Baby gets frustrated!

[@llli*misspea78]

Hi Everyone,
New here. My baby boy is 6 days old today. He was delivered three weeks early and is small (5.1 lbs) but healthy. In an effort to keep him eating and gaining weight, I am pumping my breast milk and bottle-feeding it to him, supplementing breast feeding. At the hospital, when nurses or lactation consultants helped me, he breastfed beautifully, but at home now, it's tough. He seems to get really frustrated. He flails with his hands, his head can't seem to get comfortable, and he doesn't get the right amount of nipple/areola into his mouth for a good latch. He does better sometimes, and other times he gets into a screaming and crying frenzy. He just seems super uncomfortable and frustrated...I try various positions. We do lots of skin to skin. I own the "womanly art of breastfeeding" book and have read all about latching. I stay calm and try to gently guide him without forcing ... but its not getting better. My pediatrician says I need to keep at it, make him "work" for the milk at the breast, as bottles are "easier" ... and I know this. But I have used bottles only because he is so small and I want him to grow. I'm afraid I've spoiled him ... I am going to a breastfeeding group next week, but between now and then, any advice would be so appreciated ... Thanks so much ...

[@llli*mommal]

Welcome to the forum and congratulations on the new baby!

I can totally understand why having a brand new, slightly premature, and very tiny baby can make a mom extremely concerned about weight gain. Even a large, full-term newborn can seem very delicate! But in general, supplementing and bottle-feeding should be avoided unless absolutely necessary. The reason for this is that it's really easy to get milk from a bottle. A baby doesn't have to latch well or suck well in order to get milk from a bottle; it will basically just drip-drip-drip into his mouth without requiring him to do much more than swallow. Babies, being the smart little creatures that they are, rapidly figure out that it's easier to eat from the bottle than from mom's breasts, and frequently start to resist latching onto mom, or becoming extremely fussy at the breast in an attempt to communicate that they want that easy bottle.

So what I'd urge you to do first is to figure out whether or not your baby actually needs supplements. Seeing a lactation consultant again, preferably one who is an IBCLC, is a good idea. I would have the LC do a weigh-feed-weigh measurement on the baby, and see how much milk he transfers. And then I would talk about renting a professional baby scale, so that you can do your own measurements at home. Collect data for a couple of days, and then figure out what your baby is capable of transferring at the breast. (A single weigh-feed-weigh test is not that informative, since the amount a baby takes in a single feeding can vary a lot.) If your baby is eating 2-3 oz on average, then there's no need for bottles and supplements.

Frustration at the breast is really common in newborns, even those who don't get bottles. Some tips for dealing with it:
- Try to get baby to the breast at the earliest sign of hunger. Crying is a late hunger sign, and once a baby is crying he is often so frantic that he forgets that latching on and sucking is the fix to his problem.
- If baby is already frantic, try offering him a pinky finger to suck, nail held down towards his tongue. If you hold it up, the nail can damage the delicate palate. A few seconds of sucking on a clean pinky can remind the baby that sucking is the solution to his hunger problem.
- Try instant reward techniques when latching baby on. A few droplets of milk expressed onto the skin of the nipple give the baby an instant taste of milk, and the taste cue can result in greater focus, more sucking, and less frustration.
- If baby writhes and thrashes, try swaddling him, and try belly-to-belly and laid-back nursing positions. (see p. 64 in Womanly Art)
- When latching baby on, remember that what is important is not how the latch looks, but how it feels. A latch that feels good generally is good.

[@llli*maddieb]

Congrats on dear baby! Your baby is only 6 days old. So I agree with mommal on everything except the expected per session milk transfer-my understanding is that after two weeks, you want to see transfer of 2 ounces or more. Before that it may well be less and that may be ok. It depends on how often baby is nursing and if baby is gaining ok. But I certainly could be wrong, your IBCLC can clarify that for you.

As mommal says, This behavior at the breast is really typical of newborns who are just learning to nurse-as you are. So I would not blame bottles at this point. What is more likely is the bottles are spoiling you, in the sense that you worry (normal-welcome to motherhood) and head for the pump and bottle because you know that 'works.'

Remember how to tell a baby this age is getting enough-baby should be pooping daily, 3 times a day or more is good. , the poops should be yellowish or getting there, and baby should not be losing weight anymore and may have started to gain. Once gain begins, an ounce a day is average. For most babies, being back to birth weight by 10 to 14 days is a sign all is well.

try to forget everything else-I hope you have help- and plan to spend the next week or so on the couch or bed with baby. Try everything that has been suggested to you and then try everything again and again. You cannot nurse too often, so offer the breast at the earliest cues or even when there is no cue.

if you go to www.biologicalnurturing.com there is a nice video about laid back that also shows nicely early nursing cues.

[@llli*mommal]

Congrats on dear baby! Your baby is only 6 days old. So I agree with mommal on everything except the expected per session milk transfer-my understanding is that after two weeks, you want to see transfer of 2 ounces or more. Before that it may well be less and that may be ok. It depends on how often baby is nursing and if baby is gaining ok. But I certainly could be wrong, your IBCLC can clarify that for you.

Thanks for correcting me, Meg!

[@llli*misspea78]

THANK YOU for the advice. I gave it a much more persistent go last night. Slept in a nursing nightgown that made it easy to quickly be ready for him ... set the alarm to wake him before he woke up hungry. That was great advice, that if he is really hungry that will just increase his frustration. Used my finger to remind him to suck. Also swaddled those wild arms tightly against him ... we were pretty successful. I kept switching positions and stopping to calm him down when he got really worked up before trying again at different breast/different position. At each feeding last night we got about 12 minutes per side. It took AWHILE -- maybe an hour per feeding -- to get those precious 25-ish minutes in, but I feel good about the fact that we hung in there and he certainly got some milk .. he went to the bathroom twice during the night and got sleepy after those feedings. I'm not having luck with the laid back position where he is lying on my belly. I have large breasts and he is so teeny -- its like he can't get his head up high enough... or maybe I am doing something wrong? I'm worried my angle is wrong somehow. This is definitely something to look into next week when we go to the class. And I checked, she is an IBCLC.

[@llli*mommal]

Good job, mama! 12 minutes of nursing per breast with a small, probably sleepy newborn is a really excellent achievement. If he consistently falls asleep while nursing, you might want to experiment with switch nursing. When the baby starts to doze off, transitioning from active suckling to shallow, fluttery, sleepy suckling, you take him off the breast, burp him or change his diaper, and switch him to the other breast. If he starts to doze on the second breast, repeat the process, switching him back to the first side. Repeat the process as many times as possible or necessary, until the baby will no longer wake. Switch nursing is not only old for sleepy babies, but it's also great for supply and for encouraging weight gain.

Large breasts and small babies are a challenge. (Ask me how I know! ) One thing you might want to experiment with is using a rolled up washcloth tucked under the breast to prop it into a better position. And keep trying different positions- not all positions work equally well for all mama-baby pairs! I personally had the most success with side-lying positions.

[@llli*boob.traveler]

It sounds like you're doing really well. You mentioned an alarm -- where is baby sleeping? If he's in the same room, his pre-crying noises will probably be enough to wake you up before he's frantic.

Like mommal said, different pairs do better with different positions. I liked the idea of laid-back nursing, but my baby never did. We figured out side-lying on our own within the first week -- only later did I read that it was "supposed to" be a difficult position for newborns.

[@llli*misspea78]

Your encouraging words made me feel so much better! Like its ok to not be good at this right away. THANK YOU. We saw the pediatrician for a weigh-in when he was four days old -- he was the same weight(4 LBS 12 OZ) as when he left the hospital, so it seemed as if the losing has stopped and he is gaining now. He looks to be gaining, anyway -- his cheeks look chubbier and his legs not so scrawny. We see doc again tues the 19th. I'm pretty hopeful he will have gained. Secretly hoping he'll be back to birth weight, but we'll see...Concerning the amounts, because I track obsessively what he eats -- time at breast or ounces in a bottle -- he generally takes 1.5 ounces in a bottle -- he's taken 2 a few times but it seems like that's pushing it because we see spit up when he eats that much. And he certainly is pooping that mustardy stuff several times a day. WAY more than 3X. And I do plan to spend a lot of time on couch and in bed with my little guy. My boyfriend and I are both off from work right now and he is not a typical guy. Does most of the cooking and washes clothes, etc... so I am free to lay around, bond, and practice with the baby. Watched the vid -- it was great. Going to grab the little man out of his co-sleeper and give it a go in a few minutes. Thanks again!!

[@llli*misspea78]

Baby sleeps in a co-sleeper next to me. I just set my cell phone alarm and put it under my pillow. Sometimes he goes for 4 hours or longer asleep -- that's why I wanted to get him onto me before he wakes starving and frantic. People say 2-3 hours between feedings so I worry 4+ can be too long ...

And yes I've tried the side-lying as well and he does seem to like that. Especially at night in bed.

[@llli*maddieb]

Sounds like you guys are doing great! btw even though we bedshare, I had to set an alarm in the early weeks with my daughter (now 8 months) because she slept so well I was getting really badly engorged. I used my phone too! I never had to do this before with my two older kids but she was (and still is) a really awesome sleeper. Which is not always good! You will probably only need to do this temporarily but if it's working, do it. (This is pretty much my mothering philosophy in a nutshell.)

BTW laid back only means mom is reclined. I know the pictures usually show a mom really laying down, but mom need not be super reclined, she can be almost sitting straight up. The point of laid back is, to be in a comfortable position and supported rather than ramrod straight or hunching over baby to nurse with no support for your back and shoulders and neck. Then, baby is simply turned into you, in any position, which would be more or less on top of you depending on your degree of recline. But the real point is to find the positions that work best for you and baby. And it sounds like you are figuring that out right on ‘schedule.’ If it feels comfortable to nurse and baby is getting enough milk nursing very frequently (which you tell by weight gain and poop) then it is a 'good' way to nurse. You guys fit together in your own unique way and this will evolve as baby grows.

People say 2-3 hours between feedings so I worry 4+ can be too long ...

4 hours may be ok, it all depends. Once a day or so at this age a longer stretch like that may be fine, as long as baby is nursing very frequently the rest of the time. A baby this age can normally want to nurse every hour or even more frequently for much of the day. As long as baby is nursing at least 10 to 12 times total in 24 hours and nursing well and gaining, and you are not getting overfull between feedings, that is fine. But it never hurts to offer to nurse more frequently if need be. "Cues" to feed can come from baby, or you, or an alarm if that works for you!