Diversification, feeding difficulties, and breastfeeding: understanding and acting with kindness

Between 4 and 6 months, during the introduction of solid foods, some babies show signs of reluctance, which can worry and raise many questions for parents. Often, it is also the pressure from medical professionals or those around that increases anxiety and guilt, and calls breastfeeding into question…

However, these feeding difficulties are common and are usually nothing abnormal, especially in breastfed babies who do not necessarily have the same reactions and expectations as babies used to the bottle.

Let’s look together at the main reasons and how to address them while respecting the child’s needs, and without questioning breastfeeding if you enjoy it and your baby needs it!

Milk: an essential base

Breast milk is a complete food that perfectly meets your baby’s nutritional needs, even after the start of complementary feeding. Up to one year, it remains the main source of nutrients and energy. That is why, if your baby refuses the bottle or solids, or eats very little, they still receive most of the nutrients they need through breastfeeding.

When the breastfed baby refuses the bottle

Introducing the bottle to a breastfed baby can sometimes become a source of stress for parents. A baby used to the breast may completely refuse this new feeding method. Yet, for many reasons — returning to work, sharing feeding with another parent, or simply the desire to switch to mixed feeding or wean — introducing the bottle often becomes necessary.

Why does a breastfed baby refuse the bottle?

Breastfed babies are naturally very attached to nursing: warmth, smell, skin-to-skin contact with mom, and the very mild taste of breast milk. The bottle, with its different nipple and more mechanical feeding mode, can be disturbing.

Some main reasons for bottle refusal in breastfed babies:

• The bond with mom and the comfort of nursing: The breast is not only a source of food for the baby but also a moment of comfort and closeness with their mother. The bottle, even when given by mom, does not provide the same pleasure and reassurance.

• A question of texture, shape, and sucking: Bottle nipples neither resemble the shape nor the texture of the nipple. The way of sucking and the milk flow are also very different, with less flow control for the baby. The baby may be disturbed by this change, refuse the new mouth sensation, or be surprised by the milk flow.

• Need for autonomy: Some babies, especially around 6-8 months, who are used to being “active” during nursing, may prefer to move directly to solid foods or drink from a cup rather than accept the bottle. The need for autonomy grows and the baby wants to discover other ways of feeding.

• The taste of milk: even more than the bottle itself, sometimes it is the taste of formula milk, completely different from human milk, that the child refuses, being used to very mild milk, with varied flavors depending on the mother’s diet, and very digestible.

What are the solutions to encourage the baby to accept the bottle?

As with many changes in a baby’s life, it is essential to be patient and adaptable. Here are some tips to facilitate bottle introduction while maintaining breastfeeding or reducing it according to your plans:

• Try different nipples: There are many nipple models on the market, with varied textures and shapes. This can really influence bottle acceptance; quite often, breastfed babies “connect” better with a longer, rounder nipple that stimulates sucking. None is equivalent to the breast, but the baby may find some models easier. Don’t hesitate to try several to find the one that suits your child best.

• Let another person give the bottle and try a different context: Often, babies accept the bottle better with someone other than mom. Seeing mom may immediately make them want to seek the breast. Changing the context (another place, when mom is out…) can also avoid associating the meal with the breast and encourage bottle acceptance. It often takes several attempts before the baby accepts the bottle…

• Offer the bottle at different times: Reactions vary depending on the baby. If the baby is very hungry, they may be more impatient and categorically refuse the bottle. In this case, offer it when they are calm and not too hungry so they have time to discover the bottle without stress. Conversely, some babies accept better when they are really hungry and have “no other choice” but the bottle to feed… Through trial and error, you will understand what works best for your child.

• Change the temperature and texture: If the baby refuses the bottle, try changing the milk temperature. If you tried serving it warm, try cold, and vice versa. Flavoring the milk with a little cereal, puree, or compote can also stimulate appetite by varying both tastes and textures.

• Try other containers: Some babies never really get used to the bottle and prefer to move directly to a cup or solids. If the bottle doesn’t work despite attempts, try a soft spout cup, a 360° cup, or even offer milk by spoon after thickening it with cereals or semolina.

• Vary ways of consuming milk: Despite attempts, if your child remains closed to the bottle, you can also incorporate infant formula into other preparations, like midday purees or evening soups, or make yogurts with infant formula. As a last resort, it is possible to replace part of the milk with some suitable dairy products if the baby categorically refuses the bottle, and compensate with breastfeeding at other times to maintain recommended intakes.

Introducing the bottle to a breastfed baby can be a real challenge, but with patience and kindness, it is possible to find a solution that suits the baby and the parents. Every baby is different, and some will take longer than others to adapt to this new way of feeding. Offering regularly without insisting, being patient, and remaining open to other alternatives are key.

When the baby refuses diversification and solids…

The introduction of solid foods is an important developmental step, but some breastfed babies may be less enthusiastic than others. Several reasons can explain these reactions:

• Preference for breast milk: Breastfed babies like the taste of breast milk, which is always available, and everything conveyed by nursing (cuddles, comfort, soothing…). They do not necessarily want or need other foods and may take time to get used to new textures, tastes, and the very act of eating “solid” food.

• Little appetite for solids: When a baby still nurses on demand and is satisfied with their milk, they may simply not be hungry for anything else. This does not mean they will never like eating, but will gradually require reducing milk intake to give them the desire and appetite to eat new foods.

• Desire for autonomy and discovery: From 6-7 months, some babies show a strong desire for autonomy. They do not necessarily want to be passive and may want to eat alone, touch, explore, which can explain refusal to be spoon-fed and require adaptation in the diversification method.

• Periods of change or illness: Some periods are less conducive to the child’s desire to explore, such as major changes (starting daycare, returning to work, moving…) or illness periods, when the baby primarily seeks reassurance and will favor nursing. In this case, be patient and offer again later!

What tips for these difficulties?

Faced with lack of interest or refusal of solids, it is important not to force and not to worry, as milk still covers most needs! Some tips to ease the transition:

• Offer regularly without insisting: Even if the baby refuses at first, continue to present and offer varied foods without forcing. Sometimes it takes more than ten presentations of a food before the child accepts it! Also offer in different ways, before or after nursing, as this can vary by baby.

• Let them explore and discover foods: Babies need to touch, smell, and play with their food to make it their own and understand the texture. Accepting — within your limits — this exploration, even if it is sometimes difficult and messy, can help the baby get used to solids and accept eating them.

• Offer them to eat independently: If your baby seems to want to eat alone, implement baby-led weaning (BLW): give them easy-to-grasp foods like cooked vegetable sticks or large pieces of soft fruit, and let them explore and bring food to their mouth on their own. If you choose this method, some safety rules must be respected: the baby should be able to sit up (around 6-8 months), be seated in a high chair, and the pieces should be of size and texture appropriate to their abilities.

• Establish a feeding rhythm: The biological clock needs cues to adjust. Gradually establish regular meal times and daily organization to encourage the child’s hunger sensations and familiarize them with this moment. Depending on their appetite, spacing nursing sessions a bit more and allowing some digestion time between two can encourage the desire to eat.

• Eat with them: Babies learn a lot by imitation. Eating together and offering family meals can make your child want to eat and encourage them to do the same!

• Accept respecting their pace: Not all babies develop the same way or have the same needs. Adapt to your child, their appetite, their needs. It is not mandatory that they eat the recommended portions for their age; the main thing is that they are healthy and have a steady weight curve!

When to worry?

If your baby refuses all forms of diversification or eats very little after 7/8 months, or if there is weight stagnation or loss, it is necessary to have a check-up with the doctor who follows them to rule out any underlying problem.

At the same time, consulting a health professional, dietitian, speech therapist, specialized pediatric nurse… to understand what is blocking and especially how to adapt diversification and intake for your baby can be very helpful and provide real support.

But remember that some babies, breastfed or not, need time to accept a new feeding method, without any problem and without any consequences for their health or future feeding!

In conclusion, every baby is different in their approach to complementary feeding. Breast milk continues to play a fundamental role until at least 1 year, and refusals of solids in the first months, or occasionally, are generally not concerning. With patience, kindness, and adaptation, your baby will eventually develop a taste for food!

PRESENTATION

Pauline Lotte – pediatric nurse – parenting consultant – specialist in child sleep and feeding

Pediatric nurse since 2007, after 10 years in specialized pediatrics and one year managing a daycare, I chose to become a parenting consultant in 2018. This decision followed a long reflection on my desire to support and assist parents in their daily role. Having acquired extensive knowledge and skills about children and their development, I chose to put them at the service of future and new parents. I am also a mother of a little girl since September 2019.

In addition to my initial training, I specialized in child sleep and feeding, and trained in other childcare topics: breastfeeding, restrictive barriers, oral disorders, babywearing, Dunstan Baby Language… to offer comprehensive support to the children and families I meet. My goal: to support you and especially to give you practical, adapted tips for your baby, your beliefs, and your daily life, to help you be as calm as possible in your parenting!