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Thread: Ten week old still sleepy at breast

  1. #1

    Default Ten week old still sleepy at breast

    I have a ten week old who is still sleepy during nursing.

    He was born at 36 weeks (had to be taken out due early due to cholestasis) then had jaundice for three weeks when he was excessively sleepy and had to be waken up to eat all the time. The jaundice since has gone away. His sleepiness did not, and he started becoming more fussy at breast so we visited a LC who diagnosed a posterior tongue tie. Her theory was the tongue tie is making him tired and that's why the sleepiness. About 10 days ago we got the tongue tie clipped. His fussiness reduced still the sleepiness hasn't gone away. His feedings take an hour. I have rented the babyweigh scale so I know how much exactly he takes per feed.

    The feedings always go like this - put on breast, he'll eat for 3-4 minutes, fall asleep. Then try to burp wake up, undress, change diaper, wet cloth, switch sides, another 3-4 minutes and fall asleep. Rinse and repeat for an hour. and at the end of the hour he'd have had 2-3 ounces. I try to do breast compressions and do all the stuff I've read to wake sleepy babies up - undress, change diaper, tickle feet, cheek, behind ear etc. But nothing seems to work.

    He's taking anywhere between 17-20 oz per day. His weight gain is 5-6oz/week. While slightly lower than average, doctor said is acceptable. He's in the 3rd percentile.

    I'm fed up. This is my second baby. Feeds for a two month old shouldn't take an hour. And I don't know what I'd do without the scale. Only due to the scale I know to prod and prod him so that he takes in a decent amount.

    I don't think supply is an issue - he gets one EBM bottle feed a day to allow me get a longer stretch of sleep and when I pump for that bottle, I always make about 3oz extra that I am freezing.

    Is he ever going to be awake while eating? Are his feeds ever going to shorten? I'm going crazy.

  2. #2
    Join Date
    Jun 2009
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    Default Re: Ten week old still sleepy at breast

    Hi parakeet.

    I agree that by 2 months most babies are capable of nursing more quickly than before, but length of session for an individual baby will vary throughout the day, and a 2 month old nursing for an hour at least sometimes is not unusual. However, if your baby is incapable of ever transferring milk more quickly, I agree there is a problem. So here are some thoughts.

    Have you seen the LC again since the tongue tie was treated? Sometimes more needs to be done- exercises, etc. At the very least, a follow up to see if the treatment helped enough is important.

    Since the feeding issue was only recently corrected, baby may still be figuring things out.

    Is baby on any type of feeding schedule? Some babies prefer to take smaller/shorter feedings at a time but, left to their own devices, will nurse much more often. Could this be your baby?

    Aside breast compressions, have you tried giving baby a tiny bit of expressed milk at the start of the feeding? Maybe in a syringe or eyedropper? Just in case it is a lack of energy issue that is causing baby to not nurse effectively, giving baby a little shot of your milk at the start may help.

    If breastfeeding checks out, I think 10 weeks is very old for excessive sleepiness to the point that it interferes with intake of nourishment. I have to wonder if there is something else (non-feeding related) going on.

  3. #3

    Default Re: Ten week old still sleepy at breast

    Quote Originally Posted by @llli*maddieb View Post
    Hi parakeet.

    Have you seen the LC again since the tongue tie was treated? Sometimes more needs to be done- exercises, etc. At the very least, a follow up to see if the treatment helped enough is important.

    Since the feeding issue was only recently corrected, baby may still be figuring things out.

    Is baby on any type of feeding schedule? Some babies prefer to take smaller/shorter feedings at a time but, left to their own devices, will nurse much more often. Could this be your baby?
    Thanks for the quick reply.

    Yes, I see the LC next week, she's out this week. Baby is not on any schedule. I feed him whenever he wakes up. Just that I don't let him go back to sleep with just 1 oz of intake as measured by the scale. A couple of times I tried letting him sleep with just that much but he wakes up immediately (like 10 minutes) so clearly he hasn't finished his meal.

    I will try giving EBM via syringe. Thanks for the suggestion.

    Since his weight gain is acceptable the doctor did not seem to worry. Is there anything specific I should ask the doctor?

  4. #4
    Join Date
    Jun 2009
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    10,694

    Default Re: Ten week old still sleepy at breast

    It just occurred to me that your baby was born a month early and you had cholestasis! So did I with two of mine, so I am a mom of 2 37 week-ers with one 41 week-er, born in between, all born via C-section, and in my experience being born even a few weeks early made a big difference and those babies took way longer to get the hang of breastfeeding. I also had to wake my oldest to nurse enough for almost three weeks, so I have some experience with how difficult it is to nurse a sleepy baby and also with the ideas I suggest below about letting baby find their own rhythm.

    Yes, I see the LC next week,
    Great
    A couple of times I tried letting him sleep with just that much but he wakes up immediately (like 10 minutes) so clearly he hasn't finished his meal.
    A baby taking a bit, then falling asleep, and waking in 10 to 20 minutes or so to have some more is a normal nursing pattern. This exact pattern is described in the book The Womanly Art of Breastfeeding as typical. Some call this cluster nursing. Many people think that a baby sleeping shorter means baby did not get "enough", and sleeping longer means baby got "enough," or that longer sleep = good meal. In fact, since a newborn has to nurse very frequently but at the same time needs a great deal of sleep, it is normal for a baby to nurse a little then sleep a little day and night, in an uneven pattern of nursing in clusters with very short sleep in between, and then this baby often sleeps longer stretches here and there. Once in a while you get a baby who nurses every two- three hours day and night like clockwork on their own, but this is not typical.

    I am not saying there is not a problem. There may be, with tongue tie, some degree of intake issues are of course likely. baby was also early, as I said before, that might be part of what is going on. But I wonder if the excessive sleepiness you are seeing is at least in part that baby needs to find his own sleep and eating rhythm.

    Maybe it would help to think of it this way. The average baby needs to nurse 8-12 times in 24 hours to get enough to eat. So lets say you decide your baby probably needs to nurse 10 times in 24 hours (normally exact frequency varies, this is just for reasons of an experiment) So then, instead of thinking baby should nurse every 2 and a half to 3 hours in order to get 10 sessions in, think of it as 10 sessions total in 24 hours. If, when left to his own devices, after half a day or so, baby is not on track to make it to 10 times, or baby has slept a really long time (more than 4 hours, say) you might try actively waking baby and offering more again. But otherwise, you might try to experiment with letting baby decide when and how long he nurses.

    If you try this, be sure you are not inadvertently encouraging baby to sleep longer. Keep baby with you, around the hustle and bustle of the family at all times, hold baby as much as you can, skin to skin when possible, avoid as much as possible pacifiers and swaddling, don't over dress/over blanket baby (don't keep him excessively warm.)
    Since his weight gain is acceptable the doctor did not seem to worry. Is there anything specific I should ask the doctor?
    I think after you have seen the LC, and any breastfeeding issues are ruled out or clearly improving, and maybe after trying my suggestion of letting baby find his own nursing/sleeping pattern, yet overt sleepiness continues, you might ask the doctor what else (aside not getting enough to eat) might cause excessive sleepiness in an infant.

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