Breast refusal – why it can happen and what you can do about it

Breast refusal can be heart-breaking for mums. It can feel like your baby is rejecting you and usually goes hand in hand with concerns about baby’s intake and growth. In this article, we’ll look at the WHY of breast refusal and offer some strategies to try out. 

Why is the baby refusing the breast?

It can be helpful to find out why a baby is refusing the breast in order to find a way to help them being happy at the breast again. Sometimes the cause is very obvious and sometimes you might need to see a Lactation Consultant to help you explore what’s happening and to get some strategies and mental support. Sometimes a cause can never be found. Luckily it’s usually a temporary phenomenon and mostly not a signal that baby is ready to wean.

Luckily it’s usually a temporary phenomenon and mostly not a signal that baby is ready to wean.

Sometimes, normal infant behaviour can be interpreted as breast refusal. The feeding pattern of a baby changes over time, as they get more efficient and may need to feed less frequent and/or shorter. Always check baby’s hydration level, are they are having enough wet and dirty nappies and are they alert and generally satisfied?

Reasons for breast refusal

The reason for breast refusal can be baby-related, mother-related or supply-related.

Baby-related

• Early days and weeks: i.e. related to birth trauma, rough handling, engorgement
• Anatomical variations: i.e. tongue tie, cleft palate
• Nipple confusion; bottle, nipple shield or dummy
• Developmental stage: Distracted (usually around 4 months), wanting mums full attention
• Baby’s mood: Overtired, overstimulated
• Unwell baby: i.e. Cold, blocked nose, ear infection, teething, immunisations, reflux, thrush, food sensitivity
• Solids: Too much solids / too early
• Hot weather: Being too hot and find skin-to-skin contact uncomfortable

Mother-related

• Overtired or overstressed
• Nipple variation; flat or inverted nipples can make it more difficult
• Different smell; i.e perfume, soap, deodorant, or salt or chlorine from swimming
• Different appearance; new hairstyle, wearing glasses (yes, really!)
• Different taste in breast milk; change diet/medication, mastitis, contraceptive pill, period, pregnancy

Supply related

• Fast milk flow and multiple strong let-down
• Slow let-down or low supply

It’s important to say that those situations happen a lot and definitely do not always lead to breast refusal (and they are not always preventable).

And now: what to do?

The most important thing is to stay calm and patient. But, I know…easier said than done…

It’s usually a vicious cycle: Baby refuses the breast, is hungry and frustrated, mum gets upset, baby feels her tension and is getting more upset and definitely not taking the breast anymore.

I hope the following strategies will help you feel more in control, less stressed, and help baby back at the breast. If not, you can think about asking a Lactation Consultant to address any other issues and for some love and support.

Trial & error

Not everything works for everyone, just give it a try:

• Attempt feeding when baby is just waking up or when nearly
• Different place; usually a dark bedroom is a good one
• Different positions; try them all to see what works for you. Usually a good one with breast refusal is feeding while you are standing up and bouncing or walking
• Humming/singing/some relaxing background music
• Baby massage
• Having a bath together and try feeding in the bath
• Clear your agenda for a few days and have a lot of time skin-to-skin ‘full access & no pressure’
• When baby latches successfully it can help to give breast compression to keep the flow going.

The first time you try something new it doesn’t always work, try a few times and see if there’s improvement. Some mums like to keep a diary with things that worked/didn’t work and to see if there is progress over the days.

Keep your baby fed and protect your supply

If nothing seems to work, there is also a time to stop trying for that session. Keep your breast a happy place, so if one of you is getting desperate, give it a break. You can give your baby some expressed milk with a tube feeding device or bottle and express to protect your supply and have something in the fridge for next time.

Keep your breast a happy place, so if one of you is getting desperate, give it a break.

Sometimes you can give a small amount per bottle and offer the breast again. The little break can help you to feel up to it again and when baby isn’t that hungry anymore he might be easier to latch.

If you give a full bottle feed it might be nice to have skin-to-skin cuddles with your baby afterwards, again, to have a positive experience at your breast/chest.

Don’t forget about self-care because IT’S HARD!!