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How to cope with a nursing strike (and get your baby back to the breast!)

by Alissa Pemberton BSc (Midwifery), International Board Certified Lactation Consultant (IBCLC) & Holistic Sleep Coach

It's painful. Physically painful. Your baby is hungry. You put them to the breast, just as you've down thousands of time before. Except this time, they scream. They arch their back, push you away. The rejection hurts. You worry about them getting dehydrated, you worry about them getting enough food, you worry about your milk supply. Mostly you worry about why your baby who would feed perfectly happily until 24 hours ago suddenly screams at the top of their lungs when you try to do the one thing that is supposed to provide them with the most comfort. This, my friend, is a nursing strike. Nursing strikes can happen for a number of reasons. The reason might be obvious, or you might never figure out what's caused it. Some common causes are:

- reacting strongly to baby biting (shouting out etc.)

- a loud noise or scary event occuring while baby was breastfeeding

- pain from teething, oral thrush etc.

- overuse of bottles/pacifiers (particularly intense use over a short period of time prior to the strike).

- unusual smell or taste (if you've recently used a new perfume, or scented moisturiser or if you've eaten something strong which has altered the taste of your breast milk). Breastmilk can also alter in flavour when you start your periods or become pregnant again. - decreased milk supply (may occur temporarily when you begin your periods again or during pregnancy. Could also be to do with introduction of formula, or separation from baby without expressing to compensate for missed feeds).

If you can figure out what caused the nursing/breastfeeding strike then great. If it's pain, a product you've been using or the introduction of bottles etc. then you can work to eliminate this. Even if you can't figure out the cause, there are steps you can take to get your baby back to the breast. Step 1) BE PATIENT! This is going to take every ounce of patience you've got. It will feel like half a step forward and five steps backwards, and then suddenly it'll click. Nursing strikes typically last between 2-5 days, most being over within 7 days. It won't go on forever, providing you are doing the right thing to correct it. Step 2) Eliminate the cause (if you can) If you think your nursing/breastfeeding strike might have been caused by pain, a change in milk supply or taste/smell then start tackling this cause straight away. Get your baby assessed and treated for thrush, manage their teething pain, cease using any new products/perfumes, check if you might be pregnant. Try to limit bottles and pacifiers (particularly if you think this may have contributed to the nursing strike for your baby, but in general eliminating this confusion is a good idea). Step 3) Don't put any pressure on feeding Your focus initially shouldn't be on feeding. In fact the last thing you want to do is force your baby to feed. Offer the breast regularly, but without any pressure. Pretend like you don't care whether baby feeds or not. Try to have your breasts easily accessible. Lay with your baby on the floor with breasts exposed and try to encourage them to latch on while they're playing. Try offering a feed in the bath/shower. If they latch on, great! If they don't, just say 'Okay, we'll try again later' and continue playing. This will take every ounce of your strength, but it's REALLY important not to force baby to feed, the trauma of this will only prolong the nursing strike.

Step 4) Express to maintain your supply The last thing you want is to finally encourage baby back to the breast only to find your milk supply is in the toilet. While baby isn't feeding, express as often as they would normally feed. Try to use a hospital grade pump if you can, or a good quality electric pump. Express both sides each time (even if baby would sometimes only take one). You can hire hospital grade pumps for short periods if you do not have your own pump.

Step 5) Look after baby's nutritional needs If your baby is <6 months:

- offer them all available expressed milk. If your baby is <3 months then cup or finger feeding are good options. For babies over 3 months cup feeding is a great idea. A doidy cup is a slanted top cup which can be used very effectively with young babies from 3-4 months. If baby will not take milk from a cup or finger feed then give it to them in a bottle. It's important we make sure baby is getting sufficient nutrients. Continue attempting cup feeds, and make sure you're also using paced bottle feeding techniques (more on that here) For a full guide on cup and finger feeding click here If your baby is >6 months: Offer them solids as normal Offer sips of water with meals from an open cup or sippy cup (whatever they are used to drinking out of). If your child will drink well from an open cup or sippy cup then use this as a means for them to take their milk. Offer expressed milk at intervals throughout the day via an open cup or sippy cup. Offer them whatever expressed milk you've got available. They may not take it from a cup at the same times of day they'd normally feed from you. Of any age: - keep an eye on babies wet/dirty nappies. If you notice any significant changes here contact a healthcare or breastfeeding professional for assessment and support. You can contact Alissa Pemberton IBCLC here

Step 6) Make the breast a happy place again. We want to 'write over' the painful or unpleasant association your baby has with the breast, by introducing positive 'breast time' outside of trying to get your baby to feed.

Try: - taking a bath together - spending time skin to skin - bedsharing (following safe practices) with your breasts exposed - wearing baby in a sling/carrier - lots of cuddles! Step 7) Shake it up! Particularly for babies who have had a scary event cause a nursing strike (like you shouting out when they bit you, or a loud noise/something frightening them while feeding) they may have developed an association with the location or position you usually feed them in. Try changing feeding positions, feeding in a different room, lying down to feed if you usually sit up (and vice versa), feeding in a carrier/sling, offering a feed in a warm bath. Creating distraction works well so try holding baby just near the breast while standing and bouncing/dancing round the room. Almost all babies experiencing a nursing strike will eventually return to the breast within a few days. If you're struggling and need support then get in touch with us here for a no obligation phone call.

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