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Expert Q&A

	By Ann Calandro BSN, RNC, IBCLC Lactation Consultant

I have a 6-month-old son who I have nursed frombirth. He has never been given formula, and will not take a bottle with breast milk in it. (OK with me.) For the last 2 months, nursing hasbecome very difficult because he pulls away after only a few minutes ofnursing. He pulls away and cries and refuses to latch back on. I've spokenwith two pediatricians. One believes it to be a "habit," and doesn't have anything else to say about it. The other believes it to be a common problem occurring between the 4th and 6th months. This second doctor thinks it occurs as a result of intestinal pain. His advice was to nurse as long as possible and then just stop until the next feeding time. He stated that the baby was getting more milk than I realized and as long as he was hydrated I should not worry.

My baby is a very efficient nurser, of that I am sure. I weighed him after a couple weeks of the pulling away and he had gained weight so I felt better. However, it is very frustrating for me and him. I am almost in tears half the time and he is a wreck. It happens about three or four out of the five times I nurse each day. I've read everything I can get my hands on and tried it all – nothing seems to work and I don't want to give up breastfeeding. Just curious as to whether you had any helpful advice, please. Thank you very much.

My goodness, this pulling away must be frustrating for both of you. Itisalso very hard to say why this is happening without observing the baby atthe breast and also without getting more history from you. Sometimes babiesact like this when mom has a very forceful letdown. The milk comes down sorapidly that it is overwhelming for the baby, and baby pulls back. Anotherpossibility could be that the baby has thrush or some kind of discomfort inhis mouth that causes him pain when he nurses. Take a good look for whitepatches on the tongue and gums. Still another possibility could be allergy.If there is something in your diet that is causing the baby to havediscomfort from your milk, you could try eliminating dairy products (thenumber one offender) from your diet and see if he settles easily on thebreast. You would need to remove all dairy -- milk, cheese, ice cream andanything that has dairy in it for 2 weeks and then look for a change inbehavior. Also, read labels to see if there is dairy in other foods you eat.Sometimes if the label says whey or casein, it is also milk. Hope one ofthese ideas will help!

Ann Calandro, RNC, IBCLC"

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