This page is about young babies who have never breastfed or who get very upset when offered the breast. If your baby was breastfeeding well but is now refusing, see our page on “nursing strikes”. Sometimes, a new difficulty with feeding is the first sign that the baby is becoming unwell. If you are not sure that your baby is well, please contact your doctor.
When a baby doesn’t breastfeed after birth, it can be upsetting, confusing and frustrating. You might wonder whether you’re doing something wrong, or even whether your baby likes you. It’s hard not to take it personally!
Babies are ‘hardwired’ to breastfeed – it is an essential survival behaviour. When a baby doesn’t breastfeed, it’s never because they don’t want to. Something is making it hard for them. Babies are never “lazy” or “difficult” – they always do the best they can. So do their mothers!
When it’s taking time for breastfeeding to get going:
- Keep your milk flowing
- Keep your baby fed
- Keep your baby close
If you do this, your baby is very likely to breastfeed when they are ready. Time, patience, and good feeding support are usually all you need.
This useful summary of the “3 Keeps” can be downloaded as a free A4 poster here.
You can read more about getting breastfeeding on track after a difficult start here.
Why isn’t my baby breastfeeding?
After a straightforward birth, most well, full-term babies will start feeding within an hour or so. Not all babies have such an easy start, though. Babies can take longer to start breastfeeding if:
- They had a more complicated birth. Babies born with the aid of forceps, for example, often take a few days to recover and feed well. If you had pain medication in labour, your baby may be sleepy and uncoordinated at first.
- Your baby was born early, or small for their gestational age. See also breastfeeding premature babies and late preterm babies (those born between 34 and 37 weeks). Even being born one or two weeks early can mean that your baby takes longer to start breastfeeding. It might take until around your baby’s due date, or a little longer, before they are ready to feed well.
- You and your baby were separated after birth because one or both of you needed medical care.
- Your baby is very sleepy and doesn’t yet have enough energy to breastfeed. See also sleepy baby and newborn jaundice.
- Your baby is unwell.
- Your baby is uncomfortable, e.g., some babies have a sore head or sore shoulder after birth.
- Your baby has low muscle tone (hypotonia).
- Your baby has a physical challenge such as tongue-tie.
You have plenty of time
Parents sometimes worry that if their baby isn’t breastfeeding well, or at all, in the first few hours, days or weeks after birth, it will never happen. While breastfeeding in the first hour after birth is ideal, the window of opportunity for babies to start breastfeeding is much longer than this. The feeding reflexes, which keep babies seeking and attaching to the breast, last for at least two to three months after birth. We have seen many babies start breastfeeding older than three months, too! There are even reports of children over a year old starting to breastfeed, when placed for adoption with a lactating mother. Where there is milk, there is always the possibility of breastfeeding.
First things first
Sorting out breastfeeding problems can feel overwhelming. There seems to be so much to do, and you might feel you have to do it all at the same time! It is helpful to know what is urgent and what can wait. This can help you to work out what to do in what order, and how best to use your time and energy. Feeding at the breast is the least urgent thing, at this stage.
If your goal is to have a full milk supply (enough milk to meet all your baby’s needs) but you need to use donated breastmilk or formula at the moment, or if your baby is not growing well just on your milk, then making more milk is the top priority. This is more urgent than your baby starting to feed at the breast.
If your baby is not breastfeeding at all yet, or is not breastfeeding effectively, you can express your milk. This gives you milk to feed your baby now and encourages your breasts to make plenty of milk for the weeks and months to come.
Your breasts may temporarily become swollen and uncomfortable, starting around 2-4 days after birth. This is called “engorgement” and is a sign that your breasts are becoming more active (though not all mothers feel it). It is important to treat engorgement, to keep your breasts comfortable and your milk flowing well. Read more here: Engorged breasts – avoiding and treating.
You can find information here on how to use bottles and other feeding tools.
Expressing all the milk your baby needs is known as “exclusive pumping” or “EP”. You can read more here. Some mothers choose to do this; many do it because their babies are not able to breastfeed. You might find it helpful to join an online support group for “EP mums”.
If you need to express your milk for a baby who is not breastfeeding yet, it is important to work with a skilled breastfeeding supporter. You might also want to connect with other mothers who have needed to express milk – they can be your best cheerleaders while you do this important job! Your local La Leche League group would love to support you.
Setting the scene for breastfeeding – happy time at (or near) the breast
Most babies need only time, patience, and gentle encouragement to help them start breastfeeding. Babies are born expecting to breastfeed, with a set of reflexes to help them do it. We need to keep them well fed (with expressed or formula milk), give them lots of relaxed time near the breast, and…. give the baby time.
Here are some ideas to try:
- Hold your baby skin-to-skin. Babies use their whole bodies to feed. The more of their skin they feel against yours, the more likely they are to find the breast and start feeding. Undress your baby down to their nappy and move your clothes out of the way. If you are cold, you can put a blanket round both of you. Even if your baby doesn’t breastfeed yet, it feels lovely, and helps your baby get used to being at or near the breast. Holding your baby against your skin helps you make more milk, too! If your baby can’t tolerate being held in a feeding position, try holding them against your shoulder.
- Avoid holding your baby in a feeding position during medical procedures, especially if your baby will be having lots. Offer the breast afterwards instead, if it calms them.
- Try “laid-back” breastfeeding. Try putting your baby tummy-down, on the slope of your body as you recline comfortably (as if you are lying on a sun lounger). Placed like this, they can use their arms and legs to help themselves find the breast and attach well for feeding. This can work better than trying to “put” the baby to the breast, especially if they have already had difficult experiences of this. This video shows you how. The safest place to do this is in a bed that has been set up following safe sleep guidance. See our article on safer sleep.
- Turn up the smell! Newborn babies don’t recognise the breast well by sight, though they do recognise your face, and love looking at it. They find the breast mostly by feel and smell. The little bumps around your nipple (Montgomery’s glands) make a scented oil which helps your baby find the breast and encourages them to feed. You can give your baby extra help by expressing a bit of milk and rubbing it on and around your nipples. This can encourage your baby to feed by increasing the smell and giving them something to lick as they approach the breast!
- Try “drip-drop feeding”. Your partner or supporter uses a cup and spoon to drip milk (expressed milk or formula) onto the breast as you hold your baby. This can encourage babies to attach and feed. You can watch a video here.
- Take a bath with your baby. When placed skin-to-skin with their mother in a warm bath, some babies find the breast and feed for the first time. Some mothers even describe it as “a second chance at giving birth”. You could set the scene with low lighting, a candle or soft music. Whether or not your baby is ready to breastfeed yet, sharing a bath can help you and your baby relax together and enjoy each other. Have another adult with you to help you get in and out safely, put the baby on you and wrap them in a warm towel when they are ready to get out.
- “Wear” your baby. Babies who are kept close in a sling or soft carrier cry less, are calmer and warmer than babies who are put down by themselves. Being carried is good for babies’ physical & emotional development and helps parents and babies make strong connections. If your baby is not breastfeeding yet, carrying them close, as much as you want, is an excellent way to help them feel comfortable near the breast. Always follow the instructions for your sling or carrier and the rules for safe babywearing. You can read more about babywearing in this book.
- Feed your baby at or near the breast. If your baby will go to the breast at all, consider using a nursing supplementer so your baby can have extra milk while they breastfeed. This can be helpful when milk supply is low and/or your baby is frustrated by the speed of milk flow at the breast. If your baby is fed by cup or bottle, try feeding them skin-to-skin with their cheek against your breast. Let your baby end the feed by sleeping with their cheek pillowed on the breast.
- Consider sleeping with your baby. Some babies will attach and feed in their sleep if the breast is near enough to smell and feel. Always consider sleep safety before sleeping with your baby in your bed. It is never safe to sleep with a baby on a sofa. You can read more about sleep safety and normal baby sleep in LLL’s book Sweet Sleep.
Babies with low muscle tone (hypotonia)
A baby who has been diagnosed with a condition that makes them hypotonic, or ‘floppy’, may show little interest in breastfeeding. To make feeding easier:
- Support your breast. Tuck a rolled-up cloth under your breast close to your chest wall, or support your breast with your thumb on one side of the areola, fingers on the other side.
- Support your baby’s chin. If your thumb is parallel to your baby’s upper lip, you can use your index finger to put gentle pressure just behind the bony part of the chin while your baby feeds.
- Try upright positions. A hypotonic baby often feeds better held with their head higher than their bottom.
- Breast compression can also be helpful, but you may also need to give some expressed milk until your baby’s muscle tone improves. Breast compressions are explained in more detail in “My baby needs more milk”.
If your baby suddenly becomes floppy and you don’t know why, seek medical advice.
When you are keen to breastfeed, but your baby isn’t yet ready, it can be frustrating. Don’t forget to celebrate how far you have already come! Every time your baby enjoys being held close to your body, or falls asleep near your breast, they are taking another “baby step” towards breastfeeding. Your baby is doing the best they can for now, and so are you.
When breastfeeding is stressful
When breastfeeding is difficult for your baby, it may become stressful for both of you. Babies who have had unhappy experiences at the breast can develop negative associations with breastfeeding. This might happen, for example, when:
- A baby is in pain or discomfort e.g. from birth injury or allergy.
- A sensitive baby is handled at the breast in a way they don’t like, e.g., if a helper tries hard to “put” the baby to the breast when they aren’t ready.
- Milk supply is low.
- A baby has a physical restriction (e.g., tongue tie) that makes attaching and sucking difficult.
A baby who is finding feeding difficult may become upset:
- A short time into the feed, when milk flow slows down.
- At the start of the feed, when milk doesn’t come straight away.
- When offered the breast.
- When put in a breastfeeding position.
- When they see the breast.
When feeding isn’t going well, babies may come to associate the breast with hunger and frustration. They may develop a preference for another feeding method, such as a bottle, if they associate it with feeling full and satisfied. You can find some ideas on how to keep your baby’s relationship with the breast positive here: using donor milk & formula milk to support breastfeeding
The ideas in the previous section (“Setting the scene for breastfeeding – happy time at (or near) the breast”) can help your baby learn that the breast is a lovely place to be, and to associate it with calm, relaxation, comfort, and satisfaction rather than hunger and frustration.
Take a break
If breastfeeding has become very stressful for you and your baby, you might need a “breastfeeding break”. You could stop trying for a few days, whilst expressing your milk to keep your baby fed and keep your milk flowing. When you’re both ready, you can try again. There is no rush! Dr Christina Smillie, an American doctor who specialises in breastfeeding medicine, calls this “rebooting the baby”.
What if my baby is still not breastfeeding?
When you are eager to breastfeed, it is hard to wait. It is not uncommon for babies to need time to begin breastfeeding well. You might be encouraged by hearing the stories of other parents whose babies took time to get going.
If your baby is still not breastfeeding even with time, patience and some of the tips in this article, there will be a reason why. A skilled breastfeeding supporter can help you find out, and work towards breastfeeding. Some babies need medical care, some benefit from feeding tools such as nipple shields and a few need treatment for tongue tie. Many just need a little more time.
A few babies never do breastfeed. Some have a medical condition that makes it impossible. Very rarely, we never find out why. You don’t have to feed your baby directly from the breast to give them the many benefits of your milk or to nurture them at your breast. We can support you to have a close, happy feeding relationship with your baby, whatever form that takes.
La Leche League Leaders (breastfeeding counsellors) can help. You can find your local group, and LLL Zoom Meetings all over the country, at https://laleche.org.uk/find-lll-support-group/
Jayne Joyce, LLL Oxfordshire & Karla Napier, LLL Edinburgh, April 2022