Ruling out maternal supply issues (surgery, illness, anatomical stuff)that
can quickly disourage babies,  I'd say if a baby won't latch and won't nurse
it's because they CAN'T.  In other words, something is the matter with the
baby.  Breastfeeding isn't rocket science and it isn't beyond the
capabilities of a normal infant.  That's why feeding problems should be
identified a  symptom  of dysfuntionality  in an infant and the baby more
closely evaluated and monitored.  Luckily, the kind of problems that throw
most babies into the "not-normal" category are transient.  They arise from
birth trauma, medication issues, small size, temporary illness, etc.  These
marginal babies probably endure interventions less well and have more
stress-affected behaviors.  They'd be likely to prefer bottles because the
bottle would be slightly easier for most.  These  worried little people can
hardly be blamed for that preference not to starve.  If you help them by
improving management and technique and keep trying patiently (all the while
making sure they are well fed on pumped milk) generally they transition back
to breast nicely.  Unless their dysfunction is more enduring, in which case
you have your work cut out for you.

Barbara Wilson-Clay BSEd, IBCLC
Austin Lactation Associates
http://www.lactnews.com

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