Baby Suddenly Refusing the Breast or Bottle: What to Do

Strike or weaning?

A nursing strike is a sudden refusal of the breast in a baby who was nursing well, usually after about 3 months. The baby may arch, cry and push away, yet still seem hungry. Babies rarely wean on their own before 12 months, and self-weaning happens slowly, not overnight. Most strikes last 2-5 days, sometimes longer.

Common triggers

• Pain: teething, an ear infection, a sore mouth or thrush.
• A blocked nose that makes it hard to breathe while nursing.
• A bite followed by a startled reaction from the parent.
• Distraction at 4-6 months, when the world gets interesting.
• A change in milk flow or taste: lower supply, a period, a new pregnancy.
• A new soap, lotion or perfume, or stress, travel or a change in routine.
• Lots of bottles with fast flow.

Getting back to the breast

• Keep the baby fed: offer pumped milk or formula by cup, spoon or paced bottle while you work on it.
• Pump or hand express whenever the baby would usually nurse, to protect supply.
• Offer the breast when the baby is drowsy, just waking, or in a warm bath together.
• Try lots of skin-to-skin without pressure to nurse.
• Nurse while walking, rocking or swaying, or in a dark, quiet room.
• Try a different position, including laid-back or one where the baby is more upright.
• Don't force or hold the baby to the breast. Stop if they get upset and try later.
• Treat what's treatable: saline and suction for a stuffy nose, a pediatrician visit for ear pain.

Biting

Calmly unlatch with a finger in the corner of the mouth and pause the feed briefly. Watch for the end of active sucking, when bites usually happen, and offer a teether before feeds.

Bottle refusal in a breastfed baby

The combination feeding guide covers basic bottle tips. If those haven't worked: - Have the bottle given by someone else, with the nursing parent out of the house. - Try at a sleepy, calm time, not when the baby is very hungry. - Change one thing at a time over several days: nipple shape, milk temperature, position. - From about 6 months, skip the bottle: an open cup or straw cup works for many babies. - Babies in childcare often drink less and reverse cycle, nursing more at night and evenings. That's normal if the baby is growing and has wet diapers.

Bottle-fed babies who refuse

Look for a cause: nipple flow too fast or slow, illness, teething, or a pressured feeding routine. Let the baby lead the pace and stop when they turn away.

When to check in

• See an IBCLC if a strike lasts beyond a few days or supply is dropping.
• See the pediatrician if refusal comes with fever, ear pulling, mouth sores, or wet diapers dropping below about 4-6 a day.