UK mothers' experiences of bottle refusal by their breastfed baby

Abstract

Little is known about bottle refusal by breastfed babies; however, an informal review of global online forums and social media suggested large numbers of mothers experiencing the scenario. This study aimed to explore UK mothers' experiences of bottle refusal by their breastfed baby in order to provide understanding of the scenario and enhance support for mothers experiencing it. A 22‐point online questionnaire was developed and completed by 841 UK mothers. Findings suggest that mothers introduced a bottle to their breastfed baby due to physical, psychological and socio‐cultural factors. Advice and support for mothers experiencing bottle refusal was not always helpful, and 27% of mothers reported bottle refusal as having a negative impact on their breastfeeding experience. When compared with eventual bottle acceptance, bottle refusal was significantly associated with previous experience of bottle refusal (p < .001), how frequently mothers intended to feed their baby by bottle and babies being younger at the first attempt to introduce a bottle (p < .001). This study provides a unique insight into the complexities of bottle refusal by breastfed babies and the impact it can have upon mothers' breastfeeding experiences. It generates knowledge and understanding that can help to inform practice and policies. In addition, a ‘normalising’ of the scenario could enable mothers, and those supporting them, to view and manage it more positively.

The differential role of practical and emotional support in infant feeding experience in the UK

“…Together, these findings bolster recent calls for support interventions to look beyond breastfeeding mothers and to provide more support to those who decide, for whatever reason, not to start or to stop breastfeeding [13,15,50,51]. Overall, our models support the underlying contention that social support should not be treated as a univariate entity, with uniform outcomes, as predicted by an evolutionary capital-based understanding of investment behaviour.…”

“…This likely reflects a range of factors, including not only unmet feeding goals but also, for example, difficulties linked to introducing both formula and solid foods and 'missing' the act of breastfeeding. Together, these findings bolster recent calls for support interventions to look beyond breastfeeding mothers and to provide more support to those who decide, for whatever reason, not to start or to stop breastfeeding [11,13,46,47].…”

“…Under perceived pressure to breastfeed, the emotional wellbeing of women who fail to achieve their breastfeeding goals suffers [11,12]. Non-breastfeeding mothers, who commonly report a lack of support with infant feeding, are also exposed to emotional difficulties [13,14]. While the literature acknowledges that social support comes in different forms, often drawing on one or more of House's [15] four types of support (informational, instrumental or practical, emotional, and appraisal), social support is broadly considered to be uniformly beneficial for physical and mental health [16].…”

Why have a bottle when you can have draught? Exploring bottle refusal by breastfed babies

“…Bottle refusal by breastfed babies is a scenario that has received surprisingly little attention in the literature, given the number of mothers globally who appear to be experiencing it (Maxwell et al, 2020). Hundreds of thousands of references are made to it in global breastfeeding groups, parenting forums and on social media with an emphasis on the negative impact of bottle refusal and, in turn, requests for advice on how to 'solve it'.…”

“…However, cup feeding appears to be unpopular with mothers and has itself been reported as being refused (Maxwell et al, 2020).…”