Expert: Sally Wendkos Olds - 4/14/2009

Question
I am exclusively breast feeding my 5 1/2 month old son. He goes to daycare so I pump while at work and he takes to his bottle very well while I'm away. He co-sleeps with me and nurses during the night with no issues. My problem is nursing him in the evening when I get home from work and before bed. He will push in on my breast with his hand on either side of my nipple while pulling out on my nipple with his mouth. It has become very painful to nurse him but I do not want to stop. I'm wondering why he's doing this and what I can do to stop it or should I just pump my milk in the evening and give it to him in a bottle. I was thinking this would be the route to go but I can't pump as much as he could drink directly from my breast. Any ideas?

Answer
Dear Diana,

First, congratulations for giving your son the best start in life by breastfeeding him! I would suggest dealing with the nipple-pulling problem the same way you would deal with a baby who bites at the breast. I'm attaching an excerpt from my book (see below) with suggestions for the biting issue, and I think you could do basically the same thing -- take him off the breast the minute he pulls out the nipple. Wait a minute and put him back to the breast. Let him nurse if he nurses normally but keep taking him off as soon as he starts the pulling routine. Babies are smart -- they can learn not to do this.

Good luck!

Sally
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Sally Wendkos Olds
Author, THE COMPLETE BOOK OF BREASTFEEDING: Eiger & Olds, 3rd edition 1999, published by Workman Publishing & Bantam Books, and available in most public libraries, bookstores & La Leche League chapters. Now in revision for a fourth edition, with pediatrician Laura M. Marks, M.D.
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BOX
How to Discourage Biting
A baby who is actively nursing cannot bite, since his tongue extends over his lower gum and if he bit down, he’d bite his own tongue. Babies are too smart for that! Biting happens most often toward the end of a feeding, or when a baby is about to fall asleep. Babies are smart: Once they realize that every time they start to bite, they get taken off the breast, they learn that this kind of behavior isn’t getting them what they really want, and they’ll stop. The following suggestions work well:
• As soon as your baby starts to bite down on your breast, withdraw your breast. Break the suction by inserting your finger in the corner of his mouth.
• As you take your breast away, look your baby in the eye and say “No” firmly but gently . Do this every time your baby tries to bite.
• Do not smile when you say this; your baby may interpret this as a game you’re playing. You might even look at your baby with a sad expression. Any baby old enough to bite can read facial expressions.
• One mother we know begins socializing her children by saying, “That hurts Mommy. We don’t hurt other people,” as she takes her biting baby off the breast. She repeats this same litany over and over again as her children grow into toddlers, providing a continuing way to teach them not to kick, hit, or do other hurtful acts.
• If your baby is teething, you can massage her gums with your finger, give her a cold washcloth to bite down upon just before you nurse her, and give her special teething toys. If she has begun eating solids, you can give her “biter biscuits” and bagels. (Be sure to watch her closely to be sure she doesn’t break off a piece that she can choke on.) If the baby seems to be in pain you can use an over-the-counter pain reliever like infant acetaminophen (Tylenol).
* Keep teething toys and soothers handy, so the minute he starts biting, you can remove him from the breast and immediately put the soother in his mouth.
• Try putting her down, walking away for a moment, and then returning to put her back on the breast. When you return, be gentle as you tell your baby “Be gentle.”
• If you can anticipate when the biting is likely to start, take your baby off your breast ahead of time. It’s counter-intuitive, but many mothers have found that pulling the baby closer works.
• If your baby keeps biting, keep your finger close to his mouth and watch him carefully; as soon as he stops nursing actively or looks playful, remove your breast.
• Or quietly say your baby’s name while drawing her close to you; this distracts her and gets her back to nursing.  
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