Five month old with bottle aversion

[u/EverythingBagelSzn]

My five month old has always been bottle fed, and has always used the Philips Avent natural bottles. She has CMPA and takes Similac Alimentum for it (has been on this formula for about 2-3 months with a lot of success with her CMPA).

For the past 3 or so weeks, she’s been having bottle aversion and it’s getting worse. She will take a sip of the bottle, then turn her head away. There are other times she sees the bottle coming and will turn her head. Our most successful times of feeding her are tricking her with sucking on a pacifier, then swapping it with her bottle. We wait to feed her until we know she’s truly hungry, scheduled feeds have been out the window, so it’s quite apparent she wants to eat when we try, but it’s a battle.

Before we resort to changing formulas, is there a different bottle brand/style you all here would recommend trying? Or have you had experience with your baby having milk or bottle aversion? It would be really disappointing to have to find another formula, since it took a lot of trial and error to find one that works for her CMPA.

[u/KikiTheArtTeacher]

My baby had a bottle aversion and thankfully are past it now. I would not change formula or bottles - what can happen is that it will temporarily ‘reset’ the aversion but then it always comes back unless you get to the root of why she’s averse. 

You mentioned she has CMPA- does she have reflux or silent reflux as well? And if so, how is it being treated and is she pain free? That part was important for us- some reflux/ allergy babies start to associate eating with pain (or a similar negative emotion) and then we can inadvertently reinforce it. We were going to great lengths to get our girl to eat and it got the ounces in but was also making the aversion worse. 

Have you mentioned it to your ped? And if so, what have they said? A lot don’t know about bottle aversion and some of what ours told us, even thought she meant well, ended up making things worse in the long run 

[u/EverythingBagelSzn → u/KikiTheArtTeacher]

You hit the nail on the head - she does have reflux. She actually just threw up her previous feed (which she was fighting) about 20 minutes ago.

She is already on famotidine and ups the dose at each of her appointments, the last increase was at her four month appointment. What did you end up doing to help your little one?

[u/KikiTheArtTeacher → u/EverythingBagelSzn]

Ah! So this was our situation as well. The reflux and feeling badly was just constantly reinforcing the aversion. For her, famotidine stopped working well enough (their bodies build up a tolerance to it and dose increases stop helping). So we needed to switch to a PPI omeprazole. I actually really recommend that because it did get her pain free and then we were able to help her relearn to enjoy bottles again. The big thing there though is the dosing and sometimes peds can be reluctant to prescribe or prescribe a dose that’s too low- and that’s brutal (too low of a dose) because for us it actually made things worse. So there’s definitely a balance! But we saw a private specialist and she helped with the dosing and got it straightened out and that was worth it because then it worked so, so well for her. 

She gave me this also about reflux and aversion, does this sound like what’s happening ?

https://www.cryingcolicandbeyond.com/_files/ugd/f47b43_ff161b679456465f8269af82b8757b31.pdf