Confused about a few things.

[@llli*rw1978]

Hi there. This is my first post, however I have read this forum for support throughout the last 7.5 weeks (age of my DS).

DS is my second child. My first, DD, was a very very difficult bf experience (horrible latching issues, low supply with slow weight gain, excruciatingly long feedings, etc). For the first few months I did not enjoy bf at all (in fact shamefully hated it), but made it to 10 months.

My DS in comparison is a cake walk. However im seeing signs of possible reflux or oald ... Im not sure if its either, but worried things my get worse if i do what i need to. I know many moms are going thru very hard times with bf and I'm not trying to look for problems. Just want to keep thing going well.
Here is some background (sorry for the length)

- Some challenges with the latch (cracked nipples, lipstick nipples, etc) which weren't fixed (LCs and pedi both said latch was great. LC said tongue tie (and lip ties) was the issue, but pedi disagreed). I nursed through the pain and things progressed well.

- My LO is an efficient feeder, and will nurse in about 15-30 min. He usually feeds every 2 hours during the day, though sometimes less, with cluster feeds from 5-8. Night time feeds are 2-3 hours apart, but sometimes in the early am every hour.

- the last while I can usually hear gulping when he feeds, and sometimes he pulls off, and a few times has chocked/coughed on the milk.

- he frequently gets upset while nursing. He'll arch his back or try to slam himself on my chest while I'm tring to burp him (while he is on my chest). I thought this was bc he needed to burb ...

-DS pits up a lot - Typically at least 2 times a feed, and often hour or more later. Often with chunky white pieces, but also without. I try to burp as much as possible. Many times he spits up with the burp.

- hes has suffered from gas very badly on and off. I believe a lot of it was related to issues pooping: at about 1.5 week mark, he stopped pooping often. First started going 3-4 dys without, and the 5-7 days. The longer he went, the worse he cried/screamed, arched his back, went red, etc. we also joticed he would throw up more. After periodic prune juice per recommendation by my dr, he was back to pooping daily without any juice, the pains, gas, spit up dramatically ruduced. until today. It's been 2days since his last bm, and today he was in pain again - though not for as long as in the past. When he does poop, it's yellow with seeds (not constipated).

-DS also seems to gag sometimes when he spits up; there were two times where his gagging really seamed like he was choking and couldn't breathe.

- weight gain is good. back to birth weight by day 8 and, gained 2lbs by first month.

I've noticed that the gagging, and fussiness during feeding is getting worse/more frequent. could this be oald and are there things I could do to keep it from progressing?

I know the above doesn't sound bad in comparison to what others are going thu. It's just that bf is going really, really well right now and I don't want that to change; I'm actually enjoying it this time around.

Any insights would be appreciated.


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[@llli*mommal]

What you describe has many features in common with OALD, including:
- relatively fast feedings for an 8 week old (but not super-fast: babies whose moms have OALD often get a full meal in 5 minutes)
- baby chokes, coughs, or gags while nursing
- frequent spit-up
- good weight gain
- gas issues
- fussiness while nursing (does baby ever pull off the breast while feeding, and if so, do you see milk streaming or squirting from the breast when he does?)
I am not sure this screams OALD- reflux is also an option based on what you describe. The back arching in particular is suggestive of reflux. However, the firstline treatment for OALD is something you can do with no harm to anyone: simply start nursing in reclined positions, enlisting gravity to slow the milk flow to the baby. If that doesn't help, let us know.

Is the fussiness you are observing worse at any particular time of day? Perhaps in the afternoon-evening?

One thing you don't have to worry about is the infrequent poops. After 6 weeks, exclusively breastfed babies may poop as little as once per week (poops will be voluminous), and that is entirely normal as long as weight gain and urine output are normal.

[@llli*rw1978]

Thanks mommal!! as of yesterday he has developed a wet sounding cough (he has been wheezy sounding and congested - particularily after feeds-until now, and still is). I'm thinking that this is reflex related ...

does baby ever pull off the breast while feeding, and if so, do you see milk streaming or squirting from the breast when he does?)

Yes he does. But I only see milk spraying when I'm really full, such as at middle of the night or first thing in the morning.

Is the fussiness you are observing worse at any particular time of day? Perhaps in the afternoon-evening?

The timing varies, and I'm not really seeing any trend wrt time of day.

One thing you don't have to worry about is the infrequent poops. After 6 weeks, exclusively breastfed babies may poop as little as once per week (poops will be voluminous), and that is entirely normal as long as weight gain and urine output are normal.

Makes sense. What's weird is that this started with him at less than 2 weeks. Not too worried about this, just really hate too see him uncomfortable and in pain

[@llli*phi]

Yes he does. But I only see milk spraying when I'm really full, such as at middle of the night or first thing in the morning.

Nursing in a reclined position can help with that. And possibly (but not definitely) with some of the other issues at least a little bit (although it does sound like reflux, so talk to your ped about that).

Makes sense. What's weird is that this started with him at less than 2 weeks. Not too worried about this, just really hate too see him uncomfortable and in pain

For the pain you can bicycle his legs, give a tummy massage, take a warm bath, and hold him upright against your chest in a squatting position (relaxes certain muscles to help pass poops).