How to end a nursing strike

A nursing strike is a sudden refusal to feed in a baby who was feeding happily, and it usually lasts days rather than weeks. Look for pain, illness or a change in routine, keep expressing to protect your supply, and offer the breast when your baby is calm.

What a nursing strike looks like

Your baby arches away, screams at the breast, or clamps shut and turns their head. Yesterday the same feed was fine.

La Leche League International calls this a strike, and it is different from weaning. Weaning is gradual, happens later and leaves a contented baby. A strike is sudden, upsetting for both of you, and temporary.

Your baby is not rejecting you. Something has changed, and the job is to find out what.

Why has your baby stopped feeding?

Pain in the mouth or ear. Teething, thrush, an ulcer, or an ear infection that hurts more when lying down. A baby who feeds on one side but not the other often has a sore ear on the refused side.

A blocked nose. Babies breathe through the nose while feeding. A cold, or a night under a cold air-conditioner, makes a long feed hard work.

Hand, foot and mouth disease. It moves through nurseries, taska and playgroups regularly, and KKM records cases every year. Mouth ulcers make sucking painful. Fever, blisters on the hands and feet, or spots in the mouth mean a doctor rather than a different hold.

A fright at the breast. You yelped when your baby bit you, or a fast let-down made them splutter. Babies can remember that for a few days.

A change in taste or smell. A new soap, a strong perfume, your period returning, or a medicine you have started. The milk is still fine. Your baby has simply noticed.

Distraction. From around four months, hearing and sight are sharp enough that a busy room beats a feed. This is very common and is often mistaken for a supply problem.

A routine turned upside down. Balik kampung, a new carer, the first week at the nursery, or a lower supply after several missed pumping sessions.

Protect your supply first

Before anything else, keep the milk moving. Express or pump about as often as your baby was feeding, overnight too, for as long as the strike lasts.

There are two reasons. Your supply depends on milk being removed, and a breast left full is how a blocked duct and then mastitis begin. Our guide to clearing a clogged milk duct covers what to do if one starts.

Store what you express. Your baby still gets your milk through the strike, and you will be glad of the stash later.

How to coax your baby back

• Offer when sleepy. A half-asleep baby often latches by reflex, so try as a nap begins or at a night waking. Keep their head slightly raised.
• Skin to skin, with no pressure. Lie down together with your baby on your bare chest and let the breast be nearby rather than offered. Many strikes end during a long cuddle, in the bath, or in a dark room.
• Change position. Try laid-back, under-arm, or standing and swaying. A baby with a sore ear often accepts the side that keeps it off your arm.
• Cut the noise. A quiet, dim room with no television and no visitors. For an easily distracted four-month-old, this alone can be the whole fix.
• Go back to familiar smells. Put away the new perfume, the new shower gel and the strongly scented laundry detergent until feeding settles.
• Stay calm if you can. Easier said than done at 2am. A tense feed is a short feed, and walking away for ten minutes before trying again loses nothing.

Never force your baby's head onto the breast. It makes the strike longer and the next attempt harder.

Going back to work, and the strike that can follow

Eligible employees get 98 days of paid maternity leave under the Employment Act 1955, so many mothers go back to work around the fourth month. That is a classic time for breast refusal.

Two things collide. Your baby has had a couple of weeks of bottles with a carer, where milk comes fast and takes little effort. Your supply may have dipped, because pumping at the office is harder than feeding at home. It looks like rejection and is usually mechanics.

A few things help. Ask the carer to use paced bottle feeding, so the bottle is not much easier than the breast. Pump on your baby's old schedule rather than whenever a room is free. Feed directly as soon as you get home and through the evening. Our guide to pumping at work covers the practical side.

Ask what time the last bottle was given. A baby who drank 150 ml at 5pm will not be hungry at 6.30pm, and that is not a strike.

Looking after yourself meanwhile

A strike is miserable at the exact moment you have nothing left in reserve. Eat something, sleep when the pumping is done, and tell someone how it is going.

Lots of short, shallow attempts can leave nipple skin dry and tender. Our Intensive Nipple Cream is a lanolin balm with shea butter and coconut oil that moisturises and protects nipple and areola skin and helps prevent cracked nipples. There is no need to wipe it off before a feed, which saves a step when your baby is already reluctant. It is halal certified by BPJPH, Indonesia. If your nipples stay sore, that is one of the reasons to get help listed below, and our guide to breastfeeding pain covers the usual causes.

When to get help

• Your baby has refused feeds for more than 24 hours, or is taking far less than usual
• Fewer than six wet diapers a day, a dry mouth, or unusual sleepiness
• Fever, blisters, or spots on the hands, feet or mouth
• Pulling at one ear, or crying when laid flat
• A hard, red, painful area on your breast, with or without fever
• Nipple pain of your own that has not settled, which usually means the latch has changed

Your klinik kesihatan can see you both and refer you on, and many hospitals run lactation clinics for mothers after discharge. Breastfeeding peer counsellor groups are another good source of help between appointments. A dehydrated or feverish baby goes to a doctor first and a lactation consultant second, and a baby who is floppy, hard to wake or struggling to breathe needs emergency care, so call 999.

Most strikes are over within a few days to a week. For many mothers, the turning point is finding the cause rather than trying harder at the breast.