Dear Doctor,

My 3-month-old daughter no longer wants to be breastfed. She doesn’t seem sick and her temperature is normal. Is she just tired of it? Is there any supplement I can give her since she hasn’t started eating?

Penny

Dear Penny,

Was your child feeding regularly before, "losing interest”, in breastfeeding? Breast milk is the best feed for a new born child and up to one year of age or so. Hence, mothers world over are encouraged to breast feed their babies till as long as possible.  Normally, by seven to nine months, babies apparently seem to lose interest in breast feeding due to multiple reasons. But this can happen earlier as well. As a baby starts growing after birth, she starts developing some interest in the environment around. Sounds in the room, bright lights, many strange faces, among other things, can be a distraction. If these distractions occur regularly, at feeding time, she may gradually lose interest in feeding on the breast. After regular breast feeding for several days, a baby can become efficient in the technique. Hence, she may feed faster and become satiated in a few feeds. Gradually, she may lose interest in breastfeeding, particularly if the breast is offered to her more frequently. The fragrance of a new soap, shampoo or some other cosmetic used by the mother can also distract the baby from breastfeeding.  Absence of the mother or somebody close for longer hours, may also make her refuse breast milk, even when the mother is available.

A blocked nose due to cold, ear infection, congested tonsils, are some conditions which make swallowing painful.  A baby cannot express her discomfort, but shall not be able to feed.

If she does not have a fever or does not seem to be sick in any way, there is nothing to worry. You have to be very patient. While breastfeeding, see that the room is calm and quiet without the presence of many persons. Lights can be made dim. Even if she refuses to feed initially, give her the comfort and warmth of breasts. Moreover, suckling by the baby stimulates the production of breast milk.  Avoid using a breast pump for some days, as this could have created an aversion for the breast. Avoid using strong smelling soaps or perfumes or any such body-care product. Gradually, she will again develop interest in breastfeeding.

Meanwhile, she can be given supplements of formula feed. But here, one has to be vigilant. Some babies take the formula very easily, whereas some are reluctant to change to a bottle.  It is also not advisable to mix breast milk with formula feed.

Dr Rachna is a specialist in internal medicine  at Ruhengeri Hospital

rachna212002@yahoo.co.uk