12 tips for when baby is refusing the breast

Sometimes breastfed babies refuse to breastfeed. This can be super distressing for mum! You might be feeling hurt and rejected, but your baby refusing the breast is not related at all to the special bond you both have. The good news is that refusal is usually temporary. There are many reasons your baby might be refusing the breast, and the truth is, sometimes we just never find out why.

Some common reasons are:

• Pain (e.g., teething, ear infection)
• Discomfort (too hot, uncomfortable position)
• Milk flow (fast and difficult to cope with, or slow leading to frustration)
• Poor latch (this leads to baby not getting enough milk or having to work very hard to get it – sometimes too hard)
• Developing a bottle preference (more on this later)

The severity of breast refusal and how you manage it is extremely variable. It can help to think about how many breastfeeds your baby has refused out of their usual amount over 24 hours. If it’s only 1 missed breastfeed out of 8, this is very different to 5 out of 8. It will also be important for you to keep an eye out for the signs to know your baby has had enough breastmilk. You can read about these signs here.

If your baby is showing the signs that they’re getting enough, trying the strategies below can help to encourage your baby back to the breast. If your baby is NOT showing the signs that they are getting enough milk, you may need to express your milk and offer it to your baby by cup or bottle while you work on getting your baby back to the breast. Please seek help from an International Board Certified Lactation Consultant (IBCLC) if this is your situation. You can book a home visit or online consultation with me here.

12 tips for when baby is refusing the breast

1. Stay calm

I know this is so much easier said than done, but it’s so important! Babies are very good at sensing your emotions and tension. If you’re feeling stressed and upset, your baby may feel uncomfortable and continue to refuse. Stress can also interfere with your letdown reflex (your flow of milk), and this can stress your baby out as well. Try hard to relax your shoulders, neck and jaw and relax with your baby.

2. Try and find the cause of baby refusing the breast

This is not always possible. Sometimes we never work it out. But if you can work it out, sometimes it can give you ideas on how to solve the problem. For example, if your baby has an ear infection, they may be uncomfortable lying on that ear or lying down in general and you can change your positioning. If your baby has been unwell, or you suspect they might be, have them checked over by your GP.

3. Skin to skin with no pressure to feed

Spending as much time skin to skin with your baby as possible with no pressure to feed can help reset your baby’s feeding instincts. Your baby might start to search for the breast all on their own. It’s really important not to force your baby to the breast or to open their mouth when they don’t want to. Feeling forced can be distressing for your baby and make the problem worse, developing into breast/feeding aversion.

4. Bath/shower with no pressure to feed

Many mums find that having a bath or a shower with their baby helps them both to relax. Again, no pressure to feed is the key here. Just spend some relaxing cuddle time with your baby and see what happens.

5. Keep chest a happy place

As mentioned above, it’s important not to force your baby to feed. That can really make things worse. Instead, try and keep your chest a happy place. If you’re attempting to feed and your baby is getting upset, try doing something else with your baby for a little while until your baby is more settled. Then when you go back to attempt another feed, try a different suggestion from this list.

6. Try different positions

Try a breastfeeding position that’s different from your usual breastfeeding position. This can help if your baby is in pain or uncomfortable or they are struggling to latch. Some mums find it helpful to try more upright positions, like laid back or koala positions, so it really feels different from what your baby is used to.

7. Offer when baby drifting off to sleep

Your baby will be relaxed and not fully aware of what’s going on. This can be a good time to offer the breast.

8. Offer dream feed

A dream feed is offering the breast to your baby when they’re already asleep. This works well for some babies because they’re relaxed and not fully aware of what’s happening and just follow their reflexes and instincts when the nipple is near their mouth and go on to feed. However, this just does not work for some babies. Once they’re asleep they may not wake enough to feed before they’re ready on their own terms. You will need to test to see if this works for your baby. If not, try a different strategy.

9. Offer when just waking up and still sleepy

For the same reasons as offering when your baby is drifting off to sleep.

10. Adjust the milk flow if necessary

If you have a strong/fast let down, feeding in a reclined position with your baby on top of you during the let down can help to slow the flow a little and make it more manageable and less stressful for your baby. If you feel your milk flow is slow and your baby is getting frustrated, you can try breast compressions to increase the flow and keep your baby interested. You can read more about breast compressions in this blog post.

Bottle preference

A common cause of breast refusal is a baby developing a bottle preference. Your baby may develop a bottle preference if there is a mix of being fed at the breast and bottle. This is often because they don’t have to work as hard to get the milk from a bottle. It flows from the teat without them having to even suck. Babies are clever little creatures, and will sometimes go with the easiest way, especially if they’re having a hard time latching well enough to get a good flow of milk.

If you think your baby is refusing the breast because they are developing a bottle preference, all of the strategies above can be used as well as those below.

11. Avoid bottle use where possible

You might find it helpful to offer the milk you would usually give in a bottle in a cup instead. You can read more about cup feeding here. If you prefer to keep using the bottle, paced bottle feeding can help to slow the flow of the milk and make bottle feeding a little less likely to be the easier way to get the milk. Find out to pace bottle feeds here.

12. Use nipple shields

Some mums find it helpful to use nipple shields as a technique to encourage a baby with bottle preference back to the breast. Nipple shields are a thin layer of silicone with a built in nipple shape that is placed over your own nipple when breastfeeding. This can be helpful in a bottle preference situation because the feeling of the silicone in your baby’s mouth is similar to a bottle teat, and they may be more likely to try and latch to that than the softer breast tissue.

Ideally, this is used as a temporary bridge back to feeding at the breast and the aim is to get rid of the shields after baby is used to feeding at the breast again, but some mums continue to use shields long term. There can be an impact on supply for some mums because the milk flow can be reduced through a nipple shield, so if you have tried to stop using nipple shields but your baby won’t feed at the breast, it’s important to get some help from an IBCLC to make sure feeding with the shields is going well and you have a plan for maintaining your supply.

Breast refusal, whether short term or long term, can be a really difficult, stressful and emotional time. Look after yourself as best you can in this time and seek support from family and friends to make other areas of your life easier where possible and get yourself some breastfeeding support from an IBCLC to help you and your baby get through this difficult hump in your journey.