’re going through is that you’re not actually being away from your baby as much so, it is an extra feeding, it is an extra stimulation so that’s I think where the whole different situations get different results.

Robin Kaplan: Rather than being in place of a feeding session we’re looking at it, where Val is actually providing it extra stimulation. How about you Christina?

Christina Williams: I actually developed little bit of an oversupply when she was about 3 months old because she was nursing on me pretty continuously and there was an awful lot of stimulation going on and that’s tapered off little bit now and we’re back in the normal range. I’m happy for that.

[00:20:19]
Robin Kaplan: And so in that case you were getting so much stimulation at night then you were getting constant stimulation by the pump while you were at work. So, again you were also having so, again it all went back to supply and demand. So, is it true that the breastfeeding mom shouldn’t be the first person to give her baby a bottle and why is that if it is?

Veronica Tingzon: Well, Keegan said you know, kind of, a little bit when she introduced her bottle, she kind of went away for a little bit. There’s a couple of things that happen if you’re there or the one offering that bottle. First of all, it’s association, okay and so you’re the breast milk provider, the breast provider and so, you don’t want the baby to see you as the bottle provider also. So no, you don’t want to be the one giving the baby the bottle. That should be maybe the grandma or dad or somebody that the baby trusts. It definitely should be somebody that the baby trusts. The other thing, I find this kind of funny because I saw it with myself but I’ve seen it with other moms as well is that we’re programmed not to like our babies crying and the more and more they cry and fuss, we get really irritated and irritable and angry and it’s not fun. And so, if the baby like in Velasquez’s situation or Christina’s situation, if they’re not liking the bottle and may be is rejecting it and crying and crying and crying and let’s say it’s daddy who’s offering the bottle and they’re sitting there going on “oh my god, he’s so stupid. He can’t even give a bottle to a baby.” And so then what we do is we walk over, we take the baby out of his arms. We put the baby on the breasts and go “ah, see you can do it.” And then, you’re just A, emasculating the daddy and B, not teaching the baby how to take the breasts. And so what’s happening is that we’re wanting to fix the situation and we’re really not fixing it at all if our goal is to give the baby a bottle.

Robin Kaplan: Okay, when we come back, we’ll be discussing what to do if your breastfed baby refuses to take that bottle. We’ll be right back.

[Theme Music]

Robin Kaplan: Alright and we’re back. Veronica, every once in a while I have a client whose breastfed baby took the bottle perfectly around 3 to 5 weeks of age and then suddenly began to refuse the bottle right around 3 months. Have you seen this and if you have what do you think may be some of the reasons that causes this?

Veronica Tingzon: There is a couple of different reasons. The first one is, okay, I tried the bottle and it went great. So, I don’t wanna ruin breastfeeding so I’m just gonna walk away from it and not come back to it until I have to. And that is the biggest mistake that you do. Like I said earlier on, you have to continue the skill. And so, you know, doing that one bottle a day or one bottle every other day is what’s really appropriate in order to continue that skill. The other thing though is the baby’s personality. Christina, you were telling me later on that your baby definitely has that personality of, no this is what I want. This is what I like. And I’ve heard it kind of, referred to as just kind of a preference as to texture, the way it’s delivered, let’s face it girls, our packages are are much prettier than the bottles. And if you think about how it’s just the right temperature and it’s just the right texture, the baby just goes, “no, you know, I could just tell that, that other thing is just so cold and sterile and it’s not that loving and embrace that my mom gives me even though somebody is holding me and giving me the bottle. It’s not that loving embrace.” And they want that. They’re so great. Now that Christina’s baby is choosing to reconnect all night long but to her dismay. But, that’s why we have those situations because I’m really loving that connection that I have with my mommy.

And then there’s another situation also is that sometimes the breast milk went frozen or refrigerated doesn’t taste right. Once you scowl it out and so it doesn’t taste right in the bottle and so I like the way it tastes you know, fresh from mom. So, that’s another situation that might be happening and that’s when there’s a high lipase content and you can scowl your milk and freeze it after warming it up and scolding it. And then finally, there’s also that kind of a, not stranger anxiety but you have the baby much more where at three months, four months, five months. They kind of, don’t want to be held by anyone else and they don’t want to be touched by anybody else and only mommy will do and so there’s that situation as well. So, it’s kind of a bonding peering and I don’t particularly think it’s bad but it’s not great if you have to go back to work either. But, they will get their nutritional needs. Christina is a testament to that. I was a testament to that. I was you know, I was breastfeeding all night long to my 2 year old you know, who shouldn’t have been breastfeeding all night long at that point of time but he was wanting to reconnect with me.

[00:25:39]
Robin Kaplan: So, how can a breastfeeding mom best avoid this if at all possible? I mean, some of these, there’s no way to fix it. But, essentially kind of going back to what you were describing, would you recommend giving that bottle as part of the routine?

Veronica Tingzon: Yeah, I would say definitely once the breastfeeding has been well established, you know, get that bottle in there once a day. Keep it as part of the routine and make that time your time. Go for a walk or go to the gym like Velasquez said, you know, just, you know, make sure that you make that your time and so that the baby can have that time away. If you have to go back to work for example, do a couple of weeks a dry runs. You know, take a half day away with whoever, the nanny or the child care provider is going to be. Yeah, it might cost you a little bit more to start a little bit earlier but, do that so that they, that baby can actually start feeling those trusting bonds between that person and them and the other thing is, you know, see if your milk tastes funny. Taste it yourself.
Don’t give your baby anything that you wouldn’t drink yourself.

Robin Kaplan: And it’s supposed to taste sweet.

Veronica Tingzon: It’s supposed to taste sweet, yeah. It kind of will, at least in my case and from what I’ve heard from other people, it actually tastes like cantaloupe juice. [Laughs]

Robin Kaplan: Hey, those are melons. [Laughs]

Veronica Tingzon: So, it does taste like warm cantaloupe juice and if it tastes kind of soapy or a little rancid then you’ve got that high lipase content. You might wanna scald the milk before you put it away in the freezer and then that
way you can know that it’s not going to be spoilt by the time it gets to your baby.

Robin Kaplan: Can you describe what the lipase is?

Veronica Tingzon: Lipase is the actual, the fat enzymes in the milk and what it does is it causes the milk to break down if there is too much of that high lipase content. It kind of eats the fats away from the milk and so that’s what causes, you know, cow’s milk to spoil and basically when you’re scalding the milk what you’re doing is you’re pasteurizing it.

Robin Kaplan: What about the nutritional value after you scowl it?

Veronica Tingzon: It is going to go down a little bit and just like freezing and reheating it, it is going to go down. But….

Robin Kaplan: But you’re just scalding from the best source though. [Laughs]

Veroinca Tingzon: Exactly, I’d just say hey it’s still heck of a lot better than giving formula.

Keegan Sheridan: I have a question about that. Actually if though, what if the baby will take it in that high lipase state and they don’t seem to have trouble with it? Is the milk spoiled? Is there something wrong with it or if they take it then don’t ask any questions?

Veronica Tingzon: Yeah, you know, it’s kind of like if that’s the way they like it, you know, they’ll take it and it’s not affecting their stomach then you know, it’s kind of like, sometimes I drink the milk in the fridge past the due date on the bottle and I’m fine. So, you know, and if it doesn’t smell funny or anything like that so, if they’re taking it, don’t ask any questions. Don’t look a gimp horse in the mouth.

Christina Williams: I actually found that I have excess lipase issue and I didn’t figure it out until just a few weeks ago. It always tasted fresh breast milk and I never had tasted what was in the fridge and I did that and I figured out that’s just part of the problem. So, now my daughter has been associating this bottle with giving her milk the taste back. So, that’s an additional barrier
to getting her to take the bottle. So, I wish that with a lot respect I had just taken a bottle refrigerated milk and tasted it months ago.

Veronica Tingzon: And that’s actually something that when I’m teaching the prenatal breastfeeding classes and we talk about pumping, it’s something that I address in that class because I don’t want anybody to go out there and have any surprises. I mean, I had one mom who had 30 bags of frozen milk and she came to me crying going, is it just all spoilt because her child wouldn’t take it? I’m like, yup, sorry and you know, and she had to start new and that was her stash for her going back to work and it was one week before she had to go to work. So, she was like, oh.

Robin Kaplan: The one thing I did find out though, now discussing with Christina and her excess lipase issue, was that you can actually donate that milk because it is going to be pasteurized anyway next with a whole bunch of other ladies milk so, if it’s something that you are comfortable doing, you can donate to milk bank and someone else can benefit from that milk even though your baby may not be able to, although it doesn’t make it any easier for the mom who has to go back to work and now has lost her stash but, there is a little bit of a silver lining on that cloud I guess.

[00:30:18]
Veronica Tingzon: There you go. A preemie baby out there loves you for it.

Robin Kaplan: Exactly. Veronica, so what tips do you have for moms whose breastfed babies are refusing to take a bottle?

Veronica Tingzon: It’s kind of baby based. One other things that I always tell the parents, especially the dads is that the dads wanna put the baby in that crook of the arm type of hold just like the regular cradle hold and I say don’t do that because you know, unless the mom has an incredibly fast let down, most of the time they’re not chugalugging and when they go with the bottle, it’s very much like “go, go, go, go” you know, it’s really a chugalug fast like, if you’re you know, taking a beer bottle down or something. [Laughs] And so the baby is not comfortable with that. They’re not liking it and so what happens is if you put the baby a little bit more upright or kind of in a more side line position and make the bottle be kind of more parallel to the floor instead of perpendicular to the baby, the flow slows
down, the baby is now guiding the flow versus the bottle guiding the flow and it’s a much more humane way of giving the baby the bottle and they tend to be more accepting of it.

And then the other thing is stopping and burping in between, like was telling Velasquez a little bit earlier on was that, you know, sometimes they have that gas fill in and just like when you drink a soda, you kind of have to stop and let the air out first before you can continue to drink that soda or else it’s gonna be uncomfortable for yourself, I guess it’s that air bubble trapped in there. So stop the baby as soon as you hear them kind of gulp some air and do that [Gulping Noise] you know, choke type thing. Stop them, take the bottle out of their mouth and then go ahead and give them a burping and then put them back in that nice humane positioning and give them the bottle. And don’t insist on the bottle until the baby is screaming and you know, ran a blue face because they’re so mad because now you’re gonna give them a negative association. They don’t wanna take it, okay, go ahead and walk away for a little bit and then come back 5 minutes later and see if we can do it a little bit better. And don’t ever introduce anything new to a baby when they’re tired or when they’re voracious. It’s gotta be kind of in that either just falling asleep or just having woken up, calm state, not historical because they’ll do better learning anything new when they’re not hungry and when they’re not tired. Nobody has patience to learn anything when they’re hungry or tired.

Robin Kaplan: Absolutely. I guess this is more targeted towards Val and Christina because I know Keegan your boys have been pretty successful in taking a bottle but, although many of your tricks, I’m sure have not necessarily worked for your babies. What tricks are those so that way may be other moms who haven’t tried them yet could give them a try?

Val Velasquez: Well, for Mila, it’s definitely my mom’s biggest trick is kind of holding her in a very you know, like kind of almost squeezing her holding her. Not squeezing her, just holding her very snugly so that she feels very comforted and that definitely works like, calming her down because I’m always wearing her or holding her so she really likes that feeling just your arms and not like stressing out because babies feed off of that. You know, so just relax, she sits on the couch, cuddles her, gives her the bottle so it’s not me but it’s still a nice comforting feeling. And then what I always told my husband frankly, is don’t wait until she’s super hungry because if
she’s already crying it’s not gonna happen. She’s just gonna get more mad and then she’s just gonna cry for 15 minutes and then eventually falls asleep without eating which has happened. So….

Robin Kaplan: How about you Christina? I know you have a pretty long list.

Christina Williams: Yeah, we tried, first of all, I can’t be anywhere near the place. I can’t even have been in the house recently. So, get away sometime before it, so sadly and then he’s tried having my clothes near him, he’s tried having my clothes not near him. With the smell she does a little bit better if you face her out instead of facing her in and sitting in the upright position like you mentioned, the bouncy seat is a little bit less dramatic than being held. What else, trying in the stroller, trying in the car, trying when there is some sort of enough of distraction where she doesn’t realize that we’re trying to force her to do something off. [Laughs] That’s her perspective. [Multiple Speakers] So, we’ve also tried other vehicles, food feeding, small cups to see if she’ll wrap it up, figure feeding, we’ve tried quite of a few other ways to get the milk in her as well.

[00:35:24]
Robin Kaplan: Well, thank you so much Veronica for your insight into how to introduce a bottle and what to do if your breastfed baby refuses a bottle.

Veronica Tingzon: Thank you for having me Robin. I appreciate it.

[Theme Music]
[Featured Segment: Overcoming Societal Booby Traps]

Robin Kaplan: Before we wrap things up, here’s Lara Adalo talking about ways to overcome societal booby traps.

Lara Audelo: Hi Boob Group Listeners, I’m Lara Audelo, a certified lactation educator, the regional marketing manager at Best For Babe and owner of MamaPear Designs. I’m here to answer some of your most common questions about how you can achieve your personal breastfeeding goals without being undermined by cultural and institutional booby traps such as what are the nests about labor medications and their effects on breastfeeding. Pain medications are routinely used during labor. With
some hospitals posting epidermal rates of high as 98 or 99% and while they may not affect your baby’s health, they can affect your baby’s ability to breastfeed any immediate postpartum period. Research is where we get the information we need to make recommendations and this evidence based information needs to make it clear to mothers otherwise it’s just another booby trap. The impact of birthing practices on breastfeeding as Levin Smith has to say, injections in the epidural space are quickly detectable in core blood. Pain relief drugs cross the placenta very quickly in a matter of seconds to a few minutes.

The drug is designed to numb sensory nerves in a mother and therefore they also affect sensory and motive nerves in the infant that affect rooting, sucking and breathing. One common myth, is that once medication is worn off in you, it is also worn off in your baby not so with the number of drugs. The pediatric half life, a measure of a duration of a medication in your system, of many medications is higher than the maternal half life meaning, they may affect your baby to breastfeed after you no longer feel the effects. Another myth is that they are formed in medication which don’t get to the baby and the truth is all drugs taken by the mother reach the baby. The third myth, there are standard epidurals which all anesthesiologists use. The truth is that epidurals can vary both in terms of the medications used and the dosage and of course the dose you and your baby get depends on how long you have one. Other consequences with epidurals which can effect breastfeeding because they weed to a cascaded interventions which can also lead to cesarean birth. Epidural use also rate the risk of maternal fever, infant fever and consequence separation of mother and baby for the evaluation and treatment of those conditions. Should you choose pain medications in labor, you can still have a wonderful breastfeeding experience. Let yourself believe that you deserve to know the evidence says about labor medication and breastfeeding and you deserve to post your experience of breastfeeding difficulties for this or any other reason. A special thank you to Tanya Lieberman, IBCLC for writing the booby trap series for Best For Babe. Visit http://www.bestforbabe.org for more great information about how to meet your personal breastfeeding goals and my business http://www.mamapeardesigns.com for breastfeeding support and be sure to listen to The Boob Group for fantastic conversations about breastfeeding and breastfeeding support.

Robin Kaplan: Thank you to all of our listeners. I hope you’ll visit our website, http://www.newmommymedia.com and our Facebook page to offer your advice on which tricks you’ve tried when your breastfed baby refused the bottle. If you have any questions about today’s show or the topics we’ve discussed, call our Boob Group hotline at 619-­‐866-­‐4775 and we’ll answer your question on our upcoming episode. If you have a breastfeeding topic you’d like to suggest, we’d love to hear it. Simply visit our website, http://www.theboobgroup.com and send us an email through the contact link. Thanks for listening to the Boob Group because mothers know breasts.

[Disclaimer]

This has been a New Mommy Media Production. The information materials contained in this episode are presented for educational purposes only. Statements and opinions expressed in this episode are not necessarily those of New Mommy Media and should not be considered facts. Though such information materials are believed to be accurate, it is not intended to replace or substitute for professional medical advice or care and should not be used for diagnosing or treating health care problems or disease or prescribing any medication. If you have questions or concerns regarding your physical or mental health or the health of your baby, please seek assistance from a qualified healthcare provider.

[00:40:16] End of Audio

View Episode

Episode Transcript

The Boob Group“Help! My Baby Won’t Take A Bottle!

Please be advised, this transcription was performed from a company independent of New Mommy Media, LLC. As such, translation was required which may alter the accuracy of the transcription.

[00:00:00]

Veronica Tingzon: Once the baby reaches about 3-­‐5 weeks of age, breastfeeding parents might consider offering their babies a bottle of expressed breast milk here and there. Every once in a while though, the infant has different intentions and may refuse to take the bottle. What’s a parent to do? I’m Veronica Tingzon, an international board-certified lactation consultant and the owner of The Original Comfort Food in San Diego, California. Today, we’re discussing what to do when your breastfed baby refuses to take a bottle. This is The Boob Group, Episode number 9.

[Theme Song/Intro]

Robin Kaplan: Welcome to The Boob Group, broadcasting from the Birth Education Centre of San Diego. I’m your host Robin Kaplan. I’m also a certified lactation consultant and owner of the San Diego Breastfeeding Centre. At The Boob Group, we are online support group for all things related to breastfeeding. Wondering how you can become involved with our show? Visit our website at http://www.newmommymedia.com where you can send us comments or suggestions through the contact link. Join our conversation on our Facebook page. You can even call the boob group hotline at 619-­866­‐4775. The Boob Group is also looking for listeners to join our blogging team. If you’d like to share your current or past experiences about breastfeeding, be sure to send us an email. Today, we’re joined by three fabulous panelists in the studio. Ladies, will you introduce yourselves please?

Keegan Sheridan: Hi, I’m Keegan Sheridan. I’m 35 years old. I’m a naturopathic doctor and also a natural food and lifestyle expert for major cereal company. I have two children. The oldest is 23 months and the youngest is almost 6 months.

Val Velasquez: I’m Velasquez. I’m 26 years old and currently a stay-­‐at-­‐home mom. I have two small children, Olivia and Mila. Olivia is 2 1/2 and Mila is almost 11 months.

Christina Williams: I’m Christina Williams. I’m 33 years old. I’m in medical education. I have one daughter. She is just about 5 months.

Robin Kaplan: Well, thanks for joining us ladies.

[Theme Music]
[Featured Segment: Breastfeeding Tips For The Working Mom]

Robin Kaplan: Before we get started with today’s topic here’s Wendy Wright talking about breastfeeding tips for the working mom.

Wendy Wright: Hi, Boob Group listeners. I’m Wendy Wright, an internationally board certified lactation consultant and the owner of Lactation Navigation in Palo Alto, California. I’m here to answer some of your most common questions about returning to work as a breastfeeding mother. One of the questions we get all the time is what should I do to plan for my first day back at work? This is a huge step. The very first day and in fact, the first week can be extremely stressful for new moms. We’re sleep deprived.

Everything is new to us and we’re missing our infant terribly. Some of the things to do before your first day back, may be you could take a practice day. A day which you’re not obligated to go to work but you could actually pretend to be at work. Drop your baby at day care or have your nanny come over. Pump during the day, run some errands and actually get out of the house, practice getting dressed and being places on time. Just a practice day should make you feel much more comfortable that first day you do need to return to the job. Also, you want to put together a pumping check list which you can have near your front door that you can check in the evening or in the morning on your way out to work.

Contain items like breast pump, shield, tooting, all your valves and membranes, collection bottles and extra storage. Everything that you potentially need to take with you in order to make your pumping day successful by reviewing your check list routinely every morning or evening, you will avoid forgetting things that will really inhibit your ability to feel comfortable during the day. Another idea to plan for your first day and first week would be to start with a short week. If at all possible, start back to work on Wednesday or Thursday, that way you have a couple of days at work and then you have two days on the weekend to regroup, fix anything that didn’t go well the first couple of days, get some sleep and then start again on Monday morning with the five day stretch. And then when you found that it could be very, very successful and also helps you ease back into the new routine. The other thing I’d like to recommend is think about your pumping schedule before returning to work. What is it going to look like and make sure to satisfy time on your calendar. For example, a pumping day may look like this. Wake up around 6 am, nurse your baby, shower dress, have a healthy breakfast and then pump one time before you leave the home. 7:30 or so, leave for work with your baby, 8:00, for example, you might drop off at day care.

Check through your care provider about your baby’s needs and then nurse your infant before you leave the day care provider. Once you arrive at work, clear messages, get organized and take your first pumping break around 10 am. Pump the second time during your lunch hour and a third pumping break sometime around 3 in the afternoon doing your very best to spread the pumping breaks evenly throughout the day. Leave work at 5:00, pick up your baby and nurse while you’re discussing your baby’s day with your child provider. Come home, eat dinner and then just work on getting the baby the closeness and togetherness of your family for the rest of the evening, nursing as necessary, once baby goes to sleep, clean pump parts, get ready for the next day and go to bed as early as possible so you’re ready to face the world. Thanks so much for listening today and please visit http://www.lactationnav.com for more great information about my business, Lactation Navigation. And be sure to listen to The Boob Group for fantastic conversations about breastfeeding and breastfeeding support.

[00:06:15]
[Theme Music]

Robin Kaplan: Today, on the Boob Group, we’re discussing the optimal time to introduce a bottle to our breastfed babies as well as what to do if that baby has refused to take a bottle. Our expert Veronica Tingzon is an international board-certified lactation consultant and owner of The Original Comfort Food in San Diego, California. Veronica, welcome to the show and thanks for joining us.

Veronica Tingzon: Thank you for having me Robin.

Robin Kaplan: Veronica, let’s start with the basics of bottle feeding the breastfed baby. For a breastfeeding mom who wants her baby to take up both the breast and the bottle, when is the best time to introduce that first bottle?

Veronica Tingzon: Well, there is kind of a time window where you really kind of want to introduce the bottle if you’re going to be needing to do so. I mean, not every mother has to but, the ones that are going to introduce it, you want to wait till the breastfeeding has established and usually that’s somewhere about 3 weeks all the way until about 8 weeks. But, what happens is a lot of moms hear the word 3 weeks and they’re tired and they go, “Okay, 3 weeks and I’m gonna introduce the bottle” and they introduce it sooner than they need to. So, make sure breastfeeding has established and the soonest you want to do is about 3 weeks.

Robin Kaplan: Okay, terrific and do you have any recommendations for techniques on how to help the baby go back and forth between the breast and bottle?

Veronica Tingzon: Well, once again first of all, making sure that the breastfeeding is fully well established and what I mean by that is that the baby has the mechanics of the latch to the mom down path. I kind of compare it to being able to use a fork versus being able to use chop sticks. Once you’ve learnt how to use chop sticks, you can go back and forth between the fork and the chop sticks just fine. But, if you try using the fork first and not using the chop sticks, then it’s kind of like “Oh, I don’t wanna learn how to do the chop sticks.” So, learn how to breastfeed properly first, then the whole method of going back and forth between breast and bottle is just keeping the skill alive. “Okay, now I’ve got breastfeeding down, now I’m gonna try to do bottle feeding once a day ‘cause it’s really not that hard of a task.” But, sometimes they don’t want to go back and forth so you still have to keep it up at least may be once a day or once
every other day so that the baby can still be familiar with going to the bottle and then, it’s a skill that they never loose.

Robin Kaplan: Yeah, ‘cause I find that sometimes, like, I’ll get phone calls from moms that are going back to work at about 3 months and the baby took the bottle great for those first couple weeks that they had, after they had introduced it and then also the baby decides they don’t want to want that bottle and so it becomes quite a challenge and a battle of wills almost. Do you find that happens as well with you?

Veronica Tingzon: Oh absolutely, I mean, I get these panic phone calls or in support groups, moms like, “Oh my gosh, can you try to see if you can do it?” you know, and once again that baby is just like, “ah, ah, no way, I want it straight from the tap. I want the real thing. There’s no way I’m going to go to that plastic artificial thing”. And eventually, they do start to take it or start to take a breast substitute. But, it can be a challenge especially if you have somebody who’s not very patient watching your child. So, if it’s a day care center versus, you know, grandma or daddy, so if you can line up somebody that, you know, is very familiar with the child and is going to be patient enough to really kind of, coax their way through to that other form of, you know, breastfeeding substitute, you know, then they’re gonna have more success than the, you know, sterile day care center that’s like forget this, that’s it I’m not even trying.

[00:09:56]
Robin Kaplan: And how should a breastfeeding mom choose a bottle for her baby because I know a lot of them are very concerned and I was as well that this whole concept of nipple confusion and so how to make it so that, would you say there’s a recommendation for how to choose which one’s best for your baby or just kind of try it out?

Veronica Tingzon: It’s kind of the one that the kid chooses. I always laugh when moms get these like, multi packs of one specific bottle and then the mom goes to use it, the kid hates it. You know, I’m like, “don’t do that”, you know, get one of the whole bunch of different kinds and figure out the one that the kid likes. You know, my kid, of course, gravitated, my first child gravitated to the one that was the $7 one that you can only purchase in Japan that my sister sent to me. And of course, that was the $7 nipple that I can find anywhere. And it was that’s just the one he liked and so of course you know, I’m ordering online, you know, $7/ nipple. Whatever, it was the one he liked and it was the one that I was able to go back to work and make sure that he liked.

Robin Kaplan: So ladies, how was that first bottle introduced to your breastfed baby?

Keegan Sheridan: Well, in both cases I think we were around 4 or 5 weeks old when we did it and the first time my husband introduced and second time it was our nanny because we had a nanny already at that, by the time we had our second son. And I just kind of, wasn’t around so, it’s almost, I don’t really, I think it was okay because I intentionally wasn’t there. I’d been told not to be there that it would be hard for the baby to take a bottle if I was around and if he could sense that I was there. So, but I think in both cases that it went actually pretty well.

Val Velasquez: Well, with my first, I supplemented in the beginning, well, I supplemented the whole time so she liked the bottle. The bottle and her were great friends. [Laughs] My boob was not her friends. So, with her, there were no problems. But, with my second, she still doesn’t love the bottle.

Robin Kaplan: And how old is she again?

Val Velasquez: She’s almost 11 months. So, now then, I didn’t even try until she was, gosh, I don’t know, may be 4 weeks old. My husband tried to give her a bottle and she screamed bloody murderer. It was almost like she was offended by it. [Laughs] She was like literally offended and I think eventually what happened is that she just kind of, fell asleep. Yes, she gave up and didn’t not take it. And then you know, and immediately my mom who is like a saint, gave it to her. You know, I’m sure she fussed and was offended by that as well. But, my mom just kind of kept it there and then when she realized that it was my milk inside the bottle, that made her happy so she took it grudgingly but she took it and now still, I mean, it depends like, even right now, like, I hope she’s taking the bottle. She just knows that it’s not the real thing so….

Christina Williams: My daughter is almost 5 months and she’s still refusing. We did get her to take about an ounce a few times but, today we haven’t been very lucky.

Robin Kaplan: And how often do you work because there is definitely a need for her to have some sort of nutrition when you’re away from her.

Christina Williams: I work almost full time so, she spends her days, I do come home during lunch and feed her but she has made up for it by nursing all night.

Keegan Sheridan: And I actually have a very similar situation with my second son. It was almost the same thing.

Veronica Tingzon: I have been going to school for lactation at that time and my husband would watch the boys on the weekend while I was going to school and he just would not take the bottle and he would scream and cry for those 8 hours to, you know the weekend days. So for 16 hours he just screamed and screamed and screamed until he was 4 months old and we, I think at last count we counted 42 different bottles and nipples that we went through to try to placate him and he hated every single one we, tried fast flow, slow flow, medium flow, hard textured nipples, soft textured nipples, flat ones, round ones, long ones, short ones and it was like a doctor seers book. [Laughs] I mean it was awful. I thought well, “ what the heck? May be I’ll try to sippy cup”. So, I tried the soft stout sippy cups. It was okay with that and then somebody said, “why don’t you try one of those little flip top straw cups?” I was like, “He’s only 4 months. He can’t do that.” She said, “He can suck it out of the breasts, he can suck it out of a straw cup.” So, I thought okay, well, lets see about that and we had a little flip top straw cup and he started drinking out of that and problem was solved. So, what we’re looking at as like the convention of okay, my baby is X months old. He’s got to have a bottle as a substitute for the breasts. No he doesn’t.

Val Velasquez: I was just gonna ask, I wonder why they do that whole, ok, I’m going to take an ounce and then get mad? She does that too, what Christina said, it’s just silly, you know, you just took it, you know that, you know, the good stuff so why you’re gonna cry afterwards.

Veronica Tingzon: Part of it I think is A, there is all the air that they’re getting and so when they’re getting it, they’re uncomfortable and they’re like, you know, “it’s not as comfortable as mom, weaaa” and then the other thing is that the suck sensation, you know, okay, it came down way too fast and not still hugging and sucking and comforting and there is that part of suck sensation that’s not fulfilling them so, they’re just kind of, restating their opposition towards what they’re doing at this moment. They’re like, “okay, I need to eat so I’ll take it. But, I want you to know I’m not liking it.” And so they’re just stating their opinion.

Robin Kaplan: Veronica, should a mother be worried about the milk supply she gives a bottle on a regular basis?

Veronica Tingzon: Yes, depending on how she’s giving the bottle, there are some moms who elect not to pump and so if they’re putting in a breast milk substitute into the bottle and they’re not stimulating the breasts, well, goodbye milk. You know, it’s just, that’s just the way it works, you don’t stimulate, you don’t get the milk. But, if they’re pumping the milk out and putting their expressed breast milk into a bottle then there shouldn’t be a worry.

However, there are moms who don’t respond to the pump as well as they do to their own baby so, there are milk ejection, they are let down whatever you want to call it is not quite as strong with the pump and so then they don’t get emptied as well and then a partial signal is going to their brains so, a lot of moms ask me when should I start pumping or I shouldn’t start pumping until 3 or 4 weeks because I’m not gonna offer a bottle. I always tell them get familiar with the pump as soon as you’re getting familiar with the baby so your brain can be tricked into accepting both forms of milking.

Robin Kaplan: That’s a great bit of advice. I’ve never heard anyone recommend that but, I mean, it makes complete sense.

Veronica Tingzon: Absolutely.

Robin Kaplan: So and then in that way, because I’ve have had many friends who they cannot let down for the pump and they have to go back to work and it is devastating because they, even with hand expression, they can get a little bit out but it’s just that they’re not emptying as well as the baby is and so
it’s just the huge stress or so. I think that, I think I’m gonna start recommending that.

Veronica Tingzon: It’s a good one. If you look at moms whose babies go to the NICU, they start letting down to the pump just fine and it’s because it was the first thing that they started doing.

Robin Kaplan: That’s terrific. Ladies, were you able to keep up your supply or have you been able to keep up your supply while your baby is taking a bottle and if you have, how so?

Keegan Sheridan: I noticed that if I have to travel which I had to start doing recently for work where I’m pumping, repetitively and not nursing that I do gradually like, the pump definitely isn’t as great as nursing and so I will loose my, start to loose supply. So, I just make sure that when I am at home, I’m really not, I’m taking every opportunity that I can to nurse and it comes back up and sometimes I have to do some other things too like, switch to just having oatmeal every morning for breakfast and may be take some botanicals or something like that but, I can get it back. So, I noticed that it’s not as, it’s not as great like a kind of means over time.

Val Velasquez: Well, I’m not working so I don’t have to take the, I don’t have to pump much. If I pump it’s just because my husband and I wanna, you know, still a night out or something like that or you know, if I’m gonna go work out or something like that. However, I’ve noticed the contrary since I am nursing her so much, when I do pump, I make more milk because my body is thinking that there is this extra nursing session or something like that. It stimulates my supply so, like, if I pump one day, then I notice that the next day I have super full breasts. So then I keep pumping and it’s sort of like this and I’m just like okay, you know…

Veronica Tingzon: But, I think conversely as opposed to what she is going through, what you’re going through is that you’re not actually being away from your baby as much so, it is an extra feeding, it is an extra stimulation so that’s I think where the whole different situations get different results.

Robin Kaplan: Rather than being in place of a feeding session we’re looking at it, where Val is actually providing it extra stimulation. How about you Christina?

Christina Williams: I actually developed little bit of an oversupply when she was about 3 months old because she was nursing on me pretty continuously and there was an awful lot of stimulation going on and that’s tapered off little bit now and we’re back in the normal range. I’m happy for that.

[00:20:19]
Robin Kaplan: And so in that case you were getting so much stimulation at night then you were getting constant stimulation by the pump while you were at work. So, again you were also having so, again it all went back to supply and demand. So, is it true that the breastfeeding mom shouldn’t be the first person to give her baby a bottle and why is that if it is?

Veronica Tingzon: Well, Keegan said you know, kind of, a little bit when she introduced her bottle, she kind of went away for a little bit. There’s a couple of things that happen if you’re there or the one offering that bottle. First of all, it’s association, okay and so you’re the breast milk provider, the breast provider and so, you don’t want the baby to see you as the bottle provider also. So no, you don’t want to be the one giving the baby the bottle. That should be maybe the grandma or dad or somebody that the baby trusts. It definitely should be somebody that the baby trusts. The other thing, I find this kind of funny because I saw it with myself but I’ve seen it with other moms as well is that we’re programmed not to like our babies crying and the more and more they cry and fuss, we get really irritated and irritable and angry and it’s not fun. And so, if the baby like in Velasquez’s situation or Christina’s situation, if they’re not liking the bottle and may be is rejecting it and crying and crying and crying and let’s say it’s daddy who’s offering the bottle and they’re sitting there going on “oh my god, he’s so stupid. He can’t even give a bottle to a baby.” And so then what we do is we walk over, we take the baby out of his arms. We put the baby on the breasts and go “ah, see you can do it.” And then, you’re just A, emasculating the daddy and B, not teaching the baby how to take the breasts. And so what’s happening is that we’re wanting to fix the situation and we’re really not fixing it at all if our goal is to give the baby a bottle.

Robin Kaplan: Okay, when we come back, we’ll be discussing what to do if your breastfed baby refuses to take that bottle. We’ll be right back.

[Theme Music]

Robin Kaplan: Alright and we’re back. Veronica, every once in a while I have a client whose breastfed baby took the bottle perfectly around 3 to 5 weeks of age and then suddenly began to refuse the bottle right around 3 months. Have you seen this and if you have what do you think may be some of the reasons that causes this?

Veronica Tingzon: There is a couple of different reasons. The first one is, okay, I tried the bottle and it went great. So, I don’t wanna ruin breastfeeding so I’m just gonna walk away from it and not come back to it until I have to. And that is the biggest mistake that you do. Like I said earlier on, you have to continue the skill. And so, you know, doing that one bottle a day or one bottle every other day is what’s really appropriate in order to continue that skill. The other thing though is the baby’s personality. Christina, you were telling me later on that your baby definitely has that personality of, no this is what I want. This is what I like. And I’ve heard it kind of, referred to as just kind of a preference as to texture, the way it’s delivered, let’s face it girls, our packages are are much prettier than the bottles. And if you think about how it’s just the right temperature and it’s just the right texture, the baby just goes, “no, you know, I could just tell that, that other thing is just so cold and sterile and it’s not that loving and embrace that my mom gives me even though somebody is holding me and giving me the bottle. It’s not that loving embrace.” And they want that. They’re so great. Now that Christina’s baby is choosing to reconnect all night long but to her dismay. But, that’s why we have those situations because I’m really loving that connection that I have with my mommy.

And then there’s another situation also is that sometimes the breast milk went frozen or refrigerated doesn’t taste right. Once you scowl it out and so it doesn’t taste right in the bottle and so I like the way it tastes you know, fresh from mom. So, that’s another situation that might be happening and that’s when there’s a high lipase content and you can scowl your milk and freeze it after warming it up and scolding it. And then finally, there’s also that kind of a, not stranger anxiety but you have the baby much more where at three months, four months, five months. They kind of, don’t want to be held by anyone else and they don’t want to be touched by anybody else and only mommy will do and so there’s that situation as well. So, it’s kind of a bonding peering and I don’t particularly think it’s bad but it’s not great if you have to go back to work either. But, they will get their nutritional needs. Christina is a testament to that. I was a testament to that. I was you know, I was breastfeeding all night long to my 2 year old you know, who shouldn’t have been breastfeeding all night long at that point of time but he was wanting to reconnect with me.

[00:25:39]
Robin Kaplan: So, how can a breastfeeding mom best avoid this if at all possible? I mean, some of these, there’s no way to fix it. But, essentially kind of going back to what you were describing, would you recommend giving that bottle as part of the routine?

Veronica Tingzon: Yeah, I would say definitely once the breastfeeding has been well established, you know, get that bottle in there once a day. Keep it as part of the routine and make that time your time. Go for a walk or go to the gym like Velasquez said, you know, just, you know, make sure that you make that your time and so that the baby can have that time away. If you have to go back to work for example, do a couple of weeks a dry runs. You know, take a half day away with whoever, the nanny or the child care provider is going to be. Yeah, it might cost you a little bit more to start a little bit earlier but, do that so that they, that baby can actually start feeling those trusting bonds between that person and them and the other thing is, you know, see if your milk tastes funny. Taste it yourself.
Don’t give your baby anything that you wouldn’t drink yourself.

Robin Kaplan: And it’s supposed to taste sweet.

Veronica Tingzon: It’s supposed to taste sweet, yeah. It kind of will, at least in my case and from what I’ve heard from other people, it actually tastes like cantaloupe juice. [Laughs]

Robin Kaplan: Hey, those are melons. [Laughs]

Veronica Tingzon: So, it does taste like warm cantaloupe juice and if it tastes kind of soapy or a little rancid then you’ve got that high lipase content. You might wanna scald the milk before you put it away in the freezer and then that
way you can know that it’s not going to be spoilt by the time it gets to your baby.

Robin Kaplan: Can you describe what the lipase is?

Veronica Tingzon: Lipase is the actual, the fat enzymes in the milk and what it does is it causes the milk to break down if there is too much of that high lipase content. It kind of eats the fats away from the milk and so that’s what causes, you know, cow’s milk to spoil and basically when you’re scalding the milk what you’re doing is you’re pasteurizing it.

Robin Kaplan: What about the nutritional value after you scowl it?

Veronica Tingzon: It is going to go down a little bit and just like freezing and reheating it, it is going to go down. But….

Robin Kaplan: But you’re just scalding from the best source though. [Laughs]

Veroinca Tingzon: Exactly, I’d just say hey it’s still heck of a lot better than giving formula.

Keegan Sheridan: I have a question about that. Actually if though, what if the baby will take it in that high lipase state and they don’t seem to have trouble with it? Is the milk spoiled? Is there something wrong with it or if they take it then don’t ask any questions?

Veronica Tingzon: Yeah, you know, it’s kind of like if that’s the way they like it, you know, they’ll take it and it’s not affecting their stomach then you know, it’s kind of like, sometimes I drink the milk in the fridge past the due date on the bottle and I’m fine. So, you know, and if it doesn’t smell funny or anything like that so, if they’re taking it, don’t ask any questions. Don’t look a gimp horse in the mouth.

Christina Williams: I actually found that I have excess lipase issue and I didn’t figure it out until just a few weeks ago. It always tasted fresh breast milk and I never had tasted what was in the fridge and I did that and I figured out that’s just part of the problem. So, now my daughter has been associating this bottle with giving her milk the taste back. So, that’s an additional barrier
to getting her to take the bottle. So, I wish that with a lot respect I had just taken a bottle refrigerated milk and tasted it months ago.

Veronica Tingzon: And that’s actually something that when I’m teaching the prenatal breastfeeding classes and we talk about pumping, it’s something that I address in that class because I don’t want anybody to go out there and have any surprises. I mean, I had one mom who had 30 bags of frozen milk and she came to me crying going, is it just all spoilt because her child wouldn’t take it? I’m like, yup, sorry and you know, and she had to start new and that was her stash for her going back to work and it was one week before she had to go to work. So, she was like, oh.

Robin Kaplan: The one thing I did find out though, now discussing with Christina and her excess lipase issue, was that you can actually donate that milk because it is going to be pasteurized anyway next with a whole bunch of other ladies milk so, if it’s something that you are comfortable doing, you can donate to milk bank and someone else can benefit from that milk even though your baby may not be able to, although it doesn’t make it any easier for the mom who has to go back to work and now has lost her stash but, there is a little bit of a silver lining on that cloud I guess.

[00:30:18]
Veronica Tingzon: There you go. A preemie baby out there loves you for it.

Robin Kaplan: Exactly. Veronica, so what tips do you have for moms whose breastfed babies are refusing to take a bottle?

Veronica Tingzon: It’s kind of baby based. One other things that I always tell the parents, especially the dads is that the dads wanna put the baby in that crook of the arm type of hold just like the regular cradle hold and I say don’t do that because you know, unless the mom has an incredibly fast let down, most of the time they’re not chugalugging and when they go with the bottle, it’s very much like “go, go, go, go” you know, it’s really a chugalug fast like, if you’re you know, taking a beer bottle down or something. [Laughs] And so the baby is not comfortable with that. They’re not liking it and so what happens is if you put the baby a little bit more upright or kind of in a more side line position and make the bottle be kind of more parallel to the floor instead of perpendicular to the baby, the flow slows
down, the baby is now guiding the flow versus the bottle guiding the flow and it’s a much more humane way of giving the baby the bottle and they tend to be more accepting of it.

And then the other thing is stopping and burping in between, like was telling Velasquez a little bit earlier on was that, you know, sometimes they have that gas fill in and just like when you drink a soda, you kind of have to stop and let the air out first before you can continue to drink that soda or else it’s gonna be uncomfortable for yourself, I guess it’s that air bubble trapped in there. So stop the baby as soon as you hear them kind of gulp some air and do that [Gulping Noise] you know, choke type thing. Stop them, take the bottle out of their mouth and then go ahead and give them a burping and then put them back in that nice humane positioning and give them the bottle. And don’t insist on the bottle until the baby is screaming and you know, ran a blue face because they’re so mad because now you’re gonna give them a negative association. They don’t wanna take it, okay, go ahead and walk away for a little bit and then come back 5 minutes later and see if we can do it a little bit better. And don’t ever introduce anything new to a baby when they’re tired or when they’re voracious. It’s gotta be kind of in that either just falling asleep or just having woken up, calm state, not historical because they’ll do better learning anything new when they’re not hungry and when they’re not tired. Nobody has patience to learn anything when they’re hungry or tired.

Robin Kaplan: Absolutely. I guess this is more targeted towards Val and Christina because I know Keegan your boys have been pretty successful in taking a bottle but, although many of your tricks, I’m sure have not necessarily worked for your babies. What tricks are those so that way may be other moms who haven’t tried them yet could give them a try?

Val Velasquez: Well, for Mila, it’s definitely my mom’s biggest trick is kind of holding her in a very you know, like kind of almost squeezing her holding her. Not squeezing her, just holding her very snugly so that she feels very comforted and that definitely works like, calming her down because I’m always wearing her or holding her so she really likes that feeling just your arms and not like stressing out because babies feed off of that. You know, so just relax, she sits on the couch, cuddles her, gives her the bottle so it’s not me but it’s still a nice comforting feeling. And then what I always told my husband frankly, is don’t wait until she’s super hungry because if
she’s already crying it’s not gonna happen. She’s just gonna get more mad and then she’s just gonna cry for 15 minutes and then eventually falls asleep without eating which has happened. So….

Robin Kaplan: How about you Christina? I know you have a pretty long list.

Christina Williams: Yeah, we tried, first of all, I can’t be anywhere near the place. I can’t even have been in the house recently. So, get away sometime before it, so sadly and then he’s tried having my clothes near him, he’s tried having my clothes not near him. With the smell she does a little bit better if you face her out instead of facing her in and sitting in the upright position like you mentioned, the bouncy seat is a little bit less dramatic than being held. What else, trying in the stroller, trying in the car, trying when there is some sort of enough of distraction where she doesn’t realize that we’re trying to force her to do something off. [Laughs] That’s her perspective. [Multiple Speakers] So, we’ve also tried other vehicles, food feeding, small cups to see if she’ll wrap it up, figure feeding, we’ve tried quite of a few other ways to get the milk in her as well.

[00:35:24]
Robin Kaplan: Well, thank you so much Veronica for your insight into how to introduce a bottle and what to do if your breastfed baby refuses a bottle.

Veronica Tingzon: Thank you for having me Robin. I appreciate it.

[Theme Music]
[Featured Segment: Overcoming Societal Booby Traps]

Robin Kaplan: Before we wrap things up, here’s Lara Adalo talking about ways to overcome societal booby traps.

Lara Audelo: Hi Boob Group Listeners, I’m Lara Audelo, a certified lactation educator, the regional marketing manager at Best For Babe and owner of MamaPear Designs. I’m here to answer some of your most common questions about how you can achieve your personal breastfeeding goals without being undermined by cultural and institutional booby traps such as what are the nests about labor medications and their effects on breastfeeding. Pain medications are routinely used during labor. With
some hospitals posting epidermal rates of high as 98 or 99% and while they may not affect your baby’s health, they can affect your baby’s ability to breastfeed any immediate postpartum period. Research is where we get the information we need to make recommendations and this evidence based information needs to make it clear to mothers otherwise it’s just another booby trap. The impact of birthing practices on breastfeeding as Levin Smith has to say, injections in the epidural space are quickly detectable in core blood. Pain relief drugs cross the placenta very quickly in a matter of seconds to a few minutes.

The drug is designed to numb sensory nerves in a mother and therefore they also affect sensory and motive nerves in the infant that affect rooting, sucking and breathing. One common myth, is that once medication is worn off in you, it is also worn off in your baby not so with the number of drugs. The pediatric half life, a measure of a duration of a medication in your system, of many medications is higher than the maternal half life meaning, they may affect your baby to breastfeed after you no longer feel the effects. Another myth is that they are formed in medication which don’t get to the baby and the truth is all drugs taken by the mother reach the baby. The third myth, there are standard epidurals which all anesthesiologists use. The truth is that epidurals can vary both in terms of the medications used and the dosage and of course the dose you and your baby get depends on how long you have one. Other consequences with epidurals which can effect breastfeeding because they weed to a cascaded interventions which can also lead to cesarean birth. Epidural use also rate the risk of maternal fever, infant fever and consequence separation of mother and baby for the evaluation and treatment of those conditions. Should you choose pain medications in labor, you can still have a wonderful breastfeeding experience. Let yourself believe that you deserve to know the evidence says about labor medication and breastfeeding and you deserve to post your experience of breastfeeding difficulties for this or any other reason. A special thank you to Tanya Lieberman, IBCLC for writing the booby trap series for Best For Babe. Visit http://www.bestforbabe.org for more great information about how to meet your personal breastfeeding goals and my business http://www.mamapeardesigns.com for breastfeeding support and be sure to listen to The Boob Group for fantastic conversations about breastfeeding and breastfeeding support.

Robin Kaplan: Thank you to all of our listeners. I hope you’ll visit our website, http://www.newmommymedia.com and our Facebook page to offer your advice on which tricks you’ve tried when your breastfed baby refused the bottle. If you have any questions about today’s show or the topics we’ve discussed, call our Boob Group hotline at 619-­‐866-­‐4775 and we’ll answer your question on our upcoming episode. If you have a breastfeeding topic you’d like to suggest, we’d love to hear it. Simply visit our website, http://www.theboobgroup.com and send us an email through the contact link. Thanks for listening to the Boob Group because mothers know breasts.

[Disclaimer]

This has been a New Mommy Media Production. The information materials contained in this episode are presented for educational purposes only. Statements and opinions expressed in this episode are not necessarily those of New Mommy Media and should not be considered facts. Though such information materials are believed to be accurate, it is not intended to replace or substitute for professional medical advice or care and should not be used for diagnosing or treating health care problems or disease or prescribing any medication. If you have questions or concerns regarding your physical or mental health or the health of your baby, please seek assistance from a qualified healthcare provider.

[00:40:16] End of Audio

Love our shows? Join our community and continue the conversation! Mighty Moms is our online support group, with parenting resources and helpful new mom stories you won’t find anywhere else! You’ll also have a chance to be featured on our shows.

Become a Mighty Mom!