This article is focused on breast refusal that sometimes happens at around 8-12 months (although those ages are not set in stone). We often use the term “nursing strike” to describe this experience. Although the word “strike” is perhaps unhelpful as it implies this is a conscious decision on the part of the nurser, and you are presumably meant to meet some demands and then the strike will be over.
Trouble is, you usually don’t know what the motivation is and what the demands are.
It’s like a group of workers go on a strike and refuse to tell their employer what their issues are. They are picketing with signs that don’t have any words written on them. They are angry at meetings where no words are spoken. Do they need something to change? Have you done something they didn’t like? Do they want to leave the profession entirely? Who the hell knows!
A baby or toddler who previously breastfed happily and enthusiastically seems to have had a switch flipped and the breast has suddenly become their least favourite place to be. It can knock you for six. It’s incredibly confusing and distressing.
You can feel as though you are expected to switch into Sherlock Holmes mode at a time when you feel rejected and upset. Is it up to you to analyse what might have happened so you can find the solution? There is an element of that, but we’ll talk about that later.
First, it’s important to give yourself some space to acknowledge that this HURTS. Not so much physical, although you do have to be careful not to get engorged, as that might mean supply reduction and blocked ducts. This emotionally hurts. Feeding your child has been happening for several months and it is part of who you are. You may feel you are part of a community online and in real life, and that appears to have changed overnight. Your breastfeeding relationship with your child may be the core of how you connect with them. It’s far far more than milk. It’s how you soothe them, help them get the sleep (perhaps multiples times a night) and how you check in when the world seems big and scary (for either of you).
That feeling of loss can be significant.
This is not simply about rejection. Your child seems to be a different person. They are no longer your partner in the breastfeeding relationship. They might feel like your adversary. You have spent months developing an understanding of your child. You KNOW them. You can read them. You communicate. And now your child feels like a complete mystery. They are rejecting milk, but it can feel like your understanding of your child has been rocked and they are rejecting YOU. For the first time, this person feels like a stranger.
And the act of trying to convince them to restart can feel ‘off’. Everything you’ve read says this is a strike and they are very likely to restart breastfeeding at this age. But then you’ve also absorbed deep in your soul that the ideal is ‘child-led’ and ‘responsive’ feeding. So, to try and trick them to do something their body seems to be rejecting runs counter to that instinct.
What might be going on? We’re not talking about an older toddler who has been winding down for a while: perhaps one or two feeds a day for ages. They may have skipped the odd day. Breastfeeding is not at the heart of their lives and they are clearly on the home stretch. We’re talking about a keen breastfeeder, who fed multiple times a day and has gone from several feeds to nothing literally overnight.
Sometimes the cause is obvious. They might have sores in their mouth from ‘hand, foot and mouth disease,’ a very common early childhood virus. They might have chicken pox or a mouth injury or oral thrush. They might be struggling with a tough few days of teething. They might have a cold and been blocked up and it’s a struggle to breathe when breastfeeding. If there has been a recent virus, it can be worth visiting the GP to rule out a lingering ear infection which can be the underlying cause of breast refusal.
It might be that they are reacting to a particular phase in your menstrual cycle. It’s not a universal experience, but sometimes fussiness can correspond to an imminent period, particularly the first one. It might also be that you are in the early stages of an unknown (or known) pregnancy. During pregnancy, some nurslings are completely unaffected and happy to continue throughout. Others are more sensitive to early hormonal changes and may even be affected in the first few weeks. They may also be less keen to feed when colostrum arrives during the second trimester (which will happen even if you are currently breastfeeding an older child). Lactose levels will drop which means less sweetness and some older verbal children even describe milk as tasting more like crisps (not a bad thing for everyone). Pregnancy may also mean a supply drop, again in the first few weeks for some. About 2/3 of pregnancies do seem to mean a reduction in milk supply. For some nurslings, that’s a deal-breaker. It might mean that some older children stop breastfeeding entirely. For some, it might mean more fussiness. Some may pause feeding for even a few weeks and then be keen to resume again after birth.
If you look online for other causes of a nursing strike, you might see discussion of the baby reacting to a different perfume, soap or deodorant. I’m not convinced by this one as I’ve seen toddlers breastfeeding in a bath with a bath bomb, while holding a piece of cheese, upside down. I’m not sure devoting hours hunting for a new scent in the home is the best use of your time, but it may help you feel as though you are taking action and trying to control a situation where you feel helpless.
You may see discussion of a nursling reacting to visitors or a change in circumstances or increased stress. However some nurslings will react to all those things by breastfeeding MORE. I’m a bit concerned when I see articles discussing how the trigger might have been your return to work or the fact you have moved house or had a bereavement. It’s not like you can undo those things and we may get into a self-fulfilling prophecy where a parent’s anxiety about an imminent nursing strike could project onto the nursling. But perhaps knowing that it might happen may mean you are at least prepared for the possibility.
Sometimes a biting incident may have been the trigger. This is an age where a child may experiment with teeth at the breast, or adjust their latch as new teeth come in. If you get a shock when a child unexpectedly bites and yelp loudly, this may cause them to be wary of coming back to breast. This can feel AWFUL because you can clearly see how your reaction has freaked them out and you can feel entirely responsible. But be kind to yourself. You are human. You have feelings and it’s not terrible for your child to begin to understand that. It’s very likely your child will resume nursing.
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.
• 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 Xmls. 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.
• 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.
There is not a standard length of time for a nursing strike and no one can tell you exactly when it might end. I’ve have personally worked with mothers who experience a strike for 2 or 3 weeks and their toddler did resume. I’ve also worked with mothers who just struggled for 24 hours. I’ve also heard of nursing strikes that go on even longer than 3 weeks, although that is unusual. Sometimes an older child may stick with only breastfeeding at night or when they are sleepy for a while.
When do you ‘give up’ trying? No one can answer that question for you. If I say that sometimes nursing strikes last for 3 weeks, that does not mean that you are then required by law to live in a state of desperation for 3 weeks and continue to work hard to resume breastfeeding. This depends a lot on how you are feeling and what your personal feeding goals are. What about if you have a 14-month-old and they were feeding twice a day and now they aren’t interested? They are calm. There’s nothing underlying going on, but they aren’t interested. Is that a nursing strike? Or maybe it’s self-weaning? Perhaps those previous two feeds corresponded with patterns in the daily routine and those patterns have changed and they are really not bothered about the loss of breastfeeding. Is that a strike? We could write another 3000 words on the definition of self-weaning. There isn’t an “International Committee of Self-Weaning” who will hear your history and decree whether or not your child’s story fit the criteria. Truthfully, self-weaning at 14 months is unusual but you have described a toddler who naturally drifted away from breastfeeding. That’s not the same as a toddler feeding 4-8 times who is a boob monster who suddenly behaves very differently overnight.
However, even your toddler might be in the drifting away category, that doesn’t mean you can’t still use some of the methods we’ve discussed to try and encourage a return to breastfeeding. You are allowed to still want to continue to breastfeed. Even if you might be wondering if self-weaning IS your situation, that does not mean you are required to walk away without trying anything. We are very focused on responsive feeding and child-led breastfeeding and we are extremely sensitive to accusations that those who continue to breastfeed are doing it ‘for themselves’. We are so sensitive to that, we sometimes don’t allow ourselves to say out loud: “I really want to continue breastfeeding. I am sad that we are stopping when I thought breastfeeding was going to continue for longer.” If you can encourage your child to get another few months or weeks of antibodies and connection, that is a positive. They really won’t be persuaded if they don’t want to be, but you are allowed to try.
You get to decide when you want to move away from trying to breastfeed. You might feel that you can’t handle the uncertainty of when a strike might break. Perhaps you weren’t that far from reaching your feeding goals anyway and you feel that you need to move on. Before you do that, just check that you have accessed all the support that might be helpful. And be mindful of the fact your emotional reaction to the end of breastfeeding might surprise you. It is natural to experience a mourning process. This is not how you felt breastfeeding was going to end, even if you have some element of control in that you have chosen to stop persisting with breaking the strike.
Most nurslings at the 8-12 months age range WILL restart breastfeeding. We wouldn’t be here as a species if nursing strikes meant the end of breastfeeding for children this young. As it goes on, be kind to yourself. Your nursling is very likely to be feeling confused and upset too. Although it may feel like they are against you, they really are on Team Boob.
Some nursing strike stories:
Katie: “We had a nursing strike at around nine months. We had a very tough start to breastfeeding. It was three months of difficulty with trouble latching, trouble sucking, lots of pumping and bottle feeding. With nipple shields, it finally clicked for us and we had about six months of easy nice breastfeeding. Then out of nowhere, she became very upset at the breast and didn't want any milk. I found it quite difficult because it took me back and reminded me how hard it had been at the start but I took some comfort in the fact I knew we could feed now. The only time she would take milk was when she was very tired right before bed. We went back to bottles in the day which he took some off but not a lot. Then I tried my nipple shields which I hadn’t used since the start. They did encourage her to have some. We fed using the shields for a few days. I kept trying to get rid of them but then she wouldn't, so we used them. Then suddenly she fed again without them and we went completely back to normal as if nothing had happened. The whole thing was less than a week.”
Kate: “My little boy had a 24 hour nursing strike at eight months which all seemed to be due to his first teeth coming through. He cried and cried and wouldn't be fed all night and all the next day and then he started again when my husband got him to sleep rocking him through the night. He latched in the middle of the night in his sleep. It sounds so minor - 24 hours and maybe not even a strike - but this was a baby who had never in his life gone longer than three hours without a feed overnight. I was lost, worried, shaken-up, confused even when it had only been a few hours because he’d never refused a feed before before. It felt like a few huge thing.”
Jamie Louise: “I experienced nursing strikes with my first and second during respiratory or ear infection. What helped me the most was reaching out to my local breastfeeding support counsellor (ABA in Australia) and being able to process what was happening, try to figure out the ‘why’ (because that can help with the resolution) and find a safe place to pour out all the emotions that came with the strike. I'd offer but tried to remain calm if turned down. Once my middle child with recurrent ear infections started antibiotics he was straight back on. He had four infections in the first 18 months so strikes were frequent. I asked my GP to see an ENT specialist and he ended up with grommets before two. Advocate for yourself and baby if needed with healthcare professionals, should the issue be recurring due to an underlying medical issue.”
Daisy: “The first strike was around eight months. It shook my world. I felt totally helpless and it was just as we went into lockdown so I didn't have anywhere to turn. I was distraught that she didn't need me anymore. She didn't take a bottle at all and refused any milk I would give her from a cup or spoon. I worried that she wasn't getting what she needed. I read up on it so much and reached out on some Facebook groups with the advice I continued to try. We had baths and skin to skin. We would have long snuggles before bed and after six days she latched again. I cried and cried. One week later we found out I was pregnant so we believe it was due to this. She also had a mini strike eleven months and thirteen months. These were much shorter and we knew a bit more about how to handle them.”
Emily: “I've had a couple that were down to illness, ‘hand, foot and mouth disease’, so sores in the mouth and on the tongue. The first was at 13 months and I was completely unprepared. He refused to feed for a week. My mood completely dipped. I have never felt depressed like that before. In the end, I expressed, kept trying to feed during the night when he was sleepy, skin to skin, baths, mouth gel for the sores. Eventually he came back to it and we continue for 2 1/2 years. So glad I kept going as I had a lot of pressure on me at that point to stop because it would be ‘easy’.”
Lizzy: “My son fed constantly, but at nine months he wouldn't feed when awake for three days. I nursed him once he fell asleep and expressed when he wouldn't feed (the first time, by hand into some Tupperware we found in the car as we were out!). When he woke up on day four, it was like nothing had happened and business was as usual. I definitely feel bed sharing helped.”
I have written elsewhere about newborn breast refusal: (https://www.emmapickettbreastfeedingsupport.com/twitter-and-blog/newborn-breast-refusal-why-didnt-my-baby-get-the-memo).
Thank you to doula Charlotte Harris (raisingwithinstinct.co.uk) for your support with thinking about this topic. And thank you to those on instagram who shared your stories.