Strategies for Supporting the Breastfed Infant Needing Supplementation and Refusing Bottle Teats - Workshop 3

Speaker(s): Susan Howard

Supplementation is sometimes medically or socially indicated—for example, when mother–infant separation, poor weight gain, or low milk supply occurs. When a breastfeeding infant requires supplementation but refuses the bottle, parents may feel overwhelmed, and lactation care providers face clinical challenges. While there are multiple methods of supplementation, some families will choose to use a bottle and bottle teat. Supporting that choice with skill and evidence-based strategies is essential to maintaining the breastfeeding relationship and meeting the infant’s nutritional needs.

This skills-based session offers practical approaches for supplementing breastfed infants who are breastfeeding but require supplementation and refusing bottle teats. Participants will explore the interaction among infant reflexes, oral anatomy, bottle teat design, and caregiver technique using anatomical infant-head models and a variety of bottle–teat systems. The session will address common causes of bottle refusal—such as bottle teat selection, infant stability, oral tension, and pressure feeding—and their impact on the parent–infant dyad.

Through hands-on practice with TieLER mouth models and dolls, attendees will apply oral exercises, positioning techniques, and bottle feeding strategies that improve infant coordination and feeding.

This workshop equips lactation professionals with evidence-informed skills to support families choosing bottle supplementation while protecting the breastfeeding relationship.