Concerned Papa

[@llli*daddydearest]

Howdy, there.

I know that, in general, fathers don't visit here, but I've been concerned, and my wife is too busy feeding our son (more on that in a moment) to check or post, so I thought I'd post my anxieties here in the hopes that someone could help us out.

Our son is 3 weeks old and up until yesterday has pretty much exclusively breastfed (I say "pretty much" because we did give him some supplemental bottles, but if you totaled all the supplemental bottles we gave before yesterday, it'd probably come out to 6 or 7). However his habits have been abnormal. My wife, lately can - and has - feed him round the clock. Literally. I don't mean feed for 45 minutes, then he sleeps for 30, then he feeds again. I mean that the other day he was on the breast for over 6 hours. He'd doze, she'd put him down, he'd cry immediately. She'd pick him up, he'd suck two or three times, then fall asleep, etc. etc.

I should add that he regained his birth weight (and then some) by two weeks, but my wife's nursing sessions were unusually long. Like 2+ hours sometimes. Often, I'd say. Maybe longer.

It was getting to the point where my wife couldn't sleep or eat properly. Add that to the fact that over the past week it got worse. My son would start screaming (not crying; SCREAMING!) when he'd poop, and that he was having green, leafy looking stools, and we were mightily concerned.

We brought our DS to his pediatrician yesterday who listened patiently, and then nodded and said, "This is normal. He's not getting enough to eat. He falls asleep because he fills with air, and then wakes up as soon as it's expelled. The green, leafy stools are - and please don't be alarmed when you hear the term - called 'starvation stools.'" He advised my wife to start every feeding of my son at the breast for 5 minutes. Then switch to the other breast for 15 minutes. His logic was that 80-90% of the quantity of the milk is received in the first 4-7 minutes of a feed at the breast. So any more, and the baby is gulping air. After feeding at both breasts, the pediatrician advised that we feed our DS a supplemental bottle of formula, and to do this every time she (my wife) feeds our son. He added that we should call him to follow up on Sunday or Monday.

Now, the formula pacified my son. There's no doubt about it. He's a completely different child. He's calm. He seems content. He sleeps during the day, whereas he never slept during the day before. But I'm concerned (as is my wife) that while we do this, her supply is dwindling, and that 'recovering' will be that much more difficult. When I asked the pediatrician about her pumping, he kind of shrugged it off and said it wasn't necessary.

We would like to go back to exclusively BF'ing if we can. But I'm afraid if we do, we will recreate the situation we had on our hands for the past few weeks - an uncomfortable papa (but I can deal with that), a VERY uncomfortable mama (which I can deal less with) and a VERY, VERY angry and uncomfortable little boy (which breaks my heart).

I'm desperate for advice. I don't want to keep supplementing if we can avoid it. I want this little boy to learn how to suck!

[@llli*mtaa]

I've never heard of starvation stools! What it sounds like is that your son may need help with his latch. He might be having the green stools because he is not getting enough hindmilk. I would schedule an appointment with a lactation consultant to get help. I had issues with green poo and they resolved when I fed my son only on one side for three feedings in a row, that way he would empty the breast completly. Things to try would be to keep him awake to eat by stimulating him and then have your wife use compressions while he is eating. If she is only keeping him one breast for a short time then he is only getting the foremilk which is less fatty, goes through the system quickly and then comes out as green poo becasue it didn't spend enough time digesting. I had tons of trouble getting started bfeeding with my daughter, it took about six weeks. Good luck! You are awesome parents wanting to do this for your baby

[@llli*daddydearest]

But is it normal for him to be at the breast for hours on end? I mean, literally, the boy was not sleeping at all during the day - he'd cry constantly if he was put down, and he'd suck lightly (and then doze) if he was at the breast. My wife did compressions to literally squeeze the milk into my son's mouth. We also tried spoonfeeding him breast milk.

I should also note that when my wife pumps she can get a pretty decent amount out - she's pumping now and I think just got 2.5oz out of one side.

[@llli*rdh2378]

I think your pediatrician is NOT well versed in breastfeeding! If your DS regained his birthweight and then some that quickly I don't think he's "starving" by any means. He might have the OPPOSITE issue... oversupply and/or overactive letdown, or foremilk/hindmilk imbalance, as suggeseted by PP. You might want to check out the site www.kellymom.com, as it provides a LOT of great information about many issues you've discussed: stooling (what's normal and what's not and what abnormalities can be caused by), how much milk do LO's need, how frequently to switch sides, etc. You are a GREAT DH and Daddy for researching for DS and Mommy, BTW! Kudos to you!

ITA with PP too about going to see an LC, and also suggest trying to get to an LLL meeting. Those two efforts alone made things soooo much better for me and my DD. I had the LC evaluate my DD's latch and suck, and she did pre and post feed weights to see how much milk she was transferring. Turns out that I have OS and OALD, and DD can get a TON of milk in a really short amount of time. And, once we figured out that I needed to sometimes block feed, as PP ALSO suggested, (offer the same side for multiple feeds over the course of a few hours before switching to other side), DD started getting a better balance of foremilk/hindmilk and green, frothy stools went back to yellow. Also, if you HAVE to supplement, you SHOULD... with EBM instead of formula, if your wife can find time to pump That said, if his weight gain is good, I don't think supplementing is necessary.

Maybe he has reflux, too, which my DD has. She gets uncomfortable when laid down right after feeding. Baby might be "comfort nursing" as there are natural pain relieving elements to BM, that formula doesn't have, and if he's in pain enjoys the closeness to mom. Your LO sounds a lot like my DD was at that age, and it did get better after working on the OS/OALD and Reflux. Hang in there, you are all doing great!!

[@llli*ooky]

Hi there papa,

I have to say that I can't agree with your doctor's advice. Green frothy stools are often observed in babies that get too much foremilk and not enough hindmilk, which often happens when a woman has an oversupply. I have never heard them called starvation stools. And his advice is certain to reduce your wife's supply and if your baby does have a foremilk/hindmilk imbalance, limiting feeding time like that will make the problem even worse!

I am not saying there is not some sort of problem, but what you have described so far doesn't sound like it is necessarily all bad either. First of all, how many wets and poops do you see in 24 hours? If you are getting 5-6 good wets a day then the baby is getting enough.

Secondly, what you have described in terms of feeding length describes the first 6 weeks of my daughter's life to a T. She also ate for hours at a time. That is very normal for BF newborns. And it is also very normal for it to go into overdrive right at 3 weeks, because there is a growth spurt right then. The marathon feeding sessions are tough, but that is how baby tells her body how much to make! Also, gas and pooping often seemed to go with some screaming at that age, especially at night, and my dd didn't even have colic! I tell you all this with the punchline that she was fine, and only got better and more efficient at nursing as time went on

[@llli*mumtothomas]

I agree with the previous posters--this doesn't sound unusual to me. And there is typically a growth spurt around 3 weeks, which can keep baby on the breast non-stop. It is hard, but usually over within a couple-few days (in my experience). As ooky said, this is how he boosts your wife's milk supply, so as frustrating as it can be, it's also a good thing in that it's supposed to happen.

The first probably six weeks of my son's life, feedings lasted anywhere from 45 minutes to an hour--longer during growth spurts--but he began to get faster and more efficient gradually after that. You and your wife are in the toughest part in my experience--hang in there; it gets easier!

[@llli*ooky]

Sorry, my phone has trouble with long posts.

Anyway, by supplementing you are messing with the supply and demand signals on both sides, so especially this early on I'd personally try to avoid it if at all possible. And any time you do supplement, your wife will need to pump to make up for the missed feeding.

Without seeing you in person it is hard to know for sure that there isn't a latch issue or foremilk imbalance or something. But let us know about the diaper count. And again, nothing you say sounds abnormal. Your wife and baby WILL be pretty much focusing on learning how to BF as a full time job for the first couple of months. I will tell you it is not easy at first but the investment is totally worth it! Keep us posted.

[@llli*aprilsmagic]

Yes, it's NORMAL to be at the breast for hours on end. That's how a baby is supposed to act. It's a survival instinct. If your wife were to put the baby down, a lion might eat him. But a baby doesn't know that a lion can't come in our modern houses, but that's what his instincts are telling him, so he is going to cry if he's put down. That's also how babies increase mom's supply. Skin to skin contact increases supply. Constant nursing increases supply.

Now, if he had not gained weight, then I would be concerned about milk transfer, as sometimes babies hang out at the breast because they are not transferring milk well. But..you's it. For him, it's a comfort thing. What I did when I had a baby like that -- and I had TWO who would be like that, and my cleft baby even is that way, even though I pump and feed him -- was slip a pacifier in. I knew they were nursing well, but if you aren't sure of that, don't do it as it can cause nipple confusion and preference.

The formula...it's more like how you feel after eating a big meal. You pass out. That's what happened to your baby. It doesn't mean that he is happier. It means his stomach may have been overfull.

First and foremost, your ped gave you some bad advice. Restricting feedings and timing feedings rom the breast is a bad idea.

The green stools actually make me think of too much foremilk, and the treatment for that is actually to NOT give just the first few minutes off of a breast. The best way to make sure baby gets more hindmilk is to actually feed from the same breast for several feedings, aka block feeding. Since your wife is already pumping that much (and tell her to STOP PUMPING -- more on why in a minute) she probably has an oversupply, and so restricting feedings is raelly going to make sure he just gets the less-rich foremilk and make this all worse.

Pumping increases supply, worsens OS and OALD (overactive letdown) and then makes the green poop worse.

What your wife needs to do is try blockfeeding: just feed from the same breast for several feedings. If baby still seems hungry, switch sides. Cosleep and let baby nurse as much as he wants. Side laying nursing. Also, get a good IBCLC and see her for breastfeeding advice, NOT a ped. They are NOT trained on BFing in medical school. You need a lactation expert, and a ped is not one.

Remember that this is all new to baby. It's hard coming into this world. Some babies deal with that by crying. So it might not be what you are doing.

Try some babywearing. Get a sling or Moby wrap (NOT a Bjorn-like carrier) and you can wear baby after mom nurses him. He may fuss at first, but he'll get it, and mom can get a nap or take a shower.

That first baby is hard. I remember being in your shoes. I was also given some really awful advice, and it was super hard dealing with that baby for the first few months of his life. I wish someone had told me to watch my baby and not the clock, about block feeding, about cosleeping. Doing those things have made my life easier with the other three kids I have.

[@llli*scienceteachermommy]

I am not a doctor nor a LC but honestly (and I will admit I am a little tired and grouchy right now) that sounds like a load of crap. It honestly sounds like your doctor doesn't know anything about BFing.

Normally you want to feed at one breast until the baby stops nursing at that breast to maximize the amount of hind milk that the baby receives. You then offer the other breast to see if the baby is still hungry.

Other than the stool issue, what you describe with your LO sounds a lot like my eldest. It wasn't that she wasn't getting enough milk; she just didn't ever want to be put down. Your wife might try baby wearing.

What precisely do you mean by green, leafy stool?

[@llli*aprilsmagic]

I missed that baby is 3 weeks. Yeah. You can't put a 3 week old baby down. That growth spurt is tough.

This will pass. Roll with it now, give baby what he needs now, and it will pay you back in spades later.