Help! My baby won’t latch anymore!
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What moms want to know:
While breastfeeding is natural, it’s not always intuitive. It’s definitely not easy! It tends to get even harder when you first leave the hospital. Here’s a common concern I hear a lot in the outpatient clinic. Read below to learn what you need to know!
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The Deets: 5 day old baby. First time mom. Outpatient visit after discharge.
Mom: My baby was breastfeeding well in the hospital, but the first night home was hell. The baby acted like he was starving and I wasn’t making milk yet so I ended up giving him formula until my milk came in. Now he won’t breastfeed. He just screams and pulls away when I try to latch him.
Lactitioner: First, a couple of questions: Did your baby have at least 1 wet and 1 poop on day one of life and 2 of each on day two of life? Did your baby need to be supplemented in the hospital?
Mom: Yes, the diapers were good. He had way more than that. He did not have to be supplemented. He went home exclusively breastfeeding. He didn’t lose much weight, either.
Lactitioner: Those are good signs that your baby was feeding well. Tell me about what happened the second day at the hospital, the day you went home.
Mom: The baby was circumcised in the morning and then after lunch we had a lot of visitors for a few hours. He didn’t feed a lot during the day. We were discharged after dinner.
Lactitioner: Ok. First, it is pretty typical for baby boys to be sleepy after the circumcision and even skip a feeding. Second, often when there are lots of visitors and the room is noisy and baby is getting passed around, babies go into a very deep sleep. This is sort of a shutdown because they are very easily over stimulated. When baby is in this state it’s nearly impossible to wake him to feed. My guess is that baby was either making up for lost time and was very hungry that night and/or possibly in some pain from the circumcision.
Mom: Ok, that makes sense.
Lactitioner: Your milk should come in somewhere around days 3-5 (possibly on the later end if you had a c-section), but you’re still making enough colostrum before that to meet his needs. In this case I would often recommend lots of skin to skin to help calm the baby and offering the breast every three hours or as often as baby wants. But girl, let’s be real…This is your first night back in your own bed in at least three days. You are exhausted from the whole ordeal of birth and recovery and caring for a newborn. If your baby is freaking the f**k out, you probably are, too!
Try these things:
- Lay in your bed (not a water bed, no fluffy blankets) and strip baby down to his diaper and remove your shirt.
- Place baby on you chest to chest (you can cover his back with a blanket if you want).
- Pat his back and talk softly to him, trying to calm him. You can also offer your finger or a pacifier to suck on. Baby will either calm down and maybe fall asleep, start bopping around looking for the nipple (maybe even doing a dive-bomb down to the breast), or just continue to not have any part of it.
- Once baby is calm or looking for the breast, assist baby in latching on. Try to express a few drops of colostrum to entice him.
- If he latches on>> great, go with that!
- If he tries to latch but is unable>> try a different position, try to entice with more expressed colostrum, or even dripping a few drops of formula on your nipple if you were sent home with some.
- Sometimes the baby has difficulty latching if the breast is beginning to get full or is engorged because the nipple flattens out or the breast tissue becomes less elastic. If this is the case, try hand expressing or pumping a few minutes to soften and elongate the nipple. (Read here about hand expression and here about pumping.)
- If he’s just not having any of it>> it’s ok to supplement the baby! The first choice is your breastmilk. If you’ve got a pump, great, give it a shot! (Read here about pumping.) Or, you may have more success with hand expression. (Read here about hand expression.) If not,(or you just need a moment of sanity) it’s not the end of the world to give him a little formula. For realz. (Read here about how to supplement.)
- Three hours later>>wake baby and start all over again, beginning with offering the breast.
- If the baby is not latching, or is only feeding very briefly (<5 minutes), you will need to hand express and/or pump to remove the breastmilk every three hours.
- If baby latches at some feedings and your breasts feel softer after those feedings and the baby is content, you may not need to pump those times. (Read here about milk supply. You don’t want to overdo it with the pump!)
- If the baby won’t breastfeed you must feed him another way. That can be your expressed breastmilk, donor breastmilk, or formula. Read here about methods for supplementing.
- In the first week of life, start by offering 1 oz of either breastmilk or formula. Increase the amount slowly if baby is not satisfied. Be sure to keep track of the number of wet and poopy diapers.
- If your baby has been receiving bottles and continues to refuse the breast, sometimes using a nipple shield helps to transition baby back to the breast. (Read here about nipple shields. (Read here about visitors. You need to be prepared!)
But don’t despair, my friend! You can do this! Do not hesitate to call the lactation consultant at the hospital for advice if you are struggling. I also strongly suggest scheduling an outpatient visit with the lactation consultant at some point (sooner than later if you are having trouble). If you didn’t work with a lactation consultant in the hospital, you can find one in your area here.