Sunday, 24 March 2013

Breast Refusal and Breastfeeding – When Your Baby Refuses The Breast

A baby’s refusal to suck at the breast is a most distressing problem to a breastfeeding mother. She cannot help feeling upset when her baby screams and turns away from her breast. She may feel that her baby is rejecting her as a mother and doesn’t want her, need her, or even like her very much.
A baby may refuse the breast at some or all feedings, at any age, and his reasons for doing so will vary with his stage of development or even his health at the time. He may suck for a few minutes, then break away with signs of distress and refuse to continue. He may refuse even to begin sucking although he is obviously hungry.
Sometimes, a baby does not actually refuse but is very fussy and difficult to feed. He may be the kind of baby who seems to be very unwilling to start sucking and takes a long time to get going, but once he has started, feeds well. A fussy baby can seem to receive little satisfaction from feeding. He sucks for a short while and then breaks away, finishing his feed after a series of stops and starts. He may be easily distracted and restless during the feed, perhaps pushing away from his mother with his fists or his feet. He stops as soon as his hunger is satisfied and may remain restless and fidgety afterwards.

When managing a fussy feeder or a baby who is refusing to breastfeed, it is important to remain calm and patient, handling your baby gently. If you are both on edge, try taking deep breathes similar to that which you may have used during labour or when trying to calm or meditate. The deep breathing helps slow your own breathing and make it more regular which can help calm everyone, concentrate on staying relaxed, use soothing music, rock your baby gently or carry him around in a sling. This relaxation will help your milk flow readily so your baby will get milk once he latches on.
If your baby is quite unsettled, cross or crying or if you are feeling angry and upset, you may find it helps to try again when you are both feeling calmer. In the meantime a cuddle or a game may distract your baby or a walk outside may relax you both. This is the time when your partner (or a friend or relative) may be able to step in and give you both a break.

Things to do to get your baby on the breast

  • Be as patient and calm as you can, even though you may be feeling frustrated or impatient. Forcing your baby to feed is likely to make the situation worse. If he has just been refusing the breast and is upset, distract him by doing something completely different – a walk outdoors, looking at toys, singing a nursery rhyme. When he has settled down he may be eased on to the breast, or he may be happier just being cuddled.
  • Walk around with your baby in an upright position against your body with her head level with your nipple. Walk and feed simultaneously. You could try putting your baby in an Australian Breastfeeding Association baby sling but remember to have your bra undone so that her face is touching the skin of your breast and she can find your nipple. The sling will need to be worn lower than normal for this purpose.
  • Try a completely different feeding position: your baby tucked under your arm (twin style); or lying down on a bed next to your baby with no body contact – this is especially good if it is very hot, or your baby is sensing your tension; or lying down with your baby cuddled in close next to you.
  • Feeding your baby while you are both in the bath may help. You may want to have someone available to help you lift your baby in and out of the bath.
  • Try breastfeeding baby after his bath when he is warm and relaxed (if he likes baths).
  • You could try playing with your baby on the floor while you are bare from the waist up. After some time gradually offer your breast.
  • Anticipate your baby’s waking time and lift her to feed while still sleepy – you may slip in extra night feeds this way.
  • Try to soothe baby with a dummy. Walking, singing and rocking while baby sucks the dummy may gradually soothe him so you can gently put your baby to the breast while removing the dummy. It may be necessary to start a very hungry baby sucking on a bottle with a small amount of expressed breastmilk, e.g. 30 ml, then gently replace it with the breast.
  • Some mothers, whose babies have become accustomed to a bottle, have found that putting ice wrapped in a flannel on the nipple or tickling the nipple and areola makes it easier for the baby to grasp. Alternatively, you may use a nipple shield to begin a feed, slipping if off quickly and putting your baby back to the breast once the milk is flowing and she is sucking happily.
  • Feed in a rocking chair.
  • Express some milk into your baby’s open mouth to encourage him.
  • Spend five minutes or so before the feed massaging your baby’s naked body to relax her, if she is receptive to this.
  • Try singing to your baby – he probably won’t mind if it is the same few lines over and over.
  • Try playing some favourite relaxing background music.
  • Once you get your baby on to the breast, it may help to provide an instant milk reward. This can be done with a nursing supplementer. This allows baby to receive additional milk at the breast whilst stimulating your milk supply by his sucking. If your milk supply continues to be low or your let-down slow or your baby is a ‘poor’ sucker, you may like to discuss with an Australian Breastfeeding Association counsellor the possibility of using a supplementer.
 Sometimes you may never discover why he did refuse. However, there are some babies who cannot be persuaded to return to the breast. If that is the case for you, it is important to remember that your baby is not rejecting you and that you will soon find other ways of relating to each other.

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