Nursing strike - nipple confusion?

QUESTION: Breast feeding has been going well up until now. I have had my husband giving Max one bottle of pumped breast milk at his 9pm feeding. He has been doing well with it since we started 1 week ago. I give him the breast the rest of the day and at night. Last night, we decided to give him formula at night and I saved my pumped milk. (I had heard stories about how babies will reject formula, due to taste, if they are not introduced to it early enough).

I am returning to work in 2 months and don't plan to nurse Max, exclusively when I return. I am interested in keeping maybe the bed time feeding only. Today, Max will not take the breast. He is fighting me, crying, fussing and we are both miserable. I have not changed soaps, laundry detergent or eaten anything outrageous today.

I am worried that this is the end for our breast feeding "team" and really want to fix this problem. My husband gave him a bottle of pumped breast milk tonight and Max took it without a second thought. Did I introduce a bottle too early? Please help.

Jennifer,

It really sounds like you are worried and concerned that Max may be rejecting you. It is not uncommon for babies to go on what is called a nursing strike once they have been introduced to a bottle. This is called nipple confusion or nipple preference. Nursing strike can occur at any stage of breastfeeding and for many reasons and regardless of the reason it is never too late to encourage him to take the breast. I generally recommend that mothers not offer a breast or a pacifier for the first 4-6 weeks until breastfeeding is well established because babies don't come with a sign on their foreheads that say "I will be a nipple preference baby!". So no, you did not introduce the bottle too early.

Until this nursing strike is over, I recommend that you try to exclusively breastfeed him. Start re-introducing the breast at times when Max is just waking or just ready for a feed. At this age, I would say that may be every 1 � hours or every 2 � hours since he may be nursing every 2-3 hours. When Max is fussy, don't offer him the breast because you do not want him to associate breastfeeding with crying. Simply try to calm him down by offering him your finger to suck on and talking to him. Try to pick him up to nurse him during his feeding cues such as: rapid eye movement, fists/hands to mouth, wiggling in his sleep, making sounds, opening eyes, etc. If max is not taking the breast, try to give him breast milk by using a cup or finger feeding. Not a bottle. I strongly recommend that you call your local La Leche League Leader so that you can have someone to talk to right away and she can help you when things that you are trying are not working.

Babies do not need to be introduced to formula. Many will reject it regardless and you probably would to if you try it yourself! They are smart, they know what is best. You say you want maybe maintain the night time feeding only. If by this you mean that you will be bringing Max to bed with you when you return to work this is truly an excellent choice and one that many working moms choose because it is much easier.

Mothers find that when they sleep with their babies and work they are not only feeling connected to their baby, but are also getting more sleep since they only have to roll over when the baby wakes and feed them. They prefer this to having to wake up, go to a different room and preparing a bottle; after doing all this many mothers cannot get back to sleep! Also, with Max in your bed you might be able to nurse him enough to keep up your milk supply so that he may not need to be supplemented as much during the day. This will also give you a chance to continue nursing Max until he is 6 months and introduced to solids.

If you are still having difficulty getting Max to take the breast, spend as much time as you can with him skin to skin (your breast exposed and Max in only his diaper) for the next 24 to 48 hours which will give him a chance to nurse more often. I hope this information helps.

Yvonne C. Bannister, B Sc, CBC, LLLL, IBCLC

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