How to end a nursing strike

A nursing strike is an abrupt refusal to feed in a baby who was feeding happily, and it usually lasts days rather than weeks. Look for pain, illness or a change in routine, keep expressing to protect your supply, and offer the breast when your baby is calm instead of frantic.

What a nursing strike actually is

Your baby arches away, screams at the breast, or clamps shut and turns the head. Yesterday the same feed was fine.

La Leche League International describes this pattern as a strike rather than weaning, and the distinction matters. Weaning is gradual, happens later, and leaves a contented baby. A strike is sudden, upsetting for both of you, and temporary.

Nobody is rejecting you. Something has changed, and the job is finding out what.

Why has your baby stopped feeding?

Pain in the mouth or ear. Teething, thrush, an ulcer, or an ear infection that hurts more when lying down. A baby who feeds on one side but not the other often has an ear on the painful side.

A blocked nose. Babies breathe through the nose while feeding. A cold, or a night under a cold air-conditioning vent, makes a long feed impossible.

Hand, foot and mouth disease. The Ministry of Health publishes weekly surveillance on this, and it moves through preschools and infant care centres here regularly. Mouth ulcers make sucking painful. Fever, blisters on the hands and feet, or spots in the mouth mean a doctor rather than a different hold.

A fright at the breast. You yelped when your baby bit you, or a fast let-down made your baby choke. Babies remember that for a few days.

A change in taste or smell. A new soap, a strong perfume, a sudden return of your period, or a medicine you have started. The milk is still fine. Your baby has simply noticed.

Distraction. From around four months, hearing and vision get sharp enough that a noisy coffee shop beats a feed. This is extremely common and often mistaken for a supply problem.

Routine upended. A trip, a new carer, the first week at infant care, or a reduced supply after several missed pumping sessions.

Protect your supply first

Before anything else, keep milk moving. Express or pump at about the frequency your baby was feeding, overnight included, for as long as the strike lasts.

Two reasons. Your supply is driven by milk removal rather than by time, and a breast left full is how blocked ducts and then mastitis begin. Our guides to pumping breast milk and clearing a clogged milk duct cover the practical side.

Store what you express. You will be glad of it later, and it means your baby is still getting your milk through the strike.

How to coax your baby back

• Offer when sleepy. A half-asleep baby latches on reflex, so try at the start of a nap or at a night waking. Keep the head slightly raised to avoid choking.
• Skin to skin, with no agenda. Lie down together with your baby against your bare chest and let the breast be available rather than offered. Many strikes end during a long cuddle, in the bath, or in a dark room.
• Change position. Laid-back, under-arm, standing and swaying. A baby with a sore ear often accepts the side that keeps it off your arm.
• Cut the noise. A quiet, dim room with no television and no visitors. For a distractible four-month-old this alone can be the whole fix.
• Go back to the familiar soap. Drop the new perfume, the new shower gel and the heavily fragranced laundry detergent until feeding resumes.
• Keep calm about it. Easier said than done at 2am. A tense feed is a short feed, and walking away for ten minutes before trying again loses nothing.

Never force the head onto the breast. It extends the strike and makes the next attempt worse.

Returning to work, and the strike that follows

Government-Paid Maternity Leave in Singapore runs to 16 weeks for eligible mothers under the scheme administered by the Ministry of Manpower, and the fourth month is a classic point for breast refusal.

Two things collide. Your baby has had a fortnight of bottles at infant care, where milk comes fast and needs no work, and your supply has dipped because pumping at the office is harder than feeding at home. The strike looks like rejection and is usually mechanics.

What helps: paced bottle feeding at the childcare centre, so the bottle is not dramatically easier than the breast; pumping on your baby's old schedule rather than when a meeting room is free; and feeding directly at pick-up and through the evening. Our piece on pumping at work covers the logistics, and boosting supply naturally covers the dip.

Ask the centre what time the last bottle was given. A baby who drank 150 ml at 5pm will not be hungry at 6.30pm, and that is not a strike.

Looking after yourself meanwhile

A strike is miserable at the exact moment you have no reserves. Eat something, sleep when the expressing is done, and tell someone how it is going.

Repeated shallow attempts can leave your nipples sore, and soreness that does not settle is one of the reasons to get help in the list below. For dry nipple skin in the meantime, Mama's Choice Intensive Nipple Cream is a lanolin-based cream that moisturises and protects nipple and areola skin. Its label says it does not need wiping off before a feed, which saves a step when your baby is already reluctant. Our guide to breastfeeding pain covers what else helps.

When to get help

• Your baby has refused feeds for more than 24 hours, or is taking far less than usual
• Fewer than six wet diapers a day, a dry mouth, or unusual sleepiness
• Fever, blisters, or a rash on the hands, feet or mouth
• Pulling at one ear, or crying when laid flat
• A hard, red, painful area on your breast, with or without fever
• Pain in your own nipples that has not settled, which usually means the latch has shifted

KK Women's and Children's Hospital and the National University Hospital both run lactation services that see mothers after discharge, and your polyclinic can arrange the referral. A dehydrated baby or a feverish one goes to a doctor first and a lactation consultant second.

Most strikes are over within a few days to a week. For many mothers, the turning point is finding the cause rather than trying harder at the breast.