The single most important factor influencing whether or not the baby eventually latches on is the mother's developing a good milk supply. If the mother's supply is abundant, the baby will latch on by 4 to 8 weeks of life no matter what in almost all cases. What we try to do at the clinic is get the baby latching on earlier, so that you won't have to wait that long. So, it is more important you keep up your supply, than avoid a bottle. The bottle interferes, and it is better you use other methods (such as a cup) if you can, but if you feel you have no choice, you should do what you need to do.
• Learn how to get the best position and latch from an experienced lactation specialist (see also information sheet When Latching and see the videos at nbci.ca). As the baby comes onto the breast, compress the breast so that the baby gets a gush of milk. Try the baby on the breast he seems to prefer, or the breast that has more milk, or the side you feel most comfortable with if neither of the previous apply, but do not start on the breast he resists more.
• If the baby latches on, he will start sucking and start drinking (get information on how to know a baby is actually getting milk at the breast—see information sheet Enough and see the videos at nbci.ca).
• If the baby doesn't latch on, don't try to force him to stay on the breast; it won't work. He will either get hysterical or "go limp." Move him away from the breast and start again. It is better to go on-off, on-off several times than to push him into the breast when he hasn't latched on. Pushing the baby into the breast won't work and may cause baby to refuse even more.
• If the baby goes to the breast and sucks once or twice, he hasn't latched on a little; he hasn't latched on at all.
• If the baby refuses the breast, don't keep at it until he's angry. Try finger feeding a few seconds to a minute or two, and try again, perhaps on the other side. Finger feeding is primarily used to prepare the baby to take the breast, not primarily to avoid a bottle.
• If the baby doesn't latch on, finish the feeding with whatever method you find easiest. Cup feeding works well and is better than a bottle.
• Using a lactation aid at the breast may be helpful, but often requires an extra hand. The baby is more likely to latch on if the flow is rapid, and the lactation aid increases the milk flow to the baby.
• At about two weeks after birth, a change in what you have been doing often seems to send a message to the baby that "there's more than one way to do this." If you have been finger feeding only, a change to a cup or bottle will sometimes work. If you have been bottle feeding only, switching to finger feeding may work (only before attempting the baby at the breast is good enough if finger feeding is too slow, and finishing the feeding with cup or bottle).