Breast Refusal

A baby refusing to breastfeed can be very distressing for a mother.

It’s can be hard not to take it personally when your baby doesn’t want your breastmilk.

The good news is that most cases of breast refusal are temporary.

There is usually a good reason why your baby is refusing your breast, and finding out ‘why’ is the key.

Knowing what you can do to encourage and support your baby back to your breast is vital.

Here are 13 tips for when your baby refuses the breast.

Breast refusal tip #1: Is It really breast refusal?

Sometimes your baby is not refusing to feed but rather is fussy or hard to feed.

All babies have individual feeding habits. Some babies are easy-going, settle easily into feeds, feed well and come off satisfied until the next feed. Other babies take a while to get going but feed well once they start. Other babies fuss from the start to the end of the feed, coming on and off and squirming around throughout the feed.

Most babies feed from both breasts at some feeds and from one breast at others. Others always feed from both breasts and others always from one breast. Some babies start out only wanting to feed from one breast and then, later on, want to feed from both, or vice versa.

Sometimes after the early months (and sometimes all of a sudden), a baby becomes very efficient at feeding. You may be used to your baby feeding for longer periods and then be shocked when your baby suddenly takes much less time to feed. You may begin to worry if you have enough milk. It is helpful to remember what the reliable signs that your baby is getting enough are.

If your breasts continue to feel comfortable, it is likely that your baby is still getting as much as he usually would. This is because if milk wasn’t being removed as well, your breasts would start to feel very full or engorged.

Breast refusal tip #2: Breasts feel very full or engorged?

Sometimes, your breasts may start to feel very full or engorged if your baby starts sleeping a longer stretch at night. This is normal and your breasts will adjust as they get used to your baby’s changing feeding habits.

However, if your breasts start becoming very full or engorged combined with your baby refusing or being unusually very fussy with feeds, (and particularly if your breasts continue to feel this way for a few feeds or more in a row), you may consider expressing. Expressing in this situation can help relieve any pain, maintain your supply, and reduce the risk of getting a blocked duct or mastitis. Your expressed breastmilk can then be given to your baby (e.g. with a small cup).

Breast refusal tip #3: Feed your baby according to your baby’s need

Babies feed best when they are fed when they are ready to feed when they are showing feeding cues.

If a baby is fed according to a schedule, he may not be ready to feed at the scheduled time. This may cause him to be more likely to be very fussy with or refuse the feed.

Sometimes babies are fussy with feeds during the day but feed like champions overnight. It’s what they get in 24 hours that counts, not what they get at individual feeds.

Feeding your baby when your baby wants to feed, helps ensure he gets what he needs. As long as your baby continues to show reliable signs of getting enough milk, this is what matters most.

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Breast refusal tip #4: Get more skin-to-skin contact

Keeping feed times positive is important to help your baby keep a positive association with them. This can be hard to do as breast refusal can be very stressful. It’s easy to get quite upset and angry when trying to feed a baby who is refusing.

Spending lots of time in skin-to-skin contact with your baby on your bare chest can help to remind your baby that this is a nurturing place to be. This could be on a bed or in a bath etc.

Skin-to-skin contact can help your baby to use his instincts to find your breasts on his own. In this way, skin-to-skin contact can take the pressure off both of you. It’s like you’re saying to your baby ‘Well, there is your food, go get it if you want it.’

Similarly, placing your baby in a sling and leaving your bra undone so that his face is near your breast could help.

Breast refusal tip #5: Is it your milk flow?

Some mothers have a strong flow of milk in the early weeks until their supply settles. Sometimes a baby gets used to the strong flow and getting lots of milk without having to do much sucking in these early weeks. He then might refuse to feed or be fussy with feeds when his mother’s supply settles down and he needs to suck more to get the same amount of milk.

If your baby drinks for a few minutes and then comes off, or tries to suck again but gets upset and fusses, it may be because your flow has slowed down. Switching to the other breast or trying breast compressions can help. Breast compressions are where you gently squeeze a large handful of your breast when your baby’s sucking slows down (taking care not to disrupt his attachment). Moving your hand to different parts of your breast as you squeeze helps to drain different milk ducts.

Breast refusal tip #6: Your baby may be distracted

Between 3 and 6 months, some babies start to become quite hard to feed when there are distractions around. If this happens, feeding your baby in a quiet darkened room can help. Offering your baby a feed when he is sleepy or has just woken up can help too. Some babies who are very easily distracted during the day feed more often (and beautifully) at night when you both are more relaxed.

Sometimes, wearing a colourful necklace or giving an older baby a toy to hold might help to keep him feeding.

Breast refusal tip #7: Are bottles interfering?

How a baby drinks from a bottle is very different from how he drinks from the breast. Also, when a baby drinks from a bottle he gets milk more immediately upon sucking and gets more of a consistent flow. A baby who has been drinking from a bottle may have gotten used to these things and may refuse to breastfeed as a result.

Skin-to-skin contact and allowing your baby to find your breasts on his own may be enough to help overcome this problem.

Sometimes, a baby might get used to the way he is held when given the bottle. If so, holding him in the same position for breastfeeds can help. This might mean holding him in a cradle hold when he feeds from one breast and then in the football (underarm) hold when feeding from the other breast.

If your baby is used to the immediacy of flow from a bottle, expressing to get your milk flowing before trying to offer your baby a breastfeed can help. Then, once your baby starts sucking, breast compressions can help to keep up a good flow of milk to your baby.

Breast refusal tip #8: Try a different feeding position

Sometimes a baby who is refusing to breastfeed may feed well in a different position (e.g. lying down or the underarm hold). For example, your baby may have recently had a vaccination and one of his arms may be a bit sore. So feeding in a different position may help to take the pressure off that arm. Some babies that have had a difficult or assisted birth may benefit from a visit to an osteopath who specialises in babies.

Breast refusal tip #9: Is it the weather?

In hot weather, some babies might refuse or be extra fussy with feeds. Feeding in a cooler part of the house or in an air-conditioned shopping centre might help. Feeding while lying down with your baby next to you could help too as there will be less body contact between you both.

Breast refusal tip #10: Too many other foods?

Breastmilk is all a baby needs for around the first 6 months and is your baby’s main source of nutrition for the first 12 months.

Giving your baby formula or too many solids will make him have less of an appetite for breastmilk. If you think this might be happening, you can reduce the amount of other foods your baby is having.

Breast refusal tip #11: Your baby may be tired or overstimulated

Babies who are tired or overstimulated may refuse a breastfeed. Skin-to-skin contact can help calm him. Sometimes taking your baby outside calms both of you. When he is calmer, he may breastfeed again.

Breast refusal tip #12: Teething pain may be an issue

Some babies may refuse to breastfeed due to teething pain. Teething can happen for days or weeks before the tooth actually comes through. You could try offering your baby something cold to chew on (e.g. a cold teething ring) before a feed. Your doctor may have some ideas about how you can help relieve your baby’s teething pain too.

Breast refusal tip #13: Could it be your hormones?

Some babies become fussy or refuse feeds in the days leading up to or during their mother’s menstrual period or when she is ovulating. This is because hormonal changes can affect breastmilk. A mother’s supply may drop slightly or the taste of her milk might change (saltier).

The hormonal changes of pregnancy often do the same things. Some babies will refuse to feed and will wean themselves while others happily continue. Some mothers choose to wean their child when becoming pregnant while others keep breastfeeding throughout pregnancy and may even tandem feed.

Sometimes you may never find out exactly why your baby is refusing to feed. The good news is that with several of the tips listed above, you may be able to help manage the refusal even without knowing what caused it. If you are still worried, have your baby checked by your doctor as sometimes a baby will refuse to feed if they are unwell. Seeing a lactation consultant or speaking with an Australian Breastfeeding Association counsellor can help too.