Midwife management of breastfeeding aversion response in a tandem breastfeeding context. Case report
1Enfermera Especialista en Ginecología y Obstetricia (Matrona), Hospital Universitari i Politècnic La Fe, 46026 València, Spain.
Breastfeeding aversion response (BAR) is a little-recognized phenomenon characterised by a sudden compulsion to remove the infant, accompanied by abrupt physical and emotional discomfort during feeding, particularly in prolonged and tandem breastfeeding due to increased physical and sensory demands. This case report describes a mother who developed BAR while tandem nursing in a context of high emotional load, fragmented sleep, and limited support. The midwife, through a series of visits, identified the triggering factors, which were related to exhaustion, overload, accumulated stress, and an increase in night-time feedings. The professional intervention included education about the phenomenon, emotional validation, promotion of self-care, and sensory- and relationship-based coping strategies, along with adjustments to the tandem breastfeeding routine and a respectful weaning process for the older child. Follow-up showed significant improvements: reduced distress, decision-making aligned with maternal values, and recovery of a positive breastfeeding experience with the younger child. The gradual weaning was successfully completed without compromising the mother-child bond. This case highlights BAR, emphasizes the importance of empathetic and multidimensional support, and underscores the need for further research to optimise its clinical management.
Breastfeeding aversion response (BAR) is a little-recognized phenomenon characterised by a sudden compulsion to remove the infant, accompanied by abrupt physical and emotional discomfort during feeding, particularly in prolonged and tandem breastfeeding due to increased physical and sensory demands. This case report describes a mother who developed BAR while tandem nursing in a context of high emotional load, fragmented sleep, and limited support. The midwife, through a series of visits, identified the triggering factors, which were related to exhaustion, overload, accumulated stress, and an increase in night-time feedings. The professional intervention included education about the phenomenon, emotional validation, promotion of self-care, and sensory- and relationship-based coping strategies, along with adjustments to the tandem breastfeeding routine and a respectful weaning process for the older child. Follow-up showed significant improvements: reduced distress, decision-making aligned with maternal values, and recovery of a positive breastfeeding experience with the younger child. The gradual weaning was successfully completed without compromising the mother-child bond. This case highlights BAR, emphasizes the importance of empathetic and multidimensional support, and underscores the need for further research to optimise its clinical management.
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