Following the interesting thread on breast refusal I think it may be
important to point out that some babies have latch on probs and some have
latch on probs r/t breast refusal.
 In my practice I have found "breast refusal" to be a very thought provoking
phenomenon that is in need of research and discussion. From my experience you
put these babies to the breast and the more you stimulate them to root and
open, the more quickly they become frustrated and push away and (most
importantly) this pushing away often seems almost to be part of the rooting,
opening reflex ie. the baby may be placidly positioned well at the breast,
you stimulate with the nipple to elicit the root /open and instead of lunging
toward the breast the baby pushes/pulls BACK from the breast! A term, healthy
baby will at the very least "allow" themselves to be put on the breast at
this point and move willingly to a complete latch etc. and SOME (particularly
gifted, probably neurologically advanced!) will actively move themselves,
sometimes ferociously TOWARDS the breast, a more active participant in the
latch!
I have often wondered whether  this is a sign of a subtle neurological injury
or immaturity but in the few instances that i have questioned other HCPs
about it, noone has any understanding of what i am referring to! I would
venture to guess that bottle fed babies might experience the same type of
response but because we can follow their head with the bottle and meet their
escalating need quickly, it isn't an issue.
As has been suggested in previous posts I would reiterate the need to not
fight with the baby about this! Teach the mother to ALLOW the baby to move
away when he wants to, CALM him away from the breast when frantic and
REDIRECT him back towards the breast whenever possible. I have found the
cobathing suggestion to be hugely beneficial with these types of babies as
the environment  is new and unique ( maybe?) and it doesn't seem to spiral
into the same negative experience. I would use cobathing a lot more if people
(in general) were more receptive to it. I find that i often have to pick and
choose the "type" of couple that I suggest it to as some look at me as if I'm
crazy!  "oooh that "far out" idea of being naked with my baby, I'd better
check with my doctor first,...or what if the cord, circ etc. gets wet....
Yikes!
Any thoughts??........

Lynn Shea Rn,Bsn,Ibclc
Franklin, Massachusetts

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