The Surprise Milestone - Bottle Refusal

By: Dr. Frank Drummond

Up until now, your 2-month old was feeding perfectly on both breast and bottle. But all of a sudden he/she has completely lost interest in the bottle and will even scream if it’s brought too close. You’re starting to panic and wonder if your baby will ever be able to drink from a bottle again! Sound familiar? If so, there is a likely chance your newborn is going through a very normal and expected behavioral reflex change called the “two-month mark”. Understanding the developmental reasons behind this seemingly spontaneous behavior will reassure moms like you that you aren’t alone and bottle-feeding can still be successful.

The two-month mark occurs in babies aged 2-4 months and is characterized by a sudden refusal of bottles, making for a frustrated baby. Now that your baby has grown a little and mastered the art of suckling; they can latch, suck, and feed more efficiently. Because of this, they can spend less time at the breast while still receiving the same amount of nourishment. In addition to this your baby is also becoming more perceptive. He/she can now see across the room and recognize familiar faces. They are beginning to analyze what is going into their mouths and can immediately recognize if it isn’t a direct part of mom. In other words, if it isn’t mom, they don’t want it. This can cause them to become frustrated and upset when a bottle is presented to them.

Many moms are not aware that their baby’s ability to feed after birth is an involuntary survival feature they are born with. This instinctive sucking reflex is activated whether they are hungry or not when the roof of their mouth is stimulated by touch. Because of this innate behavior, babies are able to sustain life immediately after birth without having to learn the motor skills behind suckling. The two-month mark is simply a successful cognitive development causing sucking to transition from being an involuntary reflex into a voluntary controlled response. At 2 months of age the roof of your baby’s mouth will no longer stimulate immediate sucking because they have developed the muscle memory necessary to control it on their own.

A “successful suck” is more complex than you might imagine. The baby’s lips flange and close around the nipple creating an airtight seal around the areola. They then move their tongue in and out- controlling the flow, pressing the nipple into the top of their mouth creating pressure. The suction of the downward movement of their jaw pulls the breast milk into their mouth. After taking another breath, the cycle continues. This cycle is called the Suck-Swallow-Breath (SSB) Synchrony. These pauses in feeding allow for your baby to make eye contact with you and form a bonding moment.

This is an exciting step for your baby because they are able to control their feeding for the first time ever. This can be a major complication for the 80% of moms returning to work or looking to take a break from breastfeeding for a night out. Not to worry! Useful tips and tricks such as warming the baby bottle nipple, letting someone else give the bottle, or using different positions other than the breastfeeding hold can provide a successful bottle feeding experience. Breast bottles, such as the mimijumi bottle, are also a successful way to introduce bottle-feeding again because of its unique breast-like design. Understanding what is happening as your baby grows helps you manage these sometimes surprising transitions and limit frustration all around.