I recently spoke on the phone with a new dad who described in a very typical way that his wife was having difficulty latching the baby on her breast. When I arrived at their home the following day the baby was sleeping like an angel and she even co-operated with us beautifully during a diaper change and the initial weigh in. It was only when the mother started to position the baby in the cross cradle hold and bring her toward her breast that this little one began to scream while arching her back and pushing herself away from the breast even before making contact with it. It was clear that she had been here before and did not feel safe returning. This was not a typical case of difficulty latching rather this baby had a developed a breast-feeding aversion. The Mom went on to explain that the baby was unable to latch even in the hospital and that the well-meaning nurses were very persistent in their efforts to get her to latch and that perhaps this had caused her extreme reaction.
The first thing we did was removed her from the breast and held her over mom’s shoulder until she calmed down. After a couple of minutes, I suggested that mom do some skin to skin, lower her in between her breasts in an upright position where we would wait for her to show us signs that she was ready to go back to the breast. I explained that for some babies establishing breastfeeding can be challenging and when their signs of distress go unnoticed or are ignored; continuing to coax them on the breast can certainly make matters worse. It creates a negative emotional response to being at the breast in addition to whatever physical challenges they may be experiencing. Of course in these situations it’s important to identify the issues that may be making breastfeeding more challenging for mom or baby but there may be times where it’s simply a matter of timing, patience, or basic breastfeeding support and education.
In general and especially in situations like this, I encourage mothers to spend as much time skin to skin: holding their baby in between/near the breasts, (no clothing for baby or for mom waist-up) without actively trying to get the baby to latch until they show signs of interest (i.e. head butting against the chest in search of the breast). This may take minutes, hours or days until the trust is restored and baby begins to show interest.
It’s important to recognize that breastfeeding can be challenging and stressful for some babies, especially for those who have had a negative emotional experience there. Providing them with plenty of skin to skin helps erase the negativity and replaces it with a positive, relaxed, and unpressured experience at the breast. This can have significant positive impact on long-term breastfeeding success. For a mom that is desperate to breastfeed it may seem like a slow approach or not sufficiently proactive- but in many cases a more patient, baby-led, approach can work wonders. And most importantly, building trust between mom and baby is the foundation of breastfeeding success and cannot be fast forwarded even in today’s fast paced world.
Thankfully in this case, after a day of relaxed skin to skin and offering the breast in a way that was respectful of the baby’s wishes- this little one went on to successfully breastfeed (and quickly began to refuse bottles) despite a very challenging beginning.
