Breast refusal (also called a "nursing strike") is a normal thing that can happen to any baby, but it is particularly heartbreaking for the working mother. She worries that her baby is rejecting her because she is working. She thinks that it is her fault that the baby won't take the breast.

Have heart - breast refusal happens to all babies, even the ones who are with their mothers all the time. The good news is that with proper intervention, it usually only lasts a couple of days, and your baby is none the worse for a couple of days of not nursing. The challenge is that your baby is probably getting bottles all day, which makes the treatment for breast refusal a little harder, and it may take a little longer, but have no fear - it can be done, and before you know it, your baby will be back to nursing happily once again.

Why Nursing Strikes Happen

Nobody's been able to ask one of the babies yet, but there are a lot of theories about why breast refusal happens. So-called "nipple confusion" is the primary culprit - the baby gets used to the fast flow of milk from a bottle, and loses patience waiting for milk from mom, or doesn't want to do the extra work to get it. Other theories are that at around 4 months, your baby just starts paying a lot more attention to the world around her, and is more distractible during feedings. It may be that she's bottle-fed facing out where she can see what's going on, and doesn't want to miss out on anything at the breast. She may just be busier and not want to sit still when you're ready for feeding time.

Treating Breast Refusal

No matter the cause of breast refusal, the treatment is basically the same - make the breast available all the time, in a non-pressuring way. How can you do this? Here are a few ideas:

• Take a lot of baths with your baby. Hold her close while you are both naked in the relaxing warm water of the tub.
• Offer your breast when your baby is sleepy and relaxed. She may be less distractible and more willing to feed at these times.
• Stay in bed for a morning with your baby - lie around with your shirt open or off, just have your breast there for whenever your baby shows interest.
• Do NOT hold your baby against your breast when she is not interested in feeding. This can make things much worse, and can be traumatic for her.
• Do NOT give bottles when she refuses the breast. Unless your baby has a medical problem, she will drink from your breast when she gets hungry. Giving a bottle reinforces that if your baby holds out, she'll get the easier meal.

´You may think "oh, I'll just keep pumping and bottle-feed her my milk". Think twice. Think about getting up in the middle of the night to pump and make bottles. Think about not being able to go anywhere without your pump. Some mothers do this, and I really admire their dedication - personally, I just can't see it. I think it's so much easier in the long run to suffer through the strike for a few days, and then return to the ease of nursing.