The moment my baby refused to nurse was devastating to me.
I just balled watching my baby girl feeding on a bottle.
Call me crazy, but having her choose another nipple over mine was hard to swallow.
I had no idea what had happened to my pro nurser who just earlier looked forward to breastfeeding.
It felt like overnight she switched on me and now hated the sight of my breasts.
She fed perfectly when she’d wake up and then right before bed, but every other feeding was a nightmare.
She would latch on then off and just scream!
I learned to dread her hunger cues!
I started to stress out before every feeding, which then made me worry about my supply!
IT WAS A NIGHTMARE!
Why is my baby refusing to latch?
My lactation consultant confirmed my fears… nursing strike (when your baby refuses to nurse, usually due to some sort of discomfort or inconvenience associated with nursing).
So what’s a momma to do?
Well, the goal is to make nursing more comfortable and convenient for your baby again!
Here are some things you could do to help your baby latch…
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What is a Nursing Strike?
Simply put, a nursing strike (or nipple/bottle confusion) is when your baby prefers the bottle to breastfeeding.
This is most common when breastfeeding has not been well established or when bottle feeding isn’t properly administered
Logically, the form of feeding that is easier and equally satisfying will be preferred by your baby.
Breastfeeding requires effort on the part of your baby.
They have to work (actively suck) to get the milk out.
If bottle feeding requires less effort (usually when the bottle is propped high enough that milk just drips out), it’s no surprise that your baby will prefer it to breastfeeding.
This isn’t always the case, especially if your baby breastfeeds well and finds it comforting, but if you have already had a bumpy breastfeeding journey, you are more prone to nursing strikes.
If your baby associates breastfeeding with discomfort, you might also find yourself battling a nursing strike.
Nursing strikes are stressful and they could really put your milk supply and entire breastfeeding experience at risk of cessation.
What You Can Do
There are some simple actions you can take, though, to return your baby to the breast.
These tips are simple but they will require effort on your part because, let’s face it, we are dealing with an independent little human being who has both needs and preferences.
Number one responsibility is that baby is fed regardless of source.
Work at breastfeeding, but ultimately feed you baby.
There are ways to supplement milk without using a bottle so I will cover those at the end of the post.
Number two responsibility is that milk supply is kept up.
Every time your baby has any supplementation, pump the same amount of milk!
The biggest reason that breastfeeding fails after a nursing strike is that milk supply drops due to baby not consistently emptying out your breasts.
Then once baby returns to the breast, there isn’t enough milk to satisfy.
So, make sure to keep these in mind as you work to get your baby back to blissfully breastfeeding again.
Feed on Cue
A lot of times babies refuse to latch because they get too aggravated and restless.
Either you missed it or you ignored baby’s first signs of hunger.
Here is a brief overview of those signs (1)…
Early Hunger Cues:
- Lip Licking or Smacking
- Mouth Movements (notice tongue movements as well)
- Sucking on Everything (especially hands)
Mid Hunger Cues:
- Rooting Around Chest
- Positioning as for a Feed (curling, laying back, pulling with or stroking at clothes)
- Fidgeting or Squirming
- Hitting Your Arm or Chest Repeatedly
- Acting Fussy
- Breathing Rapidly
Late Hunger Cues: (at this point you’ll have to calm your baby down before attempting to feed)
- Frantic Head Movements from Side to Side
- Turning Red (Total Meltdown)
Make sure to feed your baby when you first notice these because, otherwise, the longer you postpone the more difficult and stressful the feeding will be for both baby and momma.
By then, your baby will first need to be calmed down then fed.
If you offer the breast as soon as you see the first signs of hunger, you will have a much higher likelihood that your baby will latch on and nurse.
Sleep on Cue
Another cause of a difficult feed is when your baby is too sleepy.
Sleepy babies are just as difficult as hungry babies.
Here are the cues for sleepiness my baby displayed, maybe you will find some similarities with your baby…
Early Sleepy Cues:
- Slower Body Movements
- Making Less Noise
- Overall Lower Activity Level than Usual
Mid Sleepy Cues:
- Pulling or Tugging at Ears
- Rubbing Face
Late Sleepy Cues: (remember, an overstimulated baby is difficult to put to bed)
- Tugging on Onesie
- Bending Backwards or Arching Back
As soon as you start seeing signs that baby is slowing down and ready for a nap, act on it.
Go to a dark room with minimal noise, make yourself and baby warm and comfortable and then attempt to nurse.
If your baby doesn’t latch, maybe they’re just hungry, so just let them nap.
A calm baby, even if reluctant, has a better chance of latching.
Express Milk/Artificially Initiate a Let-Down for the Impatient Baby
Sometimes, babies are just impatient when it comes to breastfeeding.
It could be the consequence of multiple factors.
Either nipple confusion, your baby is used to the fast and immediate flow of a bottle, or your baby is just too active and worked up… or your baby could just be plain ol’ cranky.
What you will get often times is baby latching on, sucking a few times, and then coming right back off and crying hysterically.
What you could do is hand express or pump to the first milk let down or just to have enough to cover the nipple.
With that, your baby is immediately rewarded for latching on.
In my case, what would oftentimes happen is that my little girl would get through the first let down and quit soon after.
If this sounds familiar, what you could do is simultaneously pump the other side.
Once a let down is initiated on one side, it will also flow on the other side.
Additionally, you could massage the breast being nursed and help baby get the milk flowing that way.
Babies that only feed with let downs are either to restless and impatient to feed (meaning you should try to feed them and let them sleep on cue) or they don’t have a great latch, to begin with.
Here are some tips to get that latch right (2)…
Make sure baby is correctly positioned, tummy to tummy and properly aligned ESH (ear-shoulder-hip).
Touch baby’s nose with nipple and slowly move down to the top of baby’s lip.
Once baby opens wide (this part is important) and tongue is down, bring in baby towards nipple with the hand opposite of the side being nursed (make sure you’re using the back of the neck not the head to guide baby, as this may upset your baby) while supporting your breast with the hand on the side being nursed. Your baby should be able to latch. Make sure the bottom and top lips are flared out!
Check out Le Leche League International for a more detailed description on how to properly latch.
Now if you missed the cues or your baby is just being extremely fussy, you will need to calm your baby down.
Your baby will more than likely not latch, and might even end up destroying your self-esteem by roaring at the sight of your breasts (been there).
To calm my baby girl down, I would pace in a dark room.
If a dark room wasn’t accessible, I would temporarily shield her face from the light using a 100% cotton, breathable swaddle.
I would hold her upright because being in a cradle-hold position just made her even more furious.
However, you know your baby better, hold them the way they prefer.
Skin-to-skin is extremely effective in getting your baby to feel more comfortable around your breasts, so get rid of the clothes.
What also worked really well was giving my baby a pacifier along with swaddling her up, she would calm down quickly with the pacifier especially!
It is not recommended to use a pacifier or bottle if you’re battling nipple confusion or a nursing strike, however, I would briefly use it to calm my baby and then immediately pull it out just as I’m about to attempt another latch.
Believe it or not, that technique alone ended more than half of our nursing battles!
Singing, talking, and stroking baby are also other things you could do.
Dream Feeds and Feeding Upon Wakings
When we were battling nipple confusion what really worked was feeding my baby when she was drowsy.
Despite being a reluctant nurser, she was too tired to notice.
She would, however, quickly latch off as soon as she realized what was happening (silly goose!).
This method also helped when my baby was going through leaps/growth spurts.
I personally refrained from waking my baby up for feeds (in other words, dream feeding) since the one time I tried it I had the hardest time putting her back to sleep.
I know of other moms who were much more successful with this method (by the way this also works if you’re trying to get baby to sleep through the night!).
Feeding baby as soon as they wake up, though, is much safer and easier option since they are already getting up (no risk to having a cranky baby!).
Make sure your baby is actually waking up, though, or else you might end up cutting off their sleep and end up getting yourself a meltdown later in the day!
Switch Feeding Positions
For some reason, my baby girl had an evolving preference over how she liked to be fed during different times of her growth (sometimes even throughout different times of the day!).
I found her changing especially after growth spurts!
No one is over exaggerating when they say what works one day might not work the next day.
Try to see if maybe a different position might work for your baby.
As a side note, be aware of when your baby opens their mouth as if going in for a latch and also take advantage of these moments!
Here is an overview of some positions that you could try (3)…
- Cradle Hold:
Hold your baby cradled in your arms (lying horizontally)with baby’s head resting on the arm at the side being nursed.
Your baby should be laying on its side, resting on its shoulder and hip with its the mouth at nipple level.
Boppies and other support pillows are very helpful with this position!
Also, make sure your tummies are touching.
The perfect alignment ensures adequate transfer of milk with minimal air.
The cross-cradle hold is very similar with the only difference of which hand supports baby’s head (the hand opposite the side being nursed, pictured above).
- Football Hold:
Place your baby at the side they will be nursing on.
Your baby should be laying on its back on your arm with its head in your hand and bum resting at your elbow bend (just like holding a football).
In this position, your baby is at your side with its face and mouth conveniently facing the nipple and ready to nurse.
- Laying Back:
With this position, you lean back comfortably (I use pillows as I don’t have a recliner) and lay your baby on your stomach, with its mouth at the nipple.
I let my baby girl rest at the crevice of my arm so that her nose isn’t blocked and she could breathe comfortably.
This position works really well during evening feeds as it is a comfortable position for baby to fall asleep in.
- Side Laying:
Lay next to your baby with your tummies facing one another.
Position your nipple at the level of baby’s mouth.
I have found this position to work better when my baby got better at latching independently.
You could also use a pillow to help with positioning and with getting more comfortable.
Make sure both you and baby are comfortable and correctly positioned otherwise you’ll both be miserable and baby won’t nurse efficiently… leading to more fussiness!
Baby Discomfort Associated with Nursing
I would notice cues of discomfort just before the periods my baby girl would go on a nursing strike.
It was either teething, a stuffy nose or a sore throat, once my baby associated the pain or discomfort with breastfeeding she refused to latch.
Often times, it was the stuffy nose.
In the mornings she’d wake up struggling to breathe through her nose because of the cold and dry air in the room!
I noticed a change in her willingness to nurse almost immediately!
Maybe your baby has swallowed too much air?
My baby girl would signal this by bending her back in discomfort.
Try burping your baby regularly.
Here are the two ways I found to be the most effective in getting that air out…
- HOLD your baby upright and gently pat on baby’s back.
Walking also helps.
- LAY your baby over your lap and gently pat baby’s back.
Careful not to do this too much or too soon after a feeding as you might cause baby reflux.
You can check out this post for more tips on getting your baby to burp!
Your baby might have gas.
You could use gripe water or simethicone gas drops to alleviate your baby’s tummy discomfort.
Maybe they’re too hot or too cold?
Change them or cover them up in a blanket!
Maybe they just need a quick diaper change?
Honestly, it is all trial and error.
Your baby is trying to tell you something and you need to figure out what that is.
This is very common once your baby starts getting older.
I noticed that feedings would become increasingly difficult as soon as my baby girl started being more interested in her surroundings.
Sometimes while she would be nursing I’d notice that the slightest noise or movement would throw her off and then get her back on was close to impossible.
What helped me was going off to a quiet and dimmed room.
This truly becomes the best nursing spot while you and your baby try to get a better handle on things!
Wearing a nursing necklace also helps keep baby focused when nursing.
At times I would notice that my baby would get just as equally distracted if I was trying to get things done and multitask on my phone.
So, it really helped to just put everything away and focus on my baby during this time.
It actually made the overall experience much more enjoyable!
Paced Bottle Feeding
Nursing strikes often come in conjunction with nipple confusion.
Your baby is used to the feasibility of bottle feeding compared to the ‘hard work’ that nursing is.
This latching on and off accompanied by screaming could be a sign that your baby just isn’t as patient with how long a let-down takes (going back to Point 3).
What you can do is mimic breastfeeding when bottle feeding your baby.
This is called paced bottle feeding, and here’s how you do it (4)…
- MAKE SURE baby is propped up during the feed (baby’s bum resting between your knee gap while baby’s back rests on the knee opposite the bottle), so that gravity isn’t helping your little one ease through a feed.
- TOUCH baby’s upper lip to initiate a latch just as you would regularly breastfeeding.
- ONCE YOUR BABY has taken to the bottle, hold the bottle horizontally so that baby is forced to suck in order to get the milk to flow.
- AFTER 20 SECONDS, pull the bottle down still keeping the nipple in baby’s mouth, giving your baby a break. Pull the bottle back up once your baby begins sucking again. You want to make sure to take breaks so that your baby doesn’t get used to a consistent flow of milk, but instead readjusts to a natural let-down and milk flow as from the breast.
- SWITCH sides just as you would regularly breastfeeding.
- ALSO, MAKE SURE you have a bottle nipple that most resembles an actual nipple and is slow flow. This type of nipple most closely resembles the real things and should be the only type used with breastfed babies that are reluctant to nurse.
Check out this video for a visual example of paced bottle feeding.
Speaking from personal experience, your baby will not enjoy this one bit if they’re used to the fast flow so you might have some tears.
However, in the long run, this is the best thing for your baby.
This positioning not only reduces colic gas, since your baby is upright and the flow is slower thus reducing the amount of swallowed air, but it also prevents obesity (your baby isn’t overfed) and tooth decay (often associated with feeding baby lying down, the consequence of which is milk sitting in the mouth).
Ultimately, with all of these, you want your baby to prefer breastfeeding over bottle-feeding.
If your baby is gaining weight accordingly and you have the ok from your pediatrician, then keep trying at it!
I have mentioned that skin contact works really well with calming a crying baby, especially a newborn.
This is why skin-to-skin is highly recommended immediately post delivery.
There is a strong bond that is established when mother and child are so close.
Not only does it reduce your baby’s stress, but it stabilizes their body temperature, heart rate, breathing rate, and blood sugar (5)!
It’s also relaxing for momma and it helps you make more milk!
How you might wonder?
Holding your baby skin-to-skin increases your body’s production of Prolactin, a hormone that stimulates milk production (5)!
Oh, and it’s way easier for your baby to latch when there aren’t any clothes blocking your breast.
All you do is take off your shirt and bra and strip your baby down to just a diaper and then have your baby lay on your chest.
You could either use a swaddle to cover your baby’s back or just wear an oversized shirt.
This is referred to as Kangaroo Mother Care (5).
Usually, after an hour or so, babies start to naturally search for the breast!
Alternative Feeding Methods
This refers to supplementation methods that aren’t the typical bottle feeding methods.
If you are trying to overcome a nursing strike, you must avoid the bottle as much as possible since it is the source of breastfeeding difficulties.
However, if your baby isn’t breastfeeding, they still need to eat somehow.
That is where alternative feeding methods come in.
It delivers a supplement, usually breastmilk but also could be formula, to your baby while your baby is attempting to nurse.
How it works is that you fill the tube with the supplement and then securely attach the end of the tube at the tip of your nipple (you can tape the tubing preferably well above the nipple).
This also works really well if you are breastfeeding with a nipple shield!
The rest of the work is done by your baby as the tube acts like a straw allowing your baby to successfully draw milk from the supplementor… and also your breasts!
So, your baby is rewarded for “nursing” and your breasts are stimulated in the process.
You are building up your supply while getting your baby fed!
That is why this is the preferred method of supplementation for a breastfed baby.
This method of supplementation also utilizes the SNS except that the tip of the tubing is secured to your fingertip instead. You just place your finger into your baby’s mouth and allow them to artificially nurse and suck the milk from the tube. This is the alternative to the former when your baby has difficulties latching or your nipples need a break because of pain. Remember to pump the same amount your baby eats so that your supply doesn’t subsequently drop!
This method is usually preferred when your baby is at least 6 months as by then they are able to drink from a cup. To avoid choking, add a small amount of milk to the cup and ensure that your baby swallows before allowing them to drink again. Again, pump the amount your baby drinks.
Dropper, Syringe, Spoon
These methods work similarly to the cup as you do most of the work in bringing the milk to your baby, however, they are meant for babies that aren’t able to drink milk from a cup yet (in other words, babies younger than 6 months). This method also requires a lot of caution when approaching as you can risk causing your baby to inhale milk if you pour/dispense the milk too suddenly. Go slow and dispense small amounts at a time while pausing in between to wait for your baby to swallow before continuing. You can get droppers and syringes specifically for babies from your local lactation consultant. Remember to pump the amount of milk your baby eats.
If all of the previous methods don’t work for your baby, then bottle feeding is your final resort. Although this is what you are trying to avoid using, if you approach bottle feeding differently, you can actually get your baby to prefer breastfeeding. As I outlined earlier in this post, one way to do this is paced bottle feeding. Another way is by ONLY using slow flow nipples for your bottles. I used Playtex Nipples as they worked really well for alternating feedings between bottle and breastfeeding.
If you found this post helpful, you might also enjoy these:
- Breastfeeding Survival Guide: 12 Things I Wish I Knew About Breastfeeding
- 11 Breastfeeding Essentials for First-Time Moms (And how to use them)
- My Breastfeeding Story: How I Went from Supplementing to a 400 oz Stash in a Month
- 8 Signs and Symptoms of a Tongue Tie
Overall, breastfeeding is a lot of HARD work.
For some moms it’s easy, but for others (like me) it does require commitment and support!
DO NOT beat yourself up if you have tried everything and it’s just not working.
Your baby needs to get fed and how your baby is fed doesn’t make much of a difference at the end of the day.
I’m just one proof of that!
I was raised on formula and I turned out fine!
More than fine.
No serious health or developmental deficits.
Now, I’m not sharing to brag or bring anyone with those deficiencies down.
I’m incredibly thankful that I was blessed so!
I’m sharing so that you realize that it isn’t the end of the world if you don’t breastfeed.
I want you to know that this is just my experience, and, although these things actually worked for me and my baby girl, they might not necessarily work in your case.
But that’s ok!
Remember, fed is best!
I wish you the best of blessings on your breastfeeding journey!
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