QUESTION:

I'm trying to get my 3-month-old son to take a bottle for when I have to go out, and he absolutely refuses. I've tried every different nipple on the market, and he just won't drink from them - even when it's my breast milk. How can I get him to do this so that I can leave my son with his dad, or anybody for that matter, without worrying that he is screaming because he's so hungry?

Name Withheld

JAN'S REPLY:

I understand your concerns - in fact I remember when I had this same question years ago. I'll try to give you the information that helped me to better understand and to meet my son's needs.

It can be worrisome for loving parents to think that their baby may be in a situation in which an important need such as hunger cannot be satisfied. However, a bottle is not a good solution. Many babies will suck only from one or the other, breast or bottle. One reason for this is that the sucking method is, surprisingly, quite different. A baby who is breastfeeding successfully can become confused by something that requires a different sucking method. But I would not recommend that you teach him how to drink from a bottle, even if you could do so. If he were to successfully learn to suck from a bottle nipple (or a pacifier), that could bring about what is termed "nipple confusion" and interfere with his ability to nurse properly. As there are literally hundreds of benefits of breastfeeding, both physical and emotional, for both baby and mother, anything at all that might interfere with this extremely beneficial relationship should be avoided.

Your son has good survival instincts! While his resistance to bottles may be frustrating for you, your baby is strongly communicating his legitimate need to be with you as much as possible. Bottles, even when filled with breastmilk, cannot satisfy a baby's emotional need for the mother's presence. For the early months and years, it is essential that he have full opportunity to bond first with his mother - only then can he successfully move on to bonded relationships with his father and, later, with other persons.

Breastfeeding, beyond all of its many physical benefits, has the added bonus of requiring the mother's presence. A baby has no sense of time and no way of knowing that an absent mother will ever return, yet he understands that her presence is essential. Thus her absence can be quite terrifying. For this reason, it is imperative to keep absences to the barest minimum (in terms of length of time and number of times), and if it is absolutely essential to leave him, try to be gone as short a time as possible, and to schedule things so that you are gone between feedings, or during naps, rather than during a time when he is apt to be hungry.

If a separation is absolutely unavoidable during a time when he is hungry, perhaps he will accept expressed breastmilk from a spoon. In a relatively short time, he will be able to drink from a cup. However, I offer these suggestions reluctantly and definitely not as a routine solution, but only as something that might be used in a rare, emergency situation. It would be far better to avoid separations as much as possible, and to carefully schedule any departures that cannot be avoided. In fact I urge you to make every effort to avoid such departures altogether if possible. Not only do alternate feeding methods interfere with his ability to nurse from you, but more significantly, all separations can interfere to some degree with his developing sense of trust and security.

I would like to stress an important practical consideration that is often overlooked. Sometimes parents assume that a baby will not be welcome or appropriate in a certain situation, when in fact they may be pleasantly surprised if they ask to bring the baby along. Many parents have had the frustrating discovery of attending a function without their baby or child, only to find that others have brought theirs along. If a mother must attend a function where babies are definitely not allowed, she can ask that the baby be brought to her for nursing breaks. Requests like this can even help others in society to become more aware of the critical importance of breastfeeding and bonding. With such a request - even if it is denied - a mother can contribute to the process of social change. In many countries of the world, babies and children are far more welcome in "adult" settings than in North America. It is time to request and advocate change in this area!

It is not only the baby who finds separation difficult. Breastfeeding mothers quite naturally find that they also become uneasy when separated from their baby. The following is excerpted from the La Leche League book, The Womanly Art of Breastfeeding (New York: Penguin Books, 1991):

"You won't want to leave your baby any more than you have to because babies need their mothers. It's a need that is as basic and intense as his need for food. 'That's all well and good,' you may be thinking, 'but what about me? I have needs too.' Of course a mother has needs, and sometimes other responsibilities and obligations cause a mother to be away from her baby more than she wants to be. But you may be surprised to find how strong the bond is that develops between you and your baby. A mother often finds that when she does leave her baby for that long-awaited 'night out', she worries so much about how the baby is getting along that she doesn't really enjoy the occasion!"

I also recommend Dr. Kimmel's short book on our site, Whatever Happened to Mother?, which explores the nature and importance of mother-child bonding.

For further information on breastfeeding, visit the La Leche League site at www.lalecheleague.org. Questions can be sent through a "help form" available on their site; an accredited La Leche League Leader will reply within a week. For a faster reply, phone a Leader in your area (check the white pages under "La Leche League" or go to the La Leche League home page and click on "How to Find an LLL Leader Near You"). Main telephone numbers for the League are (847) 519-7730; in the U.S. phone toll free 1-800-LALECHE).

Give your baby a hug, and write again if needed.

Jan