Breastfeeding - when babies won't feed

Some new babies take a while to learn how to attach to the breast and feed effectively. Others feed well at first, then become fussy. These problems can be very distressing: seek help if the following ideas do not help.

Attachment problems

Babies have a sucking reflex, but some need help to attach well to the breast and suck strongly. Some may be very small (eg born prematurely) or unwell at birth and unable to go to the breast straight away. They may need more help when they are able to feed.

Hold the baby close, encourage (and wait for) a wide open mouth, then bring the baby quickly onto the breast so most of the areola area is in the mouth.

If your baby gets upset and won't attach, try expressing a little milk for the baby to taste. This may encourage a wide open mouth. It may help to express even more milk so the areola is softened and the milk lets down. This way the baby will get an immediate reward when trying to suck.

Stroke the baby’s lips or cheek to stimulate the rooting reflex.

Get the baby to suck on a finger then quickly transfer to the breast.

You can put some expressed breastmilk in a syringe and trickle it onto your nipple as the baby tries to attach.

If your baby is very sleepy, try to wake him by unwrapping and undressing him, and playing with his toes or hands.; Or if your baby is fussy, try feeding when he is drowsy.

If your baby won't take one breast, offer the other.

If nothing else works, a nipple shield may help.
Have your baby's health checked by your doctor. Your baby may be unwell - eg a blocked nose which causes problems with breathing and sucking at the same time, or thrush.
Seek help. Don’t stop trying unless you really want to. There is a lot of help available, and most problems can be overcome. You can see your local child and family health nurse, Lactation Consultant.

Not wanting the breast (breast refusal)

Sometimes a baby who has been feeding well does not seem to want the breast and may cry and push away. This can happen at any time, but often at around 3 - 8 months. It can be very upsetting as it seems like the baby doesn't want you.; It is important for you to know that is does not mean that the baby is rejecting you. It usually does not last long. If you are patient and continue to breastfeed it usually gets better by itself.
There can be many reasons why a baby won't take the breast.
Baby reasons:
sore throat, sore ears or a blocked nose

gastro-oesophageal reflux (see the topic "Reflux")

teething

thrush in the mouth making the baby's mouth sore

efficient feeding - as babies get older they empty the breast more quickly and get fussy if you push them to take more

distractibility - the baby wants to look at other things, is easily distracted and so stops feeding. This is common after 3 months when babies grow more slowly so they are not as hungry as before.

the baby has been using a dummy at an early age, before breastfeeding has begun to go well, or at an older age sucking on the dummy satisfies the baby's need to suck.
Mother reasons:
early on - overfull breasts may cause an overactive let down where your milk squirts very fast into the baby’s mouth and they can’t co-ordinate the suck swallow pattern

flattened nipples can cause some difficulty with your baby attaching and lead to fussiness and refusal

your milk supply is low, or you have a lot of milk that comes too fast for the baby

changes in the taste of the milk

hormone changes – when your periods start again, you start using the contraceptive pill, or if you have become pregnant

you have eaten something different

you have been exercising just before the feed (the milk may taste different for a short time)

smoking before a feed.

you have been having lots of caffeine drinks that can make your baby irritable

you are not well or are taking medicines

you have had mastitis recently

you have changed your soap or deodorant.
What you can do to help if your baby does not want to take the breast.
Don't worry if your baby only wants a few minutes at the breast. By the time they are 3 to 5 months old, babies can take a lot of milk in 2 or 3 minutes.
Don't force your baby onto the breast. This can upset or frighten your baby and make it less likely she will want to be near the breast. Try to be calm and patient with your baby.

Feed in a quiet, dark room.

Try different feeding positions.

Feed when the baby is asleep or sleepy (after the baby is 3 months old). This often works well.

Give more feeds at night, especially in hot weather.

Walk around and pat your baby or use a rocking chair while you are feeding.

Try singing, rocking, wrapping or a massage before you start a feed as this may help her feel calm.

Express to get the milk flowing, then put the baby on the breast.

Get your baby to suck on your finger or a dummy, and then quickly slip the breast in instead.

Have your baby checked by your doctor if you think there is a health problem.

Try leaving your baby on your chest, skin to skin, near your breast.; Your baby may after a time seek your breast and attach on his/her own.

If your baby refuses to feed for a few hours, you can express the milk to keep up your supply.
Tongue-tie

A baby is said to have a tongue-tie when the bit of skin between the tongue and floor of the mouth (the frenulum) joins near the tip of the tongue rather than further back.
This can have the effect of holding the tongue down so that it cannot move forward over the baby's lower jaw and lip, and the baby cannot poke out her tongue very far.

If the tongue-tie is severe, this may affect breastfeeding, causing problems like sore nipples or low supply, because the baby cannot attach properly to the breast.

In these rare cases, the frenulum can be snipped to free the tongue so that it can move properly.; This can help ease the pain when breastfeeding as the baby can draw more nipple and areola into their mouths which makes sucking and swallowing easier.
Most times, the tongue-tie is not a problem, and it doesn't usually affect speech development. However, in recent times snipping the frenulum has become common practice as it is known to help the breastfeeding.