Nursing Strikes

Babies and toddlers can go on a nursing strike for a variety of reasons. With babies under 6 months, one common cause can be if the baby has got used to the faster flow of milk from a bottle, or has been given lots of bottles in a row, especially if there bottles were given without being paced: https://youtu.be/OGPm5SpLxXY?si=5aFnap2U2qDD1l-X  

Older babies or toddlers might suddenly reject the breast if their mother has inadvertently cried out in pain when being bitten during a breastfeed. Their mother’s totally understandable reaction can spook the child and lead to them associating the breast with a scary experience.

Another common cause of a nursing strike is when a child has a sore mouth or throat, meaning that having milk or food in their mouth and/or swallowing causes them pain. Children who are teething, or unwell with illnesses such as tonsillitis or Hand, Foot and Mouth disease might refuse to breastfeed because of associating sucking at the breast with pain. Ear infections can also cause breast refusal due to pain when sucking and swallowing. And if a baby has a blocked nose, breathing while breastfeeding can be a struggle and this might put a child off the breast.

Occasionally babies or toddlers will refuse the breast if a mother is about to get her period as milk supply can dip temporarily and there might be a change in the flavour of the milk.

Nursing strikes can be upsetting, confusing, frustrating and extremely worrying for breastfeeding mothers. I’ve compiled a selection of posts by members of the Facebook groups NWL Breastfeeding and NWL Breastfeeding - 6 months and beyond who have experienced nursing strikes, and attached my responses, as well as those of other members of the groups, in the hope that they might be helpful to those going through this distressing experience, and also to give hope that when handled with sensitivity and patience, nursing strikes can be overcome.

Nursing strike due to illness

Chickenpox:

‘My 14 month-old is refusing the boob. He's got chickenpox (but nearing the end). His grandma has been here to look after him whilst husband and I are working. (He's been at nursery for 2months now). He's super upset when he sees me, fine briefly for a cuddle, but when I try to feed him he briefly opens his mouth then arches back and screams. I don't think this is due to illness/pain, I think it's upset/anger at being cared for by someone else and seeing me come in/out of the living room. I'm not too worried about dehydration as he took a bottle from dad (with me and grandma out of sight!). I just want to know if it will pass!’

Here's my response: ‘So sorry to hear your toddler is ill and now on a nursing strike. It may be that he has sores in his mouth that make sucking painful. He’s probably taking a bottle because it’s easier for him. I would suggest you keep offering the breast very gently (no insisting) and in the meantime do some pumping or hand expressing to protect your supply. Nursing strikes aren’t unusual with any illness that causes discomfort in the mouth or throat, so it’s likely he’ll go back to breastfeeding once he’s better. Keeping my fingers crossed.’

A week later I checked in with this mum: ‘Thanks for checking! Things are better now. I found that he was totally angry for a long time, until I took him for a sling walk, and then he forgave me. Breastfeeding seems to have been fine ever since.’

Babywearing and offering the breast in the sling worked well for this member too:

‘My baby went through a nursing strike that was much shorter but what broke it was carrying her in the sling all day; I used to sling feed a lot. Worth a try?’

Offering the breast first thing in the morning worked for IBCLC lactation consultant Stacey Zimmels:

‘My son had a nursing strike at 14 months when he had Hand Foot and Mouth. But at 12 months he was very uninterested in breastfeeding in general and I thought he was going to stop, plus he was biting a lot. He went back to the breast after about 5 days. In terms of the nursing strike I didn't offer other milk as he was eating and I just kept offering the breast. In the end he went back to it when he was feeling better after the Hand Foot and Mouth. What worked was offering the breast first thing in the morning when he was thirsty and wanting cuddles. The sleepy /middle of the night/first thing in the morning feeds were the first to come back. This was key to getting started again. You will need to continue to pump to keep up supply for when (hopefully) baby goes to the breast again. He went on to breastfeed until he self-weaned at 3 and a half years’.

Here’s a post by a member of NWL Breastfeeding who experienced a nursing strike due to Hand, Foot and Mouth disease:

‘Is there any chance my 13-month-old will return to breastfeeding after over a week of nursing strike? I’m in despair. It started due to Hand foot and mouth - he still has a cough. Am trying lots of strategies: trying when he’s sleepy, baths together, hanging out naked, but no luck. He doesn’t take breastmilk from a cup or bottle. He previously breastfed 7 times a day/night. When close he pokes at /blows raspberry on the nipple - it’s like he’s totally forgotten how to breastfeed. Latched for a millisecond whilst asleep. Feels a bit like we’re strangers sharing a bed. I’m now really worried that he won’t come back to it. I’ve tried to remain optimistic but other strikes people got over seem to have been shorter. Is there anything else I should try/do? He also just started nursery (2 days a week), and I start work next week. Awful times. He also isn’t really replacing fluids and nappies are wet but much drier than usual - not sure if I should worry about that.’

Here's what IBCLC lactation consultant Kathryn Stagg replied: ‘It can take a good week or two. Express some milk and use it in his food to keep your supply going. Keep offering but in a no stress "don't really care if you do or don't” way (I know this is easier said than done) and he should come back. Night times and sleepy daytimes are the most likely feeds to work. He's probably worried breastfeeding is going to hurt.’

Here’s another post by a mother whose baby went on a nursing strike due to Hand, Foot and Mouth disease:

My almost-13month old has Hand Foot and Mouth and stopped breastfeeding 4 days ago, which I think is now turning into a nursing strike. At the start he was trying to latch but couldn't due to pain, and would wistfully lay head on boobies, the next day just nibbling/biting (which I gently stopped him from doing), but now he seems just not interested, turns head away. He was off food and liquids but has now started eating a little and drinking again, which makes me think his mouth may not be so sore anymore (though he does have a cough), but still no breastfeeding.

I would appreciate any thoughts on the best way forward. Previously he would feed several times a day, feed to sleep, and feed several times on both sides during the night, co-sleeping - so all in all a big boob fan! In the past month he has been eating more solids and would sometimes go 5-6 hours without a feed in the day (but of course only 2-3 hours without a feed at night - hah).

 Should I be using some of the tactics suggested elsewhere to help encourage him back to boob (such as feeding when asleep, etc), or leave more time for him to recover, if needed? I will certainly try bathing together! I don't have much success with hand expressing, so haven't been able to express into his mouth (and it seems a bit pushy, if he doesn't want it?) At night he lays head on breast, but not interested in latching. I am wondering about the fine line between encouraging and putting off! (On the first day or two when he couldn't latch I got very engorged and had to stop him leaning on/poking my boobs because of the pain, and I wonder now if this episode has put him off somehow?)

Also, how much should I be pumping to maintain supply? At first I was very full but didn't pump too much as I didn't want to over-stimulate (thinking he'd be back to feeding soon), so was pumping just twice a day. But now am thinking I need to maintain supply, and ought to do more so there is decent supply if he does try to latch again? He has sipped small amounts of expressed milk from his straw bottle, but otherwise drinks water. He doesn't seem especially keen on the breastmilk, and previously only had it direct from breast. I hope he will come back to feeding, and just want to be sure I'm doing the right things to assist this. Thanks for any advice.’

This was my response: ‘I’m so sorry to hear that HF&M has led to a nursing strike. I would try all the recommended strategies (see the table at the top of this article), particularly offering the breast when he’s just waking up. I’m sure you will know how do it sensitively. Double pumping two to four times a day to maintain your supply would be a good idea.’

Nursing strike due to teething

‘My little one (9 months old) seems to be on a nursing strike since Sunday night. I was able express milk for her with a pump (about 750ml a day from 3 pumping sessions) and she is drinking it from a bottle before bedtime, in the morning and in the afternoon. She’s now teething, so the nursing strike may have to do with that. I must say that I was really worried at first because she’s not very keen on solids and breastmilk has been her main source of nutrition. She has in fact lost a bit of weight recently, although I’ve been breastfeeding on demand. I’m relieved that she’s happy to drink it with a bottle, but I wonder if the quantity is enough and if I will need to supplement with formula.

 Also, thinking ahead, I’m wondering if this goes on for a while will it have an impact on my supply? I understand that nursing stimulates the flow and supply more than expressing with a pump. And, in general I’m wondering if I can continue our breastfeeding journey like this and for how long? Have any of you ladies experienced something similar? Or, do you have any advice?’

Here's my response: ‘I’m sorry to hear you’re having this worrying experience. Nursing strikes need to be handled with care, but if they are, they can pass pretty quickly. I think you’re probably right that it’s linked to teething and as soon as that discomfort passes, it’s likely she’ll go back to the breast. Make sure when you offer the breast to do so gently and not try to force her in any way.  

In the meantime, you will need to pump from both breasts as often as she was breastfeeding, in order to protect your milk supply. You’ll also need to make sure you offer the bottle using the paced feeding method.’

Nursing strike due to mother screaming after being bitten

‘Nursing strike at 10 months! He is teething and drooling a lot and has two bottom teeth. He bit me earlier this week to which I screamed slightly and said ‘No’. For the last two days he is totally off the boob - sees it and starts crying and goes to his dad. Also had the return of my periods last week so don't know if that's related. To add to it he's never taken a bottle and won't drink milk in a sippy cup either, so really confused about what to do!’

Here are a some more responses from members of the groups:

‘We had exactly the same at 12 months, I really feel for you. Teething/biting, period came back, nursing strike, doesn't take bottle/beaker. It does pass but, in the meantime, try to hand express or pump every few hours to avoid problems (I didn't and got mastitis 😩). We did lots of skin to skin lying down in bed and eventually she latched and was back to normal. Hope it's settles, sending hugs.’

I’m so sorry to hear you are going through this. I went through a difficult strike with my daughter at 11months. She didn't go back to breastfeeding, but I did a lot of research at the time. There are stories of babies going back to nursing. From what I read it would most commonly happen spontaneously, at the baby’s lead and often when baby was in a more intuitive mood - sleepy/cuddly/wanting comfort. Also, people have found ‘disorientation’ can work. Might be easier with a younger baby. Things such as spinning on a chair and then coming to latch as you spin, or rocking in your arms standing and rocking ‘on to’ the breast. Some babies seem to feed if they don’t realise they’re going to and once they’ve latched again that seems to break the strike. I also just wanted to share that it can have a big hormonal impact on mums to stop nursing suddenly so be kind to yourself and try and ride any big emotional waves if you can. It can be tough to think a breastfeeding journey could end this way so give yourself a bit of time and space to be sad if you need to. You’ve done amazing getting this far. See if you can find any comfy cuddling/snuggle positions with your little one. This will be a good time to reconnect and may be a chance for her to initiate feeding again if she wants to.’

‘My son had a couple of longish (week+) nursing strikes around this age, linked also to similar triggers (biting, teething).What worked for us was a mixture of things:

• I would offer him a feed as he was falling asleep or when he was asleep. If he was going for a nap, I would cuddle him first rather than offer my breast first. He would happily latch on once he was sleepy. It eased any engorgement, and for those times he was a bit awake it helped remind him that feeding from me was a good thing.

• I continued to offer, and we spent a lot of time in bed where it was easy and relaxing to accept.

• I read the book “Teeth Are Not For Biting” over and over to him, and tried really hard to reinforce the positive behaviour, and not react if he bit me again. But that’s really tough, and I am sure I didn’t always get it right.

• I know other people have used other techniques like taking a bath together.

We got through his strikes - even though it seemed impossible at the time - and he continued to feed until he was over 1000 days, so it is possible. Sending good wishes.’

 Links:

Emma Pickett on nursing strikes:

https://thenaturalparentmagazine.com/its-like-a-switch-has-flipped-the-older-baby-nursing-strike/?fbclid=IwZXh0bgNhZW0CMTEAAR0aXf_wgWcrTJq5DIvLD-MQOZNrEawu1ytgjm3qCXVEwCSocTYZdZGfSRM_aem_HTpUUAY6C_YJdnNxB2DKRg

La Leche League: https://llli.org/breastfeeding-info/nursing-strikes/  

Kellymom: http://kellymom.com/ages/newborn/nb-challenges/back-to-breast/

 Breastfeeding Support: https://breastfeeding.support/how-to-get-baby-back-to-breast/