Breast Refusal

What is breast refusal?

It is the circumstance in which a baby refuses to breastfeed from one or both breasts.

If baby has had trouble breastfeeding from birth, the problem is likely not breast refusal, but other issues connected to a weak latch, sleepiness or trauma. Read more on latching problems here.

The first assumption that is usually made, when a baby refuses the breast, is that Mom has a low/ inadequate milk supply. Do not be pressurised into giving baby supplements, but make very sure of what the problem actually is, before deciding to go that route. 

If baby only refuses one breast, it could indicate the following:

·  An ear infection

·  Congestion of baby’s nose.

·  Injury that occurred at birth or any other ordeal.

·  Flat or inverted nipple on just one breast.

·  If Mom puts baby on one breast more often than the other, it can cause one to produce more. This can cause baby to prefer one breast over the other.

·  In very rare cases, it has been found that a baby may refuse a breast that is later found to be cancerous. If Mom is concerned about this, she can go for ultrasound or mammography, which does not have to interfere with breastfeeding.

If baby is refusing both breasts it can indicate:

Also referred to as a “nursing strike”, this is when baby has been breastfeeding fine, but then suddenly refuses to breastfeed. A nursing strike will usually last between 2 to 4 days.

What can cause these nursing strikes?

·  Illness in baby.

·  Teething pain.

·  Extreme stress in Mom.

·  Baby may also refuse to drink if Mom shouted at him/her for biting while breastfeeding.

·   If Mom returns to work, baby may not handle Mom being gone for long stretches of time.

·   If the milk tastes different due to any of the following: Mastitis, during menstruation, new pregnancy, new foods introduced into Mom’s diet, new medication taken by Mom, new perfumes used by Mom.

Tips for one sided breast refusal:

·   Try different breastfeeding positions. For example: If baby is refusing to breastfeed from the left side breast, you could breastfeed him/her in a football hold on the left side or in a more upright position.

·    Soften the rejected breast by pumping before breastfeeding.

·    Use breast compressions while trying to breastfeed.

·    As a last resort, Mom should know that it is possible to continue feeding baby from only one breast. Read more on breastfeeding from only one side.

Tips for when baby refuses both breasts:

·   Try to breastfeed with skin to skin contact. Try to breastfeed in a calm environment and make time to kiss and cuddle baby, this will help reduce stress that might have caused or made the nursing strike worse. Try to minimize any distractions and breastfeed in a dim lit room.

·   Try to feed baby when baby is calm or sleepy. It’s best to try right after baby has woken or just before baby falls asleep. Do not try to breastfeed when baby is upset or crying. Do not try to force baby onto the breast.

·    Breastfeed baby while walking with baby held in your arms or in a sling.

·    Short, frequent nursing sessions can help baby accept the breast again.

·    If you suspect that baby is getting frustrated with the slow flow of milk “let-down”, you can pump a few minutes before breastfeeding to stimulate the flow of milk.

·    If baby is gulping while feeding, it can indicate a very fast flow of milk.

Read more here on tips for fast and slow let down issues.

During a nursing strike, it is important that Mom still makes sure that baby is getting in enough milk, she can do this by offering baby the expressed breast milk in a syringe, cup or with the finger. Avoid the use of artificial nipples before baby is 6 weeks old.


 

Top of breast refusal page

Tracy Behr, CBC, CLD (CBI)

Reference: Breastfeeding counsellor course information through childbirthinternational.com on physiology of breastfeeding / breastfeeding problems / Latching problems / nursing strike.


Other pages on breastfeeding problems connected with this page

* Alternative feeding methods

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Site by BFeeding Mamma, Tracy Behr, Studying through Child birth international (CBC, CBD), Author and Mommy of two.