Is Baby Weaning or Is It a Nursing Strike?

by Nancy Mohrbacher, IBCLC

Your baby has been nursing well for months, then suddenly begins refusing the breast. What does it mean? Is there something wrong with your milk? Is baby sick? Is baby ready to wean?

When a baby refuses to breastfeed, it may not be because he or she is ready to wean. If the baby is younger than a year and has not been eating much solid food or drinking from a cup, the most likely cause is a nursing strike.

A nursing strike is a baby’s way of communicating that something is wrong, and many babies who go “on strike” are obviously unhappy about it. Some nursing strikes come on suddenly, others more gradually. But a nursing strike does not have to mean the end of breastfeeding. If a mother encourages her baby to continue breastfeeding, a nursing strike usually lasts between two and four days, although some last longer. With lots of patience and persistence it is almost always possible to convince the baby to go back to nursing, which offers many benefits to both mother and baby.

POSSIBLE CAUSES OF A NURSING STRIKE

Sometimes the cause of a nursing strike is obvious, but other times, the mother may never discover the reason. Some common causes include:

  • mouth pain from teething, injury, cold sore, or a fungus, such as thrush,
  • an ear infection, which may cause pressure or pain while nursing,
  • pain while being held in the nursing position, perhaps due to an injection or an injury,
  • a cold or stuffy nose that makes breathing difficult while nursing,
  • too many bottles, overuse of a pacifier, or frequent thumbsucking, which may also lead to a reduced milk supply,
  • regular distractions and interruptions while nursing,
  • a strong reaction to a baby’s bite,
  • yelling or arguing while nursing,
  • overstimulation, stress, or tension from an overly full schedule or an upset in the home,
  • an unusually long separation from mother,
  • a major change in routine, such as moving or traveling,
  • limiting and/or rigidly scheduling feedings,
  • repeatedly putting off the baby when she wants to nurse or leaving her often to cry.

Becki Hallowell from Guam discovered on the third day of six- month-old Todd’s nursing strike that “we had all the usual causes and then some. We all had bad colds. (Todd’s was the worst.) We were all very tired and in a new situation with extra stresses. Todd’s grandparents, whom we hadn’t seen in a year, were visiting us for a month. During their visit, Grandpa ended up in the hospital. There had also been two deaths in our family within a week of each other only a few days before. Todd had been biting me due to teething, and I had reacted strongly.”

Other, less common causes of a nursing strike include: sensitivity to a food or drug the mother or baby has ingested (including vitamin or mineral supplements and fluoride drops), creams or ointments applied to the mother’s nipples, change in the taste of the mother’s milk due to a breast infection, and a reaction to a new product (such as a soap, shampoo, or laundry detergent) the mother has used on her body or her clothing. Iowa mother Carol Strait had to play detective to find the reason for her two-and-a-half month old daughter’s nursing strike. “My first clue was that Christie always seemed fussier and wouldn’t nurse when we went somewhere. This was because I had just showered and applied spray deodorant. I’m not sure what ingredients in the spray were responsible. My big problem was easily solved by simply switching from a spray to a solid stick deodorant.”

Naturally not all babies will respond to all of these possible causes by refusing to nurse. Some babies are more sensitive than others, and different babies will display a wide range of reactions to the same thing. For example, one baby with an ear infection might continue nursing well, while a second baby becomes fussy at the breast, and a third baby refuses the breast altogether.

AN UNHAPPY TIME FOR EVERYONE,

No matter what its cause, a nursing strike is upsetting for everyone. The baby may be unhappy and difficult to calm. The mother may feel frustrated and upset and worry that her baby is rejecting her. She also may feel guilty, believing that her baby’s refusal to nurse means she has done something wrong.

Anne Monroe from North Carolina, whose daughter Meghan went on a five-day nursing strike at eight months, “felt terrible grief and rejection during the strike.” Victoria Schnaufer from Pennsylvania, who weathered a ten-day nursing strike with her son Jonathan, says, “Until Jonathan went through a nursing strike at eleven months, I had no idea how emotionally stressful and physically draining this challenging breastfeeding situation could be. By the third or fourth day I was extremely frustrated and was becoming angry.” Carol Strait found her mind racing when two-and-a-half month old Christie began refusing the breast. “A thousand thoughts ran through my mind–I must be eating the wrong foods, maybe she was teething, I was probably too nervous (what nursing mother wouldn’t be nervous when her new baby suddenly refused to nurse?), perhaps she was weaning herself–and even the fearful thought that she didn’t like me!”

There are also physical considerations. As the baby misses feedings, the mother will soon become uncomfortable as her breasts fill up with milk. If her breasts become engorged, she will be at risk for a plugged duct or breast infection. And the baby still needs nourishment. Worries about how to feed the baby can add to the mother’s upset.

KEEPING MOTHER AND BABY COMFORTABLE

While the mother is trying to persuade her baby to take the breast, she will probably need to express her milk about as often as her baby had been nursing. This will keep her comfortable, prevent plugged ducts, and provide her baby with the milk he or she needs.

Expressing milk by hand or with a small breast pump is a learned skill that takes practice to master. If a mother whose baby is on strike is having difficulty expressing her milk, another option is to rent a full-size electric breast pump (available at many medical supply houses and drug stores). The full-size electric pump does not depend upon skill or practice to be effective, because its suction- and-release mechanism automatically mimics the suck of a breastfeeding baby. A double-pumping attachment is available with this type of pump that allows both breasts to be pumped at the same time, cutting pumping time in half.

Then the mother needs to decide how to give her expressed milk to her baby. Most mothers think of bottles first, but it may make it easier to convince a baby to go back to breastfeeding if bottles and pacifiers are avoided during a nursing strike. Artificial nipples satisfy the baby’s urge to suck, decreasing the desire to nurse. In some hospitals in Africa, bottles are never used. Even premature and ill babies are fed from small cups. If the baby is already drinking from a cup, try offering the expressed milk in that. Other feeding methods include spoon, eyedropper, and feeding syringe. Using a different feeding method may be messy at first, but with patience and practice, a baby will usually master it quickly.

The mother also may be concerned about whether her baby is getting enough milk. To set her mind at ease, she can keep track of her baby’s wet diapers. At least six to eight wet cloth diapers per day–five to six disposables–indicate that the baby is receiving enough fluid.

GETTING BABY BACK TO THE BREAST

Patience and persistence are the keys to getting a baby back to the breast. But if either mother or baby become frustrated when the breast is offered, it is time to stop and try again later. Attempts to breastfeed should be kept as pleasant as possible, so that the baby will associate nursing with positive feelings.

The following time-tested suggestions have helped many mothers overcome a nursing strike.

  • Try nursing when the baby is asleep or very sleepy, such as during the night or while napping. Many babies who refuse to nurse when they are awake will nurse when they are sleepy.
  • Vary nursing positions. Some babies will refuse to nurse in one position but take the breast in another.
  • Nurse when in motion. Some babies are more likely to nurse when rocking or walking rather than sitting or standing still.
  • Nurse in an environment that is free from distractions. Some babies, especially babies older than three months or so, may be easily distracted. Turn off the radio and television, and try nursing in a quiet, darkened room.
  • Give the baby extra attention and skin-to-skin contact. Focused attention and extra touching are comforting to both mother and baby. When offering the breast, whenever possible undress to the waist and clothe the baby in just a diaper. A baby sling or carrier can help keep the baby close between attempts to nurse. Taking warm baths together can also be soothing. Sleeping together provides extra closeness and also provides more opportunities to nurse while the baby is sleeping.

Sharon Stauffer from Ontario, Canada, “realized that I had been very busy with a new responsibility and had not given a lot of attention lately to my baby. Ten-month-old Sheldon is usually a very contented child, willing to play nicely by himself, so I unconsciously ignored him. He became more irritable and demanding and he stopped nursing. When I understood what the problem was I immediately laid aside all my other work and for two days played with him and held him a lot. After a while, he let me cuddle him again, and then he nursed while he was asleep. Finally, after three days, he nursed while he was awake and more often, as he had before.”

Monica McMaken from Arizona, whose son Ryan had a stuffy nose and went on strike at two months, found two suggestions especially helpful. “First, I nursed Ryan while he was sleeping, but if he woke up he would stop. Second, I tried nursing him while walking up and down the hall. If I sat down he would stop nursing. My arms sure were sore, but I was so happy to have my baby nursing again.”

Viola Marshall from British Columbia, Canada, blamed her son Keegan’s nursing strike on the three-to-four-hour schedule recommended by the hospital. Keegan spent many hours crying while Viola watched the clock. With the benefit of hindsight she wondered, “How many hours could have been saved for us both if I had given up the schedule!” The most helpful advice came from her husband, “who convinced me to nurse Keegan when he wanted, and not to use ‘fillers’ like apple juice in a bottle or a pacifier in between our scheduled nursings. Nothing changed overnight; it took three days of devoting myself totally to Keegan and trying to nurse him whenever he cried. The first two days he refused to nurse during the day, and I manually expressed my milk, feeding it to him by cup and spoon. Fortunately, he nursed willingly and happily in his sleep. Once Keegan’s nursing strike was over and the schedule was forgotten, nursing became less tense, more comfortable for both of us, and the time never became important again.”

Lee Roversi from Connecticut, who had been feeling overwhelmed by her son Sky’s “seemingly constant need to nurse,” had a change of heart when his erupting eye teeth made nursing painful for him and he went on strike. “We spent the next two days in almost constant touch– holding, reading, cuddling, bathing together, rocking. Thankfully, he would nurse in his sleep during the night and that, along with hand- expressing some of my milk, kept my breasts from becoming uncomfortably full. When his strike ended and he asked again for ‘nanas’ I knew that I had regained my perspective. All else could wait–indefinitely–while I treasured the moment.”