What To Do if Your Baby Won't Nurse

If you are reading this and trying to find information you have come to the right place, but I am sorry you are here.  Having a baby who wont nurse, when you desperately want them to, is a cruel, cruel joke and honestly it feels like grieving a death.  So treat it as such and give yourself permission to grieve fully.

You will get through this.  It is totally possible to get your baby to nurse, it may only be comfort nursing, but either comfort nursing or full nursing are absolutely possible.  And if its not in the cards for you and your baby, Exclusive Pumping gets easier and easier.  You can do it!

If you haven't already, read my previous post, Make Your Boobs a Happy Place.  Once you have made your boobs a happy place, THEN you can read this post and try these ideas.

Like I mentioned before, I am not a IBCLC or an expert of any kind.  I do have background in childbirth as a Doula and Childbirth Educator, but I have no certifications in lactation counseling at all.  This is simply a list of things I did to help Penelope figure out how to nurse.

Also, please note that Penelope is a comfort nurser.  I never was able to stop pumping or stop giving her a bottle.  From various scale weighing attempts, she can get anywhere from .5 to 2 ounces in a nursing session.  The ones where she has gotten 2 ounces, she was nursing in her sleep for two straight hours.  She probably could have survived if I stopped pumping and cut the bottle out, but I am more concerned with her being in 100% perfect health than I am about stopping pumping.  As much as I HATE pumping, her getting as much milk as she wants is my priority.

And honestly, comfort nursing was enough of an success for us.  All of my friends kids breastfeed, and she acts just like they do, in the way she nurses.  I know that even though she doesn't get a full feeding from nursing at all, she is not lacking in any way by having a bottle, or her bubba, as she likes to call it, in addition to her comfort nursing.

Ok, so this is what we tried, in no particular order, once I made made my boobs a happy place (and fixed all her physical problems that were impending her ability to nurse, more about that on another post).

First and foremost, do not give a pacifier to your baby!!  Offer a finger or your boob, NOTHING else. A week after we stopped finger feeding and went to bottle feeding, I gave in and gave her a paci.  I felt like all hope was lost when we gave her the bottle, so I thought, what the hell difference does a paci make now?  Well, it makes a huge difference, trust me on this one and don't do it.  Taking her paci away at 12 weeks was a huge turning point for us (although it made for a very stressful two weeks).

1. Try a Medela nipple shield.  Sometimes baby can have a hard time latching because of flat nipples, if flat nipples are the only problem, nipple shields can be an easy fix.  Be warned, that although they may make it easier for baby to latch, they can actually make it harder for some babies to get the milk out.  As was our issue.  So when we used the nipple shield, it caused her to get even less milk (when she was newborn and still latching and I wasn't pumping yet).

2. If you already have tried a nipple shield with some success, you can try and put the nipple shield on the nipple of the bottle, when ever you bottle feed, or on your finger for comfort sucking, to get them more used to the nipple shield and more likely to latch on and stay latched.  Be warned, this is very cumbersome for the babies, so they may not want anything to do with this technique.  For us, this helped Penelope not to have a negative association with nipple shield and she would actually latch on a bit with the nipple shield after doing this a couple of times.

3. When you bottle feed, or bottle nurse, as I like to say, make your baby "latch" on to the bottle.  So put the nipple on the area in between the nose and top of the mouth.  Make baby open up real wide and then press bottle nipple down into their mouth, towards the top of their palate.  Once they feel the nipple at the roof of their mouth, they start sucking, just like regular nursing.  Then as they are sucking, you "pace feed" them.  So that means, they suck, suck and swallow. Suck, suck and swallow, just like nursing.  A bottle feed should take 15 to 20 minutes, just like nursing.  You tilt the bottle up for them to get a little milk and then back down to give them a break.  They learn they need to keep sucking to make more milk come out, that they need to work for the milk, just like they do if they are nursing.  Several people ask me,  "well, doesn't baby get more air that way?"  I don't really know the answer, but I don't really give a shit.  The pace feeding is more important than a little gas or burping.  Just burp your baby very well and do a little baby yoga to help pass gas, this is the least of your worries right now.

4. Hold your baby like you would if you were nursing.  Once I made my boobs a happy place and took care of Penelope's TMJ (it actually made it painful for her to even lie on her side, let alone open up her mouth) I held her in a cradle position with her cheek on my boob, kind of like a little pillow.  Her cheek was high up on my boob, because that was most comfortable position to hold her in with one hand and feed her the bottle with the other.  Later, I found out that I needed to have my nipple be right by the corner of her mouth.  So I had to lower her position down and turn her more towards me so that we were more belly to belly.  The IBCLC that gave me that tip, described it like this: "imagine that that they are leaping from point A to B.  From bottle feeding to nursing.  Right now it is a HUGE leap for her, so do everything you can to make the leap as SMALL as possible by making bottle feeding as much like nursing as possible."  She also told me to bottle feed lying down on my side, like side-lying nursing, again, just trying to make bottle feeding as much like nursing as possible.  This had never occurred to me before she mentioned it and it was so nice to be able to lay down.  I had been doing all our feeding times in my piece of shit rocking chair.  Next baby we are going to get the Cadillac of rocking chairs, learned our lesson the hard way!

5.  Once I got the hang of the belly to belly, nipple-in-the-corner-of-her-mouth position, she would often un latch from the bottle and turn towards me.  It was pretty amazing actually.  She could smell the milk inside me! Their rooting reflex and desire to nurse is so STRONG!  If she turned towards my nipple she would get lots of positive reinforcement (Yay! Penelope! You can do it!) and I would offer my nipple.

6.  The Bait and Switch technique works best in the middle of the night when they are half asleep.  You start out with the bottle, and super fast, ninja-like, you pop your nipple in and pray to God they latch on and nurse.  Sometimes this worked for us, if only for a moment.  Instead of getting discouraged that she would spit my nipple out and want the bottle back, I saw each little thing as improvement. As in, "OMG she latched for 2 seconds!!"  Each new milestone was baby steps toward our goal.

7. Contraptions (if anyone ever tells me breastfeeding is free, I just might slap them):

• We used almost every single one on the market.  As far as supplemental nursing systems goes, I liked Lact-Aid much better.  I think if I had tried that when she was newborn, she might have got the hang of full nursing.  The Medela SNS is great for good nursers, but Mama's supply is low. The Lact-Aid is what you need if you have a baby who has trouble nursing and baby can't get the milk out.  I wish I had introduced the Lact-Aid before we did finger feeding. Our IBCLC we were working with, at the time, did not recommend this to us for whatever reason, but I think it's what we should have done.  I feel like if we had done that, if we had kept her at the breast at all cost, she might have figured out how to really nurse. (Lact Aid did not pay me to say that, I have purchased a Medela SNS, a Medela Starter SNS AND a Lact-Aid and this is my honest opinion).  Ease into using it a couple of times per day, at times when baby is very drowsy - either going to bed,  waking up, or down for a nap - whatever combination works for you.  I got that tip from  a fellow blogger who, amazingly, had a very similar experience as us, but she was able to get her baby to fully nurse.  Her blog is a wealth of information as well.  Here is a link to a video of her showing how to use Lact-Aid.  And here is her nursing saga. 
• Like I said before I tried a Medela nipple shield.
• I also bought this nipple extractor thingy called the Evert It Nipple Extractor (don't laugh!) to draw out my nipples to try and make it easier to latch.  On top of ALL of Penelope's physical problems that made nursing nearly impossible, I have flat nipples.  I really like this product, if flat nipples are your only issue.  Pumping first to draw out nipples and induce let down are something else we tried too.
• I also bought this syringe bulb type thing, called the SuppleMate (seriously, who came up with these names!) from the same company.  The idea is to drip a few drops of EBM into their tongue to get their rooting reflex turned on. Then to drop some on your nipple so there is milk on it to encourage them to latch or to suck once latch.  Then you can also slip it in the corner of their mouth to encourage them to keep sucking, and not have to wait for milk let down.  You can use actual syringe, which has a smaller tube, but this was the easiest to maneuver for me.  And its kind of like a bottle, in the way that I could set it on the counter for a few hours (gotta love BM!) and use it when I needed it/felt like it, instead of having to set something up every time I tried something.
• I also tried Medela's nipple extractor thingy, called Soft Shells.  They really didn't work for me, but maybe it works better for other people.  In fact, they really stressed me out, putting them on and wearing them.  I think skin to skin is more important and you have to wear a bra or tank to keep them in place.  And if you are pumping, and have flat nipples, the pump will draw them out eventually.  Mine are still not pointy, little, erasers like a lot of women, but the pump has broken down the hard tissue and they are very malleable now and easy to sort of mush/pull into an erect nipple.  Here is another link with info about inverted nipples.

8. In the mean time, should you finger feed, bottle feed or cup feed??  Click here for a link of more info on all options.

• We finger fed Penelope with a syringe for three weeks.  Then one day it just broke.  We had been using disposable ones from our IBCLC.  Looking back, I am sure she just thought we would have gotten the hang of nursing and was trying to save us money, but I wish I had bought the Medela Starter SNS right from the get go.  Because we would have finger fed her longer with it, since it holds several ounces in the bottle.  It was a NIGHTMARE to finger fed with a syringe.  Every 10 cc's you had to fill it back up.  There are 30 cc's in one ounce. So to do a 1.5 or 2 ounce feeding, it took FOREVER. And she would scream her head off every time we stopped to fill up the syringe, so it was really stressful on both of us.  So if I could do it again, I would have finger fed her for at least the first 12 weeks, because finger feeding is more like nursing than bottle feeding, in the way it develops the jaw and mouth muscles needed to be an effective nurser.
• If you do go to a bottle, use the Breastflow one.  We first used Medela bottles, because I figured, "Hey, its Medela!" They must only sell the best bottle for breastfeeding success for moms and babes.  And they had glass bottles which I liked. Nope. I was wrong.  Medela makes some great products and some shit products.  Their bottles are some of their shit products (more about the ways Medela is not as great as everyone thinks here).  The Breastflow bottle requires a compression and sucking movement more similar to nursing than other bottles and it has a wide base and short nipple to feel most like mama (although no bottle can compare, this one comes the closest).  Then later once Penelope was latching, the IBCLC we were working with at the time, told us that plain old, Even Flow nipples (they fit on Medela pump bottles) are good too.  Whatever you buy, get the shortest nipple possible and the slowest flow possible.  Then you must also pace feed.
• We never tried cup feeding, but it is also an option. 

 9. Sort of in line with the Make Your Boobs a Happy Place post, do everything you can to be very attached and in tune with your baby.  Wear your baby, sleep with your baby, take lots of baths with your baby, do EC with your baby (it will help you learn all your babies cues faster and be more in tune with your baby)...and the point of all of that, is to catch your baby rooting and to be ready to quickly offer the boob, in calm, detached manner.

10. Do exercises for jaw/mouth muscle development.  Throughout the five million appointments with lactation people, chiropractors, cranial sacral therapists, physical therapists, speech therapists, etc several recommended doing things to Penelope's mouth to make sure she was developing mouth/jaw muscles properly.  Such as:

• Tap around baby's mouth in a circle.  This stimulates their rooting reflex and helps create muscle tone.  
• Then take your finger and draw a circle around their mouth, with enough pressure like you would if giving a massage. Then do the same thing on her actual lips.
• Then take your finger (wash your hands first and use a brush to clean under your nails) and "swipe" your fingers along the inside of the their cheek.  Once up top, once in the middle and once along the bottom of her cheeck.
• Then press your fingers along their gum line, top and bottom.  You are trying to get her tongue to move toward your finger for this one.
• Then try and press your finger to the top of her palate and try to get her to suck on your finger.  Have her finger suck as long she can.  Try this several times throughout the exercises and try to notice any changes in her sucking.
• Also massage the outsides of their jaw.  In a circle motion, all around the cheeks and jaw bone.  
• And lastly, introduce all sorts of textures to baby's mouth.  She needs oral stimulation that is she lacking from not nursing, to have her mouth nerves develop properly to make sure speech is not impeded later.

I plan on doing a third post that explains all of Penelope's physical issues in detail and all the types of professionals we went to see.  It may take me awhile to get that post done, so the short version of the story is: take your baby to a chiropractor and cranial sacral therapist as soon as you can.

Phew!  Are you exhuasted? I sure am.   If you have any other tips and techniques that you have tried with success, please let me know in the comment section and I will add another section for tips and ideas from other people. I would love for this to be an all-inclusive resourse page for Mama's trying to get their babies to nurse.

And as always, send me an email if you have any further questions, I am always here to help.