Need help with breastfeeding pull-off move

by Justine - Answer by Heidi Holvoet, PhD
(California)

Question: Hi, I have been trying to do the breast feeding pull-off move for many months now with varying success. Can you give some pointers?

Basically I wait for my baby to slow down from actively sucking milk and when he is just doing very light flutter-sucking I gently remove my nipple from his mouth. I understand that I am supposed to tilt his chin upward, to close his mouth, but I have NEVER been able to achieve this part of the maneuver. Instead of that happening he whines and reaches back for the nipple. If I don't give it to him then he rolls over and sits up and cries. If I don't give him back the breast then he stands up and walks or crawls away crying. So we try the whole thing over again and again until finally he rolls away from me when I remove the nipple from his mouth and he falls asleep (immediately). I don't think I am getting enough time between nursing and him falling asleep to break the suck to sleep association...

He still nurses many many times in the night, but he does just nurse and then roll away - he doesn't have to stay on the breast for a long time sucking away. Of course, he is a year old this week and I would very much like him to only nurse once or twice in the night! We have tried logging and nursing for shorter periods of time, but it just doesn't seem to change anything over the long term! In fairness he is teething, but REALLY? 7 or more nursings in the night at 1 year?? Oh yes, and we co-sleep and don't want to change that. Thanks for your advice.
Best,
Justine

Heidi's Answer: Hi Justine,

Sorry to hear you are still struggling. I thought from your emails below, that the pull-off method had started working, at least for a while.

From what you write now, yes it does sound like you have been trying to remove him too early. For now, let him fall asleep completely, even wait a while after he stopped nursing. Wait until his breathing slows down and he is all relaxed (can be up to 20-25 minutes). Then when he's fast asleep you do the trick: gently squeeze your finger between your breast and his mouth. While you take away your breast, tip his chin up: do it gently but do use some pressure too.

Only when this works well for a while (meaning he does not wake up at pull-off) you can go towards pulling off a bit earlier, before he is so deeply asleep. And then earlier and earlier.

About his waking up in general: yes teething may be involved but probably also some comfort nursing. I would still suggest weaning off one awakening at the time as in our original plan: so you refuse to nurse at say the third awakening of each night, for a week or so. Pick him up, rock, hold or walk him to sleep, have your partner tend to him but do not nurse. Once the sleeps through that awakening, wean off the next one, and so on.

Have you considered a pacifier/dummy? Unless you have a strong feeling against them, dummies can be a good help with comfort nursing.

No worries about the co-sleeping, no need for you to change that. But maybe double-check whether he is comfortable enough: does he have enough space, could he be too cold or too hot, …?

How are his naps?

Could you shift his bedtime to earlier? A half hour earlier could suit him better and help him sleep longer stretches too. Or if you feel he already goes quite early (say 6pm) you could go half an hour later.

Let me know, with the answers to the above we may find more.

Kindly,
Heidi