PULLING AWAY FROM NIPPLES

Cameo: My 4 1/2 month old daughter has started to pull away and yank on my nipples when nursing. As a result my nipples are getting sore. I used to enjoy nursing and would like to continue. What can I do to break her of this bad habit?

Anne: There are a number of reasons for babies to become fussy at the breast after they have passed the newborn period (the first six weeks or so). One is that babies become much more social during this time. A newborn infant will blissfully nurse for an hour or more, totally oblivious to his surroundings. There could be a major earthquake, and a newborn would nurse right through it, because newborns love to suckle. Once a baby learns to actively interact and smile at you, she becomes much more distractible. She wants to nurse, but she also wants to play and smile at you at the same time. She is very interested in his surroundings, and wants to look around the room if the TV is on or a sibling is playing in the corner. It is very difficult to stay attached to the breast and look around the room at he same time. This can be very frustrating to babies, and can cause them to fuss and pull off the breast.

Another factor is patience. Your milk lets down vigorously at the beginning of a feeding, then slows down to a trickle. If your baby keeps nursing, she will be rewarded with another let-down. While a newborn is perfectly willing to keep nursing while he waits for another let-down (remember, he doesn't have much else to do that's fun at that point), an older baby may get antsy after the initial flow of milk slows down, and may not be willing to continue nursing while she waits for another let-down.

Many older babies will get all the milk they need in less than five or ten minutes. Your let-down reflex is well established by this time, and babies become very efficient at nursing. The baby who pulls off the breast after a few minutes and refuses to take the second side may simply have gotten her fill. Many older babies will also begin to fight sleep, especially in the evenings.

Many babies will fight sleep even while their eyelids are drooping and you know for a fact that they are exhausted. Most babies at this age do better with the early am and middle of the night feedings, but fuss with every feeding in between. Does she do better with some feedings versus others, or fuss all the time?

With a four month old, teething can definitely be a factor as well. I had two out of six babies get their first teeth at four months, and teething can go on for weeks or months before babies actually get their first teeth. Some babies like to nurse more when they're teething, and some don't like they way it feels when their gums rub the nipple. It may help to let her chomp on something (a teething toy, a knuckle, or a frozen washcloth) before you nurse her or when she pulls off.