Afterward a few weeks or months, breastfeeding has often settled into an easy rhythm. Just what if y'all're still dealing with a fussy breastfed baby or breastfeeding feels a struggle? Bold any illness has been ruled out by your babe's doctor, contacting an IBCLC lactation consultant can help begin why your baby seems unsettled at the chest at any age or phase. There are many possible reasons—from your infant having a sensitive personality or existence easily distracted by the world effectually him, to being hungry and just needing more breast milk. Cows' milk allergy, reflux or temporary lactose intolerance could too be involved in unsettled behaviour as could sensory processing bug or high musculus tone. This article reviews some of the common causes of fussy, restless behaviour in a breastfed infant.

#ane Positioning

Before looking for a more complicated reason, information technology can exist helpful to rule out positioning or latch (the way a infant 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 detect information technology hard to latch and might cry or pull abroad from the breast. Conversely, when a babe feels stable and tin can utilise their feeding reflexes to assist them, they volition usually latch more securely (take more chest tissue into the mouth as well every bit a nipple). A deeper, more stable latch helps babies control the menstruum and supply of milk from the breast more hands. For assistance with positioning see Breastfeeding Positions for Newborns, Latching Tips and Breastfeeding Videos. A breastfeeding specialist is the ideal partner to help with skilful positioning.

baby breastfeeding on their tummy
Before looking for a more complicated reason, it tin be helpful to dominion out positioning or latch as a cause of fussy behaviour

#2 Underweight or hungry infant

A restless baby who constantly feeds or has problem sleeping may not be getting enough chest milk, especially if these behaviours are accompanied by poor weight gain (see Understanding Your Baby'southward Weight Chart). Dr Jack Newman, a Canadian paediatrician and breastfeeding expert, believes that the most common crusade of fussiness at the breast is when a baby is frustrated with slow milk menstruation resulting in hungry babies who fuss, cry, pull at the breast or keep coming off the breast.1 Difficulty with driving the milk supply or with getting enough milk can exist due to a poor latch, or poor positioning (see #1 higher up)—although there are other reasons for low milk supply.

Get skilled help

An IBCLC lactation consultant is the platonic specialist to help you identify the reasons for low milk supply or help identify other causes for fussy behaviour related to breastfeeding. For cocky-help with ho-hum flow of breast milk, or low milk supply run into How to Brand More than Breast Milk, Is My Infant Getting Plenty Milk? and What is Chest Pinch?

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

#3 Bottle 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 tin seem to get-go to fuss at or turn away from the breast in preference for the bottle. This is sometimes called bottle preference or nipple confusion. Bottle preference is more likely to happen if a baby assembly breastfeeding with frustration and slow milk period just finds the bottle more rewarding, or if a baby has a lot of bottles before they have got the hang of breastfeeding. If your baby is having more than and more bottles and is starting to seem grumpy or unsettled at the chest, options to endeavor include:

  • Cut dorsum on the number of bottles for a while and give baby lots of opportunity to breastfeed, or
  • Effort our Tips to Bottle Feed the Breastfed Baby and see Best Bottle for a Breastfed Baby?
  • Consider whether a supplemental nursing arrangement or cup feeds could be alternatives for supplementary feeds if needed
  • See How to Go Baby Dorsum to Breast if your baby is actively refusing feeds.

#4 Normal behaviour mistaken for fussing

Sometimes what may seem like fussy or sensitive behaviour is normal infant behaviour. For example it is normal for a newborn infant to protest when they are put downwards; they love to be held and feel safest adjacent to an adult body. It'southward 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 antisocial to be strapped in a motorcar seat. The Womanly Art of Breastfeeding has several useful chapters on ages and stages which explain the normal behaviour of a breastfed baby as he grows. For example in the chapter "Half-dozen Weeks to Four Months: Hit Your Stride" nosotros are reminded that babies are individuals with different characters and with different needs:

Maybe you've got a sparkler – an intense, sensitive baby who needs input, input, input! His only settings are loftier and off. That's the downside. The upside is how truly bright and curious he is likely to become. You'll piece of work hard as a female parent to this baby. Look for other mothers of sparklers, to share notes with. Keep your sense of humor and try not to compare your busy days with those of your placid-babe friends. And keep your petty sparkler close to y'all – your presence and bear upon will often get a long style toward calming him.

#v Fussy baby at 4 months

If your baby has been breastfeeding well for several months just then becomes a fussy babe at four months (or 5 or 6 or older!) it can be puzzling to find a reason for the change. Around this age is a common time for babies to refuse some breastfeeds and become easily distracted with noises, activities, new surroundings and siblings—particularly during the day fourth dimension.The Womanly Fine art of Breastfeeding calls this The Four-Month Fussies. It'southward a stage that volition soon pass merely y'all may need to remind your busy baby to breastfeed in the solar day and it may assist to cut downward on distractions at feed times such equally closing the curtains to lower the lighting or putting subtitles on the television to reduce background noise.

baby on tummy in a cute hat
Babies enjoy and need a variety of sensory experiences and being confined to a low sensory surroundings in the home can create unsettled behaviour

#6 Allergies every bit a cause of fussy behaviour

Babies who are allergic to something from their mothers' diet passing into breast milk may announced unhappy at the breast—they might pull off and/or cry in one case milk starts to menstruation because information technology hurts their inflamed oesophagus (eosinophilic oesophagitis) or gives them breadbasket ache. They may adopt to breastfeed in unusual positions and may be very tense and seem to clamp down or bite the breast causing pain and sore nipplestwo. They may take symptoms of reflux (#8) and/or tend to accept very runny, copious and often green muddy nappies with symptoms of  lactose overload (#9). Allergy is thought to be a possible cause of infant colic (unexplained crying). Writer Maureen Minchin describes a feature prepare of allergy-related fussy behaviours including disturbed sleep, erratic and persistent crying:

  • [Babies] who are either hyperactive before [in the womb], and persistently miserable afterwards birth, or
  • [Babies] who start screaming in the 2nd or 3rd week of life, and
  • [Babies] who requite 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

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

#7 A fast allow-down or too much milk

Some babies may find information technology difficult to cope with a very fast menstruation of milk causing them to coughing, choke and constantly come up on and off the breast. Babies have to coordinate sucking, swallowing and animate during breastfeeding and, when the flow of milk is very fast, they may discover 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 (#i). When baby's attachment is expert they are better able to cope with the flow of milk fifty-fifty a fast let-downward.
  • A baby who wants to continue to suck for comfort or to autumn asleep after they are total,  only the milk is flowing faster than they want (Newman, 2014)
  • Oversupply or "as well much milk". Having plenty of milk is normally a good thing but 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 (come across #ix below). For more than information run across Oversupply of Chest Milk and What is a Fast Let-Down? Babies who are getting a lot of milk speedily may also spit up frequently (#8 below).

#eight Reflux

Spitting up some chest milk after a feed is quite normal or babies and about babies are "happy spitters". All the same if your infant has reflux and is very fractious and miserable—encounter Reflux in Newborns for more data. Reflux can exist continued to allergy (#6 in a higher place) and as well much milk (run across #7).

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

#9 Lactose overload

Lactose is the chief sugar in chest milk. If lactose is prevented from being digested properly in the intestines it could crusade a temporary lactose overload. This might happen if there was any harm to the special cells in the abdominal wall that produce the enzyme that digests lactose, or if the volume of low fat chest milk passing through the intestines overwhelms the available enzyme. An overload of lactose might cause a baby to exist unsettled and have stomach anguish, air current (farts) and lots of frothy copious dark-green poop. Lactose overload can exist acquired past/associated with cows' milk allergy (#6 to a higher place) and may exist ane explanation for babe colic. For more data and how to resolve it see Lactose Intolerance in Babies.

#ten Non plenty sensory input or physical contact

Sensory impecuniousness 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 Approach;

Babies cry for many reasons—it is the merely mode they take to communicate their needs. Many people believe that if yous choice upwards or otherwise answer to a baby who cries, he will cry more than and more; if you ignore his cries, he'll cease. But inquiry has shown only the reverse. The babies who are responded to nigh quickly and consistently weep less by the time they are a year quondam. Even more than importantly, they tend to talk earlier and make more efforts to communicate, obviously because they take learned they volition be listened to.

Nearly babies require physical contact; conveying them in a sling and accepting they need to be with y'all much of the fourth dimension can help to meet their need for closeness. Babies savour and need a variety of sensory experiences and being confined to a depression sensory surroundings in the home can create unsettled behaviour.3 For some babies the opposite—over stimulation—might create an unhappy baby (#11).

#11 Sensory processing or high muscle tone

Some babies may accept sensory processing issues, or loftier muscle tone that may contribute to intense and unsettled behaviour. Reading the linked articles may assist to discover whether any of these could be an issue for your baby and what to do.

#12 Other causes of a fussy baby

Other ideas that may explain unhappy or restless behaviour could include modest aridity (permit your baby breastfeed often to quench his thirst), infant being besides hot, too cold, being smoked over, wearing an overly tight nappy, having sore skin from an allergy, having sore gums from teething or thrush or being poorly e.grand. having an ear infection4.

Medications

Parents may discover a connection between their baby'southward behaviour and sure supplements or medications they have themselves or their baby takes. Fenugreek can affect some nurslings if the mother takes medicinal doses for her milk supplyv while vitamins or fe supplements can impact others causing discomfort6.

Vaccinations

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

My older baby is still fussy!

Some of the ideas above might still be useful to problem solve the reasons for a fussy older baby, or you may enjoy reading The Fussy Infant Book by Dr William Sears which covers birth to five years. If the fussing is happening particularly at dark you may find Baby Waking Upward At Night 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 as being hungry, having allergies, sensory processing issues or lactose overload and more. Checking with your md will rule out a medical cause for your infant's unsettled behaviour and the best way to dominion out whatever breastfeeding related reason is to contact a breastfeeding specialist to assistance yous. More prolonged and persistent crying in breastfed babies is discussed in Colic and Breastfeeding.

* Extracts reproduced by permission from Pinter & Martin.