Feeding problems occur for a number of reasons, many of which vary according to age. Most of these challenges can be met through proper breastfeeding instruction from a nurse or lactation specialist and the natural development of a breastfeeding rhythm. It may come as a surprise, then, if your baby develops a resistance to feeding weeks or even months after you thought this was no longer a problem.
One thing to consider when this happens is whether the taste of your breast milk has changed. Breast milk taste can change for a number of reasons, including the following:
- New or different food in your diet
- Medication you are taking
- Pregnancy in the mother, which sometimes causes nursing babies to wean themselves a few weeks or months after the mother conceives
- Strenuous exercise, which can lead to a temporary buildup of lactic acid
- Breast infection, such as mastitis
- Change in the taste of your skin caused by using lotion, cream, or oil on your breasts
Avoiding the new food, changing or stopping your medication if possible, exercising less strenuously, or refraining from applying oil or lotion to your breasts may be all that is necessary to encourage your baby to breastfeed at his normal rate again. If you have mastitis, seek treatment from your doctor right away and encourage your baby to breastfeed in order to drain your breasts. Once the infection has been treated and has passed, the taste of your breast milk will return to normal. You may be able to help your baby adjust to the new taste of your breast milk during pregnancy if you are persistent and patient and hold off on offering formula as an alternative.
If your baby starts to engage in frenzied short feedings that seem to signal frantic hunger, it may simply mean that your let-down reflex is occurring more slowly than she would like. If this is the case, try massaging your breast and expressing a little milk before you begin a feeding. This way, your milk will flow faster from the very beginning of the feeding and your baby will feel more satisfied.
If you do not believe that the taste of your breast milk has been altered or that your let-down reflex is causing the problem, consider whether you are experiencing a high level of tension or stress. Such emotional discomfort can be communicated to your baby, preventing her from settling down to feed well. Of course, we cannot always eradicate stress from our lives, but for the moments preceding breastfeeding, do your best to put upsetting thoughts out of your mind. Relaxed sessions not only will help your baby get more milk but may decrease your own stress level. Breastfeeding your baby and holding her skin to skin often promote a sense of well-being. Meanwhile, consider ways in which you might improve the general tenor of your day-to-day life.
It is also possible that your baby’s own condition may be making it harder for her to breastfeed. Decreased interest in feeding—possibly accompanied by lethargy, fever, vomiting or diarrhea, cough, or difficulty breathing—may indicate an illness. Consult your pediatrician or family physician if your baby resists feeding or you have any concerns that your infant may be sick.
Illness in your infant may affect your baby’s feeding pattern and desire to nurse, thus decreasing the amount of breast milk she receives. If she has a cold, clogged nostrils may make it difficult for her to breathe while feeding, or an ear infection may make nursing painful. Clearing the infant’s nasal passages with a bulb syringe prior to feeding may help with temporary nasal congestion. Teething can cause gum pain when nursing. Thrush can make nursing painful and requires a pediatrician’s attention.
Some babies take in a great deal of milk but then spit up what appears to be a large part of it after each feeding. Spitting up is common during or after feeding, and some babies spit up more easily than others. There is generally no need to be concerned, however, that your baby’s spitting up is preventing her from getting enough milk.
Spitting up (as well as hiccups) can be minimized by keeping your breastfeeding sessions as calm, quiet, and leisurely as possible. Avoid interruptions, sudden noises, bright lights, and other distractions. Try to hold your baby more upright during and right after feedings, and attempt to burp her after she finishes each breast. Don’t jostle or play vigorously with her immediately after she has breastfed.
If she vomits forcefully a number of times or if you notice blood or a dark green color when she vomits, call your pediatrician right away.
Occasional small spit-ups or wet burps are generally more a laundry problem than a medical one. Fortunately, spit-up breast milk is less likely to smell sour or cause clothing to stain than infant formula. If you are worried that she is spitting up too much, consult your pediatrician, who will monitor her weight and check for any signs of more serious illness.
As always, the best way to be sure your baby is getting enough milk is to monitor her physical condition, her weight gain, and the content of her diapers. It is very important to call your pediatrician if you notice that your child is not showing usual interest in feeding, she has a dry mouth or eyes, or she is producing fewer wet diapers than usual. These may be signs of dehydration. Severe dehydration, while uncommon in adequately breastfed infants, can be extremely dangerous or even life-threatening and is most likely to occur when a young baby refuses to feed or is experiencing frequent vomiting or diarrhea.