More babies are starting life with nature’s perfect food: breast milk. The Centers for Disease Control and Prevention report that 75 percent of American newborns are now breastfed. That’s good news. Breastfeeding has amazing benefits for both mom and baby. But when a happily breastfed baby starts putting up a fight at every feeding, it brings anxiety and drama into an otherwise peaceful relationship.
Nursing resistance and nursing strikes — brief periods when a baby resists or refuses breastfeeding — are frustrating, disheartening, and stressful.
Most babies will go through a phase of fussy nursing as some point, says Dr. Susan Rothenberg, associate director of Obstetrics at Beth Israel Medical Center in New York.
Nursing resistance is commonly misinterpreted, says Rothenberg. Moms often blame dwindling milk supply, but that’s usually far from the truth.
“Once breastfeeding is well established, inadequate supply is rarely an issue, but a very common misconception,” she explains.
It’s also easy to assume that a baby is ready to give up nursing, but successfully breastfed babies under 1 year old seldom self-wean. Instead, says Rothenberg, a baby who resists or refuses nursing may be reacting to common, treatable conditions: hyperlactation, a slow letdown reflex, discomfort, or changes in the mom’s diet or hormone levels.
Hyperlactation is the result of an overly strong milk letdown reflex that causes milk to flow too quickly and forcibly for a baby to comfortably swallow. According to lactation consultant and registered nurse Laura Burnett, nursing supervisor at Texas Health Harris Methodist Hospital, hyperlactation can overwhelm a nursing infant, sending them into a sputtering, coughing tizzy.
How to help: Burnett suggests nursing in a reclined position to relax both mom and baby. If an oversupply of milk is contributing to the problem, she recommends nursing on one breast per feeding. After a few days, the body will reduce its milk production to a more manageable level.
A slow milk letdown reflex can frustrate babies, particularly those who receive bottles, which provide instant milk gratification.
Babies will latch on momentarily, only to dissolve into a teary tantrum if milk doesn’t appear within seconds. A fussy baby contributes to mom’s stress and intensifies the problem.
How to help: While tactics like gentle massage, heat, hand expression, or pumping can help get milk flowing before feedings, they won’t resolve an underlying issue.
“It’s important to explore reasons for a slow letdown,” says Burnett. Returning to work, changing a nursing routine, or starting new medication are factors that can contribute, she says.
A slower-than-normal letdown reflex is often a sign of stress or distraction, notes Rothenberg. Her advice: “Take time to relax, ignore the chores piling up, and focus on your special bond with your baby.”
You may not feel up to eating when you’re experiencing pain or tummy troubles, and your baby is no different. Teething, earache, nasal congestion, or mouth pain caused by thrush can make nursing difficult.
Occasionally, a baby’s dairy protein sensitivity can lead to uncomfortable gas and fussiness at the breast. This is not lactose intolerance, says Burnett, but a sensitivity to milk proteins in the mother’s diet.
How to help: If you’ve ruled out other causes and your little one is still unenthusiastic about nursing, see a pediatrician to check for pain or illness. A dairy elimination diet can help relieve symptoms of dairy protein sensitivity, says Burnett, but it may take several weeks to see an improvement.
If you consume a varied, flavorful diet, your breastfed baby probably does, too. Breastmilk varies in taste depending on a nursing mom’s diet. Hormonal changes resulting from birth control, a resumed menstrual cycle, or a new pregnancy can also affect milk’s taste.
Most babies show no reaction to these changes. A few will voice their displeasure if a new taste isn’t to their liking, and temporarily resist nursing.
How to help: Taste variations in milk are generally temporary. If a baby has a strong reaction to a particular taste, eliminating the offending food should resolve the problem.
Feeding while baby is very sleepy, feeding in a warm bath, and skin-to-skin contact during nursing can help minimize resistance to breastfeeding during these changes.
Pump or hand-express to stay comfortable during nursing refusal. If you’re worried that your baby isn’t getting enough to drink, do a wet-diaper count. At least five to six wet diapers per day mean he’s probably taking in enough fluid.
Like most babyhood phases, nursing resistance is usually short-lived. And it has a silver lining: once you weather this minor breastfeeding storm, you’ll be rewarded with more confidence, patience, and a greater knowledge of your breastfeeding babe.
Malia Jacobson is a nationally published sleep and health journalist and author of “Sleep Tight, Every Night: Helping Toddlers and Preschoolers Sleep Well Without Tears, Tricks, or Tirades.”