An OB Shares Her Patient's Questions About Breastfeeding

  • Is there a nursing strike? A "nursing strike" can occur if a well nursing baby, beyond the newborn period suddenly refuses to nurse. This can occur often after 4 months of age when a mother will state "my seven-month-old baby just suddenly weaned herself." These babies are not weaning but are actually facing a situation where nursing has become unpleasant, boring, or painful.

    • Often these infants need to be taught to return to a functional breastfeeding pattern with increased skin to skin contact, trying to nurse in a quiet, calm environment without distractions, such as nursing at night in bed. Bottles should be avoided but spoon or cup feeding with expressed milk is acceptable. If the underlying cause is treated, most babies will happily go back to their normal nursing pattern.
    • Is the baby getting sick? Causes of poor latch can be an undiagnosed ear infection, a urinary tract infection, or an upper respiratory infection. Check with your pediatrician to be sure an illness is not being missed. Maternal stress can also cause this problem.
      Regardless of the problem, it is important to remove the milk as efficiently as possible if an established supply exists to avoid engorgement which will lower or cause the milk supply to disappear.

      If the baby is not latching, it is important to stimulate the establishment of milk production through use of a pump.

    How do I Decrease Supply After I Wean?

    Weaning is the time the baby transitions away from the breast. Time frames for weaning can vary from weeks to months. Slow weaning is always more optimal. In this case you will drop the least sought-after feeding. A few weeks later you might substitute a meal for a feeding. Eventually your baby is weaned and your milk supply is minimal.

    Some mothers will use the pump for weaning and stop breastfeeding entirely. One option for weaning would be to reduce the time per pumping, ie instead of pumping for 15 minutes, reduce it to 10 minutes. This can gradually be dropped down to 2 to 3 minutes per session.

    An alternative way to wean is to increase the interval between pumping sessions, e.g. from every 3 hours to every 4, 6 or even 8 hours. If desired, one can use ice packs after pumping for comfort. Also, Motrin can be used for anti-inflammatory pain relief. A comfortable, tight bra can also help with support and relief. Nursing pads can be used to prevent excess leakage. A recommended herbal remedy can be drinking 3 cups of sage tea which is available in health food stores. It has a strong and astringent taste so adding honey makes it more palatable. Do not use this if currently pregnant since it has abortive action.

    On occasion, sudden weaning becomes necessary. Discomfort is generally greater since the breast continues to make milk and the breast remains engorged. Nursing can be replaced with pumping but only pump the breast to allow comfort and not to completely drain. Increase time frame between pumpings.

    Three days of Sudafed can help dry up the milk production. The milk supply decreases as you feed less. The milk quality also changes becoming more salty and colostrum-like which many babies do not like. Consequently, this also helps diminish the nursing.

    Dr. Brown, founder of Beauté de Maman, is a board-certified member of the American College of Obstetrics and Gynecology, a member of the American Medical Association, the Fairfield County Medical Association, Yale Obstetrical and Gynecological Society and the Women's Medical Association of Fairfield County. She is a magna cum laude graduate of Tufts University, completed her medical training at George Washington University Medical Center and completed her internship and residency in obstetrics and gynecology at Yale-New Haven Hospital. Dr. Brown has a busy obstetrical practice in Stamford, Connecticut and, as a clinical attending, actively teaches residents from Stamford Hospital and medical students from Columbia Presbyterian Hospital in New York.

    Copyright © Michele Brown. Permission to republish granted to Pregnancy.org, LLC.