Caring for the baby that refuses to latch on

Caring for the baby that refuses to latch on

 

Possible issues for a baby refusing the breast from the first nursing

  • Pain- A baby may be in pain due to a birth injury. If the pain is aggravated by being held, the baby may cry at the first attempt at nursing. Examples of birth injuries are: a broken clavicle, bruising, misaligned neck vertebrae, or a pinched nerve.
  • Breathing issues- A baby having trouble coordinating suck, swallow, and breathe reflexes may well have a problem with breastfeeding.
  • Oral aversion- Some babies resist having anything in their mouth, often due to a trauma such as being deeply suctioned.

 

There are some mechanical issues that can cause a baby to have an ineffective suck. These issues include:

  • Cleft palate- It is possible for a baby with a cleft lip to nurse effectively, with the mother using her finger to close off the cleft, but if she has a cleft palate, she will need extra help to keep breastfeeding.
  • Tongue tie- Tongue tie is when the frenulum beneath the tongue is too short or tight to allow for full range of tongue movement. If the baby doesn’t get full movement of her tongue, she may have a difficulty in getting the milk she needs. One sign of tongue tie is when the tongue does not extend over the gum line. If the baby can suck, this will cause sore nipples.
  • Clamp-down reflex- A baby with tongue tie may use the clamp-down technique, using his gums for the job of holding the breast that his tongue can’t do. Other babies with a range of issues also use this technique. Clamp-down reflex may be evident when it is very difficult to unlatch a baby from the breast. Mom may have a nipple that is misshapen and she may feel bruised.

 

What to do?

If the mother wants to breastfeed there are several different ways for her to provide her baby with breastmilk if the baby cannot latch on.  They are as follows:

  • Syringe Feeding – This device can be used directly at the breast or for finger feeding. Feeding the baby at the breasts should be the first choice. When a baby is not able to latch on in the early days, this can be a great way to supplement. When the baby gets fed from a syringe held at the breast, she can feel successful feeding at the breast while the underlying breastfeeding difficulties are identified.
  • Supplementation at the breast – Supplemental Nutrition System (SNS) and Lact-aid are commercially available feeding aids that bring milk to the breast by means of thin tubing.
  • Cup feeding – Cup feeding can work for getting food into a baby without introducing nipples. Breastmilk is put in a smooth rimmed, shallow cup. The cup is place at baby’s lips and baby can sip the milk. There are specially designed cups for cup feeding an infant.
  • Finger feeding – The finger feeding method involves a tube or syringe that delivers milk to the baby. It can be the tube of a supplemental feeding device or a special fingerfeeder. In the case of tube, a small flexible tube is connected to a container of milk.  It is taped to the caregiver’s finger and as the baby sucks on the finger she receives milk.
  • Haberman Feeder – If the baby is refusing to breastfeed and is having difficulties with other feeding methods a specialty feeding nipple such as the Haberman Feeder by Medela can help.  A Haberman Feeder is a specialized nipple designed for babies with facial or oral problems that interfere with their ability to breastfeed effectively.

 

Caring for the baby that refuses to latch on