MY NEWBORN HAS NEVER REALLY GOTTEN THE HANG OF NURSING. HOW CAN I GET HIM BACK TO THE BREAST?

 

There are many reasons why a newborn may be reluctant to nurse. If your baby is past the newborn stage, please skip to the section on Getting an older baby back to the breast below, you may also find our resources on nursing strikes helpful.

 

If your newborn is not latching on to the breast, is too sleepy to take his first feed or needs medical attention, you can ask your health care team to show you how to hand express and give your colostrum by teaspoon or syringe. Your baby may sleep for a few hours after this first feed – feel free to cuddle him and wake him if you want to feed. He may feed four to five more times in the first 24 hours.

 

You can begin expressing colostrum within the first few hours after birth. You may be comfortable using hand-expression or you may prefer to use a pump.

 

Colostrum is produced in small amounts but even the smallest quantity can be saved and given to your baby by spoon, dropper, or feeding syringe. As long as your baby is not latching on, it is important to express regularly in order to avoid becoming engorged and to keep up (or build up) your milk supply for when he does begin to nurse effectively.

 

GETTING YOUR BABY BACK TO THE BREAST TAKES PATIENCE AND PERSISTENCE

 

The following ideas might help:

• Try nursing when your baby is asleep or very sleepy, such as during the night or, while napping.

• Vary nursing positions. (Some babies will refuse to nurse in one position but will take the breast in another).

• Try feeding in a quiet, darkened room or a place that is free from distractions.

• Give your baby extra attention and skin-to-skin contact, which can be comforting for both of you. Babies often latch on and nurse more efficiently during and after skin-to-skin contact.

• When offering the breast, undress to the waist and clothe your baby in just a diaper/ nappy whenever possible. Use a shawl or blanket around you if the room is chilly.

• Use a baby sling or a carrier to keep your baby close between attempts to nurse.

• Take warm baths together to soothe you both and maximise skin-to-skin contact.

• Sleep together in order to provide closeness and more opportunities to nurse. See our post on sleep.

• Pump a little before putting him to the breast to get your milk flowing so that your baby gets an ‘immediate reward’. If your baby is having a problem latching on then pumping can also help to draw out your nipple, you can then transfer your baby and hopefully get him latched on – this can be useful if your nipples are flat, or your breasts are engorged.

• If your baby needs a supplement you can give it in a cup or syringe. A flexible medicine cup that is scrupulously clean can  be used to offer sips of expressed milk. The Womanly Art of Breastfeeding  lists a number of devices for supplementing a breastfed baby, which all apply to a baby who is transitioning to the breast. It states that bottles ‘can undermine breastfeeding’.

• Another way to eliminate bottles is to supplement at the breast. This has been helpful to some moms and babies transitioning from bottle to breast. For this you will need a nursing supplementer.

• If your baby has been used to feeding from a bottle, and is too hungry or agitated to take the breast at the beginning of a feed, you might find he is happy to do so after taking a small volume from a bottle first – enough to calm him. When your baby is calmer try to switch your baby to the breast. If he is used to a bottle, and completely refusing your breast, he may be willing to feed at your breast with a nipple shield. If you have been using a bottle for feeding you might find our post on nipple confusion useful.

• Another tool that mothers have found very helpful is breast compression. Put your baby to your breast and let him latch on and nurse. You’ll see the little fluttery sucks at first while he is waiting for the milk to let down, then his sucking will change to slow sucks and you’ll be able to hear him swallowing. That’s how you know your milk is flowing (also called “letting down”). When the milk stops flowing quickly, your baby may go back to the quick, fluttery sucks. Then you grasp your breast, with your hand well back away from the nipple, and squeeze and hold. You may see your baby goes back to slow sucks again, as your milk begins flowing quickly and he drinks your milk. Keep holding the squeeze until he goes back to flutter-sucks, then release the squeeze for a few moments, and repeat. You can continue breast compression, followed by releasing the compression, for the whole nursing session. Doing breast compressions can really help your baby get a lot more milk in a short time.

• You may find these pages on relactation useful too.

 

You can express your milk and feed it to your baby for as long as you need. Your local LLL Leader can offer support and more suggestions if these don’t seem to be working. Just having someone to talk to can often relieve stress and help you relax, which also will help your baby relax.

 

GETTING AN OLDER BABY BACK TO THE BREAST

 

There are a number of reasons why an older baby may have stopped feeding at the breast, or may never have fed at the breast. They include being adopted, being unable to nurse for medical reasons such as having a cleft palate, mother and/ or baby having experienced a long period of illness, or maybe mother and baby have had a long period of separation.

 

Sometimes a mother may regret her decision to stop breastfeeding and decide to relactate. You can find information about relactating here.

 

If your baby is beyond the early months, has been breastfeeding happily and stops suddenly this may be a nursing strike, you can read more about nursing strikes here.

 

If your baby has not been breastfeeding, ever or for a sustained period, it may take time to coax him to feed at your breast regardless of whether you have a good milk supply or not. Forcing your baby to your breast is extremely unlikely to work, it is more likely to cause your baby stress, and may result in him forming an aversion to breastfeeding. As your baby gets better at nursing and is able to get more milk at your breast, he will grow to trust that breastfeeding works and will have more patience when latching on.

 

Lots of skin-to-skin contact (baby in only a diaper against your bare chest) can help your baby nurse better and even gain weight faster. Keep your baby with you as much as possible, and give him lots of opportunities to nurse, don’t worry if you’re not successful at first, keep offering.

 

If you allow your baby to fall asleep, skin-to-skin, at your chest, you can catch his earliest hunger cues when he wakes again. If  your baby moves toward your breast and then falls asleep before even mouthing your nipple, or after sucking a few times, then these are positive first steps, not failures.

 

Carry your baby close to you (a sling or other baby carrier can help with this). “Wear,” carry, hold and cuddle your baby as much as possible; carry your baby on your hip while doing other things, play with your baby, and give him lots of focused attention.

Sleep near your baby. If he sleeps with you, you’ll get more skin-to-skin contact, plus give him more access to your breast. See our post on sleep. If your  baby is not in the same bed, have his cot/bed beside your bed or in the same room so that you can catch his early feeding cues, breastfeed easier at night, and get more sleep.

 

Offer your breast when he is not hungry. Try giving him most of his feeding by bottle and then switching over to breastfeeding.

If he is used to a bottle, and completely refusing your breast, he may be willing to breastfeed with a nipple shield.

 

The following approach works for some families. You will need an at-breast, or chest supplementer link to do this.

• Only mom feeds the baby (both solids and bottles).

• Baby is always held by mom when being fed.

• Don’t allow baby to hold his own bottle. If baby is used to holding his own bottle you may need to gradually get him used to you holding it. Put a sock over it so that it looks more like a piece of clothing than a bottle.

• When baby is comfortable with mom holding the bottle, and being held by mom while feeding you are ready to try the at breast supplementer.

• The first step is to thread the tube of the supplementer through the nipple of the bottle he usually takes, and feed him that. It may contain your expressed milk or a supplement.

• Next, move the bottle nipple over your own nipple.

• Once he is comfortable sucking on the nipple with the at breast supplementer over your nipple you are ready to try and move him to your breast. Toward the end of the feeding try and switch him to your breast.

• You may try to feed at first with the supplementer (even if you have a good supply) as baby may like the faster flow he is used to getting from the bottle. You can eventually wean your baby off the supplementer.

• Even if you don’t manage to wean your baby off the supplementer it is a lovely way to share a nurturing at-breast relationship with your baby.

• Read more about supplementers here.

 

*Parts of the contents of this page was generously supplied by La Leche League International