My Baby Won’t Breastfeed - La Leche League GB

Breastfeeding is normal and natural but some babies don’t get the hang of it straight away. They may struggle and cry, find it difficult to latch on, or simply nurse ineffectively at the breast. It can be upsetting for both of you if your baby won’t nurse. Remember he’s not rejecting you. If your baby finds going to the breast upsetting he will need you more—even if only to cry on your shoulder. Unhappiness is worse if you’re alone!

Why is my baby refusing to breastfeed? It’s not always easy to understand why this has happened. Some of the more common reasons for newborn babies refusing to breastfeed are:

A difficult labour or delivery—he may feel sore or have a headache.
Medication used during labour— anaesthesia, epidural or pethidine can make your baby sleepy or groggy.
He was separated from you after birth —even for a few minutes.
Discomfort due to a birth injury or bruising.
Swallowing mucus at birth and suctioning can make your baby feel congested, nauseous or uncomfortable.
An early unpleasant experience of nursing, such as being pushed onto the breast.
Blood tests and other medical procedures while nursing. In some cases, a baby may also have difficulty latching on and nursing.

Whether or not your baby has breastfed, you may need to consider:
Give him your milk
Coping with distress
To calm your baby
Keeping calm yourself
Ways to help your baby feed
A calm environment
Skin-to-skin contact
Make Breastfeeding Pleasant
Frequent feeds
Other things to try
Baby with low muscle tone
Time and patience may be needed
Seek support

After the first few days

Whether or not your baby has breastfed, you may need to consider:

Engorgement—expressing a little milk can soften the breast enough for your baby to latch on.
Stress—your baby needs time to get used to his surroundings. Being handled by too many people or undergoing tests can upset him.
Poor co-ordination of sucking and swallowing—often improves as your baby matures.
A tongue-tie that needs treatment.
Fast let-down of milk—try catching the first spray of milk in a cloth, then put your baby back to the breast when theflow slows.
Delayed let-down—if you feel tense, this may delay the let-down of your milk. Babies become easily frustrated and this becomes a vicious circle. Relaxation techniques may help.
Nipple confusion—babies who are given dummies or have fed from a bottle may find it difficult to latch on. More information on dummies and breastfeeding.
Sensitivity to food or medicines in your milk.

Give him your milk

If your baby hasn’t nursed well by 12–24 hours after birth it’s important to give him some milk. Expressing your milk by hand or pump will stimulate your breasts to make milk. Aim to express as often as your baby would be feeding, about 8–12 times in 24 hours. Your expressed milk can be offered by spoon, cup or syringe while you both learn how to breastfeed. Using bottles or dummies may cause nipple confusion and make matters worse.

Coping with distress

It can be hard when the very activity that soothes most babies—nursing—is a source of distress. You may feel like there is nothing you can do to help. What really matters is that you care enough to hold your baby close. He really needs to be in your arms where he can feel secure.

To calm your baby

Sing and talk calmly.
Hold him against your shoulder if he doesn’t like to be held in a nursing position.
Keep the environment peaceful.
Take a walk outside.
Take a relaxing warm bath together.

Avoid holding your baby in a nursing position during medical procedures. Offer the breast afterwards to calm him instead.

Keeping calm yourself

Take one feed at a time.
Minimise any other stresses. Give yourself permission to ignore other distractions and concentrate purely on your baby while encouraging breastfeeding—it’s worth the wait!
Make yourself comfortable. Keep drinks and healthy snacks to hand as you try to breastfeed.
Express milk for your baby and to establish milk production. Milk producing hormones can be calming.
Use relaxation techniques when either you or your baby become distressed—massages, relaxing music, warm baths, subdued lighting and the breathing exercises taught for labour.
Enlist help from your partner, friend or other support person. They have an important role of taking care of you both.

Ways to help your baby feed

Handle your baby gently when trying to breastfeed. Your role is to calm your baby, give him access to the breast and follow his cues. It’s your baby’s job to feed.

A calm environment

You and your baby need to be warm, comfortable and relaxed—but not too warm. Babies who are too warm tend
to be sleepy and unresponsive. Room temperature should be around 18°C. Subdued lighting and quiet can help some babies concentrate on breastfeeding. Things may improve once you are at home. It’s wise to restrict visitors at first, as you will want space and privacy to concentrate on your baby. Your partner can help with this.

Skin-to-skin contact

Try laid back or natural breastfeeding positions—you lay back in a comfortable, supported, semi-reclining position with your baby lying on you, his whole front in contact with your body. This position often stimulates a baby’s instinct to attach and suckle well. It’s also easier for you to watch for signs of him stirring and gently encourage feeding. Combining this with skin-to-skin contact, with your baby undressed down to his nappy, can be even more effective. Many babies will start to suck spontaneously if they can snuggle up close to their mother’s bare chest. A lightweight blanket can help keep you both warm and covered. Spend as much time in close contact as you can, even if your baby needs supplementary feeds. Comfortable Breastfeeding.

Make Breastfeeding Pleasant

Allowing your baby to take the breast at his own pace will help him relax and feel in control. You’ll want your baby to associate being at the breast with pleasure. Pushing him onto the breast is likely to have the opposite effect, as he will instinctively fight against it.

Frequent feeds

Offer a breastfeed before your baby becomes very hungry. It’s hard to learn a new skill when you’re ravenous. Your baby may want to feed soon after he’s had some expressed milk. Early feeding signs include rapid eye movement while asleep, clenched fists, head turning, sucking hands and general body movement. Try not to wait too long as crying makes it harder for him to breastfeed well. Offer feeds frequently, unless your baby is repeatedly and persistently refusing to breastfeed.

Source: United States Breastfeeding Committee

Other things to try

Experiment with different feeding positions—your baby may be uncomfortable in some positions or may simply have strong preferences. Use the position in which your baby is happiest to be held.
Try standing with your baby held against your shoulder, so he can move down to the breast. He may latch on while you are walking, rocking or swaying.
Some babies like to be wrapped firmly while others hate to be wrapped.
Express a little milk by hand so your baby gets an instant reward. Or drip expressed breastmilk on your nipple to keep him interested.
Breast compressions can help milk flow—ask an LLL Leader for details.
Some mothers find a visit to a chiropractor skilled at working with infants can help relieve any pain or discomfort babies experience following birth.
Ask an LLL Leader or lactation consultant for information about using a nipple shield or nursing supplementer.
If your baby is unhappy at the breast, feed him your expressed milk and concentrate on helping him learn to enjoy close bodily contact with you without pressure to nurse. With time and patience, most babies will learn to breastfeed.

Baby with low muscle tone

A baby who has been diagnosed with a condition that makes him hypotonic, or ‘floppy’, may show little interest in breastfeeding. To make feeding easier:

- - Tuck a rolled up cloth under your breast close to your chest wall, or
  - Support your breast with your thumb on one side of the areola, fingers on the other side. If your thumb is parallel to your baby’s upper lip, you can use your index finger to put gentle pressure just behind the bony part of the chin while your baby nurses.
  - At first it may be hard for your baby to get enough milk from the breast. A hypotonic baby often feeds better held with his bottom lower than his head.
  - Breast compression can also be helpful, but you may also need to give some additional expressed milk until your baby’s muscle tone improves.

If your baby suddenly becomes floppy and you don’t know why, seek medical advice.

Time and patience may be needed

If your baby is resisting the breast, it’s easy to feel frustrated and helpless when you’re tired and can’t find a solution.
But a baby’s behaviour can change very quickly. Patience and understanding will help while your baby refuses to nurse.
Behaviour often changes in response to gentle repetition.
Your baby can still have your expressed milk until he is ready to breastfeed.
With time and patience, most babies will breastfeed.
Your baby is lucky to have a mother who is willing to explore every option to make breastfeeding work.

Seek support

Contact an LLL Leader. She can understand your feelings and help you find a solution.

Written by mothers of LLLGB.