Dealing with Breast Refusal

Most mums who breastfeed will experience the anguish and frustration of breast refusal at one time or another. It can occur at different ages and for many different reasons – but the good news is it’s not always permanent. A positive outcome will depend on the support that’s available to you, your commitment to solving the problem (though times can get tough, and there’s no shame in turning to formula if you feel you must), and whether or not the experience is a positive one for your baby.

Early booby traps

There are mechanical reasons that can prevent newborns from latching on and sucking well at the breast. These include tongue-tie, bub having a high palette or receding chin, or pain from birth trauma. Mum may have flat or inverted nipples or large, pendulous breasts, which can also make it tricky for bub to latch on.

Seeking professional help is important, as a hungry bub is likely to become distressed, leading to poor sleep and further feeding problems. Poor breast attachment will also lead to poor milk supply and ongoing feeding frustrations. Expressing and giving your milk to your munchkin in a bottle or using nipple shields can be helpful until professional advice can be sought.

You may find that your breasts become full and firm during the early days of breastfeeding, and this can also be behind problems. The tense areola (the dark area around the nipple) can make latching on difficult for your child, but hand-expressing to soften the area will help.

Problems with breast refusal can be emotionally draining, and especially tough if you’re alone at home with your new bub, but emotional upset can make your littlie unsettled, too. This is why positive support during the early weeks of breastfeeding is so important for successful outcomes.

Time to grow

Babies go through a growth spurt at around six weeks of age and after this developmental period, bubs are more alert and aware of their surroundings. This itself can pose problems for breastfeeding – your curious littlie may be easily distracted, meaning that feeding takes a backseat! (This can be a particular problem as he gets older, too.) If this is the case, you may find it necessary to go somewhere quiet to complete a feed, or to drape a feeding wrap over your bubba.

Intolerance or allergy symptoms can also present in bub if your milk contains substances he has problems with, and these discomforts can cause breast refusal, followed by hunger, poor sleep and more breast refusal – the cycle continues! Be alert to any family history of allergy or intolerance and seek professional dietary guidance if you think there might be a problem (breast refusal along with poo changes can indicate gut discomfort).

Also, about two hours after you eat, foods can be tasted in your milk. Bub’s refusal to eat, then, might have something to do with what you’ve been tucking into, so you may want to try varying your diet to see if that does the trick.

Other possible reasons for breast refusal may be that your baby has nasal congestion, a sore throat or inflamed tonsils. Offering shorter, more frequent feeds can help here.

Also, babies from four months of age start having longer periods between feeds and may refuse the breast if it’s offered too early. Wait 30 minutes and try again.

The right formula?

Offering formula to a baby who fusses at the breast can seem a good solution. Indeed, hungry babies thrive on formula top-ups, but this can result in permanent breast refusal, because they soon learn a quicker feeding alternative follows. A supplementary bottle in the afternoon plus expressing after feeds to increase supply can keep breastfeeding going longer.

Thanks for the mammories!

As your baby grows older, he’ll begin to enjoy other forms of nourishment. Once you’ve decided to wean him, it’s generally easier for both of you to do it gradually. This means dropping one feed at a time, starting with the one bub is least interested in. Substitute this feed with food or milk – or even water – from a cup or bottle. The amount and choice of this alternative nourishment will depend on your child’s age and ability. (Note that bottles aren’t necessary when babies are over six months, so you can go straight to a feeder or straw cup.)

Once your breasts feel comfortable, another feed can be dropped. If your breasts continue to feel uncomfortable, express a little milk to help ease the pain. There’s no need to throw this milk out – you can add it to your child’s food or store it for later use. You can continue partially feeding as long as you like. Your breasts will accommodate the demand.

To make weaning as smooth and stress-free as possible, it helps to…

  • Offer plenty of alternative fluids or foods.
  • Avoid sitting in your usual breastfeeding spots for a few weeks.
  • Wear non-breastfeeding clothes to avoid temptation.
  • Avoid any breast stimulation and wear a firm bra and top.
  • Say ‘no’ and mean it by providing a distraction.
  • Give extra cuddles, smiles and eye contact.

Be consistent and keep going once you’ve made the decision and started to wean your baby. Remember it can take several weeks to change a habit!