Some babies don’t latch on as newborns.  Some may have started out breastfeeding and then stopped. Or maybe they never started. We’ll look at possible causes and solutions for each of these situations.

All mammals breastfeed after birth, without any special instructions, unless something interferes.  If a newborn “won’t” latch, it’s because they can’t for some reason.  Newborns may be unable to nurse because of:

•     Prematurity.  Babies as early as 28 weeks may be able to nurse, but often it takes some weeks for them to latch effectively.  
•     Birth interventions and medications.  Some drugs take days or weeks to leave a newborn’s body.  
•     Physical and medical issues for you or your baby. 

Whatever the reason for your challenges, most babies will latch in the end. In the meantime, following the “3 keeps” buys you time while you both figure things out.

The Three Keeps: Keep your baby fed, keep your milk flowing and keep your baby close. 

Keeping your milk flowing

It’s important to express your milk as often as your baby would breastfeed, which is every hour or two for the first day or two, to begin building your milk production and to avoid breast problems. 

In the first few days, hand expression is usually much more effective than pumping.  Colostrum is thick, sticky, and produced in very small amounts – often too small to cover the bottom of a container, so much of it simply sticks to the pump parts.  If you choose to pump, wipe off all the droplets you can with a clean finger, and give them to your baby. 

It’s important that you remove more colostrum and milk from your breast than your baby takes in.  Your baby may be eating a bit less because of this unaccustomed way of feeding, and you want to set up (calibrate) normal milk production.  Your milk production will increase automatically over the first few days, and frequent expression helps that happen faster, more smoothly, more fully, and with fewer problems. 

As your thick, small-quantity, sticky colostrum changes to thin, larger-quantity liquid milk, your baby will probably take more at each feed, and feeds will probably become more widely spaced.  A hospital-grade, double, electric breast pump may become an effective option at that point. Most of the world uses only hand expression, so if you prefer it, it’s a great technique.  Whatever method you use, at this stage express milk at least eight times each 24 hours.  It’s much easier to cut back later than it is to boost your production if it’s set too low at the start. 

Keeping your baby fed

You can feed your baby the milk you express via spoon, syringe, cup, “finger feeding”, a feeding tube or bottle. Even a few drops of colostrum may be enough to wake your baby enough to latch directly. Some people hand express directly into their baby’s mouth. 

There is more information here on feeding options

Reach out to an LLL Leader here or health professional for more support with these options. 

  Keep your baby close

• Provide plenty of skin to skin contact.  Some babies latch on by themselves if you lean back and relax in bed or in a warm bath together, baby on your chest. Use a baby sling or carrier to keep your baby close between feeds.
• Keep the process as relaxed as you can. You don’t have to try to latch your baby at every feeding, or even every day.  Everything will come together in time, especially if you have a skilled, gentle, hands-off helper.
• Offer the breast when your baby is asleep or very sleepy, such as during the night or while napping.  Babies can latch instinctively without opening their eyes and even without waking up completely. Sometimes they do better half-asleep than fully awake.
•  Dim the lights and practice in a place that’s free from distractions.
•  Offer to nurse when your baby is already partly full, not starving hungry. If your baby falls asleep at your breast without breastfeeding, it will make them feel the breast is a safe, positive place. 
• Relax with your baby in different positions – your baby expects to have their whole front against your body, with their head higher than their hips, rather than completely sideways. They expect to have their feet supported. They reach with their hands too, maybe holding your nipple when they find it, like little mountain climbers. They expect to “approach from below.”  Babies can push themselves forward, but they can’t back up.  If they “overshoot,” it can help to move them back a little so they can push forward again.
• Consider sleeping in bed together, once you’re home, with both of you topless.  Many babies have started nursing at night “accidentally”, when the pressure is off and the breast is right there waiting. Before you bedshare, be sure to read about Safe Sleep here so you know how to make your bed as safe as possible.

You’ll find much more information on expressing milk, supplementing and the early days in general in the “Art of Breastfeeding”, which you can buy here via our bookshop. And you can WhatsApp us here for 1:1 support.  

This article is adapted from the La Leche League International article “The baby who doesn’t nurse”