After a few weeks or months, breastfeeding has oft settled into an easy rhythm. But what if you're still dealing with a fussy breastfed babe or breastfeeding feels a struggle? Assuming any illness has been ruled out by your baby'south doctor, contacting an IBCLC lactation consultant can help brainstorm why your babe seems unsettled at the breast at any age or phase. There are many possible reasons—from your baby having a sensitive personality or being easily distracted by the globe effectually him, to existence hungry and simply needing more breast milk. Cows' milk allergy, reflux or temporary lactose intolerance could also be involved in unsettled behaviour equally could sensory processing issues or loftier musculus tone. This commodity reviews some of the mutual causes of fussy, restless behaviour in a breastfed baby.

#i Positioning

Before looking for a more than complicated reason, information technology can be helpful to dominion out positioning or latch (the style a baby attaches to the breast) as a cause of fussy behaviour. If a baby feels unstable, has to turn their head into an awkward angle, or is prevented from using their feeding reflexes; they may discover it difficult to latch and might cry or pull away from the chest. Conversely, when a baby feels stable and can use their feeding reflexes to help them, they will usually latch more than securely (take more breast tissue into the oral fissure too every bit a nipple). A deeper, more stable latch helps babies control the flow and supply of milk from the breast more easily. For assist with positioning see Breastfeeding Positions for Newborns, Latching Tips and Breastfeeding Videos. A breastfeeding specialist is the ideal partner to help with good positioning.

baby breastfeeding on their tummy
Before looking for a more complicated reason, it can be helpful to rule out positioning or latch every bit a cause of fussy behaviour

#2 Underweight or hungry baby

A restless babe who constantly feeds or has trouble sleeping may non be getting enough chest milk, specially if these behaviours are accompanied by poor weight gain (see Agreement Your Baby'south Weight Chart). Dr Jack Newman, a Canadian paediatrician and breastfeeding expert, believes that the most mutual crusade of fussiness at the breast is when a baby is frustrated with slow milk flow resulting in hungry babies who fuss, weep, pull at the breast or proceed coming off the chest.1 Difficulty with driving the milk supply or with getting enough milk tin be due to a poor latch, or poor positioning (encounter #1 above)—although there are other reasons for depression milk supply.

Get skilled help

An IBCLC lactation consultant is the ideal specialist to help you lot identify the reasons for depression milk supply or aid place other causes for fussy behaviour related to breastfeeding. For self-help with boring menstruation of breast milk, or low milk supply encounter How to Make More Breast Milk, Is My Baby Getting Enough Milk? and What is Breast Compression?

Babies who fuss, cry, pull at the breast or keep coming off the chest may not be getting plenty milk ⓒMurielleB/Adobe Stock

#3 Canteen preference or nipple confusion

If a baby has started to have quite a few bottles as replacement feeds whether with expressed breast milk or formula, some babies can seem to showtime to fuss at or plough abroad from the breast in preference for the bottle. This is sometimes called bottle preference or nipple confusion. Bottle preference is more than likely to happen if a babe associates breastfeeding with frustration and slow milk flow but finds the bottle more rewarding, or if a baby has a lot of bottles before they have got the hang of breastfeeding. If your infant is having more and more bottles and is starting to seem grumpy or unsettled at the chest, options to try include:

  • Cutting back on the number of bottles for a while and give baby lots of opportunity to breastfeed, or
  • Try our Tips to Bottle Feed the Breastfed Baby and run into Best Bottle for a Breastfed Baby?
  • Consider whether a supplemental nursing system or loving cup feeds could exist alternatives for supplementary feeds if needed
  • See How to Go Infant Dorsum to Breast if your baby is actively refusing feeds.

#four Normal behaviour mistaken for fussing

Sometimes what may seem similar fussy or sensitive behaviour is normal infant behaviour. For example it is normal for a newborn babe to protest when they are put downward; they love to be held and feel safest adjacent to an adult body. It's normal for newborn babies to feed very frequently, they are doubling their weight in a matter of months! It's normal for an older baby to go through a phase of hating to be strapped in a car seat. The Womanly Art of Breastfeeding has several useful chapters on ages and stages which explain the normal behaviour of a breastfed babe as he grows. For instance in the chapter "Half-dozen Weeks to Four Months: Hitting Your Stride" we are reminded that babies are individuals with unlike characters and with different needs:

Maybe you've got a sparkler – an intense, sensitive babe who needs input, input, input! His simply settings are high and off. That's the downside. The upside is how truly vivid and curious he is likely to get. You'll piece of work difficult as a mother to this babe. Look for other mothers of sparklers, to share notes with. Keep your sense of humour and try not to compare your busy days with those of your placid-infant friends. And keep your little sparkler close to yous – your presence and touch will often get a long way toward calming him.

#5 Fussy baby at four months

If your baby has been breastfeeding well for several months but then becomes a fussy infant at four months (or five or half-dozen or older!) it tin be puzzling to find a reason for the change. Effectually this historic period is a mutual time for babies to refuse some breastfeeds and get easily distracted with noises, activities, new surroundings and siblings—particularly during the twenty-four hour period time.The Womanly Art of Breastfeeding calls this The 4-Month Fussies. It's a phase that will soon pass but you may need to remind your busy baby to breastfeed in the day and information technology may help to cut down on distractions at feed times such as closing the defunction to lower the lighting or putting subtitles on the television to reduce background noise.

baby on tummy in a cute hat
Babies savor and demand a variety of sensory experiences and being confined to a depression sensory environs in the home can create unsettled behaviour

#6 Allergies as a crusade of fussy behaviour

Babies who are allergic to something from their mothers' diet passing into breast milk may appear unhappy at the breast—they might pull off and/or cry once milk starts to flow considering information technology hurts their inflamed oesophagus (eosinophilic oesophagitis) or gives them breadbasket ache. They may adopt to breastfeed in unusual positions and may exist very tense and seem to clamp down or bite the breast causing hurting and sore nipples2. They may take symptoms of reflux (#8) and/or tend to have very runny, copious and often light-green dirty nappies with symptoms of  lactose overload (#9). Allergy is idea to exist a possible cause of infant colic (unexplained crying). Writer Maureen Minchin describes a characteristic set of allergy-related fussy behaviours including disturbed sleep, erratic and persistent crying:

  • [Babies] who are either hyperactive before [in the womb], and persistently miserable after nascency, or
  • [Babies] who start screaming in the 2d or tertiary week of life, and
  • [Babies] who give many indications of gut discomfort
  • [Babies] who progressively develop other minor symptoms, like dark sweats, cradle cap, or patches of rough skin
  • [Babies] who do not respond more than than briefly to mothercraft skills

See Milk Allergy in Babies for an in depth discussion of dairy or other allergies in breastfed babies.

#seven A fast let-down or besides much milk

Some babies may find information technology hard to cope with a very fast flow of milk causing them to cough, choke and constantly come on and off the chest. Babies take to coordinate sucking, swallowing and breathing during breastfeeding and, when the catamenia of milk is very fast, they may notice feeding quite stressful causing them to be restless and keep releasing the breast to prioritise their animate. Difficulty with controlling milk flow may be due to:

  • Suboptimal latch and positioning at the breast (#1). When baby's attachment is good they are better able to cope with the flow of milk even a fast allow-down.
  • A baby who wants to continue to suck for comfort or to fall asleep subsequently they are full,  but the milk is flowing faster than they want (Newman, 2014)
  • Oversupply or "as well much milk". Having plenty of milk is normally a proficient matter merely sometimes the sheer volume of available milk can itself be a cause of unsettled behaviour or crusade a temporary lactose overload with signs of discomfort and fussing (see #ix beneath). For more information see Oversupply of Breast Milk and What is a Fast Let-Down? Babies who are getting a lot of milk quickly may also spit upwards ofttimes (#8 below).

#8 Reflux

Spitting up some breast milk after a feed is quite normal or babies and well-nigh babies are "happy spitters". However if your baby has reflux and is very fractious and miserable—come across Reflux in Newborns for more than information. Reflux can be connected to allergy (#half-dozen above) and too much milk (see #7).

Spitting upwards is a normal event for babies and doesn't usually cause them a problem although more severe forms are possible east.g. GORD or GERD [gastroesophageal reflux affliction]. Sure underlying causes such as allergy or oversupply can make reflux worse. Working with an IBCLC lactation consultant alongside your health professional can help find ways to reduce reflux or identify other possible reasons for an otherwise healthy breastfed baby to be miserable and fussy.

#nine Lactose overload

Lactose is the chief sugar in breast milk. If lactose is prevented from being digested properly in the intestines it could cause a temporary lactose overload. This might happen if there was any damage to the special cells in the intestinal wall that produce the enzyme that digests lactose, or if the volume of depression fat breast milk passing through the intestines overwhelms the available enzyme. An overload of lactose might cause a babe to exist unsettled and have tummy ache, air current (farts) and lots of frothy copious green poop. Lactose overload can be caused by/associated with cows' milk allergy (#half dozen above) and may be one caption for infant colic. For more data and how to resolve it run across Lactose Intolerance in Babies.

#x Not enough sensory input or physical contact

Sensory deprivation or lack of physical contact can cause a baby to be fractious. Jack Newman attributes this to a fear of "spoiling" a baby and he calls it the English Nanny Arroyo;

Babies cry for many reasons—it is the merely way they have to communicate their needs. Many people believe that if you lot selection up or otherwise respond to a babe who cries, he will weep more and more; if you ignore his cries, he'll finish. But research has shown but the reverse. The babies who are responded to most quickly and consistently cry less past the fourth dimension they are a yr quondam. Even more than chiefly, they tend to talk before and make more efforts to communicate, apparently considering they take learned they will exist listened to.

Most babies crave physical contact; carrying them in a sling and accepting they need to exist with you much of the time tin help to see their demand for closeness. Babies enjoy and need a variety of sensory experiences and being confined to a depression sensory environment in the home tin create unsettled behaviour.three For some babies the reverse—over stimulation—might create an unhappy babe (#11).

#11 Sensory processing or loftier musculus tone

Some babies may have sensory processing issues, or loftier musculus tone that may contribute to intense and unsettled behaviour. Reading the linked manufactures may help to observe whether any of these could be an issue for your baby and what to practice.

#12 Other causes of a fussy baby

Other ideas that may explain unhappy or restless behaviour could include minor aridity (let your infant breastfeed frequently to quench his thirst), babe being too hot, too common cold, existence smoked over, wearing an overly tight nappy, having sore skin from an allergy, having sore gums from teething or thrush or being poorly eastward.g. having an ear infection4.

Medications

Parents may observe a connection betwixt their baby's behaviour and certain supplements or medications they take themselves or their babe takes. Fenugreek can affect some nurslings if the female parent takes medicinal doses for her milk supply5 while vitamins or fe supplements can bear on others causing discomfort6.

Vaccinations

Some babies could exist fussy if they have had a reaction to a recent vaccination. Parents can admission patient information leaflets listing side effects for vaccines in the UK from the NHS Childhood Vaccines Timeline.

My older babe is however fussy!

Some of the ideas above might still be useful to problem solve the reasons for a fussy older baby, or y'all may enjoy reading The Fussy Baby Volume by Dr William Sears which covers nativity to v years. If the fussing is happening especially at night yous may find Baby Waking Upward At Dark or Sweet Sleep: Nighttime and Naptime Strategies for the Breastfeeding Family helpful.

Summary

There are lots of reasons why a breastfed baby might sometimes seem unhappy or fussy such every bit being hungry, having allergies, sensory processing issues or lactose overload and more than. Checking with your dr. will rule out a medical cause for your baby'southward unsettled behaviour and the best manner to rule out any breastfeeding related reason is to contact a breastfeeding specialist to assist you. More prolonged and persistent crying in breastfed babies is discussed in Colic and Breastfeeding.

* Extracts reproduced past permission from Pinter & Martin.