Here is an outline of a CERP session I did at the Oregon LLL Area
Conference 1996.  Please credit appropriately.  I have a full reference
list too.
BACK TO THE BREAST:  BABY ON STRIKE AND RELACTATION
Opening Comments: Because breastfeeding receives so little societal support
in the US it is essential to help mothers determine if babies are really
weaning or "on a nursing strike."  Strikes are used by many non-supporters
as instant signs of readiness to wean, especially in older babies.
Whatever the underlying reason for refusing to nurse, the mother should be
reassured and reminded not to take it personally.  Having outside worldwide
perspective is helpful...

Is it Weaning?
Weaning from a global perspective
 Worldwide Age of weaning is 4.2 years
 Only 6% of US babies are breastfed beyond one year
 Traditional societies nurse for 2-7 years
Weaning Age Based on non-human primate Anthropologic Models
After quadrupling of  birth weight (2.3-3 or more years)
Age at one third adult weight 6-7 years
Formula based on adult female body weight (3.7 years)
In relation to gestation length--6x gestation length (4.5 years)
Age at eruption of the first permanent molar (5.5-6 years)
Childled weaning is almost always a gradual process---not abrupt--TAKE
NOTE:  9 month "self-weaning" is a myth
It is very rare for babies under 12 -18 months to wean
Nursing Strikes occurs when a baby who has been bresatfeeding well
suddenly refuses to nurse and is unhappy about it.

Possible Causes of Strike
Mouth Pain (teething, injury, cold sore, thrush)
Ear Infection
Pain in nursing position (Injury, immunization)
Cold, Flu, or stuffy nose
Too many bottles, artificial nipples, etc.
Distractions, interruptions,  rigid scheduling, or delaying nursing
Long Separations from mother
Reaction to baby's bite
Stress or Tension in Mother's or Family's life
Overstimulation of baby or mother
Food Sensitivity
Drug, soap, shampoo, detergent or topical lotion
Offering Support, Info and Suggestions to the Mother
Take a thorough history:  age of baby, birth & pregnancy experience,  birth
weight, two-week weight, nursing patterns up to this point, previous
refusal of breast, any medications, new foods
Try to identify underlying cause and address it (e.g. refusal to nurse
bceause of thrush probably won't end until the thrush is treated, as well
as the mother's nipples being treated)
Refusal of just one breast needs to have medical evaluation to rule-out
mastitis, ear infection, breast tumor; however it may just be a preference
or supply issue
Keep mom comfortable
Relieve pressure, express in shower, ice packs, electric pumps, mild
analgesia (ibuprophen, acetomenophen)
Persuading baby to nurse
nurse while baby is sleeping
vary positions
nurse in motion (rocking chair, walking, etc)
skin to skin contact (in bed, bath, etc)
lots of attention
carry baby
stimulate let-down before attempting to latch baby onto breast
relax baby--baby massage,  baths, other:
Offer lots of encouragement
For a frustrated mother, suggest she ask a friend or relative for a break
to have a short time (even just 1/2 hour) alone or to relax/exercise
Extended Strikes lasting more than a few days
Don't compound problems
Keep baby well hydrated
Keep mom's milk supply up via expressing
May need SNS or other assistance

Resources and References
"How to Handle a Nursing Strke." LLLI pamphlet #62.  Schaumburg, Illinois:
LLLI; 1992.
"Manual Expression of Breast Milk:  Marmet Technique."  LLLI #27.
Schaumburg, Illinois:  LLLI; 1989.
"A Time to Wean:  An Anthropologist's View" presentation by Kathrine a.
Dettwyler, PhD at July 1995 LLLI conference session #121, Chicago,
Illinois.
"Is Baby Weaning or Is It a Nursing Strike?" by Nancy Mohrbacher in NEW
BEGINNINGS, Nov/Dec. 1992 pages 173-174, 176.
Mothering Your Nursing Toddler by NJ Bumgarner, LLLI 1990.
The Breastfeeding Answer Book.  Revisedby LLLI, 1997, page 268-271.
"Breastfeeding Techniques and Devices: Lactation Consultant Series #17", by
K. Auerbach, PhD;   available through LLLI, published by Avery Publishing
1987.
"Back to the Breast:  Retraining Infant Sucking Patterns:  Lactation
Consultant Series #15"  by MW Ross; available through LLLI, published by
Avery Publishing 1987.
"Relactation and Induced Lactation:  Lactation Consultant Series #1"  by A.
Sutherland and K. Auerbach, PhD, available through LLLI published by Avery
Publishing, 1985.
Breastfeeding and Human Lactation.  by J. Riordan, EdD, ARNP and K.
Auerbach, PhD; available from LLLI, published by Jones and Bartlett, 1993.


: )Chris Hafner-Eaton, PhD, MPH, CHES, IBCLC  email: [log in to unmask]   : )
: )HSR & Health Educational Consultant        voice/fax: 541 753 7340    : )
: )LLLLLLLLLLLLL**CHANGE THE WORLD, NURTURE A CHILD!**LLLLLLLLLLLLLLLLLL : )