need help reading his code

[@llli*paytek]

My LO is3 weeks.
1. Is he supposed to be more alert now, or am I just not feeding him enough?
2. We had breastfeeding issues before, so I had been pumping. Because of this, lactation consultant said only have baby at breast for 15 minutes at a time, offer bottle after. Today he emptied my right breast after 20, and still ate about 4 oz of milk after, and then still acted crazy hungry. What gives?
3. We do co sleeping, and he seems to sleep better when closer to me, but doesn't want to wake himself up for food during our day time naps. I wake him up, eventually (3 hr mark). Anyone else experience this?
4. If it's been 2 hours ( since last feeding), and he stirs, briefly sucks on his hand, and goes back to sleep, is he hungry and should I wake him or wait until he wakes himself? (I don't let him sleep more than 2.5 hours at a stretch during the day, 3.5 at night)
5. We give him a pacifier to help him get to sleep. Is it possible that he would ever be hungry and not eat because he was given the pacifier? He does spit it out if hungry in lieu for bottle/breast.

This really boils down to...I don't want him to go hungry. He had weight issues ( took 2 weeks to get back to birthweight) because of milk movement. The lactation consultant and many reassuring friends tell me that if he's hungry, at this age, he will definitely let me know.

But I'm really scared about missing his cues or neglecting him in one way or another and him not getting fed or thriving.

[@llli*lllmeg]

Hi, so baby is still not alert? Yes, in general, a baby who has been sleepy before begins to "wake up" and cue more often after about 2 weeks. This is in general, so if your baby is still sleepy but nursing frequently enough (at least 10-12 times a day) and gaining well then it is probably not too big a deal, but baby will likely start asking to nurse more frequently very soon.

Are you still pumping? Supplementing? If not, (and even if you are but baby has started to transfer milk well) you can probably stop limiting nursing session length, if you are not sure, you may want to call your LC and ask her. It is in general not a good idea to limit nursing session length except in special circumstances as you were having. Babies will normally nurse all different lengths of time through the day.

Today he emptied my right breast after 20, and still ate about 4 oz of milk after, and then still acted crazy hungry. What gives?

Many babies will take a bottle after nursing and drink whatever is in it. This is because babies have an intense need to suck as their survival depends on it and will thus suck whatever is available. If it is a bottle, they end up drinking whatever is in it, hungry or no. This (taking a bottle) on it’s own, does not mean baby is hungry or cannot get enough at the breast! More breastfeeding moms have been misled and undermined by this than I care to think about. As long as baby is gaining well by nursing alone, I would suggest you avoid giving bottles and nurse again instead. 4 ounces is a ton-it is more than a 3 week old would typically take in one session nursing OR from a bottle.

We do co sleeping, and he seems to sleep better when closer to me, but doesn't want to wake himself up for food during our day time naps. I wake him up, eventually (3 hr mark). Anyone else experience this?

Yes it is normal (and so nice) for a baby to sleep better when with mom. Try to not worry about how long is has been since the last feeding so much, and instead think about how many times a day baby is nursing. There would not normally be any patterns to nursing at this point, baby may nurse twice or more in an hour, and then take a longer break. Since baby had weight gain issues, you probably do not want to go longer than 3 hours during the day and one 4-5 stretch at night for right now, but the most important number is how many times overall baby has nursed in 24 hours.

4. If it's been 2 hours ( since last feeding), and he stirs, briefly sucks on his hand, and goes back to sleep, is he hungry and should I wake him or wait until he wakes himself? (I don't let him sleep more than 2.5 hours at a stretch during the day, 3.5 at night)

Yes he is hungry and yes offer to nurse him, he is cuing. He may be able to latch and nurse well in his sleep, if not, go ahead and wake him up. It’s still early days and he has had weight gain issues, so I would say, much better to wake baby to nurse than let baby sleep at this point. He will still get plenty of sleep.

5. We give him a pacifier to help him get to sleep. Is it possible that he would ever be hungry and not eat because he was given the pacifier? He does spit it out if hungry in lieu for bottle/breast.

Absolutely. A baby needs to suck, and in a newborn, after a certain amount of sucking, a hormone called CCK (for short) is released that relaxes baby, tells him he is full, and he can go back to sleep. The SUCKING releases this hormone. So, a babies body can be ‘fooled” by a pacifier. This is one reason why pacifiers have been linked in several studies to slow weight gain and poor milk supply. Even for a baby with fine weight gain, it is usually recommended to hold off on pacifier introduction for the first several weeks (some say 4 weeks, others 6, others 8.) Even after breastfeeding is well established, it is important to avoid overuse of pacifiers.

[@llli*paytek]

Hi, so baby is still not alert? Yes, in general, a baby who has been sleepy before begins to "wake up" and cue more often after about 2 weeks.

No, he's awake more before feedings, seems more patient, and a little harder to get back to sleep afterward, which is why I was wondering. (Because up until now it was mostly.. wake up, eat, sleep and start all over again)

Are you still pumping? Supplementing? If not, (and even if you are but baby has started to transfer milk well) you can probably stop limiting nursing session length, if you are not sure, you may want to call your LC and ask her.

Still pumping and supplementing after nursing sessions. I have my next appointment with my LC on Monday, but he's moving milk so well now (draining the breast within 20-25 minutes) that I really don't want to limit him anymore, but I have another question about that that I will post later in this thread.

As long as baby is gaining well by nursing alone

We're not sure as of yet, since the LC wanted to give him a week of getting adjusted to his tongue and another week of bottle-feeding the breast milk, though wanted me to keep putting him to the breast (She said in this case it would do more good than harm and put him ahead of the power curve that he was behind because of his previous weight issues).
Next appointment with her is on Monday, and she'll do a before/after nursing weight to see how much milk he actually is transferring, and from there if he's transferring milk well I get the 'go' for solely breastfeeding, or the 'no go' and have to use an SNS.

Try to not worry about how long is has been since the last feeding so much, and instead think about how many times a day baby is nursing. There would not normally be any patterns to nursing at this point, baby may nurse twice or more in an hour, and then take a longer break. Since baby had weight gain issues, you probably do not want to go longer than 3 hours during the day and one 4-5 stretch at night for right now, but the most important number is how many times overall baby has nursed in 24 hours.

It's so hard to go from "How many ounces is he eating in 24 hours?"--which is a static number, to "How many times has he nursed in 24 hours?" Just because with a bottle you can easily say 'okay, yeah, he's eaten like 22 ounces today in total', but with the breast you can't really put a comforting number on what he's taking in.


So, this morning at 0600, I breastfed him from the right breast. He drained it. I put him on my left breast. After about 10 minutes he fell asleep. I tried burping him to wake him up, he stayed sleepy-eyed. I swaddled him and he still looked like he was heading for bed. As soon as I put him down in his bassinet (so I could pump!!!), his eyes popped open wide and he started munching on his hands (a feeding cue). I took it to mean that he was still hungry. I gave him the bottle and he drank 1.5 oz. (with expressed breast milk, of course), and after a few minutes he was falling asleep again. I tried putting him down, he woke up and munched on his hands. We went through this for 2 hours (from 0640-0830) until finally I laid him down in bed next to my husband and he fell asleep quickly.

So, was this kid trolling me, hungry, just wanting to suck on his hands for sucking's sake?

[@llli*lllmeg]

He is a newborn and newborns like/need to nurse in patterns that can feel pretty much like mom is nursing constantly and often object to being laid down in the crib, they would rather be held. In other words, I think your baby’s behavior sounds perfectly normal. It will not always be like this, eventually recognizable patterns will emerge and nursing will become less frequent. But this is normal for at least the first couple of months. All this cueing and nursing and needing to comfort in your arms will be easier for you to handle once you are not also needing to pump and bottle feed.

You refer to baby draining your breast. This is not really possible as your body is constantly making milk. I just want to reassure you that, once you and your LC are comfortable baby is getting enough at the breast, if baby cues again, you can just nurse him again, no need to give a bottle.

I swaddled him and he still looked like he was heading for bed.

Swaddling is a technique for putting baby to sleep/keeping baby sleep. It does not always work, but that is what it is designed to do. BTW swaddling is also thus possibly related to slow weight gain in the newborn, since it can make a sleepy baby stay asleep too long.

[@llli*paytek]

Oh wow. Thanks again!!