More babies are starting life with nature’s perfect food, breast milk. That’s good news, since breastfeeding has amazing benefits for both you and your baby. But when a happily breastfed baby starts putting up a fight at every feeding, it can bring anxiety and drama into an otherwise peaceful relationship.
Nursing strikes — brief periods when your baby resists or refuses to breastfeed — can be frustrating and stressful. But most babies go through a phase of fussy nursing at some point, notes Dr. Susan Rothenberg, associate director of obstetrics at Beth Israel Medical Center in New York.
Nursing resistance is commonly misinterpreted, says Rothenberg. Moms often blame dwindling milk supply, but that’s usually far from the truth. “Once breastfeeding is well established, inadequate supply is rarely an issue,” she says.
It’s also easy to assume baby is ready to give up nursing, but successfully breastfed babies under one year of age seldom self-wean. Instead, says Rothenberg, a baby who refuses to nurse may be reacting to common, treatable conditions: hyperlactation, a slow letdown reflex, discomfort, or changes in your diet or hormone levels.
Hyperlactation is the result of an overly strong milk letdown reflex that causes milk to flow too quickly for baby to comfortably swallow. According to lactation consultant Laura Burnett, R.N., nursing supervisor at Texas Health Harris Methodist Hospital, hyperlactation can overwhelm a nursing infant, sending them into a sputtering, coughing tizzy.
How to help: Burnett suggests nursing in reclined position to relax both you and baby. If an oversupply of milk is contributing to the problem, nurse on one breast per feeding. After a few days, the body will reduce its milk production to a more manageable level.
Slow Milk Letdown
A slow milk letdown reflex can frustrate babies, particularly those who receive bottles, which provide instant milk gratification. Babies will latch on momentarily, only to dissolve into a tears if milk doesn’t appear quickly. A fussy baby contributes to mom’s stress, which intensifies the problem.
How to help: While tactics like gentle massage, heat, hand expression, or pumping can help get milk flowing before feedings, these won’t resolve an underlying issue. “It’s important to explore reasons for a slow letdown,” says Burnett. Returning to work, changing your nursing routine, or starting a new medication are factors that can contribute.
A slower-than-normal letdown reflex is often a sign of stress or distraction, notes Rothenberg. Her advice: “Take time to relax, ignore the chores piling up, and focus on your special bond with your baby.”
Baby’s Pain or Illness
You probably aren’t up to eating when you’re experiencing pain or tummy troubles, and your baby is no different. Teething, earache, nasal congestion, or mouth pain caused by thrush can make nursing difficult.
Occasionally, a baby’s dairy protein sensitivity can lead to uncomfortable gas and fussiness at the breast. This is not lactose intolerance, says Burnett, but a sensitivity to milk proteins in your diet.
How to help: If you’ve ruled out other causes and your little one is still unenthusiastic about nursing, see a pediatrician to check for pain or illness. A dairy elimination diet can help relieve symptoms of dairy protein sensitivity, says Burnett, but it may take several weeks to see an improvement.
If you eat a varied diet, your breastfed baby does, too. Breast milk varies in taste depending on your diet. But hormonal changes, a resumed menstrual cycle, or a new pregnancy can also affect the taste of your milk.
Most babies show no reaction, but a few will voice their displeasure if a new taste isn’t to their liking, and temporarily resist nursing.
How to help: Taste variations in milk are generally temporary. If a baby has a strong reaction to a particular taste, eliminating the offending food should resolve the problem. Nursing when baby is sleepy, feeding in a warm bath, and skin-to-skin contact during nursing can help minimize resistance to breastfeeding during these changes.
Getting Back to Happy
Pump or hand-express to stay comfortable during nursing refusal. If you’re worried that your baby isn’t getting enough to drink, do a wet-diaper count. At least five to six wet diapers per day mean he’s probably taking in enough fluid.
Like most babyhood phases, nursing resistance is usually short-lived. And it has a silver lining: Once you weather this minor breastfeeding storm, you’ll be rewarded with more confidence, patience, and a greater knowledge of your breastfeeding babe.
— Malia Jacobson is an award-winning health and parenting journalist and mom of three. Read more at maliajacobson.com.