Newborn baby not feeding mother milk
Why is my baby refusing the breast? 8 tips that help | Baby & toddler, Feeding articles & support
Whether your baby refuses the breast as a newborn or when they’re older, it can be very stressful. Here’s why it might happen and what to try…
Why won’t my newborn baby breastfeed?
Sometimes, newborn babies struggle to latch on to breastfeed after they’re born. It can be worrying for new parents when this happens – you might think something’s wrong.
There may be a simple explanation. This information could help you find your own solution, or decide if you need further support.
Some of the more common reasons for newborn babies finding it difficult to latch onto the breast could be:
- a difficult labour or birth – your baby might feel sore or have a headache if the mother has had interventions in labour or if they were born very quickly
- medication used during labour – anaesthesia, epidural or pethidine can make your baby sleepy or groggy
- your baby being separated from you after birth – even for a few minutes
- discomfort due to a birth injury or bruising
- swallowing mucus at birth can make your baby feel congested, nauseous or uncomfortable
- an early unpleasant experience of attempting to breastfeed, such as being forced onto the breast
- the baby might have tongue-tie
Why won’t my baby breastfeed anymore?
Sometimes, older babies seem to refuse to breastfeed when they’d been breastfeeding just fine until then. This is known as a 'nursing strike.' They might refuse to breastfeed for 2-4 days, but it can be up to 10 days (Mohrbacher, 2013).
Reasons that your older baby might refuse to feed at the breast could include:
- something has changed that makes it difficult for baby to latch
- a strong or fast flow of milk, which your baby is struggling to take
- a painful mouth, due to an infection like thrush or because they’re teething
- being more aware of their surroundings and being easily distracted, for example by noise
- a change in the taste of your milk, such as that due to your menstrual cycle
- the introduction of more solid food
- a small number of babies might struggle because of severe or persistent reflux, known as gastro-oesophageal reflux disease (GORD), so they may link feeding with pain.
(Mohrbacher, 2013; Gonzalez, 2014; BellyBelly, 2016; NICE, 2017; Public Health England, ND)
What can I do when my baby refuses to breastfeed?
8 top tips to help your baby who’s refusing to breastfeed:
1. Try to identify what’s going on for your baby. Knowing the cause can help not only with a plan but it can be reassuring to understand what is happening and know there’s a solution. You could think about the following:
- Do they have a cold or an infection?
- Was there something that might have caused them to not want to feed?
- Talk to one of our Breastfeeding Counsellors or contact our Infant Feeding Line on 0300 330 0700 (option 1) for further support. It can be a great way to get some help to find out what’s happening.
- You could also contact a health professional to investigate any medical reasons why your baby might not be feeding.
2. Try to stay calm and not force a feed. Instead, allow your baby to take the lead.
3. Especially for young babies, many mums find skin-to-skin contact in a laid-back position helps to take the pressure out of the situation. It allows your baby to use their own natural instincts to feed (Burbridge, 2017).
4. Don’t worry if your baby bobs their head or moves it from side to side, they’re not rejecting the breast as it might appear. These are your baby’s natural ways of finding your breast (Coulson, 2012).
5. Try a different feeding position to see if you can get your baby more comfortable. Some babies find a laid-back breastfeeding (also called biological nurturing) position helpful if they are struggling to get a deep latch or if you have a strong let-down of milk (Coulson, 2012).
6. Sometimes, feeding your baby while they’re sleepy or even asleep can be helpful. Many mums say that these ‘dream feeds’ can be very effective for a baby who is uninterested when awake (Pitman and Bennett, 2008).
7. You could try feeding your baby while rocking them or walking around, singing or playing with them or playing white noise or background music to them (Australian Breastfeeding Association, 2017).
8. You might want to try feeding in a quiet room, away from distractions, as some babies are so keen to be involved that they limit their feeds (Gonzalez, 2014).
What can I do if I’ve tried everything but my baby still won’t breastfeed?
One of the key things to consider is maintaining your milk supply. You might need to consider expressing, either by hand or with a pump. You can find more information about expressing and storing your milk here.
Another consideration is making sure your baby is getting enough milk. How might you know how much milk your baby is getting, you might ask. The answer lies in their dirty and wet nappies. You can expect six wet nappies in 24 hours if your baby is over a week old (UNICEF, 2016). If you’re unsure, it’s best to ask for support from your health visitor, GP or NCT breastfeeding counsellor.
In the short term, you might need to look at alternative ways to feed your baby if you think they’re not getting enough milk. A newborn baby needs to be fed regularly and parents can use syringe or cup feeding as an alternative to a bottle in the early days (Flint et al, 2016; NHS, 2016).
If you decide to use a bottle, it might be helpful to feed with plenty of skin-to-skin contact (UNICEF, 2018). Gently offering the bottle to your baby by tickling their top lip, waiting for the wide-open gape might also help mimic a breastfeed (UNICEF, 2019). That can support the transition back to the breast.
Taking frequent breaks during the bottle feed, and perhaps swapping sides, can be helpful (UNICEF 2018). Continuing to have skin-to-skin time with your baby and allowing them access to the breast will help this. It’ll also be a bonding and calming experience for you both.
How can I deal with the stress of my baby refusing to breastfeed?
When a newborn refuses the breast, or an older baby goes through a nursing strike, it can be very upsetting for both you and your baby. You’re definitely not alone in struggling with the emotions of breastfeeding problems. So here are some tips that might help:
- Try to take time to enjoy plenty of extra cuddles and quiet time together.
- Many mums find a ‘babymoon’ helpful for allowing their baby access to the breast in a non-pressurised way. A babymoon means spending some hours together in a relaxed setting, such as lying down snuggling in bed. This can allow you to enjoy your baby without worrying about feeding.
- For older babies, some mums find that having a bath with their baby or bringing their baby into bed with them helps their baby to latch.
- Try to find some support from other mums and trained breastfeeding supporters. Chatting with other people about this can help to unburden the stresses and worries you might be feeling. Breast refusal is not uncommon and you might find that chatting to someone who understands is invaluable while you’re struggling.
- For many mums, time and patience can help the situation. Your baby’s instincts and behaviour can change and develop, especially in the early days.
- If you’re struggling, do contact the NCT Infant Feeding Line and speak to a breastfeeding counsellor. They’ll listen, offer you information and will support you to find your own path.
This page was last reviewed in August 2019.
NCT supports all parents, however they feed their baby. If you have questions, concerns or need support, you can speak to a breastfeeding counsellor by calling our helpline on 0300 330 0700, whether you are exclusively breastfeeding or using formula milk. Breastfeeding counsellors have had extensive training, will listen without judging or criticising and will offer relevant information and suggestions. You can also find more useful articles here.
National Breastfeeding Line (government funded): 0300 100 021.
NHS information on mastitis.
Best Beginnings - Bump to Breastfeeding DVD Chapter 7 'Overcoming Challenges'.
Healthtalkonline.org: Managing Breastfeeding – dealing with difficult times.
Australian for Breastfeeding Association (2017) Breast refusal. https://www.breastfeeding.asn.au/bf-info/breast-refusal [Accessed 22nd February 2019]
BellyBelly. (2016) Breast refusal – 13 tips for a baby that refuses the breast.
https://www.bellybelly.com.au/breastfeeding/breast-refusal/ [Accessed 22nd February 2019]
Burbridge A. (2017) Nursing strikes. La Leche League GB. Available at: https://www.laleche.org.uk/nursing-strikes/ [Accessed 1st August 2019]
Coulson S. (2012) Biological nurturing: the laid-back breastfeeding revolution. Midwifery Today, 101 Available at: https://midwiferytoday.com/mt-articles/biological-nurturing/ [Accessed 1st August 2019]
Flint A, New K, Davies MW. (2016) Cup feeding versus other forms of supplemental enteral feeding for newborn infants unable to fully breastfeed. Cochrane Database Syst Rev. (8):CD005092. Available from: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD005092.pub3… [Accessed 1st August 2019]
Gonzalez C. (2014) Breastfeeding Made Easy. London: Pinter &Martin
LLLGB. (2016) My baby won’t breastfeed. Available at https://www.laleche.org.uk/my-baby-wont-breastfeed/ [Accessed 1st August 2019]
Mohrbacher N. (2013) Is your formerly nursing baby refusing to breastfeed? Breastfeeding Reporter Blog. Available at http://www.nancymohrbacher.com/articles/2013/1/26/is-your-formerly-nursing-baby-refusing-to-breastfeed.html?rq=refusing [Accessed 1st August 2019]
NICE. (2017) Breastfeeding problems. National Institute for health and Care Excellence, Clinical Knowledge Summaries. Available at: https://cks.nice.org.uk/breastfeeding-problems#!scenario [Accessed 1st August 2019]
Pitman T, Bennett H. (2008) 0-1 year: nursing strikes; breastfeeding while baby’s falling asleep may help end a nursing strike. Today’s Parent. 7:137.
Public Health England. (ND) Breastfeeding challenges. NHS, Start 4 life. Available at: https://www.nhs.uk/start4life/baby/breastfeeding/breastfeeding-challenges/reflux/ [Accessed 1st August 2019]
UNICEF. (2016) Breastfeeding checklist for mothers – How can I tell that breastfeeding is going well? UNICEF UK Baby Friendly Initiative. Available at https://www.unicef.org.uk/babyfriendly/wp-content/uploads/sites/2/2016/10/mothers_breastfeeding_checklist.pdf [Accessed 1st August 2019]
UNICEF. (2018) Skin-to-skin contact. Available from: https://www.unicef.org.uk/babyfriendly/baby-friendly-resources/guidance-for-health-professionals/implementing-the-baby-friendly-standards/further-guidance-on-implementing-the-standards/skin-to-skin-contact/ [Accessed 1st August 2019]
UNICEF. (2019) Responsive bottle feeding. Available from: https://www.unicef.org.uk/babyfriendly/wp-content/uploads/sites/2/2019/04/Infant-formula-and-responsive-bottle-feeding.pdf [Accessed 1st August 2019]
My Baby Won’t Breastfeed - La Leche League GB
This page is about young babies who have never breastfed or who get very upset when offered the breast. If your baby was breastfeeding well but is now refusing, see our page on “nursing strikes”. Sometimes, a new difficulty with feeding is the first sign that the baby is becoming unwell. If you are not sure that your baby is well, please contact your doctor.
When a baby doesn’t breastfeed after birth, it can be upsetting, confusing and frustrating. You might wonder whether you’re doing something wrong, or even whether your baby likes you. It’s hard not to take it personally!
Babies are ‘hardwired’ to breastfeed – it is an essential survival behaviour. When a baby doesn’t breastfeed, it’s never because they don’t want to. Something is making it hard for them. Babies are never “lazy” or “difficult” – they always do the best they can. So do their mothers!
When it’s taking time for breastfeeding to get going:
- Keep your milk flowing
- Keep your baby fed
- Keep your baby close
If you do this, your baby is very likely to breastfeed when they are ready. Time, patience, and good feeding support are usually all you need.
This useful summary of the “3 Keeps” can be downloaded as a free A4 poster here.
You can read more about getting breastfeeding on track after a difficult start here.
Why isn’t my baby breastfeeding?
After a straightforward birth, most well, full-term babies will start feeding within an hour or so. Not all babies have such an easy start, though. Babies can take longer to start breastfeeding if:
- They had a more complicated birth. Babies born with the aid of forceps, for example, often take a few days to recover and feed well. If you had pain medication in labour, your baby may be sleepy and uncoordinated at first.
- Your baby was born early, or small for their gestational age. See also breastfeeding premature babies and late preterm babies (those born between 34 and 37 weeks). Even being born one or two weeks early can mean that your baby takes longer to start breastfeeding. It might take until around your baby’s due date, or a little longer, before they are ready to feed well.
- You and your baby were separated after birth because one or both of you needed medical care.
- Your baby is very sleepy and doesn’t yet have enough energy to breastfeed. See also sleepy baby and newborn jaundice.
- Your baby is unwell.
- Your baby is uncomfortable, e.g., some babies have a sore head or sore shoulder after birth.
- Your baby has low muscle tone (hypotonia).
- Your baby has a physical challenge such as tongue-tie.
You have plenty of time
Parents sometimes worry that if their baby isn’t breastfeeding well, or at all, in the first few hours, days or weeks after birth, it will never happen. While breastfeeding in the first hour after birth is ideal, the window of opportunity for babies to start breastfeeding is much longer than this. The feeding reflexes, which keep babies seeking and attaching to the breast, last for at least two to three months after birth. We have seen many babies start breastfeeding older than three months, too! There are even reports of children over a year old starting to breastfeed, when placed for adoption with a lactating mother. Where there is milk, there is always the possibility of breastfeeding.
Photo: Jen Valsler
First things first
Sorting out breastfeeding problems can feel overwhelming. There seems to be so much to do, and you might feel you have to do it all at the same time! It is helpful to know what is urgent and what can wait. This can help you to work out what to do in what order, and how best to use your time and energy. Feeding at the breast is the least urgent thing, at this stage.
If your goal is to have a full milk supply (enough milk to meet all your baby’s needs) but you need to use donated breastmilk or formula at the moment, or if your baby is not growing well just on your milk, then making more milk is the top priority. This is more urgent than your baby starting to feed at the breast.
If your baby is not breastfeeding at all yet, or is not breastfeeding effectively, you can express your milk. This gives you milk to feed your baby now and encourages your breasts to make plenty of milk for the weeks and months to come.
Your breasts may temporarily become swollen and uncomfortable, starting around 2-4 days after birth. This is called “engorgement” and is a sign that your breasts are becoming more active (though not all mothers feel it). It is important to treat engorgement, to keep your breasts comfortable and your milk flowing well. Read more here: Engorged breasts – avoiding and treating.
Read here about how milk production works and how to increase your milk supply.
You can find information here on how to use bottles and other feeding tools.
Expressing all the milk your baby needs is known as “exclusive pumping” or “EP”. You can read more here. Some mothers choose to do this; many do it because their babies are not able to breastfeed. You might find it helpful to join an online support group for “EP mums”.
If you need to express your milk for a baby who is not breastfeeding yet, it is important to work with a skilled breastfeeding supporter. You might also want to connect with other mothers who have needed to express milk – they can be your best cheerleaders while you do this important job! Your local La Leche League group would love to support you.
Setting the scene for breastfeeding – happy time at (or near) the breast
Most babies need only time, patience, and gentle encouragement to help them start breastfeeding. Babies are born expecting to breastfeed, with a set of reflexes to help them do it. We need to keep them well fed (with expressed or formula milk), give them lots of relaxed time near the breast, and…. give the baby time.
Here are some ideas to try:
- Hold your baby skin-to-skin. Babies use their whole bodies to feed. The more of their skin they feel against yours, the more likely they are to find the breast and start feeding. Undress your baby down to their nappy and move your clothes out of the way. If you are cold, you can put a blanket round both of you. Even if your baby doesn’t breastfeed yet, it feels lovely, and helps your baby get used to being at or near the breast. Holding your baby against your skin helps you make more milk, too! If your baby can’t tolerate being held in a feeding position, try holding them against your shoulder.
- Avoid holding your baby in a feeding position during medical procedures, especially if your baby will be having lots. Offer the breast afterwards instead, if it calms them.
- Try “laid-back” breastfeeding. Try putting your baby tummy-down, on the slope of your body as you recline comfortably (as if you are lying on a sun lounger). Placed like this, they can use their arms and legs to help themselves find the breast and attach well for feeding. This can work better than trying to “put” the baby to the breast, especially if they have already had difficult experiences of this. This video shows you how. The safest place to do this is in a bed that has been set up following safe sleep guidance. See our article on safer sleep.
- Turn up the smell! Newborn babies don’t recognise the breast well by sight, though they do recognise your face, and love looking at it. They find the breast mostly by feel and smell. The little bumps around your nipple (Montgomery’s glands) make a scented oil which helps your baby find the breast and encourages them to feed. You can give your baby extra help by expressing a bit of milk and rubbing it on and around your nipples. This can encourage your baby to feed by increasing the smell and giving them something to lick as they approach the breast!
- Try “drip-drop feeding”. Your partner or supporter uses a cup and spoon to drip milk (expressed milk or formula) onto the breast as you hold your baby. This can encourage babies to attach and feed. You can watch a video here.
- Take a bath with your baby. When placed skin-to-skin with their mother in a warm bath, some babies find the breast and feed for the first time. Some mothers even describe it as “a second chance at giving birth”. You could set the scene with low lighting, a candle or soft music. Whether or not your baby is ready to breastfeed yet, sharing a bath can help you and your baby relax together and enjoy each other. Have another adult with you to help you get in and out safely, put the baby on you and wrap them in a warm towel when they are ready to get out.
- “Wear” your baby. Babies who are kept close in a sling or soft carrier cry less, are calmer and warmer than babies who are put down by themselves. Being carried is good for babies’ physical & emotional development and helps parents and babies make strong connections. If your baby is not breastfeeding yet, carrying them close, as much as you want, is an excellent way to help them feel comfortable near the breast. Always follow the instructions for your sling or carrier and the rules for safe babywearing. You can read more about babywearing in this book.
- Feed your baby at or near the breast. If your baby will go to the breast at all, consider using a nursing supplementer so your baby can have extra milk while they breastfeed. This can be helpful when milk supply is low and/or your baby is frustrated by the speed of milk flow at the breast. If your baby is fed by cup or bottle, try feeding them skin-to-skin with their cheek against your breast. Let your baby end the feed by sleeping with their cheek pillowed on the breast.
- Consider sleeping with your baby. Some babies will attach and feed in their sleep if the breast is near enough to smell and feel. Always consider sleep safety before sleeping with your baby in your bed. It is never safe to sleep with a baby on a sofa. You can read more about sleep safety and normal baby sleep in LLL’s book Sweet Sleep.
Babies with low muscle tone (hypotonia)
A baby who has been diagnosed with a condition that makes them hypotonic, or ‘floppy’, may show little interest in breastfeeding. To make feeding easier:
- Support your breast. Tuck a rolled-up cloth under your breast close to your chest wall, or support your breast with your thumb on one side of the areola, fingers on the other side.
- Support your baby’s chin. If your thumb is parallel to your baby’s upper lip, you can use your index finger to put gentle pressure just behind the bony part of the chin while your baby feeds.
- Try upright positions. A hypotonic baby often feeds better held with their head higher than their bottom.
- Breast compression can also be helpful, but you may also need to give some expressed milk until your baby’s muscle tone improves. Breast compressions are explained in more detail in “My baby needs more milk”.
If your baby suddenly becomes floppy and you don’t know why, seek medical advice.
When you are keen to breastfeed, but your baby isn’t yet ready, it can be frustrating. Don’t forget to celebrate how far you have already come! Every time your baby enjoys being held close to your body, or falls asleep near your breast, they are taking another “baby step” towards breastfeeding. Your baby is doing the best they can for now, and so are you.
When breastfeeding is stressful
When breastfeeding is difficult for your baby, it may become stressful for both of you. Babies who have had unhappy experiences at the breast can develop negative associations with breastfeeding. This might happen, for example, when:
- A baby is in pain or discomfort e.g. from birth injury or allergy.
- A sensitive baby is handled at the breast in a way they don’t like, e.g., if a helper tries hard to “put” the baby to the breast when they aren’t ready.
- Milk supply is low.
- A baby has a physical restriction (e.g., tongue tie) that makes attaching and sucking difficult.
A baby who is finding feeding difficult may become upset:
- A short time into the feed, when milk flow slows down.
- At the start of the feed, when milk doesn’t come straight away.
- When offered the breast.
- When put in a breastfeeding position.
- When they see the breast.
When feeding isn’t going well, babies may come to associate the breast with hunger and frustration. They may develop a preference for another feeding method, such as a bottle, if they associate it with feeling full and satisfied. You can find some ideas on how to keep your baby’s relationship with the breast positive here: using donor milk & formula milk to support breastfeeding
The ideas in the previous section (“Setting the scene for breastfeeding – happy time at (or near) the breast”) can help your baby learn that the breast is a lovely place to be, and to associate it with calm, relaxation, comfort, and satisfaction rather than hunger and frustration.
Take a break
If breastfeeding has become very stressful for you and your baby, you might need a “breastfeeding break”. You could stop trying for a few days, whilst expressing your milk to keep your baby fed and keep your milk flowing. When you’re both ready, you can try again. There is no rush! Dr Christina Smillie, an American doctor who specialises in breastfeeding medicine, calls this “rebooting the baby”.
What if my baby is still not breastfeeding?
When you are eager to breastfeed, it is hard to wait. It is not uncommon for babies to need time to begin breastfeeding well. You might be encouraged by hearing the stories of other parents whose babies took time to get going.
If your baby is still not breastfeeding even with time, patience and some of the tips in this article, there will be a reason why. A skilled breastfeeding supporter can help you find out, and work towards breastfeeding. Some babies need medical care, some benefit from feeding tools such as nipple shields and a few need treatment for tongue tie. Many just need a little more time.
A few babies never do breastfeed. Some have a medical condition that makes it impossible. Very rarely, we never find out why. You don’t have to feed your baby directly from the breast to give them the many benefits of your milk or to nurture them at your breast. We can support you to have a close, happy feeding relationship with your baby, whatever form that takes.
La Leche League Leaders (breastfeeding counsellors) can help. You can find your local group, and LLL Zoom Meetings all over the country, at https://www.laleche.org.uk/find-lll-support-group/
Jayne Joyce, LLL Oxfordshire & Karla Napier, LLL Edinburgh, April 2022
Formula cannot fully replace mother's milk
Deputy Chief Physician of City Hospital No. 5 - Center for Maternal and Child Health, chief freelance specialist in obstetrics and gynecology Elena Levanovich told the correspondent of the Center for Public Health and Medical Prevention why even the best mixtures cannot replace mother's milk, until what age can a child be breastfed, and also spoke about the practice of breastfeeding by nurses.
Many doctors say that there is nothing better for newborns than breastfeeding: mother's milk contains all the substances and elements necessary for the child. However, the world does not stand still, infant formula is constantly improving.
Can these formulas compare with mother's milk today?
Breast milk contains antibodies that help the baby cope with many of the infections and viruses that occur in the first months of life.
They are not in mixtures. Moreover, whatever breast milk substitutes are in terms of their composition of fats, proteins, carbohydrates, vitamins, they cannot be compared with mother's breast milk enriched with the same substances.
Certain bacteria are transmitted from the mother to the child, the intestines are populated with beneficial microflora, which helps the child avoid diseases associated with the gastrointestinal tract, allergies.
With artificial feeding, unfortunately, such diseases occur in children. They very often suffer from constipation, become restless, they are not comfortable, it hurts, of course, the mother is also nervous and becomes restless.
Breastfeeding is also convenient. Mom does not need to heat milk, spend money on mixtures, bottles, nipples, do not have to think about how to sterilize and store them.
But most importantly, when a child suckles, he feels the warmth of his mother, hears her heartbeat, thus achieving maximum psychological comfort for the baby. On artificial feeding there are no such tactile sensations.
There are cases when mother's milk is not suitable for the child, or it is not enough for the full nutrition of the baby. What to do in such cases?
There are medical indications for breastfeeding, for example - HIV infection in the mother. A woman is taking antiviral therapy, and in order to avoid vertical transmission - transmission through breast milk, we recommend that such mothers do not feed.
The same applies to women who take drugs for an open form of tuberculosis. It happens that children aged a month or two are diagnosed with intestinal dysbacteriosis, skin rashes are observed.
It turns out that the reason for this is lactose deficiency. These babies lack an enzyme that breaks down the protein in breast milk.
Here, experts recommend that mothers remove milk and sour-milk products from the diet. Sometimes on such a diet, the child recovers both stool and sleep, and allergic problems go away.
Then there are subtleties of a genetic nature: there are congenital deficiencies in enzymes, this is a very small percentage, then mixtures for special nutrition are selected with specialists.
Can a young mother improve the quality of her milk and the formation of the required volume?
Of course. First, the first four days after birth, all mothers produce colostrum. We always talk about this, but often women come to us on the second day after giving birth with a complaint about the lack of milk. In the early days, everyone produces colostrum in different volumes, but you need to apply the baby on demand.
At first, babies eat every hour, and the more he sucks, the more active the flow of milk will be. There are so-called lactation crises - on the tenth day, in a month. Mom has a rush of milk these days, sometimes the temperature rises, the breast becomes dense with infiltrates. Here we recommend breastfeeding more often to prevent mastitis.
The fact is that the child grows, he needs more milk, and it comes. As a rule, everything ends favorably, the child eats more and in the future the volume is regulated.
For breastfeeding, mothers need good nutrition so that a sufficient amount of protein, vitamins, and fatty acids enter the body. During this period, you need to eat 5-6 times a day, consume about two liters of fluid.
It is said that nuts can increase the fat content of milk, but there is no clinical evidence for this. It happens that after two or three months, mother's milk becomes insufficiently nutritious. We watch the baby gain weight.
If a breastfed baby is gaining less than 500 grams per month, you need to add supplementary food. Pediatricians should be involved here. But this does not mean that the child should be weaned from the breast. It happens when mothers categorically refuse to feed the child, find some reasons and start taking drugs that stop lactation. Our psychologists work with them.
Once upon a time there was a common practice when children were fed not by mothers, but by wet nurses. Do such practices exist now?
We do not currently have such practices, but in any case, the donor must be examined for various infections - hepatitis, HIV, tuberculosis.
How much you can trust another person in this matter with his microflora, with his bacteria, with his eating style, is a big question. In any case, in this matter, the decision depends on the mother.
Once upon a time, noble children were fed by nurses, but there were fewer infections before, there were not so many dangers, including HIV.
Recently, there are recommendations for mothers who have a lot of milk, who periodically have a fever, have lactostasis, we recommend expressing and freezing milk, observing the rules for storing it.
When there is less milk, it can be used. Perhaps someday we will come to the creation of a breast milk bank. Detailed studies are needed.
When can I stop breastfeeding?
We recommend that you breastfeed your baby for at least six months. After that, you can begin to introduce supplementary foods: vegetables, dairy products, meat, fish and, last but not least, fruits.
To completely wean a child from the breast - there are no such recommendations.
It happens that children are fed up to two or three years. In rare cases, they feed up to four or five years. But we must understand that after a year and a half it is more difficult for children to wean psychologically from the breast.
Interviewed by A. Pribylova
Solutions to six breastfeeding problems in the first week
Having difficulty breastfeeding your newborn baby? Read on for expert advice on tackling the main challenges of the first week of breastfeeding.
Share this information
Cathy Garbin, child health nurse, midwife and lactation consultant:
Katie, a mother of two, was a research fellow at the renowned Human Lactation Research Institute, founded by Peter Hartmann, for seven years, supporting breastfeeding mothers in clinics and at home. Today, she still works as a family counselor, and also conducts seminars for attending physicians and speaks at international conferences.
Breastfeeding is not always easy, so if
you are having difficulty, know that you are not alone. A US study found that out of 500 young mothers surveyed, 92% had problems breastfeeding by the third day. 1 Fortunately, most early breastfeeding problems are easy to resolve. Below you can read recommendations for solving the main problems that mothers often face in the first week of feeding.
Problem #1. Breastfeeding hurts!
Pain during feeding is usually associated with tenderness or inflammation of the nipples, especially when milk "comes" on the second to fourth day after birth. 2 The baby will beg for a breast every couple of hours, and this can quickly aggravate the problem: for some mothers, the nipples crack, bleed or blister. This is, of course, very annoying.
- Check for baby latch on. An incorrect latch is one of the most common causes of pain during breastfeeding. A newborn baby should take most of the lower half of the areola (dark skin around the nipple) into his mouth, and your nipple should rest against his palate, supported from below by the tongue.
- See a lactation consultant or healthcare professional to make sure your baby's mouth and torso are properly positioned during feeding and there are no other latch-on problems. The doctor may also examine the baby's mouth for physical abnormalities.
- Try other feeding positions. Reclining, cross cradle, underarm, or lying positions can relieve pressure on the most painful areas of your breasts.
- Gently wipe soaked nipples with water-soaked cotton swabs after each feed to remove milk residues that can cause infection.
- Air dry nipples or pat dry with a clean, soft muslin or flannel cloth to prevent bacterial growth in humid environments. Use disposable or reusable bra pads to absorb leaking milk and remember to change them regularly.
- Soften your nipples. An ultra-pure lanolin treatment will help relieve inflammation and dry skin. You can also apply a few drops of your own breast milk to your nipples. In both cases, you do not have to wash your breasts before the next feeding. You can also apply refrigerated hydrogel pads* to your nipples. They soothe the nipples and help relieve pain during feeding, as well as speed up healing.
- Protect your nipples. Nipple shields* protect the inflamed area from rubbing against clothing.
- Be patient. Inflammation usually resolves after a few days as your body adjusts to breastfeeding and your baby learns to suckle.
- Seek medical attention, if pain with feeding does not improve after a few days. Persistent inflammation of the nipples may indicate an infection that requires prompt treatment.
Problem #2. Baby doesn't latch on properly
Some newborns do not immediately latch on properly. Maybe both of you just need more time to learn how to breastfeed, or maybe the baby was born prematurely, feels unwell after a difficult birth, or mom has flat or inverted nipples.
- Contact a lactation consultant or healthcare professional, , who can help identify the cause of the problem and suggest solutions.
- Flat or inverted nipples must be pulled out. Nipple Shapers* fit comfortably in the bra and apply gentle pressure to the nipples to help them come out for easier feeding.
- Try different positions and ways to support the newborn. The baby needs to feel supported. He must be comfortable and breathe freely in order to suckle properly. Do not hold the child by the head and do not put pressure on it. Lean back and let your child take the lead. This stimulates his natural reflexes and helps him find and latch on to his breasts. 4
- When feeding, try to find the optimal position. Instead of putting your baby on and off, stressing both of you, try to position him in a way that is easy and comfortable for him. Hold the torso and legs of the baby close to you, support him by the shoulders and hold him firmly so that he feels safe. Let the baby's head rest freely on your arm so that he can tilt it back slightly and breathe freely. The chin should be pressed against your chest. If these small adjustments don't make feeding more comfortable for your baby, seek help from a lactation consultant or healthcare professional.
- Use nursing pads. If your baby is having difficulty latch-on, a lactation consultant or healthcare professional may suggest trying nursing pads*. A nipple with an overlay is more convenient to take in the mouth, so it is larger and more rigid. Do not use nursing pads for a long time.
Problem #3. Not enough breast milk
You will produce little breast milk at the very beginning, as the hormonal changes that trigger milk production occur slowly and do not end until the second or fourth day after birth. 2 You may be worried that your baby is not getting enough milk, but in the early days his stomach is still too small and feedings are frequent, so don't worry. The only things to worry about these days are excessive weight loss, too few wet and soiled diapers, or signs of dehydration in the baby. For more information on how often a newborn should urinate and void, see Breastfeeding Newborns: What to Expect in the First Week.
- Contact a Lactation Consultant or your healthcare provider who can determine if you are having problems with milk production. The sooner you do this, the better.
- Feed your baby on demand, not on a schedule. In the first week after birth, your baby will ask to breastfeed every two to three hours (or more often!), both day and night. Such frequent feeding helps to establish the production of breast milk.
- Take care of yourself. It's not always easy with a newborn, but try to rest whenever you can, eat right, and accept any help around the house or with older children that your loved ones can give you to fully focus on breastfeeding.
- Try expressing milk. If a baby is feeding frequently but not gaining any weight, a lactation consultant or doctor may recommend pumping to increase breast milk production. If milk is not coming out at all, you can try the Medela Symphony Dual Electric Clinical Breast Pump**. It features an Initiate program that mimics a baby's natural sucking rhythm for the first few days.
Problem #4.Breast full and heavy
Your breasts will become fuller and heavier as milk comes in.
If the baby suckles well and often, this should not cause any problems. However, in some women, the breasts become so full that they become hard and painful. This condition, called breast swelling, can cause discomfort. The swollen chest seems to be “burning”, now all the activity of your body is concentrated in it, resembling a busy traffic at rush hour. Fortunately, this condition usually resolves within 24 to 48 hours. However, due to the swelling of the mammary glands, the nipples can become flat and the baby may have difficulty latch-on. 5
- Feed your baby often. Try to breastfeed at least 8-12 times a day. This is the main way to alleviate this condition. For more tips and tricks, see the article on Breast Swelling. 6.7
- Call your healthcare provider, if symptoms persist for more than 48 hours, you have a fever, or your baby is unable to breastfeed because of swelling.
Problem #5. Milk is leaking
Breast leakage is very common during the early days of breastfeeding when milk production begins. Milk may leak from one breast while you are feeding the other, when you sleep on your stomach, or when something accidentally triggers the milk flow reflex, such as when you hear a baby crying in a store. The leakage usually stops after about six weeks.
- Protect clothes from stains will help disposable or reusable bra pads to be used day and night.
- Don't waste precious drops! Breast milk collection pads* fit inside the bra and allow you to collect any leaking milk. This is a very useful thing when there is too much milk and the pads are not absorbing well, or when one breast is leaking while you are feeding the other. If you want to save the collected milk, use only the milk collected at the feeding. Place it in a sterile container and refrigerate immediately if you are not supplementing with it right away. Collected milk must be used within 24 hours. The breast milk collection sleeves should not be worn for more than two to three hours at a time.
Problem #6. There seems to be too much milk
Sometimes when milk comes in, too much is produced! In the first few weeks there may be an overabundance of milk, but usually everything returns to normal soon. 7 Up to this point, the breasts may be heavy and sore almost all the time, even immediately after a feed, and a lot of milk may leak. A strong flush can cause a baby to cough or choke, vomit immediately after a feed, have tummy discomfort, or have hard, frothy, greenish stools. These are all signs that you are having too much milk, but the problem may resolve itself as your breasts get used to the new function.
- Express some milk by hand at the start of each feed to ease the force of the flush.
- Try to feed while leaning back: this will help your baby control milk flow. The "cradle" position is also good: hold the baby obliquely by the shoulders so that the head can lean back slightly while on your arm. The torso of the baby will be located diagonally on you.
- Be kind and patient. Let your baby rest and absorb milk both during and after feeding. Don't move your baby too much or too fast, as this can make him nauseous. As the baby grows, he will learn to better cope with the rush of milk, which is likely to weaken anyway.
- Use the towel or swaddle to soak up spilled milk if the baby can't handle the flush, and place the breast milk collection pad on the other breast to catch any spilled milk.
- Contact a lactation consultant or doctor if problems persist after a few weeks . He will examine you and may suggest one-sided feedings or hourly breast changes (“breast duty”) to reduce your milk supply.
Related materials: Difficulties in breastfeeding in the next few weeks and problems with breastfeeding after the first month
1 Wagner EA et al. Breastfeeding concerns at 3 and 7 days postpartum and feeding status at 2 months. Pediatrics . 2013: peds -2013. - Wagner I.A. et al., "Breastfeeding Problems at Days 3 and 7 of a Baby's Life and Type of Feeding at 2 Months of Age". Pediatrix (Pediatrics). 2013:e865–e875.
2 Pang WW, Hartmann PE. Initiation of human lactation: secretory differentiation and secretory activation. J9 Mammary Gland Biol Neoplasia . 2007;12(4):211-221. - Pang, W.W., Hartmann, P.I., "Lactation initiation in the lactating mother: secretory differentiation and secretory activation." G Mammary Gland Biol Neoplasia. 2007;12(4):211-221.
3 Cadwell K. Latching - On and Suckling of the Healthy Term Neonate: Breastfeeding Assessment. J Midwifery & Women ’ s 2007;52(6):638-642. — Cadwell, K., "Latching and sucking in healthy newborns: evaluation of breastfeeding." F Midwifery Women Health. 2007;52(6):638-642.
4 Colson SD et al. Optimal positions for the release of primitive neonatal reflexes stimulating breastfeeding. Early Hum Dev . 2008;84(7):441-449. - Colson S.D. et al., "Optimal Positions for Provoking Primitive Innate Reflexes to Induce Breastfeeding." Airlie Hume Dev. 2008;84(7):441-449.
5 Jacobs A et al. S3-guidelines for the treatment of inflammatory breast disease during the lactation period. Geburtshilfe Frauenheilkd. 2013;73(12):1202-1208. - Jacobs A. et al., "Recommendations 2014;9(5):239-243.
7 Academy of Breastfeeding Medicine Protocol Committee. ABM clinical protocol # 20: Engorgement. Breastfeed Med . 2009;4(2):111-113. - Protocol Committee of the Academy of Breastfeeding Medicine, "AVM Clinical Protocol No.