Why doesn't the baby take the breast, freaks out and cries? And how can I help him?

Sometimes it happens that the baby does not latch on to the breast after birth. This is one of the most difficult obstacles to breastfeeding. When the baby screams when trying to attach him to the breast, the mother feels complete helplessness, even despair. Many people give up. I'm familiar with this. With my eldest daughter this lasted a week. I almost gave up, but then the baby latched onto me. Having become a consultant, I have already encountered this problem many times with other mothers. The main thing I want to say is: it can be overcome!

Here I look at cases where the baby did not take the breast after birth or stopped taking it in the first days. The next article will talk about what to do if a child refuses breastfeeding by one month or later. There are other reasons and another solution.

From the article you will learn:

Why doesn't the baby latch on?

First of all, it would be good to understand the reason: why does the baby not take the breast? What's stopping him?

The most banal explanation: in the first days the child was given a bottle with a pacifier, and he realized that this device was easier for him to suck. Of course, not everyone refuses to nurse after a bottle, but no one knows in advance how your baby will behave.

The risk increases if the child is introduced to the bottle before the breast. This can happen if mother and baby are separated after a difficult birth. In the first hours after birth, the newborn imprints, as the norm, everything that it encounters for the first time. He may be very surprised that the breast is sucked in a completely different way (different movements of the tongue, different groups of facial muscles are involved) and refuse to take it.

Anesthesia during childbirth can be a disservice to the mother. Especially promedol administered intravenously. It is an opioid analgesic and is also called “obstetric sleep.” Now, fortunately, it is used less and less during childbirth, at least in Moscow and the Moscow region. Its half-life, depending on the metabolism of a particular person, is 2.5-4 hours. This is the time during which 1/2 of the dose is removed from the body. Over the next 2.5-4 hours, half of the remaining dose is removed from the blood, that is, 1/4 of the original volume, then 1/8, etc. That is, the drug will leave the body for quite a long time.

Moreover, anesthesia is eliminated faster through the general bloodstream. But in maternity hospitals, the umbilical cord is cut quite quickly - even before the placenta is separated, sometimes immediately after birth. The baby’s body eliminates the drug on its own much more slowly. This makes babies sleepy and uncoordinated and makes it difficult for them to latch and suckle. Some people don't succeed at all.

Contrary to popular belief, epidural anesthesia can also affect a child's activity. The analgesic it uses (lidocaine or other "-caines") enters the mother's bloodstream, although in smaller quantities.

It happens that a child does not latch on to the breast due to anatomical features. The short frenulum itself rarely prevents the baby from sucking. But in combination with a flat or inverted nipple in the mother or with supplementary feeding from a bottle, it may well be the cause.

A cleft palate prevents a child from creating a vacuum. Sometimes this feature is difficult to notice (unlike a cleft lip) if the palate is not completely cleft, in the depths of the mouth. Fortunately, this is very rare.

An inverted nipple is difficult to hold in the mouth. There are difficult cases when the nipple, when pressed on the areola, “hides” in it completely. Even if the baby has a movable tongue and the frenulum is normal, it will be very difficult for him to latch onto such a breast. Perhaps he will be able to do this only when he grows up a little.

A flat nipple that hardly protrudes above the areola is actually not that big of a problem for your baby if he is not familiar with the bottle. However, swelling of the areola during breast fullness may prevent the baby from latching.

In my practice, I often encounter children who do not breastfeed after a difficult birth or numerous interventions in their process. They have spasms of the structures of the skull involved in sucking, or the upper spine. Such children can be distinguished by external signs: cephalohematoma, asymmetry of the face or skull, burst blood vessels in the eyes, “stork kisses” - red spots on the skin, a head sunk into the shoulders. These are traces that in most cases are left behind by attempts to speed up the birth of a baby: the introduction of artificial oxytocin, puncture of the bladder, pressure on the abdomen. The baby's long periods of pushing, entanglements, incorrect presentation of the fetus and other unfavorable features can also be the cause.

Often, children who had a particularly difficult time during childbirth latch onto the breast in the first 1–3 days, but do not cope well with emptying it. Then the milk comes in, the breasts become full, the areola swells, and they stop sucking altogether.

Immaturity and low weight of the child are often an obstacle to breastfeeding. Everything here is very individual. Some can breastfeed at 32–34 weeks, weighing only 1.5 kg. Others cannot latch on until they reach 40 weeks gestational age (that is, 40 weeks from conception) and gain 2.5-3 kg.

Physical reasons for breast refusal

Incorrect attachment to the breast

Reason . The baby does not latch onto the areola, but only sucks on the nipple—no milk comes in, and the baby becomes upset.

Treatment.

hold the child in your arms until he calms down;
lubricate the nipple and areola with milk, lightly squeeze the areola with your fingers to make it easier for the child to grab it, offer it to the baby;
Make sure that the baby does not “slide” towards the nipple.

Baby cannot latch on to an overfilled breast

Treatment . Before feeding, express a little milk so that the areola becomes soft.

Inverted, flat, small nipple

Treatment

For many women, such nipples do not interfere with feeding their children. Think about it: if in nature the children of women with such breasts died of starvation, then, according to genetics, no one would have had such breasts for many millions of years. Over time, with regular feeding, the nipple takes on a normal appearance.
If that doesn't work, feed with feeding pads.
You can try to pull out the nipple. True, it was better to start doing this before giving birth. Make a simple mechanism: remove the piston from a 5 ml disposable syringe, use a knife to cut off the part of the syringe where the needle is inserted to make a tube. Insert the piston into the cut end. Place the free end (where the finger rests) on the nipple and pull the plunger so that the nipple is pulled into the syringe. Leave it for a while. With regular exercise, the nipple will stretch.

Different breasts

Reason . It is easy to suck on one breast, but difficult on the other for some reason. There may be a refusal of this breast.

Treatment

Try to get rid of the cause.
Do not stop feeding with this breast, slip it in for every reason (first when feeding, sleepy, hungry, in a good mood...).
You can also feed a baby with one breast.

Example . I saw somewhere that a child refuses the right breast because during feeding he cannot hear the natural sound of his heartbeat... No comment.

Tight breasts

Reason . For women who are breastfeeding for the first time, the ducts that carry milk to the nipple may be very narrow. So much so that the baby has to make a lot of effort to suck out any milk. The baby sucks for a while, but you can’t hear him swallow. He lets go, screams, grabs his chest again and screams again. The baby is not gaining weight, sleeps poorly, and has fewer than 8 wet diapers per day. The breast does not empty or only slightly. The main signs are the mother's full breasts and the baby's lack of weight gain.

Treatment

Talk to a lactation consultant.
Calm down! When a woman is nervous, everything shrinks even more. Relax.
Before feeding, do a light relaxing massage of the chest (back, front - along the ribs), mammary glands - so that they become softer (look for massage in the Appendix).
For the same thing, take a hot shower on the chest and mammary glands before feeding, or you can simply try to feed while lying in a warm bath.
“Reverse feeding” - position: the baby lies on the bed, the mother leans over the child, leaning on her hands and gives the baby a dangling breast - this is how the milk flows with the help of gravity.
When the baby draws in milk, you can lightly massage the breast, “pushing” the milk from the edge of the breast to the nipple (do not forget that the mammary gland begins right under the armpit and from above, almost immediately under the collarbone).
To soften the breasts, you can apply warm crushed cabbage leaves or semi-alcohol compresses (look in the Appendix).
Since the breast works on the principle of “supply and demand”, and with this problem the baby can suck, for example, 20 grams instead of 50, then tomorrow there will be 20 grams of this milk... I would advise trying to pump out the milk after feeding, decanting the breast. Over time, the ducts expand and milk flows more easily, and I would like there to be more of it.
This milk should not be given from a bottle.
Wait for the baby to grow a little, become stronger and find it easier to suck. And for the next child, no problem at all.

Example . It is my problem. That is why I write about this in such detail. You can read my experience in the article “Two Stories of One Mother.”

Full fat milk

Reason . The milk in a woman’s breast is divided into two types: first, the foremilk flows, more watery, but filled with vitamins and minerals, it is easy to suck, but the second, hind milk, is fattier, thicker and requires effort to suck it out. Some lazy or weak children don't want to or can't do this.

Treatment

Do a breast massage (look for massage in the App).
When the baby draws in milk, you can lightly massage the breast, “pushing” the milk from the edge of the breast to the nipple (do not forget that the mammary gland begins right under the armpit and from above, almost immediately under the collarbone).
Check every time if you have doubts: the baby asked for a second breast because this one ran out of milk or simply because it became difficult to suck. Some lazy babies suck only foremilk from both breasts, eating the required amount of food, but do not gain weight, because foremilk contains very little fat and protein. Don't follow the lead of the sloth. If during one feeding the baby sucked on both breasts, then start the next one with the breast that he sucked last.

Reason . Sometimes milk can be very fatty due to poor nutrition of the mother - an excess of fats (fatty meat, full-fat milk, cottage cheese, a lot of hard cheese, butter, nuts).

Treatment . Adjust your diet.

Reason . Milk can become thick in summer, during hot weather, due to lack of moisture that comes out with sweat.

Treatment . Remember to drink more than at normal temperatures.

Tasteless milk

Reason . A newborn baby's tongue has hundreds of times more taste buds than a human. And the taste of milk changes depending on the mother’s diet. And foods such as onions, garlic, cauliflower, spices, spicy foods, and radishes may not be to your baby’s liking. Some medicines and medicinal herbs have the same property.

Treatment

Don't eat anything your child doesn't like.
Under no circumstances should you take medications without a doctor’s prescription, and remind him several times: “I am breastfeeding,” and then carefully read the instructions to see if this can be used by nursing mothers, because medications can not only spoil the taste of milk, but also harm your health. child.

Example . My daughter, in my opinion, on the contrary, liked “garlic” milk. Tastes could not be discussed.

Alien smell

Reason . They conducted an experiment: barely born babies were given a choice of several worn T-shirts. And they unmistakably recognized the one that mom was wearing! Newborn babies search for breasts by smell and sleep better covered with mother's clothes. That's why they often don't take someone else's breast. And if the mother has sprayed herself with perfume, deodorant, or for some other reason does not smell like herself, then the baby may not “recognize” her.

Treatment . Take a bath with baby soap and do not mask unpleasant odors in the future, but simply take a shower more often. Wear clean or other clothes of your own.

Menstruation, pregnancy

Reason . During menstruation, and sometimes before it, as well as during pregnancy, the taste of milk deteriorates.

Treatment . Just be patient until your period ends, everything will get better. Over time, children usually get used to it.

Feedings by the hour

Reason . Some children, at the insistence of their mother, calmly switch to feeding after 3-3.5 hours. But there are children who are born with too small a stomach. People feel full when their stomach is full of food. So these children have a feeling of fullness when they eat, for example, 60 ml of milk, instead of 120 according to age. It is clear that this small amount will be absorbed faster and the child will want to eat much earlier than the prescribed 3 hours. But many parents believe that the child is capricious and, “showing firmness,” listen to the children’s cries until the right time comes.

It is clear that a screaming baby will not be able to suck normally or will refuse to do so altogether. But even if he starts eating, he will be able to eat no more than 60 grams again. At the end of the month, the clinic will find that the child is not gaining weight or is gaining too little. They will immediately remember the constant screams and tell the mother that she does not have enough milk. Next - a bottle, mixed, and then completely artificial feeding. And this despite the fact that mom has enough milk!

Treatment . Definitely feed not according to time, but according to the child’s demand. Over time, the baby's stomach stretches and the intervals between feedings increase.

Example . For the first three months, my daughter let go of the breast for a maximum of half an hour. With her in my arms, I got the hang of doing a lot of housework (my son was 3 years old at the time, and no one helped me during the day). After 3 months, the situation changed dramatically: I forced my daughter to take an overfilled breast. She then gained a kilogram a month.

Advertising

Reducing feeding time

Reason . Sometimes it is advised not only to feed on time, but also to keep the baby at the breast for no more than 15-30 minutes. But weak or slow children do not have time to suck out the required amount of food during this time. It is also difficult for them to do this with tight breasts or to demand milk from a mother who is distracted. The signs are the same as in the previous case.

Treatment . Keep your baby at your breast as long as he wants. At the maternity hospital we were told that a newborn baby (up to a month old) who suckles for less than an hour raises suspicions about whether he is healthy. Focus on your child.

We reduce risks!

When a child no longer takes the breast, freaks out and cries, it takes a lot of strength to overcome the problem. Not everyone has them after giving birth. However, you can prepare in advance and try to prevent complications.

The smoother the birth, the lower the risk that you will have any difficulties with breastfeeding. The child will be calm, he will have more strength and will to win. Therefore, if you are determined to breastfeed, prepare carefully and carefully choose the place where your baby will be born.

Many complications and interventions can be avoided if you are allowed to freely behave during labor (accept the positions your body asks for) and are allowed to use alternative relaxation and pain relief techniques. You can learn all this in a “gentle birth” course, and then choose a maternity hospital that supports a natural approach to birth.

There are maternity hospitals that have received the World Health Organization's BDR (Baby Friendly Hospital) certificate. To obtain this status, health care facilities must create certain conditions to support breastfeeding. Employees are trained in the WHO theoretical course “Breastfeeding Counselling”.

However, due to the lack of practical knowledge among medical staff and staff turnover, even the BDR often does not know how to help.

Why older children refuse breastfeeding

Older children who have breastfed well for some time sometimes suddenly stop breastfeeding. Here are the reasons why an older baby might choose not to breastfeed.

Colds: Breastfeeding a sick baby can be a challenge. If your baby doesn't feel well or has a stuffy nose, it may be difficult for her to breastfeed and breathe at the same time.
Distraction: As babies get older, they become more curious about the world around them. Older babies are more easily distracted and sometimes there are simply too many other interesting things they would rather do than breastfeed.
Fast eaters: Older children eat much faster than younger ones. An older baby can often get a large amount of breast milk in just a few minutes
Low milk supply: If you are not producing as much breast milk as you used to, your baby may become frustrated with breastfeeding and stop breastfeeding.
Pain: If your baby is teething, has an ear infection, or has oral thrush, it may be painful for him to latch on. If your baby has colic, he may experience discomfort from gas, bloating, and digestive problems, which can also interfere with breastfeeding.
Taste: Hormonal changes after your period returns, a new pregnancy, or starting birth control pills can affect the taste of your breast milk. Smoking cigarettes before breastfeeding or eating certain foods can also change the taste of your milk. If your baby doesn't like the taste of your milk, he may not want it.

Calm, just calm!

If your baby does not latch on, the main thing is not to panic. Remember that the child feels the mother’s condition very well while in her arms. Stress hormones change body odor, breathing rhythms and heartbeat. Realizing that mom is nervous, the baby will be even more upset.

Do not put a nipple into a baby's screaming mouth. If after another attempt the baby starts crying, first calm him down! Pressure creates an emotional problem. There is no need to force a child to breastfeed through crying, by doing this we scare him even more and reinforce negative behavior.

Of course, it’s easy to say “calm down!”, first you need to calm down yourself. However, when your baby is squirming and screaming under your breast, it is very difficult to maintain composure. Postpartum hormones force a woman to immediately mobilize when her baby cries. What kind of peace is there?

Try to consciously shift your focus from your baby to your body. Breathe deeply and evenly, watch your posture, straighten up, imagine yourself from the outside. This way you can regain control over your emotions. This will make it easier for you to calm your child down.

It helps a lot: take the newborn vertically to the shoulder and rock from side to side with a small amplitude. You can rhythmically pat him on the back, lightly. Hiss like “sh-sh-sh”, imitating “white noise”. Interestingly, rocking and rhythmic actions also calm the mother!

If the baby is crying too much, swaddling helps. But there is no need to swaddle “strictly”, as they did in Soviet times. Loose swaddling is best: we create some tightness, like in the womb, but in such a way that he can hold his arms and legs in a way that is comfortable for him.

Everything that reminds the baby of the sensations that he experienced in the womb has a calming effect on him. That is why among the best “sedatives” is motion sickness. He slept, rocking in his stomach when his mother walked, and woke up when his mother took a motionless position. For the same reason, “white noise” helps - it is similar to the monotonous sound background that the work of the mother’s internal organs creates for the unborn baby.

If a child does not latch on to the breast, how to feed him?

Many people think that the baby will take the breast when he is more hungry. It's a delusion! After a long break without food, children become impatient, quickly fall into despair from failures, and lose coordination of movements.

If you were unable to attach your baby as soon as he woke up, and even more so when you have already made several attempts and see that the whimpering is now breaking into a scream, it is better to feed the baby with expressed milk. But how to do this? After all, a bottle can only increase the baby’s reluctance to take the breast?

Options for what and how to supplement a baby’s feeding without a bottle are listed in the article “Mixed feeding of a newborn.” (The link to it is below this text).

Here I will describe in detail only one of the most accessible methods - feeding with a finger and a syringe:

We draw milk into a syringe and leave it on hand.
We place the baby at an angle of 45 degrees (to prevent choking). Incubators in hospitals are already inclined. At home, you can use a bouncer or car seat for babies. A soft pillow in which you can form a dent is also suitable.
We give the child a finger in the mouth (index or little finger), with the pad to the palate, and the nail on the tongue. The baby attaches itself to the finger and begins to make a “wave” with its tongue from root to tip. These tongue movements imitate breast sucking. The bottle sucks completely differently, especially if you tilt it well.
Take a syringe with milk. We insert into the corner of the mouth, close to the finger, the nose of the syringe, onto which the needle is usually placed.
We move the piston when the baby makes sucking movements with his tongue. Some people create such a vacuum around their finger that they suck up the contents of the syringe on their own.

There may be so little colostrum that it is impossible to fill a syringe with it, especially in the first days after birth. It is quite natural that this makes mothers very upset. Remember that you need to regularly express those drops that your breasts have already begun to produce, and there will be more milk! What is important here is not the duration of one pumping session, but the frequency of breast stimulation. Colostrum can be collected in a tea or coffee spoon and immediately poured into the baby's mouth.

Poor position of the baby at the breast

If your newborn does not latch on well, his sucking will not be effective and he will not be able to get milk from your breast. As your baby becomes more hungry and frustrated, it becomes more difficult for her to breastfeed and she may begin to refuse the breast altogether. When your baby latches onto your breast correctly, he will take your entire nipple and most of your areola, the dark area around your nipple, into his mouth.

What to do to get your baby to start breastfeeding?

Offer when coming out of sleep and during sleep

Attempts to attach the baby should begin when he is “looking” for the breast. Yes, the baby may not take it, but “search behavior” is built into it at the level of reflexes. When waking up and moving from deep sleep to superficial sleep, he will lick his lips, move his head with his mouth open, and stick out his tongue. This is the most favorable moment for application. Very often, children take the breast for the first time without opening their eyes, in an unconscious state, in a doze.

If the baby stubbornly does not wake up and does not look for the breast, it helps to express a little colostrum and lubricate the baby’s mouth with it: the tongue, the palate and the inner surface of the cheeks.

Relieve swelling from the areola

However, it also happens that after a long sleep the baby, on the contrary, stops latching. This is explained by the fact that the breasts became full during the break and the areola became very swollen. Then we use the areola pressure technique suggested by consultant (IBCLC) Jean Cotterman. We place our fingers around the base of the nipple, as shown in the pictures, and press towards the ribs for at least 1 minute (less is not effective).

Under finger pressure, the fluid moves away from the areola into the breast, and the area around the nipple becomes soft. This will make it easier for the baby to latch on.

"Skin to Skin"

If the problem is much more serious than swelling, and the baby stubbornly does not take the breast for a day or more, then simply preparing the nipple will not do. This requires more systematic actions, which may have to be repeated several times.

You can convince your baby to breastfeed through skin-to-skin contact. When the baby's skin touches his mother's, he becomes more active and exhibits instinctive behavior necessary for breastfeeding. Endorphins are released into his blood - hormones that overcome pain and bring pleasure.

The larger the area of gentle contact between your bodies and the baby, the longer the contact you give him, the better this affects the psychological and physical state of the baby. Mom’s body is like a tuning fork for him. Using it, the baby adjusts its biological rhythms - heartbeat, breathing. Mom's body stimulates his blood circulation and warms him.

Skin-to-skin contact is the basis of the Kangaroo method, which has proven itself very well for nursing babies born prematurely. Being on the mother's body, babies gain weight faster and experience fewer complications than when using special equipment. If the baby does not attach to the breast due to low weight and physiological immaturity, prolonged skin-to-skin contact is the best help for him.

"Self-application"

As for babies born on time, they can “suddenly” latch on to the breast even after very short contact with their mother’s skin! The so-called “self-attachment” (also called “auto-attachment”) is built on this.

This technique appeared thanks to observation of the baby’s behavior after natural childbirth. It turned out that our children themselves know what to do and how to latch on to the breast if the birth took place without medical intervention, and after it the child was allowed to rest on the mother’s breast. Having recovered a little after a tiring journey into the light of God, they begin to literally crawl to the nipple and grab it on their own (in the video below).

If, after a difficult birth or anesthesia, the baby was “out of shape” for a long time and was unable to latch onto the breast, if he was separated from his mother and fed from a bottle, you can do the same later, when he is ready. You just need to create the conditions for “self-attachment”.

Sit in a reclining position, leaning deeply on your back. A pair of pillows behind the back, one on each side as armrests. In this position, the mother's comfort is especially important. We place the baby skin to skin (for example, in one diaper) between the breasts, tummy down (not sideways!), just above the nipples. If it's cold, you can cover yourself with a flannelette diaper or a baby blanket. And wait until the baby begins to rise, moving systematically either to the left or to the right, and rummage around the mother’s skin with his mouth until he comes across the nipple. Having discovered it, he will try to capture it in his mouth.

Here it is necessary to make a reservation that the child does not always immediately begin to move towards the nipple; he may freeze in surprise with his eyes wide open, as if listening or waiting for something. He can instantly doze off, spreading out on his mother in blissful bliss. He may cry inconsolably. This depends on his state, including emotional, at the time of this contact.

I urge you to respect his feelings! If he cries, you need to calm him down before he falls into distress. If he decides to rest, wait. After all, even when he gets to the breast, he won't necessarily be able to latch onto the nipple. Or it will grab, but the application will not be of very high quality.

After each unsuccessful attempt, “auto-attachment” must be started again, from the position between the breasts, but only after the baby has calmed down!

Osteopathy

If there were complications or interventions during childbirth or you see signs indicating that the baby may have experienced great overload on the way to this world (bursted blood vessels in the eyes, cephalohematomas, asymmetry, etc.), contact an osteopath. These specialists relax the spasmodic structures, due to which the child frees up a large resource of strength that was previously spent on overcoming physical discomfort. There's nothing wrong with that! "Osteopathic clamps" are easily removed during the first year of life. Our generation of 40+ was generally routinely “squeezed out” by pushing. We live with this, work, give birth to children.

Lactation crisis

Starting from 3 to 4 months of age, a phenomenon such as false breast refusal, or a lactation crisis, may occur. At this age, the toddler can show characteristics of his character: he screams, ignores the breast, turns away, and demonstrates his refusal to breastfeed by any means.

The emerging crisis should not frighten the mother, much less become a reason to refuse breastfeeding. During this period, you need to gain strength and patience and continue to breastfeed your baby both day and night.

It is very important that during a lactation crisis a woman remains calm and has more frequent contact with the baby - this will help strengthen and maintain a spiritual connection. This phenomenon, as a rule, does not last long, and soon the baby will again begin to ask for his mother’s breast.