by Anne Smith, IBCLC
You and your baby have been happily nursing for several months. You have overcome the common problems nursing couples have in the early weeks, such as sore nipples or engorgement, and things are progressing nicely. 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?
This abrupt breast refusal, usually in a baby between three and eight months old, is called a "nursing strike". It is possible that a baby younger than one year will wean himself, but it is very unlikely unless he is at least nine months old. A baby who is weaning himself will usually do it gradually, and will not be unhappy about it.
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.
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 -- see Medela products), or finger feeding system (Hazelbaker feeding system -- see Medela products). 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. Bottle-feeding 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.
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. See article on Teething and Biting for suggestions on how to handle teething pain.