Why won't my baby breastfeed?

Baby refusing to breastfeed? Mama of five, midwife and lactation consultant Stephanie Callaghan-Armstrong, shares a few common reasons why. 

Photography: Catherine Smith

Breastfeeding is journey, hopefully a beautiful one, but one thing is for sure it will be full of unknowns. You can plan the itinerary, yet you’ll find it takes its own unique path for each baby you have.   

One of the unexpected turns in the road is what we call a breastfeeding strike. It’s when baby all of a sudden stops latching and feeding. It can be very distressing, scary and bewildering for both you and the family, as baby is hungry and inconsolable, and your breasts become uncomfortably full without being emptied, putting your supply at risk.

Firstly let’s troubleshoot the reasons why babies may strike suddenly. I do want to reassure you that it’s usually short-lived and reversible and there are many ways to approach getting baby breastfeeding again! Ask for help from a professional promptly too because maintaining your milk supply is important.

Babies don’t usually abruptly wean, especially when very little.

Strikes usually happen when feeding is well established, so it can sometimes be confused with thinking baby does in fact want to suddenly wean. But usually a feeding strike is about baby telling you something isn’t feeling right for them.

TEETHING PAIN

Teething can be a cause of quite severe oral discomfort for a baby, that can start around four months (even before any teeth come through). Their gums and mouth hurt and it’s likely worsening with suckling, so feeding becomes associated with pain.

Fresh little baby teeth also may mean pain for mama, maybe baby bit your sensitive nipple and you scared your little one with a scream or saying no loudly and they associate that with being on the breast now.

SICKNESS

Is baby unwell? Viruses may mean baby may be unable to breathe well while suckling if their nose is blocked. They could also have painful ulcers in their mouth or just feel unwell and don’t want to suckle.

MILK SUPPLY

As you continue along your breastfeeding journey your milk supply can change. Maybe baby is frustrated by a decreased supply, especially if they are also having bottles of faster-flowing expressed milk or formula if mixed feeding, and are protesting about having to work harder for it on the breast.

Sometimes this happens when mum goes back to work and another caregiver feeds baby a bottle. Or in contrast, you could have an overactive let-down and they find keeping latched on while the milk is flowing out very fast overwhelming.

TASTE

A new pregnancy or even ovulation returning can also affect the milk taste and supply, causing baby to refuse it.

NIPPLE CONFUSION

Nipple confusion also can be a cause, even with older babies who start mixed feeding on teats or increased use of dummies.

TONGUE TIE

Maybe if it’s earlier in the breastfeeding journey baby could have another reason for not breastfeeding, such as a tongue or lip tie or oral thrush.

SCENT

Have you done something as simple as changed your deodorant or washing powder? As crazy as that sounds, baby could have an aversion to it or it makes them react as if it’s not a familiar thing.

STEPH'S TIPS

Whatever the reason (and sometimes you may never know what the cause), here are some tips to get baby back feeding on the breast.

Firstly, don’t panic. I often get panicked messages and phone calls from mums who are unable to latch baby, and stressing can make the situation worse as milk flow decreases when you are stressed.

Try your best to be calm and remember this situation is usually temporary.

The most important next step is to maintain your milk supply. If baby isn’t latching, milk needs to be removed as it sends a message to your brain to release hormones, to keep making milk at the same volume (supply and demand). If feeds are missed or less is removed, your supply may drop which can make the situation harder. There is also a risk of mastitis and engorgement if you don’t breastfeed or pump, which is an added complication you really want to avoid. Get a good breast pump and pump in place of feeds.

If you can, plan some at-home days together. Skin-to-skin is the best way to connect with baby and calm you both. Sometimes a warm bath together or feeding skin-to-skin in the dark or low lights where it’s more relaxing, can work wonders.

If you need to give baby milk another way while you sort the strike out, try a sippy cup, straw or bottle depending on their age.

If your supply is low or latching is suddenly tricky, under the guidance of a professional, you could try a nipple shield or feed line to increase the ease of latching and getting milk instantly off the breast.

Some other recommendations are to ‘go cold turkey’ and hold out until baby gets really hungry and eventually they will latch. If you are mixed feeding with bottles, it’s also a good idea to remove these to get baby exclusively back on the breast and undo any nipple confusion.

Sometimes dropping milk into baby’s mouth with a syringe, right by the breast, can help coax them back into breastfeeding. One mum I remember working with, had experienced a week of baby not latching before she contacted me. She was so upset and had almost resigned herself to not being able to continue to breastfeed. We went straight to building up her supply and doing skin-to-skin with bottle feeding. After a few minutes of suckling she ‘tricked’ baby by slipping the nipple into her mouth and voila, it worked!

Try different feeding positions as well. If you have very full breasts, express a little first to get the milk flowing and help baby latch on. Try ‘laid back’ feeding, which is where baby lies on top of you, or lay baby on their back and try latch by having your breast available above them.

It’s a good idea to also see a doctor to check if there’s anything painful in baby’s mouth or ears. Pain relief like paracetamol or ibuprofen can help make baby’s mouth comfortable or try some teething remedies.

If you think baby might have had an injury or you think there is pain in baby’s neck or jaw, consider an osteopathic appointment. I’ve seen success stories with body work also for things like ear infections or tightness in the jaw or recovery from tongue tie release. 

If you’ve been bitten by baby, you have my sympathies! Being bitten is certainly painful and it’s hard not to react. The best way to stop baby doing it isn’t to yell, but to firmly say no in a low voice and put baby down away from you for a moment. If this has happened, skin-to-skin is wonderful for building bonding and trust again.

If milk supply is low, expressing using a breast pump can work brilliantly. Double pumping is the best way to increase prolactin, and levels are highest during the night so best to express around the clock. Natural supplements such as blessed thistle capsules or fenugreek taken as directed can be beneficial also.

Eat well, increase protein in your diet (smoothies are great), and add plenty of whole grain carbs and calories. Probiotics are good for restoring gut flora in both you and baby, and can naturally treat or help prevent thrush, as well as help gut discomfort and digestion.

Watch your diet for foods that can create wind in baby or that may have a particular strong taste or odour, such as garlic. You never know if something like that has caused the aversion. Reducing food intake to lose weight or exercising a lot can affect supply. Ask a professional to help you so you can maintain your milk supply well during this time.

Try and feed with no perfumes, deodorants or creams applied to your skin. If you’ve changed your washing powder consider changing it back to see if that makes a difference. Baby’s sense of smell is heightened to help initiate and establish breastfeeding and the Montgomery glands around the areola (little bumps) secrete a sebum that attracts baby to feed. Releasing a little milk and massaging them to release the scent may help overcome any aversion.

Catch up with other breastfeeding mums to encourage and support you when you’re going through a struggle like this too. It makes a big difference to help you keep going rather than have family or friends say it’s time to give up. A few days of persistence and usually you’re on track again.

Keep going, stay calm and get help if you need it. I’m always available for advice if this ever happens to you, just reach out. Well done mamas, enjoy your breastfeeding journeys, you’re amazing!

Stephanie Callaghan Armstrong is a mum of five, experienced lead maternity carer, midwife and lactation consultant and also runs a breast pump rental and sales business with husband, Dr Mikey from The Barnstead in Coatesville. Find her at babymed.co.nz, @babylove.midwife.life and @babymednz on Instagram.