Expert: Sally Wendkos Olds - 6/20/2006

Question
I'm a first time mother and new to nursing. My son is now 11 weeks old and been fussing, pulling off screaming and not wanting to nurse unless he is ready to fall asleep, for the past month now. When I know he should be hungry. I never really felt it when my milk came in and, never ever leak. Also I have some trouble with letdown. I don't know what the problem is. I tried, my mother tried, giving him breast milk in the bottle and also formula and he freaked out even more. I spent 70 dollars on bottles and different nipples nothing worked. I hate making him so upset, I cry along with him some of the time. I don't know if it maybe low milk supply. Please help everyone I talked to is no help. I tried warm compresses, massaging, manually pumping. Thank you for your time look forward to a reply.

Answer
Dear Krista,

First, congratulations for giving your son the best start in life by breastfeeding him!

I'm sorry to hear of the problem you are having, and I can really empathize with the upset you are feeling. It's hard for me to know what's going on without more information. I'm including in this message an excerpt from my book (see below) which discusses this kind of problem. If none of these measures works, I suggest that you contact a lactation consultant who can see your baby's behavior and make suggestions. To find one, you can contact the International Lactation Consultant Association (email to info@ilca.org) who can refer you to someone in your area.

Good luck!

Sally

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.
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THE OLDER NURSING BABY
Sometimes in the first few weeks after birth, but more often between four and ten months of age, a baby will nurse a couple of minutes, then arch his back and cry. Nothing the mother can do will induce him to go back, and yet it's obvious that he wants something. What's wrong? And what can you do about it? As with so many other childrearing issues, you have to look closely at your own baby and see what is going on in his life. The following suggestions have worked in some situations, and Box 15-10 lists several possible causes, along with some specific solutions.
  * If you want to continue nursing, don't start to give bottles now. Doing that may make the problem worse, and chances are that this "nursing strike" may last only a day or two, and your baby will then go back to being an eager nurser.
  * If your baby has begun to eat solid foods, increase her portions of these for a few days to tide her over. If she has been eating large amounts of solids, however, this may be causing the problem. She may be too full of food to be interested in nursing.
  * Express or pump your milk and give it to him in an eye dropper, a teaspoon, or a cup, until he resumes taking the breast.
  * Keep offering your breast. The most effective time to do this is to pick him up while he's asleep or very sleepy; he won't remember to reject the breast, and once he's back in the routine of nursing, he may decide it's pretty good, after all.
  * Vary your nursing positions. Your baby might prefer one you haven't used yet.
  * Nurse in motion -- in a rocking chair or walking around.

  
  BOX 15-10  WHEN AN OLDER BABY REFUSES THE BREAST
  * Has your baby turned against the taste of your milk? It may have changed because of a cream you're using on your breasts, a new food you're eating, a new medicine you're taking, a new strenuous exercise program you've begun, a developing infection in your breast, or because you may be pregnant. Explore these possibilities, one by one. Keep a log of what you eat and what your baby's reaction is, so that you can identify and eliminate an offending food. Schedule nursing sessions before exercise sessions, as suggested in Chapter 7. If you feel a lump in your breast, first treat it as a clogged duct; if it has not healed in a couple of days, see your obstetrician.
  * Is she teething? If her gums are tender from the pressure of new teeth coming in, it may hurt her to nurse. If she bit you, she may have been startled by your cry of pain and be afraid to nurse again.
  * Is he wildly hungry? If he can't seem to wait for the milk to let down, try picking him up about 15 minutes before you would ordinarily feed him, or express a little milk first to give your let-down a chance to work.
  * Does she have a cold? She may be having trouble breathing through her nose. Use a vaporizer in the room where she sleeps or ask your doctor whether nose drops would help.
  * Does he have thrush? This mouth infection, described earlier, can make nursing painful. If you suspect it, treat it immediately, first to relieve your baby and also since the infection can spread to you.
  * Does she have an earache? If so, she may find nursing painful.
  * Is your baby consistently refusing only one breast? If so, see your own doctor, since this may signal a medical problem that should be explored.
  * See the suggestions in the section "Helping the Older Baby Who Isn't Gaining."
  * Are you under tension? If you're going through a particularly difficult time emotionally, your feelings may be coming across to your baby, who in turn becomes too upset to nurse. Make a conscious effort to forget about your cares, at least while you're nursing. You'll enjoy these oases in your life and your baby may be calmer, too.
  END OF BOX