Truthfully, you may never know the cause. In many many cases, the cause is not obvious. At a time when you are already feeling low, and you’re missing out on your usual oxytocin too, you can feel worse by focusing on the necessity of being Sherlock Holmes. It might be more positive to focus on the solutions.
Whatever the cause, the list of suggestions is fairly universal:
• Use your acting talents. This means keep the pressure off and don’t make it really obvious that you are distressed and desperate. You are nonchalantly lying on the sofa with your top off watching Peppa Pig and if they happen to toddle across and want to breastfeed, that’s great. But you are CHILL. You aren’t forcing them towards you or pleading or bribing. You are CHILL. It is vital that the breast does not become a battleground.
• Be close. Have baths together. Use a sling. Lie together. Your body and your breast are still their friends and the place where they are safe and secure. Don’t have a reveal of the breast only associated with <drumroll> an attempt to breastfeed. We don’t want the only time they hear the click of a nursing bra to be, ‘Uh Oh, this is the bit where she tries to get me to breastfeed again.” The breast is just THERE. It’s no big thing.
• Use sleepy time. This is often the key. Many times, a strike ends because of acceptance of a breastfeed when a child is falling asleep, transitioning between sleep cycles or very sleepy. This is when co-sleeping can be useful because you are literally part of the furniture and you can experiment with offering at different times in their sleep cycle.
We don’t want the only time they hear the click of a nursing bra to be, ‘Uh Oh, this is the bit where she tries to get me to breastfeed again.”
• Use ‘distracted brain’ time. A bit like when a child is sleepy, and most of their brain is busy focusing on something else, offer when they are only half-noticing. I once saw a video of the lactation consultant Edith Kernerman working with a baby who was reluctant to feed. She had the mother bouncing on a birthing ball (or was it moving on an office chair) while loudly saying, “CHICKA CHICKA CHICKA”. The baby had this expression of wonder, like they were thinking, “WHAT are you doing?” and were so distracted they didn’t seem to mind being asked to latch on. Latching might happen when they are in a sling and you are walking outside, singing, talking, swaying.
• And the complete opposite might also work. Go into a distraction-free room. Maybe even black out a room and see what happens.
• If they do have a sore mouth, oral gel might help and you can talk to your GP about options. Sometimes a breastmilk ice lolly can bring relief and it’s also a way to get milk into them.
• Think about how the baby will be fed. Obviously this depends a lot on how old they are and how they are getting on with solids. Don’t automatically think, my child is X months old so their 24-hour intake of milk must be X mls. Therefore, I must pump and give non-human milk if necessary but it must be X mls total in 24 hours. Clearly, we don’t want a baby to be dehydrated, but a little bit of hunger may be a motivation and if you are giving vast amounts of milk, you may be removing that motivation. If you are giving milk using a bottle, you may also be meeting their need to suck. Some suggest offering milk via a cup, spoon or syringe while you are trying to encourage them back to the breast. If they are happy to suck on a finger, you might be able to finger feed with a feeding tube. You can ask a lactation consultant more about this.
• Protect your supply. If your child is older, your supply will be less vulnerable than it was in the early weeks. However, you still operate on a supply and demand basis. Over time, if milk isn’t removed, your supply is likely to decrease. Expressing approximately when your nursling might have fed is probably sensible. If your supply was to decrease further, a slower flow might mean that they are less keen at the breast. Sometimes slow flow was partly the reason behind the initial reluctance so some work on increasing supply might be useful. Occasionally, fast flow is the problem and a strike occurs if a nursling just can’t face coping with being overwhelmed. If that might be the case, connect with a breastfeeding counsellor or lactation consultant who can support you.
• Use expressed milk as part of your strategy at the breast. Trickle milk over your nipple. Let them suck milk off your finger. You could also express just before an attempt to help the flow to get started.
• Anyone else around to model breastfeeding? There’s a famous story of a gorilla learning to breastfeed by watching a mother. Maybe visit a group where breastfeeding will be happening or get a breastfeeding toddler to visit. Or pretend to breastfeed a toy or another object.
Some suggest offering milk via a cup, spoon or syringe while you are trying to encourage them back to the breast.
• Stop trying for a little while. Just take the pressure off and have a break, even for a couple of days, and then try again.
• Give yourself space to have an emotional reaction and seek necessary support. You may be surrounded by people who don’t quite get what the problem is. They may feel you’ve already been breastfeeding for quite long enough and even see this as an opportunity. An early priority would be to communicate why this matters to you and what you need from them. Failing that, you may want to reach out to online breastfeeding support communities or even your local peer support, who will absolutely empathise with how you are feeling, as well as support you with the practicalities. Breastfeeding support is there for you at any stage of your feeding experience: peer supporters, breastfeeding counsellors and IBCLCs.
• If nipple shields or bottles are already part of your life, they may be a tool to help bring a baby back to the breast. This might mean loading a nipple shield with milk so they immediately get a mouthful or starting with a bottle and then quickly switching to the breast. You can also bottle feed while skin-to-skin.