There are a few things I always try to put in focus with mothers who are
struggling to "get the baby to take a bottle" Other than the idea that a baby
can be alternatively fed if needed( cup, spoon, etc.) women need to stop
feeling "if only I'd introduced the bottle from birth, like so- and -so and
her baby does both beautifully". I tell moms that the majority of babies need
to get BF going well before intro of a bottle- this is the NORM,; babies who
recieve early bottles and do "well" are the exception. Secondly a baby who
has difficulty switching feeding methods later would probably also have been
the normal baby who refused to nurse after the early intro of a bottle. Yes
she has a "problem" now, but she would almost certainly have had the reverse
problem earlier, as well. She does not need to worry that she made a mistake
by not giving bottles sooner.  I also mention that many babies who take a
bottle easily and often at 4-6 weeks may still go on to refuse at 3-4 months,
as they become more aware of their environment, and begin to have preferences
and the skills to use them. This is one of many future "negotiations" with
this child!
     I remind mothers that nursing and bottlefeeding are different skills
physically, and the sensory experience is very different. An artificial
nipple does not shape to the baby, does not respond like, smell like, or
taste or feel like, mom's. I think it was Janet Tamaro who wrote that nursing
and bottlefeeding are like tennis and racquetball- they may look like they
should be similar activities, but they are very different in timing and
strategy. Even if the bottle if full of EBM it is not like being nursed as
far as the baby is concerned. For some mothers this is a new realization.
     Lastly, as gently as I can, my goal is not to make anyone feel guilty, I
remind the mother that the baby may be reacting not to the bottle itself but
the the fact that it is NOT Mom. Sometimes babies simply won't take a bottle
because they want to nurse - get the totoal experience that bottlefeeding
does not and cannot provide. I also tell them their babies are "smart" as was
mentioned before, and that smart is good, but not always "easy". Some babies
are not refusing the bottle, but refusing to put up with the lack of Mom.
This baby may even take a bottle from Mom but will cry until lethargic and
withdrawn if someone else tries to give it. This is a tough situation. One
mom who encountered this situation was told  by the wife of a well-known and
gentle-parenting pediatrician that, to be honest the mother has two choices:
give in and don't go away yet. or "break the baby's spirit" and eventually
she'll eat. When we  face  the emotional reality of what we are actually
asking babies to cope with, we see that, lucky fur us, many babies adapt, but
a few cannot. It is easy to believe that someone else providing food and
warmth for a baby in a mother's absence is the same as BF but it isn't enough
for some babies. We can be glad that there are wonderful and loving
caregivers out there for  little ones, but for some babies, only Mom will do
for the time being. These babies should be praised for their perseverance.
     I offer the information gently so a mother is free to hear it or not
hear it. I am careful not to judge, how do I know this woman and her life?  I
provide all the tips and tricks I've heard over the years so that this baby
remains healthy and well-fed until Mom returns, and Mom still has a supply to
nurse. I explain that if the baby turns away from the breast/Mom when she
returns this is a normal (grief) reaction, not a sign of natural weaning, and
I give tips to re-establish a nursing relationship if she wants to do so.
     The truth is, that a woman who feels she can BF and still have the life
she feels she needs to have is more likely to keep nursing that baby, and go
on to nurse any others she may have. If she feels a nursing baby is too
demanding, or difficult, and doesn't fit with HER needs, she may just wean
abruptly and decide not to even nurse at all with subsequent babies. If at
some point she needs help, she will come to us and feel free to ask her
question,
 because we helped her where she was, by helping her get her baby to take a
bottle.
    Jeez, that was long. hope it's helpful.
    Judy Fram, MEd., PT, LLLL, IBCLC  Brooklyn, NY