Coaxing unsatisfied baby to the breastfeed and Nurse 1

Your goal is to coax the baby to the breast. Do not attempt to force your baby to breastfeed, there are other methods of coaxing baby that would be discussed here. Forcing the baby to the breast does not work, stresses baby, and can result in baby forming an aversion to the breast. As the baby gets better at nursing and is able to get more milk via nursing, he will grow to trust that breastfeeding works and will have more patience when latching.

• Wear clothing that allows very easy access to the breasts. The baby may get very impatient in the split-second it takes for mom to lift the blouse and undo the bra. Spend time, if possible, in a warm place that allows both mom and baby to be naked from the waist up.
• Lots of skin-to-skin contact can help your baby nurse better and even gain weight faster. Keep your baby with you as much as possible, and give him lots of opportunities to nurse (even if you’re not successful). Get skin-to-skin with him, first when he is sleepy, right after a bottle feed (or however you’re supplementing). This way baby has the opportunity to sleep and wake up happily, skin to skin at mom’s chest, and mom is right there to catch the earliest hunger cues. If baby moves toward the breast and then falls asleep before even mouthing the nipple, or after sucking twice, then these are positive baby steps, not failures. (Read more about kangaroo care or take a look at the book.)
• Offer the breast often. Try breastfeeding in baby’s favorite place, in his favorite position, in the bath, while walking around, while lying down, with baby upright, baby flat on his back, in his sleep, just as he is waking, any time baby looks as if he might be interested, or any other way you can think of, i.e. any time, anywhere.
• Avoid pressuring baby to nurse. Offer in an ultra-casual way and pretend you don’t mind if he refuses (easier said than done, but try not to show any frustration – your aim is to avoid pressuring baby to nurse). Don’t hold the back of baby’s head or push or hold baby to the breast. If baby pulls off the breast, then don’t try to make him go back onto the breast at that time – simply try again later. If baby seems frustrated with your offering the breast, then turn the pressure down and simply make the breast available (lots of skin-to-skin!) without offering. It can be helpful to have lots of skin-to-skin time with baby where he is cuddled at the breast with no pressure to nurse – give control over to your baby, so that baby decides if and when to nurse and when to stop nursing.
• Carry your baby close to you (a sling or other baby carrier can help with this). “Wear,” carry, hold and cuddle your baby as much as possible; carry baby on your hip while doing other things, play with baby, and give baby lots of focused attention.
• Sleep near your baby. If the baby sleeps with you, you’ll get more skin-to-skin contact, plus baby has more access to the breast (see this information on safe co-sleeping). If the baby is not in the same bed, have baby’s bed beside your bed or in the same room so that you can catch early feeding cues, breastfeed easier at night, and get more sleep.
• Nipple shields can be helpful at times for a transitioning baby to the breast. Talk to your lactation consultant about using this tool.
• Comfort nursing is often the first to come, followed by nutritive nursing. Offer the breast for comfort any time you see a chance- at the end of a feeding when the baby is not hungry when baby is going to sleep or just waking up, when baby is asleep, and whenever he needs to comfort suck If your baby is actively resisting nursing, then try encouraging comfort nursing after baby is comfortable with skin-to-skin contact. After baby is willing to nurse for comfort, you can then proceed to working on nursing for “meals” as well.

You are working to seduce your baby back to breast. Again, coax, don’t force!

“Instant Reward” techniques

For a newborn who is not latching or an older baby who does not want to wait for letdown, try these techniques that help to teach (or re-teach) your baby that nursing is a way to get milk:

• Hand express or pump until let-down, just before trying to latch baby, so that baby gets an instant “reward” for latching on. Another way to elicit let-down is by doing reverse pressure softening.
• If you are using a nipple shield to transition to nursing, try filling the tip of the shield with expressed milk prior to applying the shield and latching, so that baby gets some milk first thing as he latches.
• Drip expressed breastmilk (if you have it) or formula onto the tip of the nipple as you’re latching (use an eyedropper or a bottle). You can continue this while you’re breastfeeding: Just drip milk toward the center of baby’s upper lip; let the drop start on the breast and roll down toward the center of the upper lip (12 o’clock position if you’re using the football/clutch hold), one drop at a time. A curved tip syringe can also be used to drip milk into baby’s mouth.
• Use a nursing supplementer to increase milk flow at the breast.

If baby starts breastfeeding but stops sucking as soon as the milk flow slows, breast compressions can speed the flow of milk. If this is not sufficient, the last two methods above can also be used.