Bottle refusal in babies under 6 months is an oral function issue, regardless of excellent breastfeeding and infant weight gain.  Infants are hard-wired to survive and feed the most efficient way to satisfy their hunger.  Around 8-12 weeks of age, an infant’s innate suck reflex integrates.  Parents start to notice that their baby may kick the nipple around in their mouth, thrust it out with their tongue, bite it, refuse to suck on it, and become upset or begin to cry if parents continue to push it.  Circulating are common myths that bottle refusal is caused by high lipase milk, cold bottles, baby not being hungry enough, or mom just breastfeeding and not “allowing”  other people to feed the baby.  Further complicating bottle refusal is its almost cruel timing at 8-12 weeks; many parents are preparing to return to work, thus making it mandatory that their baby be able to bottle feed at childcare.  Panic ensues.  This is where I come in.  With an individualized care plan, including daily exercises, bottle and nipple changes, and daily parental diligence, most parents will slowly start to see daily progress.