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Making It Work

Refusing to Eat

From: NEW BEGINNINGS, Vol. 23 No. 3, May-June 2006, pp. 118-120

"Making It Work" is a regular feature of the magazine NEW BEGINNINGS, published bimonthly by La Leche League International. In this column, suggestions are offered by readers of NEW BEGINNINGS to help mothers who wish to combine breastfeeding and working. Various points of view are presented. Not all of the information may be pertinent to your family's lifestyle. This information is general in nature, and not intended to be advice, medical or otherwise.

Mother's Situation

My 11-month-old just started in a new child care setting and will not eat or drink while she is there. It's been one week and she won't take solids, a bottle, or a cup. The care provider is very concerned that my daughter will become dehydrated and thinks it might be easier if I wean her, which I don't want to do! How can I help my daughter and the child care provider through this difficult transition?

Mother's Response

My first child was in daycare as an infant and drank very little (anywhere from a half to two ounces of my expressed milk about three or four times during the day). Both daycare providers and myself were very worried. I tried all sorts of different things to help my son drink more milk (i.e., different types of nipples, various sippy cups, and cups without lids). Most of these things didn't make much difference.

If your daughter is healthy, I suggest that you and your care provider try not to worry. Have her hold and comfort your child and offer her something to eat or drink, but not force anything if your daughter isn't interested. The transition to a new setting is a big adjustment, and it may take a while for your child to feel more comfortable.

I found it useful to nurse my son when I dropped him off in the morning, and I often tried to go into work a little later so that we had more time together in the morning. If I was able to, I visited during my lunch. But often, I'd work through lunch so that I didn't need to work late. Taking work home with me allowed me to shorten my child's day at daycare and I could work in the evening after he went to bed. We also found that cosleeping helped him to make up for whatever he didn't drink during the day. Some children take in their necessary calories during the daylight hours. My child did this during the night instead.

As he gradually became more accustomed to solids, he started to eat a little more while with the daycare provider. He never drank very much expressed milk, just small amounts at a time. It helped me to know that children who drink human milk consume less than those on formula, so even small amounts were very beneficial. My child continued to have lots of wet diapers and didn't show any signs of dehydration, plus he continued to grow and develop normally, reaching and exceeding developmental milestones.

Because we were apart during most of the day, I found the time we did spend together to be incredibly precious. Continuing to nurse my child helped us to reconnect at the end of the day. Picking up my son at daycare was my favorite time. I'd sit down on the floor and nurse him, he'd snuggle in, hold my hand, and smile up at me. I wouldn't have missed out on the joy that breastfeeding gave us for anything.

Suzanne Nurse
London ON Canada

Mother's Response

My daughter has days where she eats next to nothing with the babysitter. On these days I know she'll be nursing all evening and waking in the night.

Some babies at about one year old may sleep all night without food or drink and no one suggests waking them so they don't become dehydrated. Perhaps asking the babysitter to keep a journal of exactly what your daughter takes in might help you. Sometimes things are clearer on paper.

Is it possible for someone to bring your child to you at work? That worked well with my son. If all else fails, look for another babysitter where your child feels more comfortable and one who supports the parenting decisions you have made.

Karen Campbell
Ajax ON Canada

Mother's Response

I went back to work as a flight attendant when my first son was 10 months old. He did not separate easily, but he tolerated staying with his dad, grandma, and occasionally a very caring babysitter who held or carried him all day if he needed it. He was not interested in solid foods at that point. At most, he occasionally chewed on a piece of steak or ate a few pieces of pasta.

I was very worried about leaving him, but his father and I decided to give it a try to see if it would work. It was pretty stressful for the first couple of weeks. He mostly refused all of my expressed milk when I was gone. We tried a variety of bottles, sippy cups, straws, and regular cups. The only thing he was willing to drink was small amounts of cold water.

After a month or so, he would drink very small quantities of cold whole milk from a plastic drink box, but he still drank mostly water during the day. Even this was in very small quantities: four or five ounces per day.

On the days that I worked, he slept more while I was gone. My shifts were long (usually 12 plus hours), but I only worked one day at a time and then had at least one day off before I had to work again. He slept with me and was always ready to nurse the second I got home. He nursed pretty regularly throughout the night. Basically, he reverse cycled. He slept a bit more during the day and only ate or drank a very small amount. He took in the bulk of his calories at night. This worked for us as I was still able to get enough sleep at night while he nursed.

Eventually, he did start eating small amounts of other foods, but he was never willing to drink my expressed milk when it wasn't coming directly from the "original packages."

I hope this information is reassuring to other mothers going through the same situation. My son has always been small for his age (just like his grandpa was as a child), but now at nine years old, his appetite is big and he is the healthiest of my three children.

Lisa Loeppky
Red Deer AB Canada

Mother's Response

Your daycare provider must be so worried! Can you talk about how much your baby is eating and drinking at home in order to help calm some of her fears? You could share information about reverse-cycle feeding, where babies "make up" for not eating much during the day by dramatically increasing their eating while they're with their mother.

Also, encourage the daycare provider to ease up a bit on the issue. Your baby may sense some of the daycare provider's anxiety about the situation, which can't be helping much. All the provider (and any of us) can do is offer a baby food. We can't force a baby to eat. Some babies don't react well to pressure to perform—and that pressure has to be increasing. It sounds like there's a power struggle going on. Ask your daycare provider if she would feel comfortable leaving some food and a sippy cup where your child can reach it and allowing her to get it herself. Many 11-month-olds can easily feed themselves and enjoy doing it.

I would suspect that in addition to your daycare provider's concern about your child, she's upset about the situation because it's unusual for her and may be disrupting her daily schedule. While showing empathy for her, be clear that breastfeeding is a non-negotiable part of your care for your child.

Kathleen Whitfield
Culver City CA USA

Mother's Response

She may not be taking much of anything at all while she's at daycare, but is she making up for lost time when you are together? Many working mothers see their children reverse cycle while in daycare.

It's normal for children to change their eating habits when going through a big life transition, be it the arrival of another child, moving homes, or starting daycare. It may just take a bit more time for your daughter to settle in before she resumes her usual nutritional intake.

Most importantly, you need to know whether your child is taking in adequate amounts of nutrition within a 24-hour period. Open communication with your child care provider is essential. She might be concerned that she is not meeting your expectations of care, but she may be reassured if she knows what is happening at home. It is the responsibility of parents, and therefore of child care providers in their place, to offer a wide variety of healthful foods. But you can't make a child eat if she doesn't want to. You can connect with your care provider in the morning to let her know how and what your child has had during the previous night, and for breakfast that morning. Check in with her at the end of the day about your child's intake, as well as what was offered and when.

Will weaning make life easier? It sounds like the transition into the new setting is more than enough change at once for your child. Many people tell us to wean without really understanding what breastfeeding means to our babies, ourselves, and our families, or how disruptive and painful weaning can be. Weaning before your child is ready is not very likely to be "easy"! Lots of mothers are pressured to wean when it seems that their children are not eating enough solids. Why give up the single most nutritive food that your child will reliably take? That was not a risk I was willing to take with my own daughter, even though she was petite and not very interested in solids.

With a bit of time, many working mothers of children who don't eat much are amazed to hear that their children are eating a veritable feast of foods that they won't touch at home. The social setting, routine, and peer pressure are usually a great incentive to children who "just won't eat."

Be sure to read the LLLI-published book written by Dr. Carlos González, MY CHILD WON'T EAT (Available from LLLI: No. 1716-12, $12.95). It's loaded with information and ideas on better understanding and evaluating our expectations of how our babies and toddlers "should" eat.

Rhondda Smiley
Toronto ON Canada

Mother's Response

I remember my son had a similar reaction when his child care provider left for the summer to visit with her family in Egypt. We decreased the amount of time he spent at the new place for a while and it helped him cope. We also arranged a small picture album for him to carry that had pictures he liked.

It is very difficult to see everybody worry about your baby. Maybe searching for other causes of her poor appetite would help. Is your child healthy? Is she teething or suffering from an infection? Besides the change of child care provider, how are the relationships with her and the children at the facility? What type of food has she been offered, and how was it presented to her?

Do you wonder if the new care provider is right for your daughter? If so, think about what made you choose this provider? How do you feel about the change? How do you feel about the situation? All these questions could lead you to some explanations of your daughter's reaction.

If nothing comes up with the above questions and you think this is related to adaptation, maybe your daughter needs to have a good conversation with you. Sometimes we forget to explain to our babies what exactly is going on. Maybe if you explain to her in very short simple words why she now goes to this new place and how you and your partner feel about it, this will help her to adapt. I hope these tricks will help your baby enjoy her new daycare situation.

Manon Forcier
L'Île-Bizard QC Canada

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