Your baby has gone on a nursing strike? Here's what you can do
Breastfeeding is ideal for a baby. Mum's milk provides all the nutrients the infant needs in the first months of life, plus antibodies that help protect against infection and boost immunity. What's more, it strengthens the bond between mother and child.
Nevertheless, it can happen that the little one refuses to nurse - pushes away your breast, cries or screams. This can be very unsettling, and you may even get panicky.
"It often occurs in the third of fourth month of [the child's] life, or between the fifth and eighth," says Katrin Görtz, a paediatric nurse at the Oberhavel Clinic in Oranienburg, Germany.
The phenomenon has various names: breast refusal/rejection or nursing/breastfeeding strike.
There are many possible causes. Your milk may have an unpleasant taste because of something you ate or a medication you took. Or your baby might not like the change in your smell due to a new soap, lotion, perfume or deodorant.
The nursing position could be uncomfortable for the baby. So it might help to try a different one. The position should be comfortable for you too. If it makes you tense up, the baby may sense it, also become tense and not want to suckle.
Your baby should be as close to you as possible when nursing. Ideally, their head and spine should be aligned, not twisted, and they should be able to effortlessly latch onto your nipple.
Another possible cause of breast rejection has to do with the quantity of milk. "The baby sucks on the nipple, but not enough milk comes out," says paediatrician Tanja Brunnert. In this case, massaging your breast can help to get the milk flowing.
Sometimes the opposite is the problem: The mother's breasts are engorged and too full of milk, making it difficult for the baby to coordinate sucking, breathing and swallowing. By leaning backwards when breastfeeding, you can slow the flow of milk.
Your baby may not want to nurse because of an infection. Parents can take the little one's temperature to determine whether it's elevated. And they should observe the baby closely - frequently rubbing or pulling the ears can signal earache. When in doubt, you should take the child to a paediatrician.
"Sometimes breast rejection is due to overstimulation," says Sandra Uffelmann, head midwife at the Oberhavel Clinic. A developmental spurt may have sharpened your baby's perception of their surroundings, and they become distracted by music or siblings' chatter and laughter, for instance.
To solve this problem, you can retire with the baby to a quiet room with low lighting, cuddle for a while and then try nursing again.
Should all else fail, you'll have to pump or express your milk by hand and feed it to the child using a cup, spoon or dropper, for instance. Meanwhile, you should keep offering the baby your breast.
"If after two days the baby still won't nurse, the mother shouldn't throw in the towel and abandon breastfeeding prematurely," Brunnert advises. It's better, she says, to consult experienced midwives.
Some communities have "baby cafes" or "breastfeeding cafes," which are informal breastfeeding support groups. Nursing mothers who prefer individual consultation can directly contact a midwife or breastfeeding advisor.
Until help is found, Görtz tells mothers at their wits' end to "keep calm."
And, most importantly, they shouldn't blame themselves, says Uffelmann: "It not necessarily mum's fault when breastfeeding isn't working out."
