Getting baby back to nursing – this is also close to my heart the way exclusive pumping was. Partly because I was unaware that breastfeeding does not always come naturally and there are sometimes challenges with it. Mostly because getting baby back to nursing seemed impossible, people telling you it is not worth trying, or not enough encouragement or motivation or support to pursue this – as it was considered waste of time or stressful. Almost every LC I met, though they provided some tips, were not very keen on this – they just tried to convince me that since baby is getting pumped milk, that should be good enough and could not relate to why I was trying to get baby back to nursing. I could sense that they were probably saying this to make me happy and not exert myself, but that was not my goal.
Hence once again, I did a lot of online research and found several tips and tried them. Some worked and some did not work for me. However I am adding all of them in the hope that they will be useful to you.
If your baby screams at the sight of the breast, the baby may have negative association with the breast. In such cases please take a break and try one of the reset methods described below.
Rest of the options work best if baby is not too tired or hungry.
Identify the issue – visit an LC
- Take help of lactation consultant and identify the issue first.
E.g. if the issue is due to supply get the supply up by pumping and try to nurse. You can continue nursing while trying to increase the supply if that works. I added a detailed post on how to increase supply here – Exclusive Pumping – Tips to increase supply . Please check this out if you need further information on how to increase supply.
If the issue is tongue-tie or lip-tie, then it might need to be evaluated.
You may be in lot of pain or have sore nipple while breastfeeding – this could be due to shallow latch – which could in turn lead to less transfer of milk. - Keep in mind that even exclusively breastfed babies go through phases of nursing strike or breast refusal. This could sometimes be aligned with their growth milestones.
e.g. a 4 month or 5 month baby whose senses are developing and starts seeing world and can grab things and do so much – are sometimes stimulated and distracted by these new senses and things, that they want to explore the new found world more than lie down and nurse.
Likewise bottle-fed babies may also feed small amounts and stop and want to explore the world and come back to feeding when they are hungry again. - I would recommend to consult with LC consultant to identify the root cause first. Based on root cause you can then determine if it requires a fix or you can continue nursing.
- I have not added much details here, because this is something doctors/LC can help better.
Express before nursing
Let us say you have been pumping for more than 2-3 months and baby is used to bottle feeding. At this time when you try to nurse, baby may reject the breast – signs include, screaming, tiny punches to the breast, crying etc.
Baby may be used to instant and fast flow from the bottle. Hence baby may look for similar experience from nipple and may cry if there is no milk immediately available.
Hence express before feeding the baby so that milk is readily available. Use manual pump or hand express or electric pump – whichever is easier for you. I used manual pump, since it was easier to drop it and latch the baby right away.
This is required in the initial few days, and after few days, you can evaluate the babies response and stop expressing before latching.
SNS System and nipple shield:
I got to know about this later (after 5-6 months), but I have read that SNS system also helps in keeping good nursing relationship, if you are exclusively pumping. This is the method where you feed the baby milk through a tube and the tube is closer to your nipple. This way baby is still drinking or suckling on the breast and maintains a positive association with the breast and helping increase supply. Check with your LC on how to do this.
Nipple shield can also help latch the baby – this did not work for me.
Take baby to bath with you
I have not tried this, but all the articles I read in internet mention this as one of the best reset methods, especially if baby has negative association with the breast. As per the articles I have read, being in bath or surrounded by water, reminds baby of uterus and hence help reset the mind and forget the negative association and helps bond.
Hence if nothing works, take the baby with you to bath and maintain skin-to-skin as much as possible and keep baby close to your chest.
Dangle feeding
Dangle feeding is where baby is lying down (elevated if possible to avoid gagging), and you feed the baby with nipple hovering over babies mouth – I think this is for gravity to help with milk flow. This did not work for me, but I had tried only once and stopped.
Baby Led Attachment
This is where mom is lying down in semi-reclined position and places baby on chest. The baby can find the food source on their own and latch with some help from mom – like mom holding baby in comfortable position while baby is looking for nipple to latch. It would work baby if hand express before so that the smell of the milk can encourage the baby to find the nipple and latch on their own.
Try when supply is best
To encourage baby well with good/abundant milk as reward for trying, nurse when the supply is good – like early mornings. Try to avoid late evening feeds when milk supply is little low and baby may also be usually fussy – as this would upset the baby more – almost as if baby is asking you ‘why are you asking me to work so hard for less milk’. Instead in the mornings baby is like – ‘wow so much milk, may be let me try some more’.
Note this is only when you are trying to get baby back to nursing relationship. If you already have good nursing relationship, please continue to nurse as per demand.
Dream feeds
Try lot of dream feeds – meaning nursing when baby is already sleeping. Babies usually open their mouth wide and are more receptive to nursing when they are in sleepy state. Avoid when baby is already fighting sleep or is fussy. This would also work best if you have already expressed a little before latching during the initial few days. As you try dream feed more often, baby would eventually get used to nursing and you can stop expressing before latching.
Skin to skin and keep baby close to your chest
Spend lot of time with baby and do as much skin to skin as possible. Keep baby close to your chest where baby can smell the milk and can get encouraged to nurse. Babies have good reflux for trying to find the food source and keeping the baby close to the milk source will help in nursing relationship. Do this even when you are exclusively pumping as it helps increase supply due to release of oxytocin.
Stop when baby screams
In the initial days of getting baby back to breast, stop after few seconds or minutes of trying. Otherwise it could cause negative association for the baby with the breast. For the mom, it could cause more stress and there by impacting oxytocin.
E.g. first 1-2 days, stop after 30 secs if baby is screaming. Continue offering everyday and increase the time based on babies response. If I remember well, my baby cried for almost 2-3 weeks but everyday the screaming started a little later – meaning on first week if the screaming started right after latching, on second week, the screaming would start after 2 mins of latching.
Note down progress each day and compare over weeks
Don’t be discouraged by daily progress. As noted above, the progress was very slow and if you rely on the recent response, it would look as if there is no improvement.
I highly encourage you to journal or take quick notes of babies response to the process. And compare the progress over a period of few days. The progress would be very minor, but you would notice some progress. This would go unobserved if you compare on daily basis.
e.g. First day, baby may even refuse to lie down to nurse. Few days later, baby may cry after latching… much much later baby may cry after few mins of nursing etc.
Note that sometimes babies feed longer sessions and some times they feed short sessions – Hence don’t be discouraged if baby feeds only for 2 mins and crawls away… Continue nursing to establish better nursing habits.
Don’t touch their head near their ears in initial weeks – or their cheeks
I was taught to hold the baby near the ears during latching or touch babies cheeks to keep them awake.
One of the LC I met explained to me that it triggers a reflux and makes baby to look for source of the touch. Hence both of these should be avoided in the initial few months.
When something touches babies cheeks, baby will immediately look for that source probably looking for food and hence moves sideways towards that source. When something touches babies near their ears (behind their ear lobes), baby will immediately pull their head backwards. Hence if both of these happen during latching or nursing process, it would confuse the baby more and cause more frustration.
Both these refluxes disappear as baby grows older – around 3-4 months.
Hence avoid doing this while latching or while baby is nursing.
Avoid distraction especially for older babies
Getting younger babies back to breast could be easier than older babies. Babies older than 4 months old are very distracted by the new senses and new world around them. They try to explore and want to spend time in discovering new things. Even exclusively breastfed mothers would notice the impact – where baby may unlatch after few mins of nursing and try to explore the world. Or bottle fed babies would stop after 1 oz and explore and then come back for another oz.
Hence take the baby to a quiet, dark room to avoid distraction. If needed use white noise machine to drown out the rest of the noise to prevent further distraction.
Establish a routine
This is in line with avoiding distraction especially with older babies. In the initial days when you are trying to bring baby back to nurse, try to follow the same routine so that baby can associate that routine with nursing. For example, use the same nursing chair or same spot in sofa or bed, sing the same song or use same blanket to wrap the baby. Keep the routine as simple as possible so that you can follow that routine every time and are not overwhelmed with the routine itself.
This is only required until you get baby back to breast. Once the nursing relationship is established you can nurse from any place provided the baby is not distracted (read point above).
Nurse when baby is calm
- Nurse when baby is calm
- Avoid when baby is very hungry or not too hungry
- Sometimes, it works if you bottle feed about 1 or 2 oz to the baby and then nurse – this way baby is not too hungry and will not get frustrated with slow flow of nipple.
- Likewise if baby is too full also, baby may not show interest in nursing.
Nurse when you are calm and stress free
- Babies can easily catch on to your emotions and hence if you get stressed, it would only make it easy for baby to scream sooner or louder.
- I know this sounds so hard, but try not to stress about latching or nursing especially if the baby is screaming. If the baby screams unlatch the baby, and hug and calm the baby. Or give the baby to another caregiver to calm down the baby.
- Keep very calm, as if you don’t care if this works or not.
- Be extra happy if possible. Have you ever seen this – you are having a funny conversation with your partner and both of you are laughing and your baby snickers from the corner and joins the fun? Babies catch on to your emotions so much that being happy will keep the baby calm as well.
- If the process gets too overwhelming, take a break and try again later.
- Have a partner or something to help you through this process.
- Being in a positive state of mind tends to attract success – hence another motivation for you to be happy and calm.
Keep baby on lowest flow nipple on bottle as long as it makes sense.
Keep baby on lowest flow nipple. Again I did not know this, but there are premie nipples available. Keep baby on 0 size for sometime and then move up to size 1 after 1-2 months. Keep baby on size 1 for as long as possible.
Sometimes pediatricians or guidelines on the bottle may suggest you to move up nipple sizes by 3 months, 6 months etc. I would recommend not to follow that. The reason is once the baby gets used to size 2 or size 3 nipple flow, it is much harder to get the baby back to breast. Also keeping the baby on lower nipple size would encourage pace feeding and hence avoid overfeeding as well
Move to next size only if you notice that baby is hardly able to draw milk out of bottle.
Use paced bottle feeding
In line with above, used paced bottle feeding. This technique is supposed to mirror nursing and hence baby gets steady flow of milk over time. Otherwise, baby will get milk very fast – this could also cause baby to spit up and cause overfeeding.
Something to keep baby occupied while nursing
Try this but avoid it if it does not work. E.g. Try a teething necklace that (older) baby can play with their hands while they are nursing – this way baby is occupied while nursing.
However if you noticed that baby is getting more distracted and unlatches to play instead of nursing, avoid these. For me this did not work, so I stopped all distractions. However, noticed that sometimes baby plays with my shirt while nursing and that kept baby occupied.
Hence this is more ‘test and use if it works’ approach.
Knowing when to stop / NEVER QUIT ON A BAD DAY
This is the hardest part, knowing when to stop. Sometimes moms have to make conscious decision to stop trying since it could be difficult to balance pumping/feeding and manage multiple kids, work etc.
As noted in my previous post, NEVER QUIT ON A BAD DAY. Turn the day around and revisit quitting at another time.
If you are not ready to give up, keep trying. If you know that you will never be able to put this out of your mind, then keep trying. Don’t worry about the outcome.
However, if it goes overboard that you are not able to enjoy the precious moments with the baby, with your family, then definitely think of moving on but be sure to let it go all the way. You should not hold on to this emotionally. It may take time to heal, but be ready to let it go and move on.
Expect help from unexpected sources
Breastfeeding issues may sometimes not be common in your circle. It could be piece of cake for someone that they would not even give this journey a second thought. Hence not only one could feel alone when going through issues with this, but that thought of ‘Why does this happen to me’ starts creeping into your mind. However, I must admit that, for some reason, I was not focussed on ‘why me’ part and was focussed only on researching ways to get baby back to nursing – so positive state of mind is very helpful.
But guess what? There are lot of women who end up exclusively pumping and then try to get back to nursing.
- There are several support groups in social networks. Find one and join so that
- You can ask questions about your unique situation and surprise, surprise – there is someone else going through this.
- They can relate to your situation. This would be so encouraging and could motivate you in your journey.
- Most of these communities are such positive community.
- They are not judgemental and respect your decision and acknowledge your hard work.
- Some hospitals also conduct breastfeeding support groups. Check with your hospital or online and visit these groups with your baby.
- Find out contact for La Leache league and connect with their leader to find out their support group schedules.
- Don’t be shy to discuss breastfeeding or take help from friends, neighbors or family.
Brush up on breastfeeding
Since you have been pumping for a long time, it is good to brush up on breastfeeding to gain confidence. Some of the topics would be:
- How to latch baby – remember the sandwich method
- How to unlatch the baby
- How to nurse baby efficiently and keep baby awake (remember the note from above, avoid touching the cheek to keep baby awake)
- How to switch breasts
- How to burp baby
- How often does baby nurse – do you have to wake up baby to nurse? or let baby sleep (your pediatrician may be able to help on this topic).
- How to handle biting situations (avoid yelping for sure 🙂 that could make baby repeat the biting to hear your funny response)
Try a nursing vacation
Once baby starts to accept nursing even a little (e.g. nurses for a min or 5 mins), try a nursing vacation. Pick a weekend when you have less workload and try a nursing vacation. No bottles, no pumping, just nursing with the baby all day long as much as baby demands.
It does require lot of patience and better to try once baby has started accepting nursing sessions. Also until you are sure the nursing is well established, I would try to add in a pump before bed (especially if baby feeds less at night) or an early morning session. However if it is only for 2 days, it should be fine too.
Take a risk assessment based on your baby’s nursing capability. E.g. if you already know that baby does not transfer well – then definitely add one or two pumping session to ensure you do not impact the supply especially when the supply is still being established.
Towards exclusive breastfeeding
If you have been exclusively pumping, you are used to seeing the quantity of the milk that baby drinks. Hence it would be little harder to completely move towards exclusive breastfeeding.
‘Is the baby getting enough milk? Is my supply getting affected? Can I keep my supply up if I exclusively breastfeed? What if baby is not draining milk well?’
These could be some of the questions that keep coming up when you replace the pumping sessions with a nursing sessions, especially if the baby is not a good nurser or does not drain breast well or is not gaining weight.
- Try to do weighted feeds few times to check if baby is draining the milk well – You can do this in LC’s office.
- Replace the pumping sessions with nursing sessions gradually. If you are in doubt put one or two pumping sessions to keep the supply up.
- Talk to the LC to work out a plan and ask all your questions to them to gain confidence in exclusive breastfeeding.
- However if the baby is gaining well and you are able to nurse on demand, then trust your baby and move on to exclusive breastfeeding.
Disclaimer:
I am not an LC or nurse or doctor. I am just a mom who went through this first hand and did a lot of research while trying to get baby back to nursing. I wanted to share my experience and research that I learnt and still learning so that someone who is in similar situation may be benefited from this information. I would highly recommend to meet with your nearest LC (there may be some LCs or La Leche League members who can come to your house). There are also online support groups you can join to garner more support and get real-time information for your questions.
This post is purely based on my experience and things I learnt in my research, hence it may not cover all the situations. If you have gone through something that is not listed above please comment below.