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What to do when a newborn is not breastfeeding

Help! My newborn baby doesn’t want to breastfeed!

One of the most distressing things that can happen to a new mom is a baby that doesn’t want to breastfeed. Oftentimes a baby will be extremely sleepy after birth and not interested in the breast, or the baby will latch on to the breast and not suck at all. Either way, the baby is not breastfeeding – not taking any milk from the breast. There are a number of reasons why this could happen, and fortunately there are quite a few things that you can do to help.

Newborn not BF

Why is baby not breastfeeding?

The first important thing to remember is that when a baby is not breastfeeding, it’s always because something is preventing him from doing so – never, ever, will a baby refuse the breast because he doesn’t like it or because the milk is not good!

There are many factors that could contribute to baby not breastfeeding after birth:

  • C-section: babies born via c-section are often very sleepy for the first day or two.
  • Difficult labour: after a normal birth with long and difficult labour, baby is often quite exhausted and needs to rest a bit first
  • Pain medications: any pain medications that were given during labour are likely to make baby sleepy. This includes epidurals! The worst effect is seen with narcotic pain medicines like pethidine (which is, coincidentally, the pain medication that is most often used in labour)
  • Prematurity: if baby was born at less than 37 full weeks of pregnancy, there’s a good chance that his suckling skills have not matured 100%. Even at 38 weeks (when elective c-sections are often done), some babies struggle to breastfeed effectively.
  • Separation from mom: if baby was taken away from you, his body may have gone in to a “shut down” – this happens when babies are stressed, and their bodies focus only on staying alive, not on feeding.

How to get baby to breastfeed

Always start with skin-to-skin

You will hear me say this a lot: put the baby in skin-to-skin contact and leave him there until he starts breastfeeding. It is the single most effective solution for almost any breastfeeding problem! Skin-to-skin contact will ensure that your baby doesn’t get cold and that his blood sugar doesn’t fall – both of those things will make baby even more sleepy. Skin-to-skin contact also allows your body and baby’s body to “talk to each other”: babies are born with all the reflexes that they need to be able to breastfeed effectively, and skin-to-skin contact helps to activate those reflexes. I seriously cannot say strongly enough how important skin-to-skin contact is if you want to get your baby breastfeeding – nine out of ten times it will be the only solution you need.

Get the milk flowing and feed the baby

When baby doesn’t want to breastfeed immediately, everyone (from the nurse to your mother-in-law) is usually very quick to start pushing a bottle. Do not under any circumstances allow this! If baby’s first proper sucking experience is on a bottle teat, it can be very difficult to get him back onto the breast. Besides, baby is not going to die of hunger: In the first 24 hours, a baby needs only drops of milk – even a baby that is breastfeeding well will take only about 30ml in the first 24 hours. As long as baby is in skin-to-skin contact, very little can go wrong.

If baby is still not breastfeeding by 6-8 hours after birth, it is a good idea to start expressing your breast milk so that you can stimulate your breasts to increase their milk production. In the beginning, when there is only colostrum in the breast, it is often easier to express the milk by hand rather than using a pump. Don’t worry if you only get a drop or two of milk – that’s quite normal. You can just sweep up those drops with your finger and put them in baby’s mouth. If you are lucky enough to get more than a few drops out, use a syringe or teaspoon to feed it to your baby.

For as long as baby is not breastfeeding, continue pumping or hand expressing at least 8 times per 24 hours to ensure that you build a good milk supply. Feed the milk to baby with a syringe, spoon or cup, but avoid using a bottle.

Help baby to get to the breast

While baby is in skin-to-skin contact, you should watch him closely for signs that he’s ready to feed. Some feeding cues that you can look out for are:

  • Rooting: baby turns his head to the side and opens his mouth when something touches his cheek
  • Chewing or sucking movements with the mouth
  • Licking or mouthing your chest or his own hands
  • Attempting to “crawl” to the breast
  • Making moaning sounds, almost as if he’s about to cry

When baby shows these signs, it’s a good time to offer the breast. Bring baby closer to the breast, so that he’s in a position where he can latch on to the nipple without having to turn or tilt his head. Often the easiest way to do this is just to keep baby in the same skin-to-skin position but to shift him a little bit down and to the side. For more details on how to position baby comfortably, check out this post.

When you have brought baby to the breast, first give him some time to explore. Usually, the best latch is the one that baby figures out for himself. If you notice that baby is getting frustrated or struggling to latch on to the breast, you can help him out using some of the techniques I’ve described in this post.

Stimulate the sucking muscles

Sometimes, the muscles of the face just need a bit of stimulation to wake them up and start baby sucking. Using your forefinger, stroke baby’s face gently but firmly (as if you’re giving a massage) in the following areas:

  • Stroke the cheek in a line running from the centre of the ear to the corner of the mouth.
  • Stroke the skin above the upper lip, moving from the centre of the lip to the corner of the mouth (repeat to both sides).
  • Stroke the lower lip from left to right and from right to left.
  • Place a finger under baby’s chin and gently massage in small circles – this stimulates baby’s tongue from below.
  • Use your finger to tap baby’s lips. If baby opens his mouth and roots for your finger, allow him to suck on it for a bit (with the pad of your finger on his tongue and the nail at the palate). Once baby is sucking rhythmically, try to slip the finger out of his mouth and the nipple in.exercises to stimulate sucking

When to get help

If your baby is still not latching after 48 hours, it’s time to call in a professional. Don’t rely on the midwife or doctor to help you breastfeed; they are not trained to handle any but the most basic breastfeeding problems. Try to get in touch with a La Leche League leader or Certified Lactation Consultant (SACLC or IBCLC) as soon as possible (Check here for contacts). In the meanwhile, keep expressing breast milk and feeding your baby. And don’t lose hope – with a bit of skilled help, it really is possible to get almost any baby latched on and breastfeeding.

Good luck!

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