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Breast refusal is one of the most difficult breastfeeding problems that can occur. It is especially difficult when a newborn refuses to breastfeed.
It is not a problem that only happens when getting started with breastfeeding. A baby refusing to nurse can happen at any time during a breastfeeding journey.
There are different causes for a baby not wanting to breastfeed. The cause of your infant refusing to nurse will determine what is the best approach to get your baby on the breastfeeding bandwagon.
In most instances the best tools to deal with breast refusal are patience, persistence, and time.
I will share some techniques and tricks that have been successful for the moms I have worked with. They may help you get your baby to stop rejecting your breast.
REASONS FOR BABY REFUSING TO NURSE
There are many different reasons for a baby not wanting to breastfeed.
Breast refusal occurs at different ages and different stages of breastfeeding.
NEWBORN REFUSES TO BREASTFEED
It can be devastating when you give birth and your newborn refuses to breastfeed.
Moms often say they experience feelings of rejection. They think their baby doesn’t like them.
They worry that their new infant could starve if he doesn’t start breastfeeding.
They stress about giving a bottle because they have heard that is bad to do when you want to breastfeed.
Dealing with breast refusal is a confusing and stressful time.
Be kind to yourself. Your baby is not rejecting you. Much of the time a baby is simply unable to breastfeed.
Newborn Refuses to Breastfeed Due to Birth Trauma
A difficult delivery can leave your baby with a bruised and sore head. This can happen from a birth that is assisted with a vacuum extractor or with forceps. There also can be bruising from a long pushing stage of labor.
In my experience, most babies will start to feel better after 2-3 days and begin nursing at that time.
There are some things you can do while you wait for your baby to become interested in breastfeeding.
- Do skin to skin
- Do hand expression of your colostrum and feed it to your baby
- Use a breast pump at least eight times a day until your baby is breastfeeding regularly
- Your health care team will help determine if your baby needs to be supplemented with anything other than your expressed breast milk.
BABY REFUSES TO LATCH DUE TO A DYSFUNCTIONAL SUCK
Some babies are born with sucking problems and are unable to suck properly.
Your baby may act interested in latching but can’t seem to do it. She may latch on to your breast and then slide right off.
Health Care Professionals Who Can Help a Baby With a Dysfunctional Suck
- Lactation Consultant
- Speech Therapist
- Occupational Therapist
- Physical Therapist
- Cranial Sacral Therapist
I have a wonderful Osteopath in my community who has done some amazing things with babies who were having trouble sucking. If you are open to alternative treatments this is definitely something you should look into.
There are times when the results are practically miraculous. However, most of the time it will take more than one treatment. A reputable practitioner should be able to give you a timeline of when you should see some improvement.
BREASTFEEDING REFUSAL DUE TO TONGUE-TIE
There are varying levels of severity of tongue-tie. A baby who has tongue-tie can have difficulty latching on or staying on the breast.
If your baby is interested in breastfeeding but unable to latch or achieve a sustained latch he should be evaluated for tongue-tie.
Tongue-tie can be treated and can make the difference between a baby who seems to be refusing the breast and one who breastfeeds with enthusiasm.
BABY REFUSING ONE BREAST
Some babies will take one breast but refuse the other side. There can be different causes for this type of breast refusal.
- Anatomical differences in mom’s nipples
- Birth trauma resulting in bruising on one side of the baby’s head
- Difference in milk production from one side compared to the other
- Slower milk flow due to significantly less nipple pores
BABY NURSING STRIKE
We call it a nursing strike when a baby has been nursing well and suddenly refuses to latch, and no reason for refusing to breastfeed can be determined. A nursing strike may be as short as a day, or it can last weeks. The longest nursing strike I have ever heard of lasted three weeks.
During a nursing strike a baby may simply not latch on. They will look up at their mom and may even smile but they won’t latch on to her breast.
A baby may push away from the breast. Sometimes when you try to bring your baby to your breast they will scream.
- The best thing to do during a nursing strike is to offer your breast regularly.
- If your baby is having a strong negative reaction like screaming or crying when you try to offer it, then just make your breast available. Open your shirt and unlatch your bra and just have a cuddle with your baby. Lay her on your chest up close to your neck.
You want your baby to remember that cuddling is a pleasant experience. Don’t put her in holds that you use for breastfeeding.
Use a breast pump to maintain your milk supply.
If your baby is old enough you can offer your pumped milk in a cup instead of a bottle. This encourages her to return to the breast to get her sucking needs met. Most babies can start cup feeding by four months of age.
Try a cup like the Munchkin Miracle 360 Trainer. This cup avoids a spout that goes in baby’s mouth, which means he won’t be able to suck on it.
If this type of cup doesn’t work the Munchkin Latch Transition Cup is a good choice. Avoid cups with bottle nipple shaped spouts.
BREAST REFUSAL DUE TO BOTTLES
While most babies will transition back and forth between breast and bottles, some will refuse the breast after even only one bottle.
When a baby is first born, they have never breastfed before. They don’t have expectations of getting large amounts of milk when they breastfeed. They are happy with the slow drip of the colostrum.
Some babies get bottles before a mom’s milk comes in for a variety of reasons. If a baby gets a bottle they may get frustrated with the slow flow of colostrum. I call this flow preference. This problem will often resolve when a mom’s milk comes in.
Breast refusal after a bottle happened to a mom I worked with a few years back. He baby was breastfeeding great but was in the NICU and the doctors felt like he needed to be supplemented. After he got the bottle he began refusing to breastfeed.
This mom had breastfed her other three children. She was persistent and patient. It wasn’t until her baby was four months old that he eventually went back to breastfeeding.
Always make sure bottle feedings are paced.
If your baby refuses to breastfeed but will take a bottle try using a nipple shield. That can coax a baby who is experiencing bottle preference to latch on to the breast.
PHYSICAL CONDITIONS THAT CAN RESULT IN INFANT REFUSING BREAST
BREAST REFUSAL CAUSED BY LOW MILK SUPPLY
For the mom with low milk supply who is supplementing with bottles her baby may start refusing to breastfeed.
- Consider using an Supplemental Nursing System to supplement.
- Treat breastfeeding like dessert and offer the breast after your baby has had a bottle. He may be more accepting of it if he is not crazy hungry.
BREAST REFUSAL DUE TO A FORCEFUL MILK LET DOWN REFLEX
Some moms have a forceful let-down that causes their baby to choke. Occasionally, this will result in a baby refusing the breast.
Try positions where your baby’s head is above your breast.
- Football hold where baby is very upright
- Laid back nursing position
- Straddle position
- Use a baby wrap to keep your baby in an upright position. The Konny Baby Carrier is so easy to use. You just slip it on.
The initial let-down is when your milk comes out the fastest. You can try pumping until your milk lets down and then latch your baby. As your baby gets older, he will be able to cope with your forceful let down.
Putting gentle pressure on your breast right right beyond where your baby is latch may slow the flow.
SELF WEANING AS REASON FOR BREAST REFUSAL
There are babies who stop breastfeeding because they are ready to wean.
HOW TO GET A BABY TO BREASTFEED
These are some tips and tricks that I have had work to get babies to breastfeed over the 26 years that I have been a lactation consultant.
- Try different positions.
- Doing skin to skin and using the side-lying position is very effective to get a sleepy baby to breastfeed.
- Try dripping expressed breast milk or drops of water over your nipple while trying to latch.
- Try offering the breast as your baby is just starting to wake up.
- Walk with your baby as you are trying to latch.
- Try offering your breast when your baby is drowsy but hasn’t fallen asleep yet.
- Do infant massage before attempting to breastfeed.
- Take a bath with your baby and let her lay on your chest. Sometimes co-bathing results in a baby wriggling over to the breast and latching on.
- Try letting your baby take a few sucks from a bottle and then switch to the breast. You may have to go back and forth several times.
- Avoid letting your baby get really upset.
- These tactics don’t always work the first time you do them. Try these things several times.
- If your baby will latch briefly start to immediately do breast compression to keep the milk flowing.
- If your baby will latch sometimes keep a log so you can see if there are any patterns to successful feeding sessions and those when she won’t latch. This also will let you know if things are improving over the days.
FOLLOW THE NUMBER ONE RULE
Feed your baby.
While some babies don’t breastfeed their first day, after that they do need to be eating regularly. How much they need will go from drops to ounces. It will vary depending on how old a baby is and how much they weigh.
Work with a lactation consultant to determine how much your baby needs and the best way to give it.
BREASTFEEDING TOOLS TO HELP WITH BREASTFEEDING REFUSAL
COPING WITH BREAST REFUSAL
A baby not wanting to breastfeed is one of the most difficult things a new mom has to deal with. It is important to be patient with your baby and yourself.
You expected breastfeeding to be blissful. I am pretty sure that no mom envisions her baby screaming at the breast or pushing away. A Baby rejecting breast is not rejecting his mom.
- Take a break from trying to breastfeed.
- Spend lots of time cuddling with your baby.
- Do skin to skin frequently.
- Keep up your milk supply by pumping. As long as you have milk you always have the option to breastfeed.
- If repeatedly attempting to breastfeed is too difficult emotionally you can always provide your baby with your breast milk by exclusively pumping. If you want to, you can always try offering your breast every so often.
FINAL THOUGHTS ON BREAST REFUSAL
Breast refusal is a difficult breastfeeding problem. Be patient with your baby and be kind to yourself.
Chances are good it will be a temporary problem.
And hugs Mama, this is a hard one.
Andrea Tran RN, MA, IBCLC
Andrea has been working with new families as an RN for over 35 years and a Lactation Consultant for over 25 years.
She has her MA in Health and Wellness with a focus in Lactation.