A baby who refuses to breastfeed and is not in the process of being weaned, is said to be on a “breastfeeding strike”. It is your baby’s way of telling you that something is wrong. It will take a little investigative work to identify the problem.

What is the most likely cause?

Some of the most common reasons for breast refusal include:

• Your baby is not latching on properly and cannot get a good enough mouthful of breast to feed effectively. Get help from a breastfeeding counsellor or infant feeding specialist to improve the situation.

• Mouth pain from teething, a cold sore or an infection (such as thrush).

• Your baby reacting to your shout of pain when she bites your breast.

• Your baby has an ear infection, which causes pressure or pain while breastfeeding.

• A cold or stuffy nose, which makes breathing difficult while breastfeeding.

• Supplementing with too many bottles of formula, resulting in reduced milk supply.

• Regular distractions, noise or interruptions while breastfeeding.

• Repeatedly letting your baby cry when she wants to feed.

• A major disruption in your baby’s routine, such as moving house or you returning to work.

• An unusually long separation from you.

Other less common causes include food or breast milk sensitivity or allergy, a cream or perfumed product applied on or near your breasts or a change in the taste of your milk. This could be caused by a drug, certain foods, the return of your periods, or if you become pregnant again while breastfeeding.

What can I do?

A nursing strike can challenge even the most dedicated breastfeeding mother. It can be a shocking experience for a baby to refuse the breast after some months of problem-free breastfeeding. By this time most mothers will have assumed that any difficulties were behind them. Whilst a mother is racking her brains to discover the reason for the strike, she may even (irrationally) feel that her baby doesn’t like her any more.

Although breast refusal can be a worrying and upsetting experience, it can be overcome, with patience and support.

While still encouraging your baby to breastfeed, you will need to express your milk by hand or pump every few hours (about as often as your baby had been breastfeeding). This will help prevent engorgement or mastitis and give your baby the milk that she needs.

Here are some ways to deal with it:

• Try offering the breast when your baby is asleep or very sleepy. Many babies who refuse to feed when they’re awake will do so when they are sleepy.

• Visit your doctor to rule out any medical causes (such as an ear infection or thrush).

• Try different feeding positions.

• Breastfeed on the move. Some babies are more likely to feed when you rock or walk them than when you’re sitting or standing still.

• Find a quiet room to feed in. It’s common for a six- to nine-month-old to go on a nursing strike as a result of his newfound discovery of the world. Babies of this age are easily distracted and often prefer to “snack” at the breast instead of settling down for a meal. Try using a dimly lit, quiet room, away from the sound of the radio or television.

• Give your baby lots of skin-to-skin contact (try breastfeeding without a shirt on or in a warm bath). A sling or carrier can help keep your baby close to you between feeding attempts.

It is easy to jump to the conclusion that a baby who doesn’t want to breastfeed is weaning himself. But it is unlikely that a baby under a year old who has been successfully breastfeeding is ready to give up.

Will it affect my baby?

Breast refusal can be upsetting for both mother and baby. Try to keep other elements of your baby’s routine as normal as possible during this time. Give her extra attention and physical contact. If you are worried that your baby isn’t getting enough food, keep track of her wet nappies. At least five to six wet disposable nappies per day – or six to eight non-disposables – indicate she is receiving enough fluid (disposable nappies are so absorbent that you may not notice every time she wees). Don’t hesitate to call the doctor if you are worried.

Can I still breastfeed?

Absolutely. It’s important to keep trying to breastfeed your baby. With patience and persistence you’ll get back on course.