Guide for Breastfeeding and Bottle Feeding Problems

The birth process was a tremendous experience, and as tough and rewarding as that part was, now it’s on to nurturing a healthy and happy infant with guidance on breastfeeding and bottle feeding problems.

It’s important to know what normal feeding is like as well as what it’s like when babies experience bottle feeding and breastfeeding problems. You should know the causes of these problems, symptoms, risks and signs of trouble. Bionix Health at Home will also provide breastfeeding and baby bottle feeding tips for parents and caregivers, including information on adjustable rate baby bottles and suggestions and recommendations for babies that gag, choke or experience other discomfort.

Helping your child feed and grow is a wonderful and joyous bonding experience that you’ll look back on wistfully when you compare it to other tasks like teaching your child to drive or helping them pick out a college.

Bionix Health at Home has compiled a summary of insider tips, checklists, and solid sources on breastfeeding and bottle feeding for helping you provide the very best for your child.

What is normal infant breastfeeding and bottle feeding?

Babies have a strong drive to suck. Their survival depends on it. There are four basic reflexes that children master based on this instinct so that they get every ounce of nutrition they need.

Top Feeding Reflexes

  • Rooting: Babies “root” to find a food source. Place your newborn on your chest and he or she may start to move their head looking for food. Go ahead and test this: Stroke near or at the baby’s mouth and it should open.
  • Suck/Swallow: When your newborn attaches to the breast or nipple, he’ll begin sucking and drawing milk into the mouth. The tongue moves the liquid to the back of the mouth so he can swallow.
  • Tongue thrust: The tongue naturally pushes out whenever baby’s mouth is touched (breastfeeding or bottle feeding). When does this occur? From birth to 4-6 months.
  • Gag reflex: Baby’s defense against choking. Babies gag when an object goes into the back of their mouth (the area that triggers the gag reflex moves from the middle part of the tongue to the back sometime between 3 to 7 months).

Chris Gade shared this helpful video on Infant Reflexes

Other Top Reflexes

You may think of your child as a budding Olympic athlete or Ninja Warrior with these reflexes, but alas, they’re common to all infants.

  • Moro reflex: The startle reflex is triggered by sound (including the baby’s own cry). The baby throws back its head, extends the arms and legs, cries, then pulls the arms and legs back in. (Lasts 5 to 6 months).
  • Tonic neck reflex: When a baby’s head is turned to one side, the arm on that side stretches out and the opposite arm bends up at the elbow. (Lasts 6 to 7 months).
  • Grasp reflex: Stroking the palm of a baby’s hand causes the baby to close his or her fingers in a grasp (Lasts 5 to 6 months).
  • Babinski reflex: The sole of the foot is firmly stroked, the big toe bends back toward the top of the foot and the other toes fan out (Lasts up to 2 years of age).
  • Step reflex: Baby appears to take steps or dance when held upright with feet touching a solid surface.


Breastfeeding and Bottle Feeding Problems

Some babies have trouble breastfeeding and bottle feeding. The National Institutes of Health (NIH) estimates that 25% of normally developing infants and 35% of babies with neurodevelopmental disabilities are affected by some form of this problem.

A University of North Carolina study by Suzanne M. Thoyre, PhD, RN noted the prevalence of breastfeeding and bottle feeding problems between typically developing children at 20% and children with other medical conditions at the following percentages:

  • 80% of children with developmental disabilities (Autism, Cerebral palsy)
  • 85% of children with complex medical conditions
    • History of prematurity
    • CHD (chronic heart disease, congenital heart defect)
    • Cystic fibrosis, Diabetes
    • Genetic disorders
    • GI problems

Wondering if your baby’s latch and sucking is going to get him or her the nourishment they need? Here are just a few tips from a Dr. Sears Wellness Institute checklist that might help you determine if things are correct.

  • Pink baby lips? Good! Baby’s lips are turned outward rather than tucked tightly inward.
  • Tight seal between baby’s month and areola? Baby needs to have a good mouthful of breast.
  • Baby’s ears wiggling? If baby is using the entire lower jaw the front of the baby’s ears will move.
  • No clicking sounds: Clicking sounds indicate that the baby is latched incorrectly.
  • Dimpling during sucking? Are the middle of the baby’s cheeks caving in? This would indicate the baby has a good seal on the breast and is not breaking the latch and suction.

While spitting up can appear to be a breastfeeding and bottle feeding problem, as this action is not normal in adults, it is quite normal for infants. Gastro-oesophageal reflux (or reflux) is a normal physiological process where the contents of the stomach come back up into the oesophagus. Reflux commonly occurs several times a day in babies, typically after feeds, peaking in the first month. It’s estimated that 73% of babies experience reflux.

If bottle feeding or breastfeeding problems are addressed as soon as your baby begins to show symptoms, such as losing weight or refusing to eat, the prognosis is generally favorable.


Typical Causes For Feeding Problems

The following list contains some of the causes of breastfeeding, bottle feeding and swallowing problems in infants:

  • Traumatic birth injuries that lead to neurological disorders (Cerebral palsy is an example)
  • Cleft lip/cleft palate
  • Autism
  • Neck and head abnormalities
  • Premature birth
  • Low birth weight
  • Respiratory problems
  • Heart disease
  • Gastrointestinal disorders
  • Medications that decrease appetite

Typical Signs Your Baby Might Have A Feeding Problem

The following list contains some symptoms and signs that your baby might have breastfeeding, bottle feeding and swallowing problems. Have you noticed any of these traits in your baby?

  • Arching the back and body while feeding
  • Fussiness or lack of alertness while feeding
  • Baby refusing bottle
  • Excessively long feeding times
  • Difficulty with bottle and/or breastfeeding
  • Coughing or gagging during feeding times
  • Excessive drooling
  • Difficulty in coordinating breathing with eating and drinking
  • Increased nasal stuffiness during meals
  • Frequent spitting up and/or vomiting
  • Poor weight gain or growth

Still not sure? You might try this helpful symptom checker to assess symptoms and determine possible causes for breastfeeding, bottle feeding and swallowing problems. Symptom Checker


Treatments For Breastfeeding or Bottle Feeding Problems

During infancy, children gain weight and grow more rapidly than at any other time in life. Some children do not gain weight at a normal rate for a variety of reasons. Below are some of the typical treatments and options for babies with breastfeeding and bottle feeding problems. Preemie baby blogger Melissa Haber also offers some additional ideas on preemie babies with breastfeeding or bottle feeding issues.

  • Medications
  • Individualized feeding therapy
  • Nutritional changes
  • Promoting an increased acceptance of new foods and textures
  • Food temperature and texture changes
  • Postural or positioning changes
  • Behavior management techniques
  • Mouth exercises to make the mouth muscles stronger
  • Tongue movement and chewing exercises
  • Promoting different types of foods, including different textures
  • Help with sucking improvement including Controlled Flow feeders
  • Altering food textures and liquid thickness to ensure safe swallowing

Breastfeeding and Bottle Feeding Tips For Parents

Pediatric Occupational Therapist Tonya of the Therapy Fun Zone has great recommendations on sucking improvement for babies. It is noted that a baby should have a rhythmic suck-swallow-breath pattern and generally have a similar number of sucks in between each swallow. The typical number is 3-5 sucks then a swallow. If a baby is taking too many sucks before breathing, he or she can become short of breath. What can you do? Try to help establish a rhythm for your baby by rocking while feeding. The baby may start to time its suck-swallow-breath pattern to the rocking rhythm.

Do you notice signs of problems with sucking? Be observant and look for one of these seven actions:

  • Too small jaw movements (baby is not creating enough negative pressure)
  • Too large jaw movements (baby is breaking the seal that the tongue has on the nipple)
  • Losing a lot of liquid out of mouth (baby’s tongue is not maintaining its seal)
  • A clicking sound during sucking (baby’s tongue is moving so strongly that it is clicking and losing its seal)
  • Taking longer than 30 minutes to drink a bottle
  • Breathing heavily or gasping for breath after drinking – means he or she is not pausing for breaths during sucks
  • Choking or coughing on the milk

Note that a baby’s latch onto a nipple or bottle is not dependent on the lips, rather it is achieved by the tongue. The tongue should curl tightly around the nipple. The jaw comes down noticeably with a good suck which creates negative pressure and the tongue makes a wave type of motion forward and backward in the mouth.

Although many moms try both breastfeeding and bottle feeding, there are some ideas and tips that are unique to each feeding method.

Breastfeeding Tips For Newborns

  • Don’t compare yourself to other moms: Each breastfeeding experience is unique. Your nursing experience will not necessarily be like your mom’s experience or your sister’s.
  • Don’t be a quitter:Before you decide to give up nursing and move to the bottle, give yourself plenty of time to adjust to breastfeeding. Six to eight weeks minimum.
  • Nursing in public: Do you feel uncomfortable nursing in public? Try practicing in front of a mirror with your nursing camisole so that you know what people can and cannot see. Getting comfortable with this will broaden your mobility and options.
  • Stay hydrated: Keep your water bottle handy and full and near you when you’re nursing. When you are hydrated, you’re passing on your health and contentment to your baby.
  • Inverted Nipples: If you have inverted nipples, some mothers have found that pumping a few minutes to draw them out helped.
  • Keep nursing even with a cold:Your breast milk could help keep your child from catching your cold. Some mothers have discovered that even when they got sick and the baby did get a cold, the cold was very short lasting.
  • Nursing and bottle feeding: Yes, you can do both – breast feed and formula Every drop, whether by nursing or formula, is beneficial to your child.

Bottle Feeding Tips for Newborns

  • Pick the best position: Support your little one’s head with the crook of your arm, prop baby up at a 45-degree angle to prevent them from swallowing a lot of air, and also align baby’s head and neck. Try tucking a pillow by your side for your arm to rest on. Also, try switching sides halfway through the bottle-feeding session.
  • Gagging or choking: What if baby gags or chokes while feeding? Try these options:
  • Reduce flow rate or use a Controlled Flow Baby Feeder
  • Check that the baby’s head is slightly elevated and straight (not tipped to one side)
  • If baby begins to choke or gag while feeding, remove nipple and sit him or her up slowly.
  • When baby is full (stops sucking or milk spills out of mouth), remove nipple from his mouth. Letting it stay may fill the mouth with milk, causing baby to choke. (If your baby weighs 10 pounds, it should be drinking roughly 20 to 25 ounces every 24 hours).

Bionix Controlled Flow® Baby Feeder

  • Burping bests: When air gets trapped in your baby’s tummy, it can make him or her feel full before they’ve had enough to eat. Burping baby can help bring up those bubbles. Most of the time, take a burp-break halfway through the bottle.
  • Discourage dozing: Check if she’s really asleep. She or he may be sucking so blissfully that they appear to have fallen asleep, but in fact baby is simply taking their sweet time. If your baby is actually snoozing, try awakening him or her by undressing baby a little, tickle their feet, burp them, change their diaper, and switch positions. If your baby routinely takes a nap mid-meal, you might have to change the feeding schedule.
  • Keep spit-up minimum: More than half of all infants spit up after (or during) a feeding, mostly because their digestive systems are still developing. Try one of these five tactics:
    • Burp every 3-5 minutes during feedings
    • Give smaller feedings more often
    • Hold baby’s head higher than feet when feeding
    • Hold baby upright after feeding and try not to bounce or jiggle
    • Keep diaper and clothing loose around belly



Helping your infant learn successful breastfeeding and bottle feeding is the first of many wonderful nurturing things that will shape your child’s life, your family’s life and all the people that child will interact with thanks to you. Bionix Health at Home hopes these tips will provide relief when you need them and allow you to focus on your little one. Congratulations on this unique and rewarding life experience you’ve embarked on. We only hope that we’ve been able to play a small part in helping you with this awesome responsibility.