When a perfectly happily nursing baby refuses to latch onto the breast for more than two nursing sessions in a row, we call this a nursing strike. This is different from the similar-sounding problem of the non-latching baby who has never really nursed successfully, so head over to that blog if that better describes your current difficulty.

A nursing strike is different from self-weaning only because you as the mother are not accepting that baby is weaning… yet. Sometimes, strikes resolve and mom and baby can go on to nurse for months or years longer. Other times, after weeks of trying to get the baby to re-latch, mom must decide to accept that the baby has weaned and decide what steps to take next.

First and foremost, if your baby is refusing to latch…

FEED THE BABY, PROTECT YOUR SUPPLY.

Before we begin to explore why your baby may be striking, it is very important that we return to fundamentals. If your baby isn’t nursing, it is not a good idea to let your breasts fill and fill while you wait and try, hour after hour, to get him to return to the boob. First, letting your breasts get too full can cause a decrease in your milk supply and can lead to other problems, like plugged ducts and mastitis. Second, offering your baby a very full breast may not help your cause. Sometimes a big, full breast is want a stubborn baby wants. Other times, a full boob is scary and overwhelming and all the more the reason to refuse to latch on.

When it comes to nursing strikes I have bad news and I have good news. The bad news is that babies are very smart. They feel things about themselves and nursing that we may never understand. They “make decisions” and stick to them adamantly no matter what we want. The good news is that babies are also pretty dumb. Well, babies younger than four months are, at least. They still work largely on reflexes and instinct, not choice. Most of the “decisions they make” are not decisions at all, but a response to some kind of internal stimuli. They can often be tricked or coaxed back into doing what we want them to do.

There seem to be four main reasons why babies strike: physical, supply, emotional, and “we’ll never know.”

  1. Baby is experiencing something physical.

If your baby goes on a nursing strike, start by making sure there are no medical reasons why your baby is refusing to latch on. Give your baby a full head-to-toe assessment. Check every nook and cranny of your baby to see if anything seems awry. Get in to see the pediatrician ASAP to rule out things like ear infection, oral thrush, or acid reflux. Once, I had a baby go on a nursing strike because he had a piece of apple skin stuck to the roof of his mouth!

  1. Baby has beef with your flow.

If your baby has been having a difficult time managing your flow, he may have decided to quit fighting with the breast.

If you have a known forceful let down or you make too much milk, baby drinks very quickly when nursing and often coughs and sputters, and he may have gotten scared of the breast and decided to no longer latch on. If you think this is the cause, check out instructions for managing too much milk.

If you have been struggling with a low supply, baby may simply have decided that nursing is no longer worth all the hard work for such a small volume. It isn’t a nice thing to say, but unfortunately it is true. Babies are smart, especially when it comes to eating for survival.

If baby doesn’t feel like his belly is getting filled when nursing at the breast, he will turn to look for the bottle so he can have a full belly. Bait and switch or tube-to-the-boob can be useful strategies here.

Bait and switch is interchangeably offering the supplemental bottle and the breast. Ideally, the bottle is offered while still in the nursing position. Offer a little from the bottle, then a little from the breast.

Tube-to-the-boob means offering supplemental formula or breastmilk while the baby is nursing via a small tube inserted into the baby’s mouth. Medela makes a Supplemental Nursing System that can be used in this case. I rarely use this strategy except for in the case of a nursing strike because it can be extremely frustrating for parents. But for a baby who thinks direct nursing isn’t worth his time, offering more milk while he is sucking can be just what it takes to get him to reconsider his “choice to quit.” Here are some pretty good instructions (with videos) about how to get an SNS to work, but I recommend working with a good IBCLC if you are considering introducing the SNS to your breastfeeding relationship.

Babies who get multiple bottles per day when apart from mom have a chance of choosing the bottle over the breast. This may be because bottles are much quicker and easier at daycare, regardless of the volume in the bottle. Or it may be because baby is being given too much milk from the bottle at daycare than he gets from the breast and he becomes accustomed to a higher volume of milk than he truly needs. It may be because your number of pumping sessions isn’t matching your missed breastfeeding sessions and your supply has dropped.

Hopefully you have discussed with your childcare provider how to use the paced bottlefeeding method to decrease the likelihood of baby choosing the bottle over the breast. If you are pumping less volume than your baby is getting from a bottle, chances are that daycare is either overfeeding your baby or your supply is decreasing. A good rule of thumb is that baby needs and ounce to and ounce and a half per hour. If baby is eating every three hours, he should consume three to four-and-a-half ounces at each feeding. If you are pumping every three hours, you should express three to four-and-a-half ounces from both breasts combined.

Another way to gauge it is to take total daily intake divided by total number of feeds. Breastfed babies rarely eat more than 32 ounces in a 24-hour period. Most eat about 24 ounces per 24 hours, regardless of their age (crazy, right?). So, if your baby eats eight times a day when home with you all 24 hours, divide 24 by eight. Baby gets about three ounces per feeding and you should pump about three ounces per feeding.

It may be helpful in this circumstance to really limit bottles offered when mom and baby are together. It is really easy and convenient to give bottles outside of work hours when you are used to pumping and bottle feeding, but that sets the precedent with baby that bottles are a choice when with mom. It doesn’t mean you can never give a bottle during off hours, but it does mean you may need to only offer the boob for few weeks while home together.

  1. Baby is experiencing something emotional.

Baby may simply not want to nurse anymore. Maybe his feelings got hurt because you left for a long weekend. Maybe he got spooked when you yelped after he bit you. There is some speculation that babies can strike when there is a lot of turmoil in the home or shouting. There is some theory that babies can strike if they are placed on a strict feeding schedule or sleep schedule or are left to “cry it out.”

If your baby seems to be holding a grudge, you can try different strategies to coax him back to the breast:

  • Offer the breast in the dark so baby can’t see the boob coming at him.
  • Offer the breast as baby is falling asleep or as he is waking up, before he is aware of what is going on.
  • Offer the breast along with the 5 Ss. It can be a circus to achieve, but if you can bounce or walk while offering the breast, try that. Rely on the My Brest Friend pillow or try nursing in a wrap or sling so you can move and bounce while offering the breast. Use loud shushing to attempt to calm him so he can stop being so pissed and actually consider latching on.

Spend lots of time snuggling and skin to skin. I don’t suggest this one too often either, because a “nursing vacation” (as they call it) isn’t much of a vacation at all… especially if the little person you are on vacation with is screaming at you and batting at the breast. But, especially if you and baby have been separated for a long time, intense time together can help.

A word on “breastfeeding boot camp” or “starving the baby out”:  Some people out there will suggest you withhold any feedings until baby breaks down and returns to the breast. This often is also coupled with not pumping during that time in hopes that the baby will eventually nurse. This breaks the “feed the baby, protect the supply” rule. That said, there is some value in letting the baby and your breasts go a little longer than usual before offering a bottle and pumping. Four to five hours seems to be a reasonable amount of time to “hold out” without pumping or feeding without hurting your supply or being cruel.

  1. Baby has stumped us. We may never figure out why he went on strike or how to get him back on the breast.

Unfortunately, many nursing strikes end in baby weaning before mom is ready. After weeks of pumping to protect supply, mom must come to the heartbreaking realization that baby is not coming back to the breast. Then, she must make the difficult decision to keep pumping in place of breastfeeding or to start to wean.

Here is what I really want you to hear me say: This isn’t your fault.

You may have inadvertently done something to cause baby to self wean, but I am almost certain you didn’t do it on purpose. In fact, you probably did it out of necessity, desperation, or because you thought it was what was best. I won’t be able to stop you for feeling guilty about this. It seems to be our burden as mothers to assume all the guilt and blame of everything that happens to our children.

So, perhaps I can convince you to be kind to yourself. If you find yourself saying mean things to yourself like, “You are so stupid and selfish for _____! Now look what happened! The baby went on a nursing strike!” I encourage you to soften it up a little bit and add in the “real life” disclaimer:

“I wish I had known that _____ might lead to a nursing strike. Perhaps I wouldn’t have done it if I had known it would lead to this, but then again, I needed to _____. I trust that I made the best decision I could with the information I had at the time. I forgive myself for not being able to tell the future.”