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What to Do if Your Child
Refuses to Nurse By Felicia Hodges
Like many expectant mothers, Davida Dinerman of Massachusetts had every intention of breastfeeding her baby after delivery. She and her husband even went to breastfeeding classes while Davida was pregnant. But when daughter Abigail made her debut on the great stage of life, she just wouldn't nurse.
"Consultants came and went," Davida says. "We really gave it the old college try." And, even with the aid of a slew of lactation consultants, a week went by with no progress.
According to some medical experts, what Davida and Abigail experienced is not all that uncommon.
"There are several possible reasons that infants may appear to reject the breast," says Judy Hopkinson, Ph.D., a lactation physiologist at the USDA/ARS Children's Nutrition Research Center at the Baylor College of Medicine. "In the newborn period, most infants experience transient difficulties with latch-on. Many new moms think they are refusing the breast, but in reality, they are just having difficulty latching on."
Latch-on problems can be caused by the baby's inability to open his mouth wide enough, the baby's position during nursing or even the shape of the mother's breast and nipples.
"Engorgement changes the contour of the breast," says Denise Archambault, a registered nurse and lactation consultant at the Women and Infant's Hospital of Rhode Island. "It's like trying to palm a basketball and the baby [may have trouble] grasping the areola." As a result, babies may actually turn away from the breast out of complete frustration. Other reasons for breast rejection, including low milk supply, traumatic injury to baby during delivery (which could cause pain when baby lays on one side), baby allergies or congestion, nipple confusion (which can be a culprit if artificial nipples or pacifiers are used excessively in the first few weeks), breast engorgement, forceful let-down reflex or even stress, can change as baby matures.
One common cause that is often overlooked is that baby simply doesn't know what to do.
"He [may not] know what that thing is for," says Constance L. Tierno, R.N., a certified lactation consultant who coordinates the Family Life Services program at Shore Memorial Hospital in New Jersey. "If he was unable to nurse for whatever reason during the first few hours of life when it is instinctive to nurse, he may not know to root and go for the breast."