Re: 4 week old fussing at breast- please help :)
Welcome to the forum and congratulations on the new baby!
The behavior you describe is very typical for a baby this age. It is often due to a fast letdown- having milk pouring into your mouth can be hard for a baby, just like drinking from a spouting garden hose would be hard for an adult! Fast letdowns often cause fast feedings (as little as 5-10 minutes) and a lot of fussy behavior, things like baby pulling off the breast and crying and refusing to latch back on. Fast letdowns are usually a product of a milk oversupply, and the fact that you got 4 oz in 5 minutes with the pump is such high yield that I think oversupply is likely to be a component of what is going on.
If fast letdowns due to oversupply are what is troubling your LO, the first thing to try is reclined feeding positions. They enlist gravity to slow the flow of milk to the baby, making her more comfortable. If that doesn't change anything, then it may be necessary to progress to block feeding, but you don't want to go there unless you have to because block feeding reduces supply and it's possible to go too far.
Signs of oversupply:
- Mom often feels full or engorged
- Mom may leak a lot or feel strong letdown sensations
- Mom may be able to pump a lot of milk with ease
- Baby may feed rapidly yet still gain weight relatively quickly
- Baby may pull off the breast while nursing
- Baby may be very gassy or fussy
- Baby's poops may be frequently or consistently green
- Baby may cough, choke, gag, splutter, or make a clicking or clucking sound while nursing
- If baby pulls off the breast while nursing, milk may be seen squirting or streaming from the breast
May I ask why your pediatrician recommended a nightly bottle?
Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
Coolest thing my little girl sang recently: "I love dat one-two pupples!"