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Breastfeeding may have been challenging for you from the get-go, or it may have been going along swimmingly and then, all of sudden, your baby becomes fussy at feeds, or totally refuses to nurse. It's hard not to take it personally.

Though you might not believe it, your baby really does want to nurse. She has just hit a rough patch and needs your help. Learn some time-tested techniques to get your baby happily back to your breast -- and find out what to do in the meantime.

What to Do If Your Baby Refuses to Nurse

Feed your baby.
Though you may have heard that babies will nurse if they are hungry enough, it's dangerous not to feed your baby if she refuses the breast. Your baby needs to be well fed to have the energy to nurse.

Use your expressed milk and feed your baby, preferably by cup or spoon. Your baby should receive between 2 and 2 1/2 oz. of milk per pound of body weight each day.

Express your milk as often as your baby would nurse.
When your baby is not nursing, or is nursing irregularly, it's important to frequently express your milk using an automatic electric double breast pump. This will help to preserve your milk supply, as well as provide milk to feed to your baby.

If you're supplementing her feeds with a bottle, make the experience as close to breastfeeding as possible.

• If your baby is comfortable in the nursing position, with her cheek resting against your bare breast, use this position to feed your baby.
• Choose a bottle nipple with a slow flow.
• Tickle your little one's lips with the bottle nipple until she opens her mouth wide, as in a yawn.
• Make sure she takes the nipple deeply into her mouth.
• Hold the bottle in a more horizontal position so the milk doesn't flow too rapidly.

Simplify your life.
Working to get your baby back to your breast can be very stressful. Here are some ways to de-stress your life:

• Prioritize and cut back, or cut out, outside activities.
• Work on establishing a support system and ask for the help you need.
• Take care of yourself.
• If you can, take a day or weekend and just crawl into bed with your baby (with the pump nearby).
• Make a list of some of your favorite things to do (taking a walk, meditating, listening to music, napping, spending a few minutes in the sun, making love, etc.) -- and do it!
• Take some time for yourself each day, even if you have to split it into a few mini-breaks.

Encouraging Your Baby Back to the Breast

Expect baby steps.
Be patient. It can take several weeks to get your baby back to your breast, but, that being said, things can also turn around quickly. One good feed can make all the difference.

If your baby isn't comfortable yet being held in the nursing position, it's a positive step when you can hold her there contentedly against your breast. Remember, one step at a time. Keep offering the breast, and, if your baby cries or fusses, just stop and calm her.

It's important not to push your baby to your breast or hold her on if she's attached and wants to take a break. You want her to see nursing as a positive experience.

Woo your baby back to your breast with skin-to-skin contact.
If you can, go topless around the house and allow your baby access to your breasts throughout the day and night. During the day, "wear" your baby in a sling and offer your breast while gently swaying. Enjoy a bath together, holding your little one on your chest. When she's all relaxed and warm, she just might surprise you by spontaneously latching on.

Sneak in a feed.
Sleep or nap together and try offering the breast when your little one is sleepy. Babies often nurse best when they're not 100% awake. You can also try some gentle baby massage, bringing your baby to your breast once she is relaxed. Work on getting your baby comfortable at your breast, even if she's not yet ready to nurse.

Offer instant gratification.
As you hold your baby with her cheek to your breast, help her to relax enough to comfortably nurse. Express some milk into your little one's mouth to get her interested, or start out the feed with some of your expressed milk, fed in the method she has become accustomed to (for example, with a cup or spoon).

Once she latches on, you can help keep your milk flowing by using warmth (like a warm washcloth) and breast massage or compression and/or a nursing supplementer (which holds your expressed milk and delivers it to your baby through a tube taped along your breast).

Safety Note

• Reasons for breast refusal include, but are not limited to: a long, difficult birth; deep suctioning following birth; an undiagnosed birth injury or other medical conditions; poor positioning and attachment (sore nipples); engorgement; suck confusion (from use of pacifiers/bottles); low or overabundant milk supply; slow or rapid milk ejection reflex; teething; congestion; earache; allergies/sensitivities; using a new product; age-related distractions (too busy to nurse); ovulation; and menstruation.
• Unexplained, continued breast refusal should be evaluated by a physician.
• If your baby is less than 6 months old, you will need to express your milk regularly for each missed or "incomplete" feed, using an effective breast pump that mimics your baby's suck, such as an automatic electric double breast pump. This will help preserve your milk supply as well as provide milk to feed your little one.
• You can be sure your baby is getting enough milk by watching output and weight gain. Your baby should be wetting five to six disposable diapers and have at least three to four quarter-sized bowel movements a day by day three. Around six weeks, less frequent bowel movements are common. Your baby should regain birth weight within 10 days to two weeks after birth and have an average weight gain of 6 oz. a week during the first three to four months, and 4 to 5 oz. per week from four to six months.
• If your baby cries inconsolably or exhibits extreme lethargy she needs to be promptly evaluated by a physician to rule out any underlying medical condition.