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My baby is now 3 months old. I produced milk after 5 days of delivery,after that my baby refused to take my left breast because of  a small nipple,I breast fed for one month but my daughter lost even her birth weight,then I started formula with breastfeeding, She prefers the bottle and takes the right breast rarely but I would like to breastfeed her exclusively. Can I do that? I got training in hospital too at Lmc, but no success, pls help me

This is a common issue for many women around the world. Breast refusal is distressing for a mom but the key is to find out the reason "Why".

I can provide you with a few tips on this to ease your mind.

· Is it really refusal or is he being a fussy eater?

Sometimes your baby is not refusing to feed but rather is fussy or hard to feed.

All babies have individual feeding habits. Some babies are easy-going, settle easily into feeds, feed well and come off satisfied until the next feed. Other babies take a while to get going but feed well once they start.

Other babies fuss from the start to the end of the feed, coming on and off and squirming around throughout the feed. Most babies feed from both breasts at some feeds and from one breast at others.

Others always feed from both breasts and others always from one breast. Some babies start out only wanting to feed from one breast and then later on want to feed from both, or vice versa. Sometimes after the early months (and sometimes all of a sudden), a baby becomes very efficient at feeding.

You may be used to your baby feeding for longer periods and then be shocked when your baby suddenly takes much less time to feed. You may begin to worry if you have enough milk. It is helpful to remember what the reliable signs that your baby is getting enough are.

If your breasts continue to feel comfortable, it is likely that your baby is still getting as much as he usually would. This is because if milk wasn't being removed as well, your breasts would start to feel very full or engorged.

· Is It Your Milk Flow?

Some mothers have a strong flow of milk in the early weeks until their supply settles. Sometimes a baby gets used to the strong flow and getting lots of milk without having to do much sucking in these early weeks. He then might refuse to feed or be fussy with feeds when his mother's supply settles down and he needs to suck more to get the same amount of milk.

If your baby drinks for a few minutes and then comes off, or tries to suck again but gets upset and fusses, it may be because your flow has slowed down. Switching to the other breast or trying breast compressions can help. Breast compressions are where you gently squeeze a large handful of your breast when your baby's sucking slows down (taking care not to disrupt his attachment). Moving your hand to different parts of your breast as you squeeze helps to drain different milk ducts.

· Get More Skin-To-Skin Contact

Keeping feed times positive is important to help your baby keep a positive association with them. This can be hard to do as breast refusal can be very stressful. It's easy to get quite upset and angry when trying to feed a baby who is refusing.

Spending lots of time in skin-to-skin contact with your baby on your bare chest can help to remind your baby that this is a nurturing place to be. This could be on a bed or in a bath etc.

Skin-to-skin contact can help your baby to use his instincts to find your breasts on his own. In this way, skin-to-skin contact can take the pressure off both of you. It's like you're saying to your baby 'Well, there is your food, go get it if you want it.'

Similarly, placing your baby in a sling and leaving your bra undone so that his face is near your breast could help.

· Feed Your Baby According To Your Baby's Need

Babies feed best when they are fed when they are ready to feed, when they are showing feeding cues.

If a baby is fed according to a schedule, he may not be ready to feed at the scheduled time. This may cause him to be more likely to be very fussy with or refuse the feed.

Sometimes babies are fussy with feeds during the day but feed like champions overnight. It's what they get in 24 hours that counts, not what they get at individual feeds.

Feeding your baby when your baby wants to feed, helps ensure he gets what he needs. As long as your baby continues to show reliable signs of getting enough milk, this is what matters most.

· Are Bottles Interfering?

How a baby drinks from a bottle is very different to how he drinks from the breast. Also, when a baby drinks from a bottle he gets milk more immediately upon sucking and gets more of a consistent flow. A baby who has been drinking from a bottle may have gotten used to these things and may refuse to breastfeed as a result.

Skin-to-skin contact and allowing your baby to find your breasts on his own may be enough to help overcome this problem.

Sometimes, a baby might get used to the way he is held when given the bottle. If so, holding him in the same position for breastfeeds can help. This might mean holding him in a cradle hold when he feeds from one breast and then in the football (underarm) hold when feeding from the other breast.

If your baby is used to the immediacy of flow from a bottle, expressing to get your milk flowing before trying to offer your baby a breastfeed can help. Then, once your baby starts sucking, breast compressions can help to keep up a good flow of milk to your baby.

· Try A Different Feeding Position

Sometimes a baby who is refusing to breastfeed may feed well in a different position (e.g. lying down or the underarm hold). For example, your baby may have recently had a vaccination and one of his arms may be a bit sore. So feeding in a different position may help to take pressure of that arm. Some babies that have had a difficult or assisted birth may benefit from a visit to an osteopath who specializes in babies.

Above is some of the tips can provide to support you. Hope this will help you to find some kind of a solution

Author: Dr Chaminda Kandauda

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