If your baby is fussy at the breast and you’re not sure why, take a look through the following list of potential reasons, along with the solutions and hopefully this will answer your questions.
Baby’s having a growth spurt.
Growth spurts are common in babies and are a time when they often become fussy. They can happen up to five times in their first year (1).
Solution: Respond to your baby’s needs during their growth spurt.
If your baby is experiencing a growth spurt, they are likely to show signs of wanting more and more milk from you, never seeming to be full. Don’t worry though, this is just a sign that they are developing correctly (1).
In response to this behaviour, simply allow your baby the amount of food they need (1). Don’t forget, your baby has a built in ability to stop eating when they are full (3), so you are unlikely to be overfeeding them.
Forceful let-down.
‘Let-down’ is the reflex by which milk in your breasts is made available to your baby which is stimulated by baby sucking on the nipple (4).
Forceful or fast let-down refers to a fast flow of milk from the breast which can often make your baby fuss (5).
Solution 1: Lie back while breastfeeding.
Lying back comfortably with your baby lying on your tummy whilst breastfeeding will slow the let-down reflex. In this position, the milk will have to flow against gravity in an uphill position and therefore it will slow down (15).
Solution 2: Burp regularly.
Forceful let-down may lead to your baby swallowing a lot of air when suckling on the breast. If you find that this is the case, burp them regularly to release the air (15).
Signs that your baby needs to be burped include crying and pulling off the breast (2).
Slow let-down.
On the other hand, a slow let-down may cause some babies to be fussy too. This is because they may become impatient with the lack of milk that they have access to (6).
Solution 1: Relax your body.
To tackle slow let-down, try relaxing your body prior to breastfeeding. If time is on your side this could include taking a warm shower or bath, or if not just taking a few moments to listen to music that you enjoy or drinking a glass of water or a cup of tea (6).
Solution 2: Stimulate milk flow.
Another way to increase the rate of your let-down, try stimulating milk flow by massaging the breasts before and during breastfeeding (6).
This can be done by gently rolling and tugging the nipples with your fingers and laying a warm, damp flannel across your breasts to warm them (16).
Solution 3: Breastfeed in a comfortable position.
Breastfeeding in a comfortable position will mean that you will be more relaxed which may help milk to flow more easily. Taking a few deep breaths may help this too (5).
Baby is going through a developmental leap.
As well as growth spurts, babies go through other developmental leaps such as teething and ‘Wonder Weeks’ (6).
Teething is likely to cause your baby to be fussy when feeding as their gums will be inflamed which may be causing them pain when breastfeeding (6).
‘Wonder Weeks’ are periods of time during a baby’s development where they become ‘difficult’ and begin exhibiting ‘The Three Cs – Clinginess, Crankiness and Crying’ (7). During this time, feeding patterns are likely to change.
Solution 1: Encourage your baby to chew on something cold.
The pain of teething can be soothed by cold (6). Teething rings that can be kept in the fridge or breast milk ice lollies are solutions that may help sore gums.
Solution 2: Respond to your baby’s needs during the ‘Wonder Weeks’.
During these developmental periods, it may be difficult to pinpoint why your baby is crying which may make parenting harder.
Do seek help from your health visitor if you feel you are struggling.
Baby needs burping.
Burping your baby is normally only necessary in their first few months and is more common in babies that are bottle fed rather than breastfed, although this doesn’t mean that it’s completely unheard of in breastfed babies (2).
Breastfed babies who have been crying before feeding, have been feeding quickly or whose mother has forceful let-down are more likely to need burping (2).
Solution: Stop the feed when your baby is fussing and burp baby.
Pause the feed either mid-feed or once the feed is over to burp your baby will help to alleviate gas and may calm their mood (2).
A good position for burping your baby is holding your baby with their abdomen on your shoulder to apply firm pressure which will help to release gas in a burp (2).
Your baby is full.
As mentioned above, babies have a built in ability to let you know when they are full (17). But how do you know what the signs are?
Solution: Offer your breast a few times, finish breastfeeding if your baby is not interested.
If your baby is no longer hungry, they will reject your breast by turning their head or won’t latch on to the nipple (17).
Your baby has oral thrush.
One reason for your baby being fussy at the breast could be oral thrush. Physical signs of thrush are creamy white spots or patches around and/or in the mouth, and a white film on the lips (8).
Solution: Contact your GP.
If your baby is displaying symptoms like these, arrange a visit to your GP who will confirm the diagnosis and prescribe treatment.
Your baby has a cold.
A baby with a blocked nose may struggle to breastfeed and therefore may be fussy at the breast as they are struggling to simultaneously breathe and feed (9).
To make breathing easier, you can clear your baby’s nose with a tissue, and it may also be wise to follow the solution below. Baby nasal aspirators can also help clear a blocked nose (14).
Solution 1: Feed baby in a steamy room.
Feeding your baby in a steamy room means that the warm, moist air will help your baby to breathe more easily (9).
Your baby has reflux.
While your baby is still young, it is quite common for the muscle between the food pipe and the stomach to allow some food back up the tube (10).
In some cases, however, this reflux can be frequent and can cause your baby a lot of pain – a condition called ‘ gastro-oesophageal reflux disease’ (GORD) (10).
Solution: Contact your GP.
If your baby is displaying symptoms like these, arrange a visit to your GP who will confirm the diagnosis and may prescribe medicine (10).
Your baby is sensitive to foods in your diet.
Some breastfed babies show signs of being sensitive to foods in their mother’s diet. This is often noticeable when your baby shows a pattern of becoming fussy at the breast after mother has eaten particular foods (11).
The severity of the reaction can depend on factors such as the timing and the amount of the food, as well as the level of sensitivity in the baby (11).
Solution: Note foods that you have eaten which make baby fussier when breastfeeding.
If your baby is showing signs of being sensitive to foods that you have consumed, make a note of the foods and monitor the level of reaction. If you are concerned, contact your GP or health visitor in the first instance and ask to see a Paediatric Dietitian who will be able to help.
Mum may need to take a break and baby senses this.
Mum can be very tired and feel overwhelmed. Your baby can sense this and react to this by being fussy and not relaxed (12).
Solution: Pass baby over to dad or grandma.
Passing the baby over to dad or grandma can give mum a break and a change of scenery for the baby. This can help relax both mum and baby. Your baby may be happy to breastfeed after the break. Mum may also be better able to handle any fussiness (12).
There may be many reasons why your baby may be fussy when breastfeeding. Many times it can be something other than breastfeeding. Persevere and don’t get disheartened. Every breastfeed can be different.
Remember you are not on your own. Please don’t be afraid to reach out for support. Speak to a lactation specialist, a healthcare professional or a friend (13).
With thanks to Lottie Harman for her research into this blog and Catriona Lawson for her editing skills.
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Sarah Almond Bushell MPhil, BSc (Hons) RD MBDA – Registered Dietitian & Children’s Nutritionist
