Sudden breast refusal in the afternoon/evening

History: DD2 is almost 6 months old. We had a difficult start. She was in the SCN for the first 3 weeks of her life and I was expressing round the clock with a couple of BF a day in the last couple of weeks of her stay. She had always BF really well. She learnt to take a bottle in hospital and has had a dream feed of EBM every night since coming home. Up until about 3 weeks ago I was expressing at that time. I stopped about 3 weeks ago as I had plenty of milk in the freezer to get me through to 6 months (my aim for exclusive breast feeding - once it runs out I plan to make the dream feed a formula feed). She has had the odd bottle during the day over the past 6 months (eg if I was out). She is taking solids really well. She absolutely loves them. She's probably eating the equivalent of 250-300ml a day. She would happily take more but I don't want to reduce her milk intake any more at the moment.

For the past 3 days, DD2 has appeared to refuse her afternoon feed (the feed after her nap). She will usually sleep for a good 2 hours in the afternoon, so it's usually been a while since she's fed. Whenever I bring her near she pulls back and cries. On the first day she would latch for a couple of seconds and then pull off and cry. After trying both sides a few times I ended up giving a bottle of EBM (which she completely drained). Yesterday and today she has refused to even latch. She's arched back so much. Both times I've given a bottle of EBM. She's not exactly a big baby and I don't want her missing feeds. On the first day she took her before bed feed fine. Yesterday she was again refusing but MIl managed to get a giant burp out of her and then she happily fed. Tonight she again refused. We tried burping but couldn't get anything. She wouldn't even latch. She fell asleep whilst I was cuddling her so she's gone to bed with no feed....

Any inspiration as to why this is suddenly happening? She feeds fine during the first half of the day. She stopped demanding night feeds at 10 weeks.

Could be hormonal changes in you. AF starting or pregnancy can cause breast refusal in bubs.

Just in the afternoon?

I'm on the mini pill and haven't had AF yet. Last time I didn't get it til I went back on the normal one. Given that I'm on it I would figure pregnancy would be unlikely.....

ha ha, tell that to my little stowaway!

i didn't use bottles with my kids, so if they got idgy at the breast I didn'thave an alternative to offer so it was probably easier for them to go back to the breast. I find jumping in a deep bath together can help a reluctant bub feed.

Really HotI? Did you get pregnant on the mini pill? Is that very common?

Maybe the bath could be an idea. Thanks!

yep, on the mini pill and still tandem feeding (just). dd weaned just after. but ds still feeding regularly.
I don't know how common it is.

Hmmmm maybe it's worth a test just to rule it out then.....

Chody just sitting here watching.... Because, well you know... I just am lol!

Thanks Joeve.

Anyone else have any suggestions as to the reason?

How is she otherwise? Still doing ok?

Yep. She's perfectly fine. She is the most happy, easy-going little baby.

Chody around six months things can start to go off the lines of normal. Or whatever is normal for your bub anyway. You know how we talk about how many feeds a baby should have in 24 hours, how much milk, how many wet nappies etc? All that only applies to six months. Then... Things can change. Could it be that she is trying to tell you she doesn't want that feed?

Another possibility - she's getting fussy and tired, it's afternoon/evening, she has to work harder to get milk out of the breast than the bottle, so she'll happily drink the bottle but is a it too tired for the breast? Just a thought.

Also, by six months, you might be right to drop the dream feed all together - what do you think she'd do if you did that?

Thanks OP. I'd say all could be possibilities..... She might be ok without that afternoon feed, but I guess I just worry as she's a small little thing (although perfectly in proportion length/weight wise according to the charts) and i don't want her losing weight....trying wouldn't hurt I guess though.

As for dropping the dream feed, I think she'd be ok with that too, but once again, I'm hesitant to drop any of her feeds. I guess I should follow her lead more....

Maybe try that for a few days, follow her lead instead. See how it goes :) You can always go back to how things were if you decide to :)

So you haven't expressed at night for a few days? Could you have a drop in supply? How many hours between feeds do you go at the max?

I always found afternoon fussiness was related to less milk, more impatient baby to work for it and my own fatigue. A day time nap for you would help or to pick the dropped feed/express and see if it helps.

I haven't expressed at night (around 9:30pm) for a couple of weeks. I guess I thought by dropping that express its kind of like my body thinking she's sleeping 7-7 (give or take an hour). During the day I try not to let her go more than 4 hours without a feed. Often it's 2-3 hourly. It's usually only 4 if she has a big day nap. On Wednesday (the first day this happened) I did think it was a drop in supply so was happy to offer the bottle. Yesterday I had heaps of milk. I was uncomfortable on my left side it was that full. After giving the bottle I quickly expressed 110ml off the left in a short time, so there was plenty there, she just refused to latch. I definitely felt like there was milk today but didn't get the chance to express.

Teething? DS was very very irritable and not feeding well in the afternoons while getting his first two teeth (and he didnt bother making up for small feeds later either)

has she been on solids long? does she eat before her nap? the intro of solids can cause tummy upsets as they get used to new sensations .

some changes I never found a reason for, just had to work with it til baby was ok again or we changed to suit baby.

Yeah, maybe just go with it for a bit and see how you go.

Just an update:
Today I waited until she was demanding feeds before offering. I also just offered the afternoon feed as a bottle as I didn't want any more negative experiences with breastfeeding (by her crying and arching away). It seemed to work well. She took her first two feeds really well. She didn't ask for her next feed (bottle of EBM) until almost 4pm. She also then fed the best she has in ages at the boob before bed (a solid 20 min feed from both sides). Usually all she will take is one side, in about 6-7 mins.

does she have reflux? I think I remember that she did from previous posts, if so, she may need a meds increase. Reflux is worse as the day goes on and this can lead to breast refusal.

Good point! The doc agreed that she 'might' have reflux and was happy for us to try meds. We were only giving half the recommended dose (once a day instead of two) and it seemed to be making a little difference (and she seemed much happier). When they last ran out (maybe a couple of months ago) we thought we would see how she went without them before getting more. She seemed fine so we stopped giving them (not wanting to medicate unnecessarily). Maybe it's playing up again?

She is also at the age when babies often do this sort of thing :) Watch her and see how she's going, then you'll know whether it's ok or not.