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Thread: Hunger vs. need to suck

  1. #1
    Join Date
    May 2013

    Default Hunger vs. need to suck

    My baby is 4 weeks old. We just started introducing a pacifier and I'm concerned about confusing hunger with the need to suck. It seems like he is constantly giving us hunger cues. He'll take the pacifier and won't spit it out and he'll fall asleep for about 10 min but when the paci falls out he starts fussing again. Sometimes I'll put him to my breast to see if maybe he's hungry but he isn't swallowing just sucking and it HURTS! when he is swallowing/feeding it doesn't hurt at all. Is he going through a growth spurt and not drinking because my supply hasn't caught up yet or is the pacifier ruining the good latch we had and he's no getting a good feeding because of bad latch ? Not sure what to do. My nipples are totally sore from constantly trying to feed him which is why we tried s paci but I don't want him to be hungry. How do I know when he's hungry and when he just want to suck and can a pacifier mess up a good latch for a 4 week old? We had been doing great with BF'ong and it never hurt anymore but now he's wearing me out!!!!!!

  2. #2

    Default Re: Hunger vs. need to suck

    Hi Babyluv510, welcome to the forum! I am sorry you are having these problems it is no fun when nursing hurts.

    Nursing hurts usually due to one of two reasons. Most common, latch is off. Second and much less common, but something to be considered especially if nursing starts hurting after going well for several weeks, is thrush. However, since you say nursing only hurts SOME of the time(?) I would tend to think it is not thrush.

    So, here are some general things that currently known about breastfeeding. First, an infant is born with an intense need to suckle. Babies feel a real need to suckle most of the time in the early weeks. This is nature’s way of making sure baby gets enough milk and mom’s milk production gets off to a great start. So, a baby nursing 10 or more (sometimes much more) times a day, nursing to sleep, nursing in sleep, nursing for 30-45 minutes at a time or more, are all entirely normal and expected in the early weeks. It is actually the act of suckling that helps a baby feel sated and relaxed so they can sleep. Suckling releases a hormone that relaxes baby.
    Basically, this means that to a baby, there is not much difference between needing to suckle and feeling hungry. Not that an infant does not feel hunger, but that sucking will go a long way to comforting even a hungry baby. So there is no difference between nursing for comfort or nursing for hunger, it's pretty much all the same to a young baby. So a baby definitely CAN feel "satisfied" by sucking on a pacifier, so pacifier use in the early months has to be done very carefully or baby may not nurse enough to gain appropriately and ensure good milk production.

    Less is clearly understood about "nipple confusion" but again, it is believed by many lactation experts that a baby might change his suck technique to 'fit' a pacifier and that may in turn cause or exacerbate nipple soreness. Basically, baby doing on mom what baby does with a pacifier may cause nipple soreness. And pacifier overuse can also contribute to breast rejection by baby.

    These things taken together means that pacifier use, particularly in the early weeks is possibly very problematic and best avoided, or, when used, used very infrequently for when mom literally cannot nurse (travelling in the car, for example.)

    Now, to your problem. Nursing should not hurt. Whether baby is getting lots of milk or very little should not matter. Basically, just as babies are made to suckle very very frequently in the early weeks, moms are made to be able to nurse them this frequently comfortably. So pain like you are experiencing is not 'normal' (although it is quite common) and is almost certainly due to a poor latch. Since it feels ok some of the time and not others, perhaps when baby is actively drinking, baby is achieving a deep and comfortable latch, but as the nursing session goes on and the milk flow slows baby "slips off" a bit and the latch becomes shallow or baby starts "clamping" a bit. Or if it hurts at some sessions and not others, maybe the nursing position or “latch on” at those sessions is not ideal?

    So basically, I think the issue is not that your baby needs to nurse so often, because that is normal, but that there is a latch issue. If you started the pacifier due to nursing hurting, then obviously the pacifier did not cause the problem. But it's certainly not going to fix the overall problem either, and may make it worse. Perhaps giving your breasts a “break’ helps you to feel better, but if the next few times baby nurses, it hurts again, the underlying issue is not being fixed.

    I suggest, pay close attention to latch and positioning. Make note of when nursing starts to hurt and see if there are differences you can see, even if you think they could not have anything to do with latch. Are you able to contact local LLL Leader or Group or some other breastfeeding support person? Having another pair of eyes to watch a nursing session can be very valuable. You could also see a board certified lactation consultant (IBCLC) too, if you like or if a non-professional cannot help.

    If this makes sense to you and you would like suggestions here about latch and positioning, it might help to know:

    What have you tried as far as latching? Does baby always latch himself, do you help, etc?
    What position do you nurse in or do you have several? What position seems the most comfortable (overall.)
    Do you use a nursing pillow? (these can cause nipple soreness in some nursing pairs) Can you describe when the pain starts, and how it feels (burning, pinching, twisting etc?) Does the pain seem worse the longer baby nurses, or just some sessions, or what?
    Also, about how many times a day does baby nurse
    Is baby 'cue fed'
    How long are sessions (it probably varies, so what is the range?)
    2 sides or one usually?
    Weight gain, output-normal?

  3. #3
    Join Date
    May 2013

    Default Re: Hunger vs. need to suck

    Hi lllmeg thanks for you thorough response. I actually JUST finished nursing him and everything was great! No pain whatsoever so again I'm now feeling dumbfounded by the whole thing. This was a short session... 15 min on one side. He normally nurses 8-10 times a day and only some of the nursin sessions are painful. It seems lie maybe when he is sleepy his latch gets sloppy. The pain is definitely a pinching and I definitely end up with compression lines after such a feeding. He does the to eat/suck for about 10 min intervals and will doze off duing feedings even when I try to keep him awake. Sometimes he only takes one breast sometimes both (usually in the evenings he takes both). We generally use the cross cradle or cradle hold as I can't seem to get him to latch well in clutch or side lying. I normally help him latch though yesterday he latched himself twice w/ no problem. I have been able to use a boppy pillow or just the cradle hold for pain-free nursing so I don't think that's a problem. He is cue fed and feedings last anywhere from 15 min to 45 min (longer in the evenings usually but not always... This morning's feeding felt pinching/pain and I swear it was like I was nursing on and off for 2 hours). The pain does get worse with the longer feedings. It almost feels like my breast empties and then he starts pinching maybe? I try to let him nurse until he voluntarily stops or until he falls off the breast asleep at which point I burp him and then offer the other breast. I also will say he sometimes falls asleep after nursing about 10 min and just when I think he's down for the count he wakes in a fury ready to eat again. I know this is a lot of info. Thanks so much for your help! Weight gain so far has been stellar. I definitely know he's not starving its just some sessions are more painful for me than others.

  4. #4
    Join Date
    May 2013

    Default Re: Hunger vs. need to suck

    Oh yes and probably worth mentioning I've also been experiencing nipple vasospasms. I think it is from him pinching though and this has gotten better as his latch has improved over the first 3 weeks of nursing.

  5. #5
    Join Date
    Feb 2012
    middle of IA

    Default Re: Hunger vs. need to suck

    it sounds like you are on the right track. i'll just add, it is totally ok for you to take him off and make him re-latch when he gets sloppy. just cuz he's tired, that doesn't mean he gets to cause you pain!
    DS1 6/7/11
    DS2 10/29/13

    Nursing, pumping, cloth-diapering, babywearing, working professor mama with the awesomest SAHD ever.

  6. #6
    Join Date
    May 2013

    Default Re: Hunger vs. need to suck

    This morning I tried to relatch several times to no avail and even tried switching sides to see if that was the issue. eventually i couldn't take the pain anymore so my husband ended up feeding him an ounce of EBM by bottle and he fell asleep for a few hours. His next feeding was perfect.

  7. #7

    Default Re: Hunger vs. need to suck

    Well, if it's to the point you are in so much pain you need to resort to pumping and bottles I strongly suggest you get hands on help asap. Because bottles due to painful nursing may lead to no more nursing very quickly. There is a snowball effect.

    It still sounds to me as if something is up with the latch that is causing baby to compress the nipple. But the fact you could not get a good latch at all is making me think again about thrush. Once latch is corrected, (or, if it is thrush, thrush is treated) the vasospasm should get at least somewhat better as well. I am going to list some of my favorite latch and positioning links but again, I strongly urge you to get hands on help.

    Tips with pictures on latch and different positioning ideas (includes side lying) http://www.llli.org/faq/positioning.html

    Laid back position http://www.llli.org/docs/00000000000...astfeeding.pdf

    Laid back video http://www.biologicalnurturing.com/video/bn3clip.html

    Here are two simple pictorials, you want the one on latch. Notice that the mother is in a “slightly” laid back position, looks like on a couch? This is a very “adjustable” position, play around to find how you and your baby are most comfortable. http://cwgenna.com/quickhelp.html

    latch and 'Breast sandwich' article http://www.llli.org/llleaderweb/lv/lvfebmar04p3.html (probably only needed if baby cannot latch or latch is hurting mom)

  8. #8
    Join Date
    May 2013

    Default Re: Hunger vs. need to suck

    Question-- would thrush cause nipples to hurt in between feedings? How about during pumping? I felt very little pain while pumping today. I had little pain when nursing on the left side today, however when I tried nursing on the right this afternoon I had to stop and pump while my husband fed him by bottle. HOWEVER, after nursing both nipples were extremely sore and experiencing vasospasms for 20 min after the nursing session! The lactation consultant at the hospital casually mentioned tongue tie, but that doesn't really make sense since it seems he latches ok w/ little to no pain on the left side, right? Also seems odd that as early as 3-4 days ago I was experiencing pain free nursing on both sides?

    I am going to try to get in with the lactation consultant at out pediatricians office tomorrow. Just hoping to find some relief until then. I am at my wits end. I am determined to BF but the pain is really discouraging.

  9. #9
    Join Date
    May 2006

    Default Re: Hunger vs. need to suck

    Thrush can definitely cause nipple pain in between feedings, and is a common cause of pain that crops up after a period of troublefree nursing. Other symptoms of thrush:
    - sensations of burning or itching
    - oral thrush or diaper area yeast rash in baby
    - vaginal yeast infection (mom)
    - nipples appear more pink/red than normal
    - dry-looking, flaking skin in the nipple/breast
    Thrush also correlates with antibiotic use, some if you've had a recent course of antibiotics that would be more supporting data.

    That being said, if you KNOW you're having vasospasms, then you're in a bit of a pickle when it comes to ruling thrush in/out, because vasospasms can cause pain which is very similar to thrush- a burning sensation that happens after feedings.

    A trouble-free or less painful latch on one side does not rule out a tongue tie. There are often anatomical differences between nipples which can make latching on one side easier and less painful- perhaps one nipple is longer than the other, for example. Definitely have the LC take a very careful look at baby's tongue.
    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!"

  10. #10

    Default Re: Hunger vs. need to suck

    Also seems odd that as early as 3-4 days ago I was experiencing pain free nursing on both sides?
    I agree, the fact there was no pain until just a few days ago makes this all a bit unusual, and that more than anything else suggests thrush to me. On the otherhand, if your baby has uncorrected tongue tie, I suppose the effects of that could get worse around this age because your milk production would normally be kind of leveling off, causing baby to nurse more often and more vigorously because the flow is not as strong. Tongue tie can make a baby tired at the breast, and that will throw off latch right there.

    Are the vasospasms new as well, or did that always happen just not so bad?

    Another thought-had you introduced pumping, bottles or pacifiers prior to the painful nursing started?

    btw the 'mechanics' of pumping are so very different than nursing that it is pretty common to have pain with one and not the other.

    I think you need to see a good, experienced and thorough IBCLC. You want your appointment to resemble what is described here http://cwgenna.com/lconsult.html

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