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Breastfeeding and nursing strikes

You and your baby have been happily nursing for several months. Suddenly, he begins refusing the breast and seems quite unhappy about it. Is he weaning? Is he sick? Is there something wrong with your milk? It could be a nursing strike. Certified Lactation Consultant Anne Smith has some tips to get you through it!

What is a nursing strike?
This abrupt breast refusal, usually in a baby between three and eight months old, is called a nursing strike. Nursing strikes usually only last a few days, but may last for a week more. It is not always easy to discover what is causing the breast refusal, and sometimes the cause is never found. Many mothers choose to wean during a nursing strike, especially if their baby is older than six months, but most of the time, babies can be encouraged to return to breastfeeding within a few days. This requires patience and determination on your part, but is well worth the effort.

Nursing strikes are frustrating and upsetting for everyone involved -- mother, baby, dad, and siblings are all affected. Your baby will be unhappy and it may be difficult to calm him down. You may feel that he is rejecting you, and also may feel guilty, thinking that your baby's refusal to nurse is due to something you have done wrong. This is rarely the case.

You may also be uncomfortable physically. If your baby skips feedings, your breasts will fill up with milk, and you may become engorged and/or get plugged ducts. If your baby is only a few months old and not eating solids, you will also worry about whether he is getting enough to eat, and how to feed him if he continues to refuse the breast.

What you can do
While your baby is on a nursing strike, you will need to express your milk as often as he had been nursing previously. If you are unable to use hand expression, don't own a good electric pump, and if the strike continues for more than a few days, you may want to consider renting a hospital-grade electric pump until he decides to nurse again. Expressing your milk regularly will help prevent problems with engorgement or plugged ducts, provide breastmilk for your baby during the strike, and maintain your supply so that when he does return to the breast, an ample quantity of milk will be there for him.

During the strike, you will need to decide how to give the milk you express to your baby. It may be easier to get him back on the breast if you avoid bottles and feed him via cup, syringe, dropper, SNS (Supplemental Nursing System -- a tube feeding system that attaches to your breast) or finger feeding system. These last two options are usually reserved for situations where nursing is postponed for long periods of time, which is not usually the case with the average nursing strike. Bottlefeeding with a rubber nipple may satisfy your baby's need to suck, making him less likely to want to nurse. This is especially true with younger babies. Believe it or not, even newborns can be cup-fed. Feeding with a syringe or dropper can be messy, but with a little practice, most babies will get the hang of it fairly quickly. Causes
There are many causes for nursing strikes. These include:

  • Mastitis. Your milk supply may decrease after a breast infection, and the sodium levels may rise, making the milk taste salty. These are temporary problems, but your baby doesn't know that.
  • Teething. Some babies respond to the discomfort of teething by wanting to nurse more often, while others will refuse to nurse at all.
  • Illness. If your baby has a stuffy nose, a cold sore and ear infection, or thrush in his mouth, nursing may be uncomfortable for him. If he has an ear infection, lying on his infected ear may be uncomfortable. Try nursing him in an upright position or the football hold to avoid pressure on the affected ear.

    If his nose is congested , ask your doctor about ways to unclog it (usually saline drops, nasal aspirator, humidifier, or he may recommend medications to decrease the production of mucus). Anytime a baby's mouth is uncomfortable, whether the cause is teething or thrush, bottlefeeding is usually more comfortable for him. Don't feel rejected if he will take a bottle, but refuses the breast.

    The mechanics of breast and bottle-feeding are quite different, and drinking from a bottle requires less effort and less mouth movement than nursing does. This is one reason that it is preferable to use another method to feed your expressed milk to your baby during a nursing strike, rather than bottles. However, if giving a bottle is the only way to get your baby to eat during a strike, don't stress about it too much. Most babies will go back to the breast after they feel better, even if they have had a few bottles.

  • Reaction to stress. Some babies will respond to negative stimuli by refusing to nurse. This stress may be due to siblings who vie for mother's attention during nursings, a change in environment (such as travel to a new place or moving to a new house), a mother's overreaction to being bitten or severe stress in your life (divorce, death in the family, etc.)
  • Prolonged separation from mother. Sometimes a baby will refuse to resume nursing after mom has left him for a weekend or longer.
  • Low milk supply. This can be caused by long intervals between nursings, overuse of bottles or pacifiers, or an illness in the mother. This can cause a Catch 22 situation -- your supply is low, so your baby won't stay on the breast long enough to build it back up; because he doesn't nurse long enough, your supply doesn't increase.
  • A change in the taste of the milk. Applying creams or ointments (other than lanolin especially formulated for nursing mothers, which is odorless and tasteless), use of a new product such as shampoo or deodorant, and rarely, something in your diet (such as dairy products or excessive caffeine) can cause babies to refuse the breast.

Read more on the next page!

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