Feeding a Fussy Baby: Causes, Challenges and Solutions

One of the most challenging aspects of having a fussy baby is feeding. Parents of fussy or high need babies often report short, unpredictable and difficult feedings, regardless of whether the baby is breastfed or formula-fed.

Common feeding issues for fussy babies include:

Fussing or crying during or after a feeding
Baby pulling away or bobbing on and off during breastfeeding
Baby fussing due to overactive letdown
Frequent feedings in the evening hours (known as cluster feeding)
Unpredictable feeding routines: some days every 3-4 hours, other days every hour or more.

These issues can leave parents feeling frustrated and confused, not knowing whether the fussy eating is related to the mother’s milk, formula, colic or reflux.

My Experience with Feeding a Fussy Baby

When my son Sammy was born, I was determined to exclusively breastfeed him. While it had taken me a while to warm up to breastfeeding with my daughter, in the end I grew to love it.

However with Sam, the fussiness and crying were so extreme, it was hard to believe it didn’t have anything to do with my milk. He cried day and night, and only had very rare moments of contentment until he was around 3 months old.

We introduced a bottle and formula very early, in the hopes that it would help his fussiness. Looking back, I’d have to say it did little (if anything) to help the crying, however it did give me a much-needed break at times!

I remember experiencing terrible feelings of guilt over having to resort to formula; looking back, I wish I had gone easier on myself. I know now that even if I had exclusively formula fed my son, he would have been just fine!

Particularly in the evenings Sammy would tend to eat frantically, whether by breast or bottle, sucking vigorously, then pull away crying. He would latch on, then pull away, latch on, pull away. It was frustrating, to say the least.

After taking him to several doctors, we decided to put him on Zantac for possible silent reflux, and cut all dairy out of my diet. While these measures definitely weren’t a miracle cure, they did seem to help a little bit. At the very least, I felt like we were doing something, in a very helpless situation.

Causes of Fussy Eating in Babies

We spent many hours trying to find the cause of Sammy’s fussy eating. You may be in the same situation right now.

You probably already know that there are many possible causes of fussy eating in babies, including:

Overactive letdown – milk comes down too quickly.
Slow letdown – milk comes down too slowly and baby gets frustrated.
Evening fussiness – the feeding itself isn’t causing the fussiness, although it can appear that way.
Reflux – According to the research, this is far less common than is generally believed. However if you believe your baby has reflux, be sure to consult with your physician.
Food sensitivity – If your baby is sensitive to particular foods (dairy is one of the most common culprits), he may react during and after feeds.
Not enough milk – If you suspect you may not be producing enough milk, taking Mother’s Milk tea can be a great way to stimulate production.
Being overtired – This is a common cause of fussy eating among colicky and high need babies.

In fussy, colicky or high need babies, it can be very difficult to tell what the cause of the fussy feeding may be. If your doctor has confirmed there is nothing medically wrong with your baby, it may simply be that your baby’s fussiness while feeding is just another display of his usual fussiness (If he’s usually fussy, why should we expect anything different during feedings?).

Common Questions About Feeding a Fussy Baby

Following are some of the most common questions I hear about feeding a fussy baby.

I asked Stacey Rubin, lactation consultant and author of The ABC’s of Breastfeeding how she would deal with the following situations. Below each response, I’ve added a personal response based on my experience with fussy and high need babies.

Baby Distracted While Feeding

My daughter has been very high needs right from birth. It took us a while to get the hang of breastfeeding, but we finally established a pretty good routine after about a month. Now that she is 3 months old however, I am finding she gets extremely distracted when feeding. I find I can’t feed her in public as she would much rather see what’s going on around her. Do you have any tips for how to keep her focused on feeding?

It sounds like your baby is very curious and aware of her surroundings! Breastfeeding a social butterfly can be a challenge.

If your baby is willing, try to nurse before an outing. When you are running errands, look for a private, quiet space for nursing. A private dressing room in a clothing store is ideal. I do not recommend breastfeeding your baby in the stall of a restroom, it is simply not a suitable environment for anyone to consume a meal!
To help your daughter focus her attention on your nursing sessions at home find a quiet space without a lot of noise from T.V., phones, or excessive conversation.
Now that she is a little older, you can trust your baby to let you know when she needs to nurse. Her sessions may be short but efficient!

My response: These are great tips! High need babies are notorious for being ‘snackers’, particularly as they become more aware of their surroundings. When possible, ensuring he or she is getting a FULL feed (not just a 2 minute snack) will help. A full feed in a quiet, boring environment BEFORE going out is ideal, if you can manage it!

Breastfeeding Strike

My 4 month old has always been a fussy eater, but the past week she has almost given up breastfeeding altogether. When I offer her the breast, she turns her head away and cries. I worry she’s not getting enough to eat. Our pediatrician has said she is perfectly healthy, and has advised that we start giving her formula to see if she’ll take a bottle. I really don’t want to stop breastfeeding. What should I do?

Good for you for continuing to breastfeed your daughter! Here are a few suggestions to help the two of you find your way back together. Be patient and stay positive. Remember, you can’t make your baby nurse!

For starters, try to uncover the cause of your baby’s sudden refusal to eat. An abrupt change in her daily routine or a developmental challenge such as teething can cause some babies to temporarily refuse to nurse.
Spend quiet, relaxed time with your baby. Try holding her skin-to-skin at nap time and before bed. She may naturally be more willing to breastfeed when she is sleepy.
Avoid over-using a pacifier. Encourage your baby to meet all of her sucking needs by nursing.
If you choose to introduce a bottle, use your own pumped breast milk instead of formula.

My response: When Sammy was 10 months old, he went on a nursing strike. He absolutely refused to nurse, and while he was eating solid foods by that time, I wasn’t ready to give up breastfeeding as I didn’t think he was ready.

After speaking with a lactation specialist, we decided the best course of action was to pump until he was ready to try again (so I didn’t lose my milk supply), and take the pressure off – for my sake and for his. At night, I would do a ‘dream feed’; which is where you latch them on while they sleep in the late evening.

In addition, I watched for cues that he was interested in feeding, rather than continually trying it. It was a MONTH’S worth of hard work, but in the end, it paid off and we were able to continue breastfeeding for many more months.

Baby Losing Weight

I had my third child about a month ago. I exclusively formula fed my first two, but really wanted to give it a try with this baby. It’s been nothing but frustration! He has lost weight, and the doctor is pressuring me to switch to formula. I have to admit, I would love to stop breastfeeding. I find myself constantly frustrated and worried he’s not getting enough, and would love to stop breastfeeding. He’s gotten a month of breastmilk. Is it really that bad if we stop now?

Congratulations on your growing family! Good for you for nursing your new baby. You have given him the gift of your colostrum. This early breast milk is especially rich in antioxidants and antibodies that work to protect his young body from illness.If you feel frustrated and overwhelmed, you do have options. Remember, this is your baby and your body. If you are willing, consider contacting a lactation consultant who will assist you in finding a solution to manage these difficulties that you are having.If you decide to end your breastfeeding relationship, celebrate the time that you spent nursing your son. It was time well spent!

My response: I know you may have had many people in your life tell you that it’s best to continue breastfeeding. It’s true that breastfeeding is ideal, but so are ‘easy’ babies! Your baby will be just fine if you switch to formula…sometimes it’s just as important to look at your own well-being and ask yourself whether breastfeeding is sustainable for you, and for your sanity.

That said, there is little or no evidence suggesting that fussy or high need babies do better when switching to formula. So if you’re giving up breastfeeding in order to possibly ‘fix’ your baby’s fussiness, it’s important that you understand this is unlikely to help.

Colic and the Pacifier

Our son is very colicky, and we are at our wit’s end. Shortly after birth, we introduced the pacifier as a last ditch effort to calm him. It is one of the few things that (sometimes) works to soothe him. So far he does fine with breastfeeding, but I’m worried he’s going to get ‘nipple confusion’ if he keeps using the pacifier. Should we wean him off it?

Sometimes we need to do what works! I have a few suggestions to [hopefully] prevent any pacifier related problems.

Avoid introducing a pacifier until your breastfeeding relationship is well established. This may take a month or so.
Be sure to nurse your baby often, and be sure that he has received a productive feeding before giving him the pacifier. This will prevent your baby from missing a feeding. Young babies can confuse pacifier sucking with feeding and miss a meal.
Finally, be sure to wash the pacifier in the dishwasher daily. Pacifiers can pass unwanted germs back and forth!

My response: In my opinion (keep in mind I’m not a doctor or lactation consultant), nipple confusion is overrated! Particularly with colicky babies, DO WHAT WORKS. If you have a baby who is willing to take a pacifier, count your blessings! I personally have never heard reports of babies missing feedings, losing weight or rejecting breastfeeding because of the use of a pacifier (soother).

Other Common Issues When Feeding a Fussy Baby

Following are 2 other common issues you may be experiencing when it comes to feeding your fussy baby.

Overactive Letdown

This obviously only pertains to breastfeeding mothers. Overactive letdown (OALD) is when milk is released forcefully from the breast. This can be distressing to newborns as they are forced to try to swallow large quantities of milk very quickly. The symptoms of OALD may include:

Fussiness or crying when at the breast, particularly at the beginning of a feeding
Choking or gagging while feeding
Frequent stools
Excessive weight gain
Mother may experience strong sensation of milk letting down, once or even multiple times during a nursing session
Baby pulling off breast or ‘bobbing’ on and off
May notice that when baby pulls off breast, milk continues to spray out
Mother may notice excessive leaking, particularly in other breast while feeding
Gassiness

Overactive letdown may be remedied by taking your baby off the breast when the milk lets down, and expressing a small amount until the flow decreases. Alternatively, putting your baby in a position where he or she is above the breast will help lessen the flow.

Cluster Feeding a Fussy Baby

Frequent feedings, particularly in the evenings, are very common among fussy and non-fussy babies alike. While your baby may go 3-4 hours during the day between feedings, it may seem like she’s feeding every hour (or more!) in the evenings.

Some lactation consultants believe this is because your baby is filling up on nutrients before a long nighttime stretch, while others believe it’s more about the comfort and soothing the baby receives during the fussy evening hours.

In either case, cluster feeding is very normal and you should never feel bad for doing it!

In fact, in a recent survey I did of parents of fussy and high need babies, I found the #1 most effective soothing technique was comfort feeding. If breastfeeding soothes your fussy baby, don’t be afraid to feed all evening if you have to!

For more information about cluster feeding and evening fussiness, see this post on the KellyMom website.

If you’re looking for tips for how to soothe and calm your fussy baby, see my post 40 Fussy Baby Soothing Techniques: The Complete Guide.

Do you struggle with your fussy baby’s feeding? What’s your biggest feeding issue? Let me know below and I’ll try to help!

Image courtesy of Lars Ploughmann under CC 2.0