Even if you have a baby who adamantly rejects nursing, getting your unsatisfied baby to breast is very possible but it will probably require time, patience, and kangaroo-style frequency. Expect “two steps forward and one step backwards.” You must know how to handle them.
Follow the Rules
The two primary rules when you have a baby who is having problems nursing are:
- Feed the baby. A baby who is getting the right amount of calories and nutrition is best able to learn how to nurse. The first choice for what to feed a non-nursing baby is mom’s own milk, the second choice is banked milk from another mom, the third choice is infant formula.
- Maintain milk supply. If mom’s milk supply is being maintained with an appropriate frequency and amount of milk expression, more time is available for baby to learn to nurse, and baby’s efforts will be better rewarded (with more milk).
Suggestions for a typical nursing session
- Very careful, supportive positioning can be very helpful when baby is having problems breastfeeding; for example, a cross-cradle hold or a modified football hold can be useful.
- If your baby is tolerating it, then work on latching for up to 10 minutes or so. If baby is getting upset, then go with shorter sessions. It’s not a good idea to keep trying for more than about 10 minutes – after this baby will be tired, latching will be harder, and there is a risk of baby developing an aversion to the breast if you persist too much.
- Don’t continue trying to get baby to take the breast after major frustration (either mom’s or baby’s) sets in; stop for a bit and calm baby (and/or give mom a break) before continuing – let baby suck on a finger, or snuggle baby high up between mom’s breasts, or hand baby to dad.
- Sometimes it can be helpful to offer a little supplement at the beginning of a feeding; this can take the edge off baby’s hunger so he has more patience to work on the breastfeeding. If you’ve been working on latching and hunger is getting in baby’s way, go quickly to whatever alternative feeding you’re using. If you’re both totally frustrated, give a whole feed, but if you think your baby is up for it (and you are too), only offer enough supplement to calm him and go back to working on breastfeeding.
- If baby does not latch or does not suck effectively (or won’t sustain a suck for more than 3 sucks even with breast compressions), then either try supplementing at the breast or stop and offer baby a little supplement (1/2 ounce or so of expressed milk or formula), and then have another try at nursing. If the second try is unsuccessful, then go ahead and finish up the feed with whatever method of supplementation you are using.
- Any time that baby does not nurse at all, or nurses but does not soften the breast well, pump after feeding baby. This will help to maintain your milk supply, plus you will have some “liquid gold” available the next time baby needs a supplement.
Feed the Baby!
- Do not try to starve your baby into nursing. Your baby is not refusing to nurse just because he doesn’t want to and is being stubborn, so ignore anyone who tells you that “baby will nurse when he gets hungry enough.”
- In general, a baby who won’t nurse, can’t nurse. Your goal is to (hopefully) identify why baby can’t nurse and either remedy the problem, work around the problem, and/or preserve your milk supply until the problem remedies itself (sometimes necessary for ill, small or premature babies). A board-certified lactation consultant is a great partner to have in this process.
- Keep baby as full and happy as possible, i.e. continue to offer expressed mother’s milk, banked milk, formula or solids (if the baby is old enough), but gradually get closer and closer to the nursing position, skin-to-skin, etc.
Maintaining milk supply when baby is not nursing
It is important to express your milk to maintain milk supply while baby is transitioning to full breastfeeding.