This would obviously make the mother anxious and concerned. Causes for this include:
• A slow let-down (milk ejection) reflex, which frustrates the baby
• A forceful let-down, which may choke the baby
• An incorrect feeding position – it could be that the head is flexed forward and the nose is pressed into the breast tissue.
The let-down reflex
• Apply warmth in the form of a wheat bag or face cloth to stimulate the reflex.
• Express a little milk before attempting to feed, to get the milk flowing.
• If the let-down reflex is very strong, attempt breastfeeding while lying back a little to slow the flow of milk down, or press the nipple inward toward the chest with palm of the hand to slow the flow down.
• If the situation is desperate and the baby has not fed for 4-6 hours, express some milk that can be given in a feeding cup.
Managing breast refusal
Positioning the baby
If it appears that the position is incorrect, do the following:
• Tilt the baby's head slightly backward, to free the nose from the breast.
• Check that the nose is clear as it may be clogged with mucus. If it is clogged, put a drop of saline nasal drops in each nostril and clear with a nose cleaner.
• If it appears that the baby does not 'like' a particular breast, allow it to feed on the easy side first – it might be that the mother feels clumsy with a particular hand.
Reduce the mother's anxiety
• The mother should take deep breaths to help her to stay calm. Sometimes this will be hard to do and she may feel frightened or angry at the baby.
• If this happens, ask another caring adult to help her regain her composure.
• Calm the baby down and do not attempt breastfeeding while the baby is screaming.
Suggestions to calm the baby
• Burp the baby by holding it in an upright position; then the wind or gas should come up easily.
• Hold and comfort it.
• Check to see if the nappy needs changing.
• Cuddle it quietly by trying different positions such as upright or on its tummy.
• Hold the baby close.
• Swaddle it in a wrap or blanket so it is warm and secure.
• Play calming music or hum gently in a low note.
• Walk the baby up and down rhythmically.
• Massage or stroke it while in a warm bath.
• Try KMC when both mother and baby are calm again so that the baby can see, feel and smell its mother.
Re-latching the baby
• Obtain help from a breastfeeding consultant.
• Try and feed the baby while it is still half-asleep.
• Allow the baby to suck on the little finger and then try and shift it onto the breast.
• Experiment with different feeding positions.
• Express a few drops of milk onto the nipple to tempt the baby.
• Express milk and feed the baby from a cup.
This article is an extract from The pocket guide to breastfeeding by Diana du Plessis.
Did you have any problems breastfeeding your baby? How did you solve them?