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Feeding Breastfeeding Common breastfeeding challenges

There are lots of reasons why your baby may be reluctant to feed. It doesn’t mean you aren’t doing a good job as a mum. Don’t put too much pressure on yourself to know all the answers straight away and speak to your midwife or health visitor if you have any questions or concerns, or are looking for ways to make feeding more comfortable.

How often should my baby feed?

All babies are different, but it's very common for babies not to feed all that much in the first 24-48 hours, and some don't attach at all. However, from day 2-3 days babies should become much more awake and feed in more frequent (but probably irregular) bursts at least 6 times in 24 hours.

How do I know if my baby's getting enough milk?

Photo of a baby breastfeeding

Breastfeeding at first can be really hard to get used to and you might find yourself wondering if your baby has had enough milk - it can be very hard to judge how much breastmilk your baby has had, but they are clever wee things and you have to have some faith that your baby knows whether it needs more milk. There are signs to look out for if you think your baby isn't getting enough milk.

Why are some babies reluctant to feed?

This happens most often when babies don't get skin-to-skin contact with mum soon enough or for long enough after the birth. Ideally, you want skin-to-skin contact with your baby straight away and for as long as it takes for your baby to want to feed. If you don’t have any complications, your midwife will help you get skin-to-skin with your baby quickly after they are born. Some reluctant babies are just too tired, sore, or sedated to feed after birth, and others can't because they are premature, ill or jaundiced.

What if I miss my baby's signs that they're hungry?

New mums sometimes miss or don't understand their baby's feeding signs – our page about learning your baby's cues explains what you should be looking for. Don’t worry if it takes a while to get used to when your baby wants a feed – it's something you are both learning together and it's baby steps for both of you. It's completely understandable to be worried about how much milk your baby is getting if they're not feeding in the early hours and days. It might help to know that babies are born with several days' supply of fluid and stored fat to get them by until they're ready to feed.

What's the solution?

Your midwife will check in on you to make sure your baby is well and to help you spot the signs that they're ready to feed – remember you can ask your midwife (in the hospital or at home) to help show you how to get in a comfortable position to help get your baby feeding. This video shows just this – very often all it takes is some help with positioning, skin-to-skin contact and a little patience!

Top tips to encourage a reluctant or sleepy baby to breastfeed

Tip #1: Hand expressing to keep your milk supply up

Start hand-expressing your colostrum – this is the first milk you make, and helps protect your baby from illness and infection. You can give this to your baby by syringe, spoon, dropper or cup. Expressing helps to build a good milk supply for when your baby is ready to feed. If this is your first time breastfeeding, it will take some time to get used to expressing your milk. You can find out more about expressing here. 

In the first couple of days you only make small amounts of colostrum so don’t become disheartened if it is difficult or takes time. It will get easier as each day and week goes by.

Tip #2: Try lots of skin-to-skin contact

Aim for lots of skin contact and being close to soothe your baby and give them the opportunity to feed.

Tip #3: Try to find a comfortable feeding position

Biological 'laid back' breastfeeding positions can help encourage babies to feed. Your midwife will be able to show you comfortable ways to feed. You can find out more about feeding positions here.

Tip #4: Get your baby ready for a feed

Massaging your baby's skin, changing their nappy and expressing a little milk for them to taste can help get your baby interested in feeding.

Tip #5: Don’t force your baby to feed

Don’t push your baby by the head or try to force them to feed as this could put them off completely.

Getting to know your baby

Learning your baby's cues

Signs your baby isn't getting enough milk

Refusing the breast

Looking after yourself with a newborn

The Scotland wide donor milk bank

This article was created as part of 

Last updated: 31 May, 2022


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:

  1. Keep your milk flowing
  2. Keep your baby fed
  3. 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.

Exclusive Expressing

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.

Baby steps

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

If the child does not eat well: what to do and what not to do

What to do if the child does not want to eat.

- Malyusik, well, one more spoon - and that's it! Last! I ate only two, let's have a little more, here's the most delicious piece for you! - says the average mother, offering a spoon with one hand, playing the accordion with the other, showing the trick with the disappearance of the handkerchief with the third, turning the cutlets over with the fourth, while doing somersaults on one leg.

Sound familiar?

Every dad has an instinct to bring home food, and mom has to feed the baby food. And if he refuses to eat, a signal is triggered - "I'm a bad mother" or "the child is sick."

In this case, the most important thing for a parent to understand is whether the child DOES NOT WANT or CANNOT eat?

If the baby is running around, having fun and looking good, without showing any signs of illness, then most likely he does not want to eat. There can be many reasons:

  • A breastfeeding child prefers milk and dairy products, intuitively understanding that he needs calcium, and now milk is healthier for him than soup.
  • The child wants a cookie, not vegetables.
  • He really wasn't hungry. For example, his metabolism is slow, breakfast has not yet been digested, and lunch is already being offered. Or the child was sitting in front of the TV after breakfast and his appetite had not yet had enough time to play out. Compared to the boy next door who was outside all day.
  • If a child is not genetically destined to become Uncle Styopa, then he can eat much less than his peer, who has tall parents.
  • Psychological problems. If earlier you accidentally gave your child a bitter cucumber, then he may refuse any green food. Or you yell at the child during the meal, and for him the food is perceived as a trauma.

If your child is lively, but at the same time he has a "bad appetite", then this is not his problem, but yours - the psychological problem of an unsatisfied instinct. If a child jumps, jumps, he has healthy nails, hair, etc., think less about what he lacks. Better think about something nice))

An active child = not a hungry child.

Wait for the natural desire and correctly distribute energy costs - walk more often, send the child to the sports section, or simply say: “If you don’t want to, take a walk, dinner is not earlier than seven and no snacks.” That is, if your child simply does not want to eat, normalize feeding - strictly at a certain time and without snacks. The body will get used to secrete gastric juice strictly according to the schedule.

And one more thing. There are no rules about how much a child should eat. He can eat a kilo (and make you very happy) and 9Send 00 grams to the toilet. Or eat 100 g and learn everything.

But it is much more difficult if the child CANNOT eat.

Causes:

  • If you are breastfeeding, you may have “tight breasts”, when it is very difficult for the baby to suck milk.
  • The child has a runny nose, and when he eats, he begins to choke.
  • Food hot, cold, sour, bitter.
  • He has sores in his mouth (for example, from toys), and they hurt when food gets on them.
  • Teeth are cut, gums hurt.
  • Bowel problems. The stomach starts to hurt while eating.
  • The child simply fell ill (cold, SARS, poisoning, influenza, etc.). If the child is sick, and he is not dystrophic, then you should not force him to eat. The body fights infections better when it's hungry. But be sure to drink.

If a child at first shows appetite and interest in food, but refuses to eat through a spoon or two, then, most likely, the process of eating causes him certain difficulties.

If the baby CANNOT eat and you can't identify or eliminate the cause, the best thing to do is contact your pediatrician. The doctor will accurately determine the problem and give the necessary recommendations.

Our clinic has a wonderful pediatrician Yuliya Vladimirovna Sinyagina with 17 years of experience! You can sign up to her))

Bon appetit everyone! As well as strength, patience and satisfied instincts!

Back to the list of articles

Why does the baby cry - articles from the specialists of the clinic "Mother and Child"

Bondarenko Margarita Gennadievna

Otorhinolaryngologist (ENT)

Clinic "Mother and Child" Kuntsevo,

I want to eat!

Most often the baby cries because he wants to eat. And to understand that he is hungry is the easiest way. At first, the baby shows concern, smacks his lips, turns his head to his mother's hand, stroking his cheek, tries to put his own fist in his mouth. All this means that there is very little time left before the hungry cry. Noticing such signs, you should not wait: feed the baby on demand. Otherwise, starting to cry, he will have to spend a lot of energy trying to calm down, and therefore, he will eat less and the next time he will get hungry again too soon. In general, for children who are breastfed, during the first month of life there is no clear feeding regimen. A newborn can be applied to the breast up to 10-12 times a day.

I want to sleep!

The next reason for screaming is, oddly enough, the desire to sleep. Many parents think that a baby can fall asleep anytime, anywhere, and even in almost any position. No, it's not like that - he needs help. How do you know if your baby wants to sleep? It's easy to guess. At first, he will behave restlessly, cry, push out the pacifier, rub his eyes, yawn. And then he starts crying. Here, too, it is necessary to try to calm the child as quickly as possible so that he does not disperse in crying, otherwise it will be more difficult for him to fall asleep. Rituals will help: you can shake the baby, sing a song, put it in the usual sleeping place.

I'm wet!

Crying can be a signal that the baby is uncomfortable: for example, his diaper is wet. Cold and wet, they irritate the skin, so he screams: “Mom, dad, change me quickly!” Crying about this is whimpering, incessant, although it sounds either stronger or weaker, it may be accompanied by hiccups, as the child freezes in wet diapers. If the diaper is changed, and the baby is warmer to cover, he will calm down. If the child is not in diapers, but in reusable diapers, you should not relax either: they can leak or get wet inside. So, the baby is also wet and cold. If the child sleeps in one diaper all night, then he may be disturbed by a greatly increased diaper volume. And of course, children do not like to be in dirty diapers (diapers): feces quickly irritate delicate skin.

I'm hot!

If the baby is hot, he will also cry about it. He will begin to whimper, scatter his arms and legs, his skin will turn red, a small red rash (prickly heat) may appear under his clothes. At the same time, the temperature of the baby sometimes even rises to 37.5 ° C. This is what saves here: the child must be undressed (and removed diapers, especially disposable ones), wiped with a towel moistened with water at room temperature, and allowed to lie in the air for several minutes. Then you need to dress the baby, but in other, clean clothes. In the fight against overheating and prickly heat, a reasonable amount of clothing and a comfortable room temperature - no higher than 24-25 ° C will help, first of all.

I'm uncomfortable!

The reason for the inconvenience can be any: the child may cry when the temperature changes, when changing clothes, changing the diaper or wiping his bottom with a damp cloth. Newborns feel more comfortable when they are dressed or wrapped in diapers, because the touch of air on the skin is not always pleasant for them. In addition, children often do not like to be changed, especially if it is winter and you have to wear a lot of clothes. There is only one way out: learn to act as quickly as possible, causing the crumbs a minimum of inconvenience.

A few words about clothes. It is better not to buy clothes with fasteners on the back and coarse seams inside - the baby may not like it. And sometimes even the slightest thread or hair caught between the clothes and the skin of the baby causes him great inconvenience.

I want attention!

Attention and tactile sensations are very important for a child. He loves to see the faces of his mom and dad, hear their voices, communicate with them. But so far, the baby cannot ask his parents to take him in his arms, read him a fairy tale, sing a song, play - but this does not mean at all that he does not need it. Therefore, crying, the baby wants to be paid attention to, requires communication. Do not worry that the baby will get used to the hands too much. While he is so small, he needs to feel a sense of security - it is this that will later help him gain confidence in his abilities. Well, different cradles, deck chairs, playpens, child seats will only help mom and dad free their hands and at the same time place their beloved child next to them.

Once you learn to understand your baby's “language”, you will see that the reasons for crying vary from case to case. A little time and patience - and very soon you will understand what the child wants, already from the first seconds of his discontent.

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to the doctor - Bondarenko Margarita Gennadievna

Clinic "Mother and Child" Kuntsevo

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