Fixing Your Baby's Bottle Feeding Problems

Baby girl drinking from bottle on sofa
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While some new parents who have problems breastfeeding think it will be smooth sailing if they switch to formula, it's important to understand that babies can have bottle feeding problems too. Refusing to eat and choking can be caused by anything from acid reflux or a formula intolerance to issues with the bottle and nipple.

Before you switch your baby's formula or buy a premium bottle that is supposed to reduce colic and gas, consider:

  • Other symptoms. Does your baby have a runny nose, cough, fever, etc? These might indicate that your baby is sick and needs further evaluation.
  • Frequency. Is your baby having problems at each feeding, or only occasionally? Occasional feeding problems could mean you are misinterpreting hunger signs and are trying to feed your baby either too early (when they aren't hungry) or too late (when they are overly fussy because they are very hungry).
  • Formula flow. Does it seem like the formula is coming out of the nipple too fast or too slowly? Either can be frustrating for your baby. When you turn a full bottle of formula over, about one drop per second should drip out. If it is much slower or faster, you might need to try a different nipple.
  • Formula temperature. Is the formula too cold or too hot? You may need to adjust how you are heating your baby's bottles.

Formula Intolerance

Intolerance might also cause a baby to be fussy during feedings, although they usually also have other symptoms, like diarrhea or a lot of gas. If your baby is on a cow's milk-based formula, talk to your pediatrician about whether you should change to an elemental formula.

Keep a diary of feedings for a few days to get a sense of how much your baby is eating each day and how often. If you have tried addressing these common bottle-feeding problems without success, talk to your pediatrician about what else could be going on.

Is It Reflux?

If a baby is fussy, doesn't want to eat, and spits up a lot, then they very well may have acid reflux. Always consult your pediatrician for advice about diagnosis and treatment of reflux or another feeding problem. Treatment for reflux might include:

  • Switching to a baby formula that could reduce spitting up
  • Lifestyle changes, especially feeding smaller amounts more frequently
  • Burping your baby more frequently
  • An acid reducer medication

Adding a bit of rice cereal to formula is a home remedy for thickening formula that works for some infants with acid reflux. Some pediatricians recommend this strategy.

If your baby has acid reflux, you usually shouldn't re-feed them after they spit up a large amount of formula or breastmilk. It is often hard to judge exactly how much they are spitting up. You may end up overfeeding your baby, leading to more spitting up. Instead, wait until the next feeding to give another bottle.

A Word From Verywell

Anytime that your baby is experiencing feeding problems, you want to make sure that your baby is gaining weight well and doesn't have a fever or other signs of illness. In addition to your pediatrician, a pediatric gastroenterologist can help with bottle and formula feeding problems. Seek immediate medical attention if your baby vomits blood or green or yellow fluid.

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Article Sources
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  2. Vanderhoof JA, Moran JR, Harris CL, Merkel KL, Orenstein SR. Efficacy of a pre-thickened infant formula: a multicenter, double-blind, randomized, placebo-controlled parallel group trial in 104 infants with symptomatic gastroesophageal reflux. Clin Pediatr (Phila). 2003;42(6):483-95. doi:10.1177/000992280304200602

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Additional Reading
  • Vandenplas Y. Pediatric Gastroesophageal Reflux Clinical Practice Guidelines: Joint Recommendations of the North American Society of Pediatric Gastroenterology, Hepatology, and Nutrition and the European Society of Pediatric Gastroenterology, Hepatology, and Nutrition. J Pediatr Gastroenterol Nutr 2009;49:498-547.