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Thread: Refusing bottle and/or refusing breast

  1. #1

    Default Refusing bottle and/or refusing breast

    Looking for some advice or insight from a seasoned mom. I'm a FTM to a 9 month old little boy. He's been EBF since he was born, I went back to work when he was 3 months old and have been pumping 3x/day since going back to work. My mom watches him during the day, and I'm typically gone about 10 hrs all together including my commute and I leave her 12 oz. Recently, my LO has been giving my mom an increasingly difficult time taking bottles (never had an issue before now), and was only taking 6-8 oz all day while I was gone, and at this point, the only place she can get him to take a bottle at all is when he's sitting in his car seat (a place where we've never fed him before now). Anyone have any experience with this?

    He loves to eat solids and has been doing great with different textures and flavors, and we've slowly increased the amount that he gets. He's eating 3 meals/day and sometimes 1 snack. Usually cereal w/ BM and fruit at breakfast, some fruit and a vegetable at lunch (more recently we've been introducing a couple TBSP of yogurt), and then a more protein focused item along with vegetable at dinner. He only bites on sippy cups, won't drink from them yet. I've kept him on the slowest flow nipple which he's done fine with. I ran it by my pediatrician and the only input they had was that he needs a decreased amount of BM at this point and it might be time to increase the amount of solids we're giving him. This seems like a behavior/developmental type of thing to me, but I can't know for sure.

    To make things a bit more complicated, this past couple of days I was snowed in at my house and my mom stayed with me since my husband got stuck out of town for work due to the weather, and when my mom was around, my LO would give me a harder time when I tried to nurse him. The first night she stayed, he refused to breastfeed, he started crying and arching his back away from me as soon as I sat down in his rocking chair in his room (where I always feed him); so I ended up giving him expressed milk in a bottle. He did the same thing to me tonight, after my mom had already left my house for the day. I tried several times to breastfeed him, and each time he started immediately crying, wouldn't latch on, and tried to get away from me. I ended up giving him another bottle of expressed milk. Is this a nursing strike? He doesn't fight me in the middle of the night at all or before he sees my mom. I'm at a loss for what to do and a bit heartbroken, to be honest.

    Anyone who made it through this novel deserves a cookie, and I would greatly appreciate any words of wisdom. Thank you!!

  2. #2
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    Default Re: Refusing bottle and/or refusing breast

    Hi and welcome!

    The first thing I will say is this is an odd age. It is an age when feeding issues seem to arise. You have two things going on, bottle reluctance and a "partial" breast refusal or nursing strike. For a 10 month old, assuming you want to continue to nurse, the breast refusal is much more serious and I would suggest do not even worry about the bottles so much. Here is why:

    For a baby who is enjoying eating solids 4 times a day, a reduction in intake of breastmilk from bottles over the same period would be expected. Unlike nursing, which a baby does for many reasons, bottles are almost entirely about hunger and thirst and so would be offset by solids and other liquids normally. Also a baby this age can start to be fed with a sippy cup if bottles themselves are the problem. Additionally, as a baby approaches 12 months, appetite tends to normally decrease as baby's gain rate slows down. If you think your baby is displaying a low appetite, you could have baby checked for low iron. But assuming normal gain and development this is not likely the problem.

    I would not suggest increase the intake of solids. Why would you do that? The amount he is eating now is (possibly) reducing what he will take in a bottle. Since your milk is more nutritionally complete than any other foods he can eat, the last thing you want to do right now is increase solids and encourage less breastmilk consumption. I would not suggest reducing solids either, he likes them and they are working for him, so great. But here is what I would suggest: If baby is getting any water or juice, I would suggest stop or reduce those. Thirst is a great motivator and breastmilk provides the best form of hydration a child can get. If baby is being spoon fed purees, you could talk to your caregiver about trying giving baby "real" foods they can pick up, bite and chew themselves. Baby learns to eally eat, and gets the joys of eating without over eating These changes may also help with the breast refusal, if baby being sated by solids is harming his desire to nurse.
    this past couple of days I was snowed in at my house and my mom stayed with me since my husband got stuck out of town for work due to the weather, and when my mom was around, my LO would give me a harder time when I tried to nurse him. The first night she stayed, he refused to breastfeed, he started crying and arching his back away from me as soon as I sat down in his rocking chair in his room (where I always feed him); so I ended up giving him expressed milk in a bottle. He did the same thing to me tonight, after my mom had already left my house for the day. I tried several times to breastfeed him, and each time he started immediately crying, wouldn't latch on, and tried to get away from me. I ended up giving him another bottle of expressed milk. Is this a nursing strike? He doesn't fight me in the middle of the night at all or before he sees my mom. I'm at a loss for what to do and a bit heartbroken, to be honest.
    This could be a beginning of a strike, and it is very possible that the abrupt change in routine brought on by the snow is the culprit. Whatever the cause of the lack of interest in nursing, try to not take it personally as it is not personal!

    Strikes can be very shortlived, last a long time then mysteriously end as abruptly as they began, or go on forever, essentially, leading to baby weaning. Which it is depends in some cases to some degree on how mom and other family members handle the strike, although of course it also depends on baby and just luck as well.

    I suggest, keep gently encouraging baby to nurse as often as you can. If it upsets him when you offer, you might try being more subtle, such as just getting topless and letting him approach you.

    Maybe he is sick of the rocking chair. Try nursing different places, lying down, etc. Also the rocking chair may be cramping both of you. A baby this age often needs to be nursed in a different position then earlier so they have room to comfortably lean their head back a bit and their chin does not tuck.

    Try to avoid the temptation to reward breast refusal with a bottle. I assume your child is healthy and developing normally, and at 10 months knows where the milk is and how to get it out. You do not say anything about being concerned about your milk production, so I assume that is not the problem. A bottle can be useful if a baby is upset and baby gets just a little in the bottle and that calms him enough to nurse. I am not saying never give a bottle when baby is refusing to nurse. I am just saying, be careful about it. A healthy 10 month old is not going to be harmed by the occasional missed nursing session.

    Here is the best article I know of for nursing strikes. Sometimes you have to try the same things again and again before something clicks: http://kellymom.com/ages/newborn/nb-...ack-to-breast/
    Last edited by @llli*maddieb; March 17th, 2017 at 03:22 PM.

  3. #3

    Default Re: Refusing bottle and/or refusing breast

    Thanks so much for responding @llli*maddieb. The nursing refusal did turn into a bit of a strike but has for the most part subsided at this time. You are right in that I'm not concerned about my milk production, however, based on my son's nursing schedule when I am home I have changed to two pumps a day at work instead of three. I have a decent amount of milk in my freezer and with him only taking 6-8 oz of breastmilk while I'm at work it seemed pointless to me to keep pumping 11-12 oz a day.

    I just took him for his 9 month well check which was fine, normal growth for weight and height, he continues to gain around 12-14 oz a month which is normal (or even on the high end). He currently doesn't understand how to use a sippy cup so therefore doesn't drink any water or juice while I'm gone for the most part, so that's a non issue. I would be more than ok if my caregiver would give him more "real" food that doesn't have as much water content, and therefore potentially increase his breastmilk intake via bottles while I'm gone. The only hiccup with that is my mom is the caregiver and she gets really nervous about giving my son real food, she worries about him choking and not being able to handle it. She has done some online first aid course that goes through how to handle it, but I'll admit she tends to panic quickly. My mom has done a great job with him thus far, but at times I feel she isn't caregiver/adult enough and just plays grandparent and is scared of being too strict I guess. Sometimes I wonder if the bottle refusal is due to her changing the routine too often, and/or not following much routine to begin with. Regardless, we are actually in the process of getting him in daycare 2 days per week to help with socialization and structure.

    I guess I just feel stuck between a rock and a hard place since my son wakes up once in the middle of the night to nurse (which is fine), but I assume until he is weaned from breastfeeding he will continue to do so. I would love to feel better rested on occasion, but my husband currently doesn't help out for middle of the night feedings, and even when he does I end up having to go in and soothe my son since he responds better to me. Sleep is a very precious commodity!

    Again, I appreciate your response, I've been feeling very lost with what to do and how to proceed. I will probably work on getting my son to use a cup of some sort to see if he will take milk that way when I'm gone, but it's hard when I have limited time with him at night and on the weekends! Any other advice or words of wisdom are appreciated!

  4. #4
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    Default Re: Refusing bottle and/or refusing breast

    Hi nlc920, glad the strike has not been too serious.

    Night waking is such a tricky issue. The fact is that biologically, babies are programmed to wake at night well into toddlerhood, and to want to nurse when they do. This does not mean your baby will do this, but it is typical. And it is typical among babies who nurse all day as well. In other words there is no clear correlation between how much a baby eats during the day and how much they nurse at night. This is of course difficult for all moms who are used to getting a straight stretch of sleep at night, but particularly problematic when mom is working during the day and unable to take naps herself. But there may be other ways to increase your own overall sleep (napping or sleeping in on days off, going to bed earlier.) It is unfortunate you do not get help overnight, but this is often the way even if dad is willing as mom is the one with the goods. However I think it makes sense to have a heart to heart with your husband, explain your exhaustion and see if he can do more in that dept. One way my husband helped with all babies was to take charge of them in the mornings so I could sleep in a bit.

    I forget if you said you do not want to or cannot bedshre? Bedsaharing is a great way to meet nighttime needs of baby and get more sleep yourself.

    When a mom is away from baby for work, what may cause more frequent nursing is baby's desire to reconnect with mom. However this is only a theory some hold. Again, there is nothing abnormal about frequent night nursing.

    A positive of frequent night nursing is that it protects mom's milk production longer term. Many moms who pump rather than nurse during the day experience a reduction in milk production even when pumping frequently. Decreasing the frequency of pumping at work as you plan would act to reduce production, but as long as your baby is nursing frequently at night, that is likely to help your production stay in fine shape.

    If your mom is willing, there are many online videos of babies eating "real" foods. Also the book Baby-Led Weaning is also quite helpful.

    I do not think schedules are needed or would make a difference with a 9 month olds eating habits. But, if baby is staying awake all day and then taking a nap very late, I guess that could be impactful on night waking. If you think that is going on, maybe talk to your mom about how and when naps are encouraged.
    Last edited by @llli*maddieb; March 30th, 2017 at 09:34 AM.

  5. #5

    Default Re: Refusing bottle and/or refusing breast

    Thanks again for the quick response, llli*maddieb. I totally understand that night waking is a biologically normal thing that happens with babies and young toddlers, and I also get that it's just tough to be a mom who works full-time and also pumps/breastfeeds. It isn't so much that my husband isn't willing to help in the middle of the night, he's more of a night owl than me; it's more so that even when he does go in to try to soothe, my son won't settle down until I go in and either nurse him or rock him or something. And there's also the fact that I wake up regardless when I hear my son cry since his room is right next to ours and I'm a light sleeper. I'd love for my husband to take charge in the morning, but he is not a morning person at all; I might have a heart to heart with him though when I get to the end of my rope and need some relief, but I tend to be a morning person and once I'm up in the morning there's no going back to sleep. In all honesty, I don't think that my son really wakes up frequently enough for me to seriously consider bedsharing as at worst he will wake up two times at night (during an 11-12 hr period), and it's usually only once a night so that's pretty manageable.

    I haven't tried to reduce or withhold nursing at night at all because I recognize that my son hasn't been drinking a whole lot of breastmilk during the day recently, along with the fact that it helps to maintain my supply. I've dropped down to two pumps per day and I'm producing about 9 oz between two sessions which is usually more than what he will take in a day while I'm gone anyway. Like I said in my original post, I was pumping 3x/day and producing about 11-12 oz, so I guess I don't see the benefit of continuing to do so if he will only take 6-9 oz/day at this time. I have quite a bit of milk in my freezer, and not a lot of extra room to spare to add more; am I wrong in thinking that if my son typically nurses 5 times per day when I'm home and he nurses 3 times when I work that I shouldn't need to pump 3 times? My work will certainly accommodate it, I just don't know what I'd do with all of the extra milk (and I'm taking a thyroid medication so I don't know that I'd be able to donate any of the excess).

    As a side note, it seems like my son is sensitive to becoming overtired easily, and like all other babies we have better and worse sleep days. But for the most part, I don't think his last nap of the day has an impact on how well he sleeps at night. I was able to talk to her today about trying more table foods and she was on board with the idea, so we can see how that will impact his thirst/hunger in relationship to bottles during the day. I must admit that I never thought that feeding my child at this age would be so overwhelming at times, I'm always worried if he's getting enough to eat (although he never acts like he's super hungry) which I logically know is kind of silly since babies eat when they're hungry and won't eat when they're not hungry!

    Again, keep the insight and advice coming! My personal goal is to make it to a year with breastfeeding and I'm not sure that I have a definite end age in mind, so I'm fairly willing to do what I need to in order to continue to be successful. Thank you!!

  6. #6
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    Default Re: Refusing bottle and/or refusing breast

    In all honesty, I don't think that my son really wakes up frequently enough for me to seriously consider bedsharing as at worst he will wake up two times at night (during an 11-12 hr period), and it's usually only once a night so that's pretty manageable.
    Ok, so I thought (assumed I guess) your baby was waking frequently at night. If baby is only waking once or twice in a 11-12 hour period, that is not frequently. While I am a big proponent of bedsharing for multiple reasons, I honestly think it very unlikely that bedsharing would reduce that waking frequency. It is more likely to increase it.

    On the other hand, if your child's nightwakings are so infrequent, then we have to wonder why you are so tired and what could help with that. If you are getting up, coming fully awake, once or twice in the middle of the night and trying for a long time to get baby settled, maybe it is the length of your waking and that you are needing to be fully awake during these times overnight that is the problem. When I think about it, when I nursed a child overnight and they woke every 2 hours and nursed, but we bedshared and I barely awoke each time, I woke up more rested than if I had to be up and fully awake for, say, 2 hours once in the middle of the night with a sick child. That kind of thing did me in.

    So while I understand about not wanting to bedshare and I agree it might not be helpful in the sleep department, I am not sure it absolutely would not result in you being more rested. It just depends.

    Moms pump at work for 3 reasons, all important. 1) to have milk for baby when they are gone 2) to prevent themselves becoming overfull and engorged and having discomfort or ill effects. 3) To make sure they continue to make enough milk so that breastfeeding continues as long as they and their child wishes.

    So since you have a good amount of milk stashed, and I assume that reducing to 2 sessions is not making you uncomfortable at work, the reason that might be impacted is milk production.

    How much of an issue this is depends in part on how long you would like to nurse. Some moms at this point think a goal of one year is what they want. Others want longer, say, 18 months or 2 years, and others do not really know how long they want to nurse. If you are planning to wean by about a year, a reduction in milk production at 10 months is obviously no big deal. On the other hand if mom is not yet even envisioning an end date, or just not sure, she might want to be sure her milk production stays in good shape for many months.

    am I wrong in thinking that if my son typically nurses 5 times per day when I'm home and he nurses 3 times when I work that I shouldn't need to pump 3 times?
    First I assume you mean eats/takes a bottle 3 times when you are at work- not nurse.(?)

    If so, it is not that you are wrong so much as that it simply depends on so many factors no one can completely predict it. It depends on your overall production and on your breast storage capacity, which is different than breast size. Both are factors in how reducing the frequency of milk removal might affect milk production and how dramatically and how quickly. It also depends on things like how much baby nurses on your days off, how many hours total between milk removal over night or during work, and how full you start to feel when it has been more than 3-5 hours since milk was removed, and how well your pump works.

    The average nursing frequency for a breastfed 10 month old is probably between 6 and 12 times in 24 hours. 7-8 times of milk removal would fall right into that average, only slightly on the low side. So it may indeed be plenty for your milk production going forward. It is just impossible to say for sure.

    Of course you could always try reducing how often you pump and just see how it goes. You would just want to think about if it is going to be any problem with your employer if you reduce pump sessions and then decide to increase them again in the future.
    Last edited by @llli*maddieb; March 30th, 2017 at 10:31 PM.

  7. #7

    Default Re: Refusing bottle and/or refusing breast

    You are so awesome for responding to my posts, I so appreciate it! To clarify a few things: I am definitely not always exhausted, usually the exhaustion results after my son has been having a tooth come through and is waking up more often, so my sleep gets quite broken up and it'll take me a while to fall back asleep. Otherwise, on occasion he will wake up at a point in the early morning that is close enough to when I naturally wake up so therefore I can't get back to sleep (so I'm exhausted by the end of the day). I was also recently diagnosed with vitamin d deficiency and have been supplementing, which has a big impact, and I have underlying thyroid issues which requires medication and has positively impacted my sleep.

    Also, regarding my pumping/nursing schedule when I work, typically my son will take 2-3 bottles (recently the total amount of milk between all of those is 6-9 oz), and he will nurse from me about 3 times in a 24 hour period. When we're together, he will often only nurse 5-6 times over a 24 hour period, every 3-4 hours during the day, and at night he will sleep for 6-7 hours, wake up to feed, and sleep for 3-4 hours or more before getting up for the day. I definitely try to offer him to nurse more frequently than that when I'm home, but it seems like lately he doesn't like to stop playing or exploring long enough to do so, and he will get frustrated and try to wiggle away from me if he isn't in the mood to nurse. I don't know if this is related to his age or not, and if it's likely that this behavior will change at some point, but I try to follow his lead as best as I can. At this point I will just see how it goes with pumping twice a day; how long is the delay between reducing pumping and reduction in supply? For example, would I potentially see a decrease in output after a week or two of changing to this schedule?

    Regardless of how this pans out, I'm so grateful that my body has been able to nourish and grow this child for as long as it has! And that it really has adjusted to however his nursing pattern has changed. I have a hard time trusting my body to do the "right" thing, and I've struggled a lot with being a first time mom without any prior experience with babies. Thanks again for your response, it sure makes me feel like I'm not on my own trying to figure all of this out.

  8. #8
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    Default Re: Refusing bottle and/or refusing breast

    Ok thanks for the clarification. I am glad you are not always exhausted and are getting help with your health issues.

    Ok so your baby nurses on the low side overall, so reducing pumping would reduce work day removal to a frequency more like the nursing only days removal. So, now I get it. But, even so, any reduction in milk removal frequency, even if done to match other days, will eventually lead to lowered milk production. I try to explain why below where I talk about how weaning happens.

    Just because milk production reduces does not mean you will not have enough -because a baby's needs change. Conversely you may experience a time your baby wants to nurse more often. Babies will often do this in order to bring milk production back up. When a mom is pumping, she just has to read her own body for signs of any problem. Of course the most obvious thing moms look for is pump output- but this is not always the most accurate measure, as pump output can reduce for reasons aside lower milk production. Other things to look at is how full you feel between nursing/pump sessions. When you feel any fullness, your body is getting the message to reduce milk production. You could look at behavior- if for example baby starts wanting to nurse more often, baby may be trying to increase milk production, so that may be a time to also increase pumping. Of course the most dramatic sign of a problem is baby becoming frustrated at the breast or refusing to nurse - this is something that can happen for many reasons even when milk production is fine, but for older babies in particular this is something that might signal low milk production.

    For example, would I potentially see a decrease in output after a week or two of changing to this schedule?
    Well, here is the thing. There is pretty much only one thing we can be sure of- If a mom (or baby) reduces how often milk is taken from the breasts, that is going to reduce milk production. Biologically we are set up this way because this is how weaning works...gradually, over time, baby takes less and less milk from the breasts and the body responds by gradually making less and less milk. This is how it works at any age, at any point, whether it is nursing sessions or pump sessions that are dropped. And usually the pattern is not that one session a day is dropped one by one until it is over. It can happen that way, but more typically there are days of more nursing, days of less nursing, several weeks or months when nursing increases for a while, times it drops off etc.

    So we know lowered milk removal reduces production. What we do not know, because it is so individual, is how long it will take or even whether it matters (as in, whether it leads to early weaning.) I point this out because if your pump output is the same after a week, that does not mean your milk production is not or will not be lowered. Eventually, it will. Whether you would see lowered output in a week- Potentially, yes, but that is not for sure in any way.
    Last edited by @llli*maddieb; March 31st, 2017 at 10:20 AM.

  9. #9

    Default Re: Refusing bottle and/or refusing breast

    All of that makes great sense, I appreciate the insight. It's so hard to know what all is going on as they change and develop. The frequency of how often my son will nurse has definitely gradually decreased over time, so even though it's difficult to imagine that he's getting enough by nursing 5-6 times a day, I know he is still gaining an adequate amount of weight. I'm always conscious about his weight since his weight is always lower on the growth chart compared to his length, however, that being said, they have both followed an appropriate growth curve.

    I must admit that more frequently my son has been getting frustrated at the breast, but I kind of feel like there are a couple of reasons for that. Since the middle of the month when he went on a partial nursing strike, I'm finding that it's taking longer for me to let down. I know that's frustrating for him when he is hungry and wanting to nurse, and I've developed some anxiety about it, afraid that if I don't let down quick enough that he'll refuse, and I'm right back to wondering if I need to feed him a bottle instead and pump. So I'm worried about whether or not he'll actually nurse long enough for me to let down and for him to get a full feeding, which I'm guessing is the reason why it's taking me so long to let down in the first place. Middle of the night feeds typically aren't an issue, unless he wakes up earlier than usual because in that case my breasts aren't all that full and I don't instantly let down, then he might fuss a bit before finally latching back on and nursing.

    I imagine that if I was experiencing low milk production that he would nurse more often, right? Or at the very least, I'm guessing that he would frequently act hungry? I hate to think that I self-induced the fussing, decrease in bottle acceptance, and partial nursing strike. Although I do understand that it's normal for babies to decrease the amount of milk they take in bottles with an increase in solids, I still have a hard time wrapping my head around my son only drinking 6-8 oz total when I'm gone at work for 10 hours a day. Not to mention that he refused all but 3 oz today while my mom was watching him! I just don't know if I should try a different bottle (we've used the same bottles and nipple size since I went back to work 6 months ago), or work more toward a real cup/sippy cup. I can't help but think that this is a developmental phase/behavior thing; my mom most recently was relying on feeding him while he was in his infant car seat (placed on top of a bed or solid surface), and now he's apparently starting to refuse to take a bottle in that setting. I don't know what else to suggest to her as he makes it pretty clear he doesn't want to be held and fed a bottle as he arches his back and tries to get off your lap. Do you think it would be worthwhile to try a different type of bottle? Or have a suggestion of where we might try to feed him a bottle?

    Thanks again for all of your help!

  10. #10
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    Default Re: Refusing bottle and/or refusing breast

    Well yes given the chance, a baby is likely to cue to nurse more often to increase milk production. But this is a biological set up that assumes biological norms, and the biological norm is for a breastfed baby and their mom to be together pretty much all the time- no separations for work or for nights, also no other means of milk intake (bottles) that may lead baby to be a little more reluctant at the breast or desire a faster letdown. So unfortunately, living in the modern world we can not always count 100% on baby doing what baby needs to do to increase production.

    When you offer to nurse more often, what does baby do? Is baby ever interested? The way I look at it, If you offer, and baby is not interested, there is not much more you can do. Keep gently offering and see if anything changes. But if your baby nursed more often, that would solve many of the concerns you are having. It would make his lack of interest in bottles less problematic, as he would be getting more milk when with you. It would give him more opportunity to figure out how to handle the slower than before (but probably still entirely normal) milk flow if that is bothering him. It would help you feel less concerned that he is not getting enough milk so you can stop worrying about bottles at night, and of course it would be helpful to milk production overall.

    This is not to say some babies do not get enough nursing 5-6 times a day. Some do. But it is on the very low end of frequency. If baby nursed just 1-2 more times in 24 hours, it might make a big difference.

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