Happy Mothers Breastfed Babies
Page 1 of 2 12 LastLast
Results 1 to 10 of 12

Thread: 5-6 week difficulties

  1. #1

    Default 5-6 week difficulties

    Hi all,
    I'm a first time poster and have been struggling with breastfeeding for the past few weeks. My daughter is 6 weeks as of tomorrow. She had an excellent latch per the LC at the hospital and we were off to a great start. 3 weeks ago she acutely had significantly decreased nursing times for a few days (she typically nurses both sides for a total for 20-25 min and would only nurse one side for 5-10 min). I developed mastitis (no known blocked duct, it seemed to pop up out of nowhere).

    The mastitis has been cleared up for about 1 1/2 weeks now, however I'm very paranoid about feeding times (I don't want to go through that again!). For the past 1-2 weeks my daughter has had times of extreme fussiness in the evening ~5-9 pm. My pediatrician diagnosed her with reflux and started her on ranitidine - I don't feel that it's helped.

    My daughter's behavior about 75% of evenings lately is that she'll latch, pull away screaming, root, latch again and pull away screaming some more. I'll place her near my breast and she'll immediately start to cry. I don't feel that it's too fast letdown since sometimes she will nurse for about 4-5 minutes then begin to scream. I don't feel that its undersupply as I can easily express milk. Her stomach does have increased gut sounds, however I'm not sure if its because she's been screaming and has swallowed more air than usual. These evenings that she refuses to eat I'll pump to be sure that I empty my breasts at least once in attempt to ward off a second round mastitis.

    For the past few days my daughter has been only eating from one side again, for shorter durations. Her output is fine but the decrease is so abrupt again....I'm not sure what to do!

    We have some local LC, however I haven't quite gotten the help/support we need. This is very stressful and I feel like its affecting my bond with my daughter.

    Any support/suggestions would be appreciated!

  2. #2
    Join Date
    Jun 2009
    Posts
    8,480

    Default Re: 5-6 week difficulties

    It would help to know the exact weight gain, but I would guess you do have a fast or "forceful" letdown. This is often part of overproduction, which is a common issue in the first couple of months. and of course also leads to engorgement and mastitis etc. Fussyness, pulling off, etc. as you describe at anytime during the feeding but especially in the first 5 or 10 minutes or so, often has to do with fast letdown! I don't know where the idea came from that it only is an issue right when the feeding starts but I can tell you from experience it is not.

    If it is NOT fast letdown, what do you suspect? Nothing else really fits the behavior you describe that I can think of. What are you thinking it might be?

    Extreme fussiness in the evening is colic, which means it is something lots of babies have and the cause is usually never found, and it goes away over time.

    Babies eat very frequently, are on a liquid diet, and digest their food quickly. Hence, lots of "gut sounds." Normal!

    For the past few days my daughter has been only eating from one side again, for shorter durations. Her output is fine but the decrease is so abrupt again....I'm not sure what to do!
    As long as baby will nurse with high frequency, this is probably the perfect way to deal with the issues of overproduction and fast letdown: Frequent feedings, (every two hours or more often) but one sided unless baby indicates they want both sides. Also, try this positioning: http://www.nancymohrbacher.com/blog?tag=Fast+Milk+Flow

    I am sure you are aware that pumping may worsen the situation. However, you are right to pump (or hand express) if baby will not nurse and you are getting uncomfortably full. However, you do not need to pump to "emptiness" but just enough to soften the breasts.
    Last edited by @llli*maddieb; September 17th, 2015 at 05:49 PM.

  3. #3
    Join Date
    Feb 2015
    Location
    California, USA
    Posts
    460

    Default Re: 5-6 week difficulties

    A few questions...

    What color are her poops?

    Do you pump?

    Do you feel very full between feeds?

    How many times would you say she nurses in 24 hours?

    How has weight gain been? Post numbers if you can.

    I'm suspecting over supply. This can lead to an increase in lactose intake which can cause tummy rumblings. This also explains fast feed and her behavior at the breast. Usually this is not harmful to the baby and will resolve on its own as long as you nurse very frequently and you avoid any milk expression. We can give you more tips if this ends up being the case. hang in there momma. This behavior, while a little frustrating, is within the realm of normal.

  4. #4

    Default Re: 5-6 week difficulties

    Thanks for your quick responses!

    A few answers to your questions:

    My LO weighed 7 lb 13 oz at birth and yesterday (5w 5d) she weighed 10 lb 10 oz. This seems to be an appropriate weight gain (I think!).

    Her poops are typically yellow, however I do notice an occasional green poop (foremilk, I assume?).

    I started pumping per my doctor's recommendations while I had mastitis and did taper off to completely discontinued when it resolved. I do go back to work in 2 weeks, I have started to pump daily 20-40 minutes after my first morning feeding to accumulate a "reserve" of milk. Is this the best thing to do?

    Last night my LO barely ate after 4:30 pm, I did pump before bed.

    I don't typically feel very full between feeds other than my middle of the night and first morning feedings (she only wakes up once to eat in the middle of the night).

    My LO typically eats 7-8x in 24 hours. During waking hours she'll eat every 2-3 hours and will go ~6 hours overnight.

    My confusion between supply issues is this:
    I understand how it could be oversupply. I will hear an occasional clicking as she drinks. Where I'm confused is why is this only happening in the evening? I feel if it were oversupply it would happen in the mornings, and she has always eaten well in the morning. I have tried positioning her as described in your link and I haven't felt that it has consistently helped.

    I did have a LC mention that since it is only evenings it could be frustration with slow flow. Manual expression doesn't seem to help, either however.

    Essentially the latching, drinking, pulling away screaming episodes only happen in the evenings, and it doesn't happen every night but seems to be increasing in frequency. Any other thoughts/suggestions? Could this be consistent with thrush?

    Also, I feel that my paranoia of mastitis is contributing substantially to my stress. During the morning/day I will change nursing positions, intermittently I will my massage my breasts while nursing (my LO doesn't typically appreciate this). If this is truly oversupply how do I prevent a recurrence, particularly with her decreased nursing?

    I do suspect that the typical 6 week fussiness is contributing, as she'll cry/fuss in between feedings as well. I guess if that were solely the case, or if it were a growth spurt, she'd be feeding more frequently.

    Going back to work in a couple of weeks is also adding to our stress. We've had my husband offer her a few "snack" bottles (~1 oz) here and there. I was hoping to switch one meal to a bottle completely next week to ease the transition. I was planning on pumping and then having my husband feed her - does this sound reasonable?

    Thanks again for your help/support!

  5. #5
    Join Date
    Jun 2009
    Posts
    8,480

    Default Re: 5-6 week difficulties

    So baby has gained about 3 lbs in the 6 weeks since birth. Yes, this is normal or high normal weight gain. In other words, not the kind of very rapid weight gain that screams oversupply, but not the kind of low gain that would rule it out either, especially given your baby's fairly low nursing frequency. It would also be odd for your milk flow to ever be "slow" given that your baby is getting plenty of milk based on that gain. Too many bottles or bottles given incorrectly can cause a baby to be unhappy with the normal flow of milk, but I am not suspecting that as a problem in this case. I think that if this is something that mostly happens in the evenings when baby is fussy, then it is very possibly just part of that normal fussiness. It is frustrating because nursing is usually calming, but when you have a baby in a colicky state they often do exactly what your baby is doing. Again, this is normal and usually temporary. Your baby is gaining well so no need to worry, just offer again a little later.

    But one thing that jumps out at me is that your baby is nursing with a fairly low (although not dangerously low) nursing frequency. This again makes me think fast letdown. The longer the time between nursing sessions, the more likely to increase the rate of flow from the breast and the "foremilk" your baby ingests. There is nothing AT ALL wrong with foremilk, it is healthy and needed, but if a baby gets too much too fast it can sometimes cause some of the issues you are seeing. Given that, I think it might make sense to try to encourage your baby to nurse more often overall. There is no need to wait for baby to cue. Offer, and see if that helps. If baby seems to not like being "obviously" offered the breast, it is often possible to increase nursing frequency by mom holding baby most of the time, skin to skin or with "easy access," holding baby while baby sleeps, avoiding or limiting pacifiers, bedsharing or room sharing with baby, and avoiding or limiting swaddling.

    Mom going back to work is always a stressful time for mom and baby and the whole family, really. But it sounds like baby takes a bottle and you know you respond to the pump, which is very good. You will also want to figure out a way to ensure enough space and time for pumping while at work, educate your baby's caregivers on how to properly feed a breastfed baby, and think about a pumping plan before hand that will give you enough milk to leave for the first day and to have an "emergency stash" to use as needed. This may or may not mean a daily pump session is warranted. Many moms far overestimate the amount of expressed milk they "need" to have in the freezer before they return to work. There are very good resources on this website and on www.kellymom.com on all of this. Since your baby already nurses on the less frequent side, you might also want to think about how to continue that increase in overall nursing frequency after you are back at work so that on a daily basis, baby is nursing considerably more than they are getting bottles for as long as possible.

    I would strongly suggest there is no need to transition baby to a daily bottle before you go back to work. There is no evidence this eases the transition, but there is plenty of evidence that bottles increase the length of time between nursing sessions and if I am right that the problems you are seeing are linked to low nursing frequency, that will only add to your stress. Of course if baby gets a bottle before you return to work, you will want to pump "around" the same time. After you are back at work, it is important to nurse with good frequency throughout your work day, which typically means about every 3 hours.

  6. #6

    Default Re: 5-6 week difficulties

    Feeding every 2-3 hours during the day is low nursing frequency? What would be normal? Or is it more the one nursing episode overnight that makes it a low frequency? We honestly wake up our LO in the middle of the night to feed her, otherwise we figure she'd sleep through the night.

    I don't suspect that inappropriate bottle use is contributing, she's only had 3 bottles total in the past week (every other day), again a small amount (<1 ounce).

    I have tried feeding her more often, or not "on demand", it really hasn't seemed to help. We do share a room with her, spend daily time "skin to skin" and only swaddle her overnight while sleeping.

    From what I've told you does this seem more colicky fussiness related or due to oversupply? Either way should this improve with time? Any suggestions on decreasing risk of mastitis?

    I work part time (3 days a week) and was planning on pumping every 3 hours through the day (I work 10-12 hour days). I don't feel that feeding her every 2 hours will be possible (how will this work with her eating every 2 hours some days?)

  7. #7
    Join Date
    Jun 2009
    Posts
    8,480

    Default Re: 5-6 week difficulties

    Normal nursing frequency in the newborn period: 8 times or more in 24 hours. Usually, more. So, 8 is low but not abnormally or dangerously low, although it certainly would not be often enough for many babies. It is clearly enough for your baby right now, weight gain wise, but this does not mean it would not be better for both you and baby if baby nursed more often. There are plenty of reasons that low nursing frequency is a problem, as I explained above, while there is no problem at all with high frequency (assuming all else is normal.) You are smart to wake your baby to nurse overnight, because a 6 week old regularly going more than 4-6 hours without nursing every night is probably going to cause issues of one kind or another. if you do not swaddle baby for sleep, will she wake more? Swaddling is a sleep lengthening technique.
    From what I've told you does this seem more colicky fussiness related or due to oversupply? Either way should this improve with time?
    yes and yes.
    Any suggestions on decreasing risk of mastitis?
    encourage baby to nurse more often.

    I don't feel that feeding her every 2 hours will be possible (how will this work with her eating every 2 hours some days?)
    I am not sure why it would not be possible- most babies nurse more frequently than every two hours for at least part of every day. it's just normal. But maybe I am not understanding what you mean. if you mean nursing, I am not saying baby should be nursed every two hours. I am saying it may help and certainly cannot hurt to offer to nurse baby more often overall. This may mean baby nurses very frequently- maybe every hour or less, even, part of the day, and less frequently other parts of the day. Or it may mean your baby nurses on a more regular pattern. Every baby is different.

    If you mean bottles, I am also not saying baby should get a bottle every two hours. Bottles are very different than breasts, and when a mom is back to work the most typical problem is that baby is overfed with bottles and this harms breastfeeding. So bottles must be given very carefully to avoid overfeeding. (This is NOT true of breastfeeding.) So with bottles, the usual idea would be that baby is fed bottles on cue, and the bottles appropriately sized and given with the appropriate positioning and with pauses built in to help the feeding be a normal length and to prevent overfeeding and too rapid feeding with bottles.

    If your mean pumping when at work, there is no need to pump while at work with the exact frequency or at the same times at which your baby might nurse. If you plan to pump every 3 hours or so at work that should be fine.

    Here is info on bottles and how much milk to leave when back at work etc. http://kellymom.com/?s=how+much+milk and http://www.llli.org/docs/00000000000...astfedbaby.pdf
    Last edited by @llli*maddieb; September 18th, 2015 at 12:03 AM.

  8. #8

    Default Re: 5-6 week difficulties

    Would nursing more frequently worsen my oversupply? I thought increased frequency of nursing was a method to boost supply? I absolutely understand how this could help our issues though!

    At what age do babies start to eat less frequently? Or at what point should I stop encouraging her to eat more often?

    We do swaddle her overnight, she won't fall asleep otherwise (those flailing arms keep her awake!

    I mistyped, I did mean offering her a bottle every 2 hours (I had read that you should offer a bottle as often as you nurse and pump as often as you feed), what a relief to know that this isn't true! How do bottles increase the time between nursing? Is it because the baby eats more?

  9. #9
    Join Date
    Jun 2009
    Posts
    8,480

    Default Re: 5-6 week difficulties

    Would nursing more frequently worsen my oversupply? I thought increased frequency of nursing was a method to boost supply?
    no, because overall intake is not going to increase, or not much, in fact, if baby nurses more often and mom makes plenty of milk, overall intake may reduce slightly. Baby still needs what baby needs overall, and this is what baby will get overall, this does not change. I have had op with all three of mine and by far the most helpful thing was to encourage baby to nurse more often.

    At what age do babies start to eat less frequently?
    every baby is different, and in fact nursing frequency does not typically decrease in any type of progression. A 4 month old may well nurse more often than a 2 month old, in other words.
    Or at what point should I stop encouraging her to eat more often?
    You can continue to offer to nurse whenever you like for as long as your baby nurses.

    One of the great falsities of breastfeeding is that less nursing sessions is better or more normal than more. This is not true.

    I mistyped, I did mean offering her a bottle every 2 hours (I had read that you should offer a bottle as often as you nurse and pump as often as you feed),
    This is generally true if you are pumping and supplementing while home with baby. When a pumping mom is at work, this is just not realistic. What you would want to aim for is for your overall pump output to per day to be about the same as your baby's overall bottle intake per day. For the total ounces to be about the same, not total bottles. Some moms need to pump more often than baby eats and some less and some the same. All normal. Also, what if your baby has a 'bad day' and does not eat much at all? This happens, but you would not want to reduce your pump frequency to match that situation.

  10. #10
    Join Date
    Jun 2009
    Posts
    8,480

    Default Re: 5-6 week difficulties

    I forgot to add that nursing more often increases milk production in a circumstance where milk production needs to be increased in other words where there is low milk production and the mother is not making enough for baby. In that case more frequent nursing increases milk production. But where milk production is normal what frequent nursing tells the body is that it is making the right amount of milk and to keep making that amount, and when milk production is too high it tells the body that is making a little bit too much and to slow down production to the right amount. This is because the baby will leave a little bit more milk in the breasts each time baby nurses. If time between nursing sessions is too long, breasts get the message to slow down production more than is appropriate, and over time that can actually harm production or lower it more than desired.

    This is why both pacifiers and swaddling can sometimes cause problems with milk production. It can lead to baby going a longer than normal time without nursing, which leads to the breasts filling up with milk. This in turn causes several things to happen- it means the next time baby nurses it will be a faster than normal letdown. It also increases the risk of plugs or engorgement and mastitis. And eventually it can cause lower then appropriate milk production. I'm not saying you shouldn't swaddle your baby, your baby is gaining fine and you have enough milk so it this point it's not really a problem. I'm just saying that if swaddling is causing baby to sleep long stretches night sometimes that means the swaddling is working too well.

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •