Why does my baby fuss at the breast and what can I do about it?
Feeling frustrated by your baby pushing and arching away from you when you try to breastfeed? Does he start tugging at the breast and thrashing his arms and legs about after just a few sucks? Does he hold your breast in his mouth shouting into it like a microphone and beat into your breast with his fists?
This ‘fussing’ is your baby’s body language to tell you he’s not happy about being at the breast right now. But why does this happen and what can you do about it? After all, you know he’s hungry — why won’t he just feed?
The good news is that fussing at the breast is very common and there is usually a perfectly good reason for it.
Baby is not ready to feed just yet.
- Baby’s fussing could simply mean “I’m not ready yet”. Perhaps he needs to burp or fill his nappy (or need a nappy change) before he can relax and enjoy a breastfeed. Discomfort will distract him from feeding and you may not realise what he needs to do until after the event!
→ Stop offering the breast for a moment and hold baby close to your chest in an upright position. Wait for a moment. Any wind will be able to come up (or down) as needed. It may take a little time depending on your little person. When he’s ready to feed he will start to look for the breast and you can try to feed again.
- Fussing can happen when you’re feeding to a schedule and waking your baby to feed by the clock instead of waiting until he shows you his feeding cues. A tired, sleeping baby is not interested in feeding — he will be frustrated by the offer to feed when he just wants to sleep.
→ Unless medically indicated, there is no reason to wake your baby to feed on a regular schedule. When he wakes by himself he will be hungry and eager to feed.
Baby has had enough for now.
- Your baby’s feeding and sleeping patterns naturally change with him as he grows. He may not feed as frequently or for as long as you expected him to. He may sometimes want just one breast, not two at some feeds. His pattern may be changing from feeding when he wakes to waiting until just before his next nap. This natural change in feeding pattern might leave you feeling worried that he’s not feeding enough and so you continue to offer the breast when he doesn’t want it anymore. His fussing is his way of saying “No thanks”.
→ Offer the breast but allow baby to accept or decline. Never force baby to the breast. Stop for now and offer the breast again later. Allow yourself to adjust to baby’s changing needs and trust that he will always feed when he’s hungry and to his appetite.
Poor positioning at the breast
- Baby needs to be well positioned so that he can latch deeply and access all the milk he needs. A shallow latch does not stimulate a good flow of milk and his fussiness indicates his frustration.
→ Baby — led attachment is helpful when you’re up against a fussing baby. Take your bra off and hold your baby in an upright position between your breasts. Allow him to help himself to the breast and to adopt a position that’s most comfortable for him (this might look strange and uncomfortable to you!). This positioning keeps your hands out of the way and encourages baby to latch himself. You’ll be amazed at how effective this simple change can be!
If baby is struggling to latch have an International Board Certified Lactation Consultant (IBCLC) or your health practitioner assess baby’s mouth for oral restrictions / ties or other reasons for a poor latch.
Milk Flow — too fast or too slow
- Have you noticed that you have one breast that seems to have a faster milk flow than the other? Does your baby feed better on the faster side and fuss more on the ‘slower’ side? Or do you have so much milk that baby pulls off and screams as soon as your let-down starts? Your baby likes his milk to flow at a pace that’s comfortable for him. Too fast can be uncomfortable and frightening ; too slow can be frustrating.
- When your breast is full your milk flow is faster; When your breast softens the milk flow slows. Baby may fuss with this flow change and may simply indicate that it’s time to swap to the other, fuller breast.
- Some mothers struggle with milk production and baby’s fussing is a frustrated response to a slow milk flow. Low milk production and slow let-down have multiple causes and can be exacerbated by stress and tiredness.
→ Gentle breast compressions throughout each feed are helpful to encourage your let-down and to help baby to remain calm at the breast. Slow, deep breaths and giving your baby lots of kisses just before breastfeeding helps to lower your stress levels as well as enabling your oxytocin to flow more freely for a better let-down.
- Some mothers produce too much milk. Constantly full, fast flowing breasts can make feeding uncomfortable as baby gulps, gags and tries to catch his breath before pulling off and screaming.
→ Positioning baby in an upright baby-led position helps baby to have control over latching on and off the breast when the flow is too fast. Express a little milk by hand before feeding to make the breast less full can also be helpful.
A Lactation Consultant can help you with positioning, assess you and baby for causes of low milk supply and methods to increase or slow down your milk supply and milk flow.
Combining breast and bottle feeding
- Your breast milk flows differently to milk from a bottle. Baby needs to suck for a few moments at the breast to stimulate the milk flow — this contrasts with the instant milk flow from a bottle teat. Combining breastfeeding with bottle feeding can lead to baby fussing at the breast due to a preference to the faster, easier bottle.
→ Avoid mixing breastfeeding and bottle feeding unless absolutely necessary whilst you’re getting started with breastfeeding. If you do need to mix feed choose a bottle teat that’s better suited to breastfeeding babies ( a slow flow teat that requires baby to create suction for the milk to flow and not a teat that simply pours freely and requires no effort from baby). ** Needing to regularly give baby a bottle is not a normal part of breastfeeding. See a Lactation Consultant if you are experiencing difficulty in making enough milk for your baby. They can also give you great tips to combining breast and bottle more easily.
Pain or Illness
- It’s important for baby to be comfortable to feed well. Perhaps his recent birth has caused some bruising on his head or neck? Has he just had his immunisations and feeling a little ‘off’? Is baby teething? Does he have a fever or early signs of illness and seems less interested in feeding than normal? Does baby look to be in pain or vomit after feeds?
→ Immunisations, teething or illness are short -lived causes for fussy feeding. Do your best to remedy baby’s discomforts and hang in there for a few days until the symptoms pass. Discomfort directly associated with feeding can make every feed stressful and difficult for both mum and baby. If you feel baby is physically uncomfortable at the breast for other reasons your Lactation Consultant will be able to help you find a more comfortable position and recommend other health practitioners to help your baby’s comfort.
Fussing at the breast is your baby’s way of saying “Stop!”. It is not always easy to work out why. Offering the breast when you sense baby is or should be hungry is always ok. But let your baby decide whether to accept or decline the offer. If he pushes away try not to feel rejected and offer again in a short time. If you’re concerned about your baby consult your doctor, health nurse or lactation consultant for further support.
Rowena Gray is a mother to 3 young daughters, nurse, midwife and International Board Certified Lactation Consultant (IBCLC) and has been both a consumer and giver of copious amounts of breastfeeding advice! She has a private practice in Melbourne, Aus. www.rowenagray.com.au
Rowena is also the author of ‘Born to Breastfeed — the first six weeks and beyond’ available in bookstores and online.