Mystery Gas/Colic/Pain in my 5-month-old
My little five-month-old and I are hoping you can help us. She and I have had a tenuous breastfeeding relationship from the start, working through the hurdles as they've come at us. For most of her life (and she has been exclusively breastfed), she's struggled with intense gas that sends my otherwise happy girl into paroxysms of pain and screaming fits. These never last all that long, and aren't limited to any one time of day—but they are very disturbing. We notice more in the evening because she's sleepier and there's less to distract her, but she struggles with this all day. Here's a description of the current state of things:
- When we nurse, she pulls off often (once let-down happens), cries, attacks my breast right away again as though she's starving, and repeats. Eventually she calms down (sometimes).
- She is a very plump baby, and has always had outstanding weight gain.
- She generally (yes, I am giving all the details) poops every 4-7 days. Her stools are not green or watery, but have been "frothy" a few times.
- We used to nurse on demand, but this was our struggle. Then I moved to nursing about every 2.5 to 3 hours. That seems to help things, but we are still struggling.
- She wakes up once in the middle of the night to nurse, about 8 hours after we put her down at 7pm. Then she nurses about 3-4 hours after that, first thing in the morning, around 7am.
- I nurse as long as I can from one breast and then switch to the other. "As long as I can" means until the above-described off-on keeps going with no end in sight. (This is usually about five minutes.) She will often nurse for a little from the next breast, doing the off-on thing, but seem content after that. I think what is going on is that she gets some, but not enough from the first side, and some from the second to get just enough.
- She often makes my nipples sore. We have had this problem since she was a newborn. Nothing is wrong with her latch (several lactation consultants have confirmed this). She appears to be clamping or doing something strange with her tongue. We live with it for the most part, but occasionally it is very painful still.
- Like I said earlier, she appears to be in pain. I can hear her little gut rumbling, and she often has gas. She will just be sitting calmly and then stiffen and cry suddenly. Two minutes later, she's fine, and I'm sad and confused.
I should also mention that my milk supply has been a continual mystery to me. Sometimes I am just bursting, but there have been a handful of days in which, by evening, it would seem that I didn't have enough milk and would have to drink lots of water and herbal tea to get my supply back up. The days where my supply has seemed inadequate (and I think this because of how baby acted those days—hungry) have been days where she just wants to nurse constantly, and I can't keep up. By her first night feeding, I will be just bursting again.
I have read tons and I keep going back and forth—is it my let-down? An allergy? Teething? ... I thought she might have been teething at 3 months because of this. Everyone tells me it will get better when she's older, but at the moment I have a very fussy baby who just wants to be happy, but seems to be in pain. Any thoughts and advice you have that can help me solve this mystery would be so appreciated.
Re: Mystery Gas/Colic/Pain in my 5-month-old
Welcome to the forum!
What you describe sounds a lot like a forceful letdown issue. Baby is pulling off and fussing while nursing, baby has gained weight very well, baby is feeding rapidly, she may be clamping down on the nipple (compression of the nipple will slow milk flow), she's gassy, and you are still frequently feeling full at 5 months postpartum (by 5 months, most moms have a milk supply which is closely matched to their babies' needs, which means that they rarely if ever feel full). Those are all classic signs of oversupply/forceful letdown.
When the baby pulls off the breast while nursing, what do you see? Is milk streaming/squirting from the breast?
The first thing I would do in your shoes is to move back to on-demand feeding. When a baby is struggling with a forceful letdown, smaller, more frequent feedings tend to improve the baby's experience, because the breast doesn't get quite as full in between feedings and that usually makes letdowns a little more tolerable. The second thing I would do is to try reclining while feeding. Reclined nursing positions enlist gravity to slow the milk flow to the baby, which can result in a more comfortable nursing experience.
Once you've done those two things, I would give it a few days, maybe a week, and see if things improve. If they don't, then you may want to move to something called block feeding, which is feeding on only one breast per feeding or for more than one feeding in a row. Block feeding leads to reduced supply, because when milk sits unused in the unused breast, the body reads that cue as reduced demand and throttles back on production. Please do NOT block feed if you are scheduling feedings- there's a chance that you could end up with supply which is too low and a baby who is not getting enough chances to nurse and not enough milk to continue growing.
Managing milk supply through block feeding is more and art than a science. Because supply fluctuates from day to day and over the course of the day, some moms will need to block feed on some days and not others, and many will need to block feed only part of the day (usually during the mornings, when supply tends to be most abundant).
Finally, on to the gassiness. If oversupply is causing the gas, managing the oversupply should help your baby feel a little more comfortable. But crying in response to gas in an otherwise healthy baby... That's probably not a health issue. It sounds more like a personality issue. Some babies are mellow about their burps/farts/poops, and some are not. The ones who aren't are the ones who let you know every time they pass gas, by looking distressed and crying.