Lactation Nursing Strikes: When Your Baby Refuses to Nurse

It is common for older babies to go through phases when they refuse to nurse. We call these phases nursing strikes. The good news is that they typically don’t last more than a few days, so don’t give up! It is important to determine the root cause and then develop a plan to address the cause. If you aren’t sure, a lactation consultant can do an assessment to help you determine the root cause as well as help you create a plan to maintain your milk supply and return to nursing. Let’s take a look at the most common culprits of a nursing strike.

Low milk Supply

Babies sometimes lose interest in nursing when supply dips, especially if they have access to bottles, solid foods and other liquids. Milk supply is directly related to demand. If your baby is not nursing often enough and you are not pumping when they skip feeds, your body will slow milk production. Your baby may lose interest in a slower flow or smaller feeds. 

Night weaning can contribute to low milk supply. Lactation hormones are higher at night and help to maintain milk supply. Going long periods at night without moving milk teaches your body to downgrade your milk supply. The protein called FIL (feedback inhibitor of lactation) is present when milk doesn’t move out of the breast frequently enough. It sends a message to your brain to slow milk production. The key to decreasing FIL is to move the milk out more frequently with the  baby or pump.

A new pregnancy may contribute to low milk supply. Most nursing parents notice a dip in their supply during a new pregnancy. Supply may increase towards the end of pregnancy when prolactin increases and milk is converting to colostrum. Milk composition changes with pregnancy and sometimes babies don’t like the new taste of the milk.

Menstrual cycles may contribute to a dip in your supply. Some women may experience a dip in supply from ovulation through the menstrual period. Blood calcium levels can dip during this time and is believed to contribute to a dip in supply. Taking a calcium-magnesium supplement during this time can be helpful.

Medications may contribute to low milk supply. Have you started any new medications? Check with the Infant Risk Center to see if they may be having an impact on your milk supply.

Babies are easily distracted the older they get. They want to see everything that’s going on in the room. They want to get down and practice their new milestone skills. This can lead to shorter feedings. Offering more frequent feedings during these phases will help keep your supply up. Stay flexible and nurse on cue. You can also try eliminating distractions and nursing in a quiet dark room.

Illness or teething

Your baby may have an ear infection, stuffy nose or mouth soreness caused by thrush. Your baby may have sore gums from teething. Short, more frequent feedings during this time may be helpful. Feeding in a more upright position can sometimes be helpful. Replace nursing sessions with paced bottle feedings or syringe feedings to keep your baby hydrated.

Too many other liquids or solids

Some babies are voracious eaters of solid foods. They may be filling their bellies with solid foods and are not hungry when it’s time to nurse. If they are combo feeding and getting bottles of formula, this may be filling them up. It takes 3-4 hours for formula to fully digest and your baby may not be hungry when we next offer a nursing session. If we are not pumping when we offer a bottle that also contributes to low milk supply.

Overactive let-down

Sometimes mom has a great supply or an oversupply and a really forceful ejection reflex. In this case, your let-down may just be a lot to manage for a newborn. Babies will gulp, gag, take breaks, fuss and back away from the breast. To help your baby deal with a forceful let-down, you may try laidback breastfeeding or feeding your baby in a more upright position such as the koala hold. You can also, wait until the let-down occurs, catch the letdown with a towel or a milk collector and bring your baby back to breast after the flow slows down. If you think you have an oversupply, your lactation consultant can help you carefully reduce your supply.

Bottle Flow Preference

Babies getting a lot of bottles can sometimes develop a preference for the flow of a bottle and refuse the breast because the milk isn’t coming out fast enough. Bottles give babies an immediate reward of milk where the breast requires a little patience for a let-down. Read more about bottle preference here. Using paced bottle feeding techniques, slow flow nipples and mimicking the wait for a let-down when offering bottles can help reduce bottle preference.

Nursing Strike Solutions

Don’t give up! If you continue to offer, nursing strikes normally do not last beyond a few days. Offer the breast frequently, and pump to protect your milk supply until your baby has resumed nursing. If you have a newborn, read my blog, “When Your Baby Doesn’t Latch”.

Spend lots of time cuddling skin to skin when you are together. Stay in when you can, keep your baby close and give them lots of access to nursing until their nursing strike is over. Skin to skin time is good for bonding and naturally encourages nursing behaviors.

Try to nurse your baby immediately after they wake or while they are sleeping. Babies are in a more primitive state of mind while sleeping and just after waking. They are more likely to nurse in a sleepy state. 

Avoid pacifiers,  while you are together to encourage sucking at the breast

Cut back on extra liquids. Talk to your lactation consultant or doctor about the appropriate amount of solids and milk your baby should be drinking at their current stage. Avoid letting your older baby carry a sippy cup or bottle around between feedings. Help avoid future nursing strikes by offering the breast before solid food meals. Milk should be your baby’s primary nutrition throughout the first year. Be careful not to replace nursing sessions with solid food feedings.

Increase your supply by pumping. Pump to replace missed feedings and do some extra pumping for 3-5 days to increase your milk supply and improve your milk flow. Power pumping once per day for 3-5 days can effectively increase your supply. This method involves pumping for 20 minutes, followed by resting for 10 minutes, pumping for 10 minutes, resting for 10 minutes and pumping for another 10 minutes. This process takes an hour total, so get comfortable, cue up your favorite series and relax.

Think about your schedule. Are you going too long between feeds overnight? Is someone giving the baby a bottle overnight or is your baby sleeping through the night? Depending on your baby’s age, they may still need night feedings for growth and development. If your baby is older and sleeping through the night with no growth issues, add a dream feed or a pumping session right before you go to bed to improve your milk supply. Nurse first thing in the morning to close the gap between milk removal. 

Stay flexible during a nursing strike and know that these typically do not last more than a few days. If you want help determining the root cause of a nursing strike, contact a lactation consultant. An IBCLC can help you form a plan to maintain and improve your milk supply, ensure your baby is getting the right amount of nutrition and coax your baby back to nursing sooner. Schedule a telehealth consult with me here or contact me at glile@nourishwell.online. 

GEORGINA LILE IS AN IN-NETWORK PROVIDER FOR AETNA and also accepts many Blue Cross Blue Shield, Cigna, and United plans through Lactation Network.

Many PPO plans cover up to 6 visits with an in-network lactation consultant if you need support with breastfeeding or a prenatal breastfeeding class; with no out-of-pocket cost to you.