Well, at 6 months we've been having some real concerns about Jax. He's been exclusively fed breast milk for the past 5 months. I work full-time, so he is fed bm by bottle from 7AM - 6PM and by breast from 6PM - 7AM.
About two months ago, he seemed to be reverse cycling...where he was refusing most bottles during the day (only drinking one, swatting all others away) and, apparently, waiting for me to get home at night. However, when I get home, despite seeming eager and desperate to feed off me the minute I walk in the door, after about 2 minutes on the boob, he pops off lays flat and stretches himself out and screams. Pissed. I switch sides, I burp him, and the result is always the same...screaming. This goes on all night. Once we put him to bed, he wakes every hour and we go through the same thing. In recent weeks, my husband was able to get him to eat two bottles per day (10AM and 2PM). So, that means he's having 8 oz. of milk during the day and two minutes of milk at breast several times per night before freaking out. Naturally, to make sure he was getting something, I began giving him a bottle of breastmilk at bedtime, which he accepts frantically as if he's starving. The problem is that I'm only pumping 2-3 bottles of milk per day. Alot of my stash in the freezer is gone because of weekend visits with grandma, etc. (She would like him to stay over one night and I can't allow that because I don't have enough milk stored to provide her with enough for an overnight stay.)
Recently, we've introduced two solids to him, both of which he's had very little interest: brown rice cereal and sweet potatoes (spits out the sweet potatoes)
Well, Friday we had his check-up and because he hadn't gained a pound in the past month or so, his doctor (whom we LOOOOVE, as she's been incredibly supportive of breastfeeding) suggests he just isn't getting the calories he needs and this is why he doesn't sleep. And I have to agree with her. I just don't think he is getting the calories based on the 12 oz. of breastmilk by bottle and the unknown amount at the breast with his constant popping on and off. She also thinks that he's popping off the breast because at 6 months, he's getting smart and finding that the bottle is easier to work (even with a slow flow BF nipple) than my breast nipple and he's getting mad because he's getting lazy. She thinks he isn't sleeping because he's hungry. So, she's suggested the following:
1) Feed him on breast when he wakes at 6:30AM
2) Introduce brown rice cereal (or some other solid) in the morning
3) Bottle of breastmilk at 10AM
4) Bottle of breastmilk at 2PM
5) Introduce another vegetable solid at dinnertime
6) Nurse him, if he'll allow me to, when I get home at 6PM. (I pump a little on the way home so that he doesn't have to work so hard to get my milk to come down.)
7) At bedtime, 8:30PM, I feed him a 4 oz. bottle of breastmilk and top it off by trying to feed him what he'll take on the breast.
8) If he's sleeping, wake him at 11:30PM and feed him a 3 oz. bottle of formula and top it off by feeding him on the breast. (While he's sleeping from 8:30 - 11:30PM, I pump.)
She thinks this should get him to sleep for at least a 6 hour stretch from 11:30PM - 5:30AM.
She says that if this works and he starts accepting the solids and eating more of them, then we can replace the 11:30PM formula bottle with breastmilk (if I can pump enough).
Does anyone have any thoughts on this plan or her assessment?
I would talk to a lactation consultant.
I don't understand why you should give him formula instead of breastmilk at 11:30 pm if you are able to pump for him.
how many wet and dirty diapers is he having per day? And is he teething? Have you tried giving him ibuprofin or acetominophen to see if that helps with his on and off popping at night?
I don't see how it could be bottle preference since he clearly has not been preferring bottles.
He's been exhibiting this same behavior since he was 4 months old? Has it been exactly the same all this time?
Sorry, I keep replying. What about giving him avocado instead of brown rice cereal? It is very nutrition dense, unlike rice.
IMO introducing formula at the same time as solids can cause problems with your LOs tummy and intestines. Can you try the solids without formula then add the formula later if needed?
Also have you tried nursing your LO laying down, when they are almost asleep? Babies tend to be more receptive to nursing when they are drowsy or sleeping. This might help with the screaming. You also might want to go see a LC or LLL leader. They may know something super simple that can help.
Is he currently getting formula when you are at work?
If you are going to supplement with formula I would do it when you aren't there and nurse nurse nurse as much as possible when you are there.
I guess I don't really understand your doctor's recommendations. Breastmilk (or even formula) has so much more nutrition and calories than any solids you could give him right now. I don't get replacing milk (or formula) with solids, it seems like that would fill him up with empty fillers.
Have you tried doing breast compressions when he is on the breast and seems frustrated?
I'm gong to try to reply to all at once:
1) He has several wet diapers per day (4-6) but rarely has dirty diapers. Sometimes can go several days without a dirty diaper..most recently went 4 days without a dirty diaper and we believe the introduction of peas may have instigated a bowel movement on Sunday.
2) As far as we can tell, he's not teething or in any pain so we haven't introduced any pain meds. When he wakes up screaming in the night, he stops immediately if we pick him up. If he was in pain, I would expect him to continue to cry.
3) This has been gradually progressing over the 4 months since I started back at work. He fed breastmilk by bottle several times a day when I first went back to work and transitioned fine to the breast when I got home at night for at least the first 2 months after I returned to work. Then he started refusing all but one bottle (taken probably out of desperation) about 2 months ago. About the same time he started to go from 2-3 hour stretches of sleep per night to waking up every hour, I'm assuming because he was reverting to a reverse cycle and wanting me to feed him every hour, which I obliged but he started to pop off. Then several weeks ago my husband adjusted his daytime feeding/nap schedule and was able to get him to eat 2 bottles per day instead of one but the one hour sleep cycles continued as did the popping off.
4) I have not tried avocado, but that's a great idea. We recently introduced him to peas, so we have to wait another day before introducing a new solid.
5) Codepink - We've already started him on the 11:30PM formula routine...we started it Friday night. As for side-laying, he's very resistent to it. I've had one or two decent experiences with him doing it, but the rest of my attempts to side-lay have been met with screaming. He seems to absolutely hate my bed. Whenever I lay him on it, he screams. (Believe me, I've tried. I've been concerned about sleep deprivation and the fact that it interferes with safe commuting and my work because I fall asleep at inopportune times. Side-laying was something I tried very hard to implement but it worked so seldom that I've given up on those efforts.)
6) Norasmommy - We offer him no formula while I"m at work. The only formula he gets is 3 oz. at 11:30PM at night and that only began this past Friday on doctor recommendation. I've tried the nurse, nurse, nurse program when I'm at home and it's hard to nurse, nurse, nurse, when he pops off constantly and screams after about 2 minutes. I also tried compressions but he still pops off screaming. I honestly think he prefers my nipple (maybe the shape, the comfort, etc.) to the bottle, but prefers the effortlessness of the bottle and gets made because it's just too much work for him to get my milk to come down.
Since we started the doctor's recommended program this past Friday, I have seen his sleeping improve. He's now sleeping in 2-3 hour stretches and even when he awakes at 1:30AM or 4AM, he's still sleepy enough that he's not popping off during those feedings. Now, it's not the 6 hour stretch the doctor suggested, but we haven't fully implemented the solids since he's not accepting the peas and we're waiting the recommended days before introducing a different solid.
Solids are not going to buy you a 6 hour stretch. My daughter didn't start sleeping in a 6 hour stretch until she was 2 years old. :gvibes
My daughter kind of did the same thing you're talking about with the popping on/off waking up frequently but it was while we were cosleeping, so it wasn't too awful. I really think it was teething and developmental milestones.
You said he hasn't gained any weight in a month. Has he lost weight? Has he gained length/head circumference? Has he started to get mobile?
My DD hasnt slept 6 hour stretch and she is 2 as well. Well, actually LAST NIGHT she slept from 10-5am so I guess that is 7 hour stretch, and that is a frist for us...at 2yo.
As for solids, with a young baby...solids are supposed to be for intro to foods and textures, not to replace nutrition. I dont get the logic behind replacing BM or formula with a jar of baby food??? :shrug How is a few oz of peas supposed to make a baby feel full? and how is their nutrition being met that way?
Formula is harder for baby's stomach to digest. That is why babies can sleep longer, cause it is sitting in their stomachs, taking a long time to digest.
As for poops, my DD would go 6-7 days between poops. That is completely normal for a BF baby! It is the perfect food for baby, and has little waste, most of the breastmilk is used, so little to come out!
Sounds as if your baby is having nipple confusion, and prefers the bottle over nipple. Is there any way that you can pump more to have more of a stash?
I agree with everything you say. However, I think what everyone who is passionate about breastfeeding like myself is overlooking is the fact that (1) he is REFUSING more than 2 bottles of breastmilk in the day and isn't getting the necessary breastmilk at night on my breast because he's popping off, and (2) The doctor isn't replacing bottles that he is already eating during the day (because he won't eat more than 2 bottles) with solids. She's adding solids to the only 2 bottles of milk that he is willing to eat during the day. She's ADDING calories that he isn't already getting by bottle during the day BECAUSE he won't drink more than 2 bottles during the day. To insure he's getting the calories he needs at night, she's having me feed him my breastmilk by bottle to insure he gets 4 oz. and then has me breastfeed him whatever he will take (before popping off) by breast.
Originally Posted by @llli*dara
Her theory is that by adding calories to his existing breastmilk diet, that he will be more fulfilled, less starving, and more likely to sleep deeper. If I was able to pump more and had more stash, I could just feed him more bottles at night to accommodate more calories since he won't stay on the breast but I'm already pumping as much as I can with my schedule so that's not an option. So she's trying to get him those calories during the day.
She's hoping for 6 hours, but even if not 6, he is already sleeping 2-3 hour stretches in the past few days compared to the 1 hour (sometimes less) sleep intervals we were seeing.
To clarify...we are NOT feeding him JARS OF BABY FOOD. We are making the food ourselves from fresh vegetables. We puree and strain the peas and sweet potatoes.
Here's what perplexes me: If he is having nipple confusion (more than 2 months after introducing the bottle) and he prefers the bottle nipple, then why is he reverse cycling and refusing daytime bottles so that he can nurse on me at night...only to refuse the very breast he's holding out for?