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Thread: fussy baby, tired momma!

  1. #1

    Default fussy baby, tired momma!

    Hi everyone,

    I'm a first time mom, with a beautiful 5 week old son. I should start this by mentioning that he has a cleft lip and a tongue tie, but is gaining weight (6# 11oz at birth, 7# at 5 days, 9# 1oz at 3 weeks, and ~11# today).

    Like many other moms here, we are having trouble with fussiness during feeds, seemingly due to rapid let down/oversupply. He often (not always) coughs, sputters, arches his back, pushes/kicks, and cries, usually within 1 minute of latching. Sometimes, this won't happen until 5 minutes or so into a feed. If we decide to stop feeding, he usually cries his hungry cry as soon as I put him down. Once he calms down (the only thing that works is dancing, with lots of spinning!), I try to feed him again. Sometimes he'll eat, but often it starts the cycle again. These cycles happen usually 2-3 times per day, and can go up to 3 hours until he falls asleep.

    I try to feed him every time he starts looking hungry or cries. I get the sense that he is easily frustrated and sometimes seems to have a sense of foreboding when he sees the breast. We were working with it until 2 days ago, when I developed a mild mastitis in my less productive breast. This seems to be clearing up, but he is now completely refusing the more productive breast - I started pumping just that side once a day, which seems to have made things even worse!

    So, lots of questions -
    1) When should we throw in the towel and decide to stop feeding for a while? Are there any cues I should look for to decide if he is truly hungry or wants to comfort nurse? I've developed a "three strikes" rule, that if he cries/pushes off three times (with soothing to a relative calm in between) then we're done for the time being. I gave him a pacifier for the first time when I was in bed due to the mastitis and couldn't dance around with him...it seems to help, but I'm uncomfortable about becoming dependent on it.
    2) I know pumping can increase supply, but can it also increase the velocity of milk ejection? This problem seems to be worse since I've started to pump, but at some point I'd like to start freezing for when I return to work.
    3) Even though he is gaining weight, I can't help wondering if his anatomy is making things more difficult for him. We have spoken with 3 doctors here about the tongue-tie (we are not in the U.S.), and it seems like frenectomy is not something that is routinely done. If it could be contributing, what are the downsides of the procedure? We will be in the U.S. when he is 4 months old for his cleft surgery - would it be worth trying to get it done at the same time, or is it too late?

    OK, he is napping now, so I should do the same. This is way longer than I intended...thanks for reading if you made it this far. Any suggestions about any of these issues would be hugely appreciated!

  2. #2
    Join Date
    May 2006
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    21,178

    Default Re: fussy baby, tired momma!

    Welcome to the forum! We have at least one active mama here who had a baby with a cleft lip and also (IIRC) palate, and I hope she'll chime in soon with suggestions for you.

    It's really hard to say when should you throw in the towel and try to comfort the baby in a way other than nursing. It's so individual. I think your "three strikes" rule makes sense, and I'd continue to go that route for now. Just don't worry about nursing "too much", because you can never do that and when a baby has an anatomical issue like a cleft and a tongue tie, the more you can nurse, then better!

    Pumping can increase both supply and letdown speed. If fast letdowns are an issue for you, it might be best to avoid the pump for now- though if you're going back to work really soon, some level of pumping may be unavoidable. It's odd that pumping just 1x per day could have had such a big effect- how much milk did you get, when you pumped?

    Even in the US, finding a doctor or dentist willing to release a tongue tie can be difficult. Which is odd, when you think about how routinely other medical procedures are performed on babies- you can get your baby's ears pierced or get a male baby circumcised, and no-one blinks an eye- but getting a frenulum released? A lot of docs just won't do it- they'd rather wait and see if the frenulum stretches out on its own, even though as far as I know there are few downsides to taking a proactive approach. I think that the standard for whether or not a tongue tie should be released is whether or not it impacts nursing. It sounds like your baby is getting plenty of milk and gaining weight normally, and you're not in pain- all good indicators that things are as they should be. But a tight frenulum and consequent lack of tongue mobility can make nursing more frustrating for your baby, in terms of preventing him from being able to deal with a rapid letdown.
    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!"

  3. #3
    Join Date
    Jun 2009
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    Default Re: fussy baby, tired momma!

    Any chance of moving up your trip to the US for treatment?

    I imagine it IS more difficult for your baby to nurse at the breast. HOWEVER, he is doing so-and incredibly well, going by weight gain. If you had left out the part about the cleft lip and tt, I would never have suspected it-because everything else sounds entirely normal...a slight case of forceful letdown, but otherwise, normal.

    When should we throw in the towel and decide to stop feeding for a while? Are there any cues I should look for to decide if he is truly hungry or wants to comfort nurse? I've developed a "three strikes" rule, that if he cries/pushes off three times (with soothing to a relative calm in between) then we're done for the time being.
    I do not understand -Comfort nursing-are you trying to avoid it or encourage it? Comfort nursing is healthy and normal and needed. First off, baby STILL gets milk, even when comfort nursing. Plus, A baby associating the breast with comfort helps prevent breast aversion when there are feeding difficulties or after bottles are needed due to separations. So comfort nursing is GOOD. Are you afraid of causing aversion by offering too much? I guess I am unclear what your concern is.

    I suggest, try some of the many methods that can help a baby handle a fast flow. DO NOT TRY TO DECREASE YOUR MILK PRODUCITON. Your baby may only be gaining so well with his challenges due to any possible overproduction. So I do not suggest block feeding.(*See article The Dark Side of Block Feeding for more.)

    But what about helping baby handle the flow by nursing very frequently and nursing slightly leaning back, baby kind of on top? And, if there is a fast flow, taking baby off briefly and let the initial letdown go into a cloth...I had good success positioning baby so his head was well above tummy while nursing. See forceful letdown article below for more.

    baby is dealing with a lot and may be overly frustrated. So maybe try not waiting for ANY signs of hunger. Bring/keep baby on you, close to the breast, with easy access, as much as you possibly can. As soon as baby makes the tiniest cue or rooting, even just fluttering eyes etc (see biological nurturing video) gently OFFER to nurse. Give baby access.

    The benefits of nursing at the breast are so immense, and eping and bottles so potentially problematic, I would suggest trying a bit longer, considering how well baby is doing thus far.

    Resource page on breastfeeding and cleft lip: http://kellymom.com/health/baby-health/bfhelp-cleft/

    Forceful letdown http://kellymom.com/bf/got-milk/supp.../fast-letdown/

    Laid back : Please note you do not have to lay back as far as mom in picture. Just slightly leaning back is also laid back. baby cna be in ANY position. Change it up so it works for you and your baby. : http://www.llli.org/docs/00000000000...astfeeding.pdf

    dark side of block feeding: http://cwgenna.com/blockfeeding.html

    "Biological nurturing" video Nursing at the sublest cue + nursing laid back = calm mom and baby: http://www.biologicalnurturing.com/video/bn3clip.html

  4. #4

    Default Re: fussy baby, tired momma!

    Thanks for the advice! I don't think I was admitting to myself how much this is affecting me emotionally, and it's helpful to talk (or type) these issues out with sympathetic and knowledgeable women!

    Quote Originally Posted by @llli*mommal View Post
    It's odd that pumping just 1x per day could have had such a big effect- how much milk did you get, when you pumped?
    4-5 ounces. I often hand-express from that side before feeding, which sometimes helps with the fussiness. I didn't pump yesterday or today, and well...I'm still engorged with super fast flow. But, we'll keep working with it!

    Quote Originally Posted by @llli*mommal View Post
    Even in the US, finding a doctor or dentist willing to release a tongue tie can be difficult.
    This is good to know. We'll definitely ask specifically about this and not assume anything. Even if he is gaining weight, my hope for a frenectomy would that it would make our feedings more enjoyable for the both of us.

  5. #5

    Default Re: fussy baby, tired momma!

    Quote Originally Posted by @llli*lllmeg View Post
    Any chance of moving up your trip to the US for treatment?
    I wish! We can really only afford one trip back during the next 6 months, so we are scheduling the surgery around my sister-in-law's wedding.

    I do not understand -Comfort nursing-are you trying to avoid it or encourage it? Comfort nursing is healthy and normal and needed. First off, baby STILL gets milk, even when comfort nursing. Plus, A baby associating the breast with comfort helps prevent breast aversion when there are feeding difficulties or after bottles are needed due to separations. So comfort nursing is GOOD. Are you afraid of causing aversion by offering too much? I guess I am unclear what your concern is.
    Oh, I completely misspoke. I would be really happy if he comfort nursed. At times, especially during the evening fussy period, he really does seem like he fears my breast and will often cry when he sees it. Holding him close and dancing with him is the only thing that calms him down, and even after that, he cries if we try to nurse again. I guess what I was asking is how do I know, when he is super frustrated and kicking and pushing, if he is really truly hungry or not. Regardless, I try to nurse. But sometimes I feel like it's doing more harm than good and getting into a cycle that could lead to breast aversion (can this happen?) If he is not truly hungry I'd feel a lot better about dancing around with him until he falls asleep.

    Thank you so much for the tips about different positions. We've tried a lot of these, but we will revisit some of them (especially the biological nurturing concept...I occasionally contort my back and arms to get him to latch, which probably isn't good for either of us in the end. The video makes nursing look so easy!)

    Does feeding on only one breast at a time count as block feeding? I started doing this unintentionally on day 1 because I didn't know any better! After reading about the downsides of block feeding, I tried to offer the other side a couple of times, but he didn't take it. It's good to know that I shouldn't be actively looking to decrease my supply, because it is certainly tempting.

    I'm not interested in starting bottle feeding at all until I return to work (which won't be until after his surgery), but I figured I could start building my freezer stash now.

    Thanks for the tips! It's a relief to have things to have concrete things to try next. Don't get me wrong, I love dancing around with him, but I just don't have the energy to go on for hours...at least I'm getting a workout in!

  6. #6
    Join Date
    May 2006
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    Default Re: fussy baby, tired momma!

    Feeding on just 1 breast at a time is a very minor form of block feeding.

    I agree that now is not the time to start trying to reduce your supply. Give yourself a little bit of time before you get into a relationship with the pump! Obviously you had no trouble getting a large amount of milk the first time you pumped- hopefully that means that future pumping will be productive, and that a later start won't impact your ability to provide for your LO.
    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!"

  7. #7
    Join Date
    Jun 2009
    Posts
    5,645

    Default Re: fussy baby, tired momma!

    Feeding on just 1 breast at a time is a very minor form of block feeding.
    VERY minor. I would not even call it block nursing. One side at a time is just normal feeding. Many moms are told they HAVE to switch sides each feeding and that increases milk production! You don't need to do that! SO keep doing what you have been doing one side at a time, as baby prefers. That is just fine.

    If it is several months before you need to return to work, I suggest, pump infrequently. A couple times a week maybe. Because it is not like you need a months worth of milk when you return, you need enough for the first day and then extra for emergencies. So, maybe enough total for 3 days for a very good cushion for unforeseen events. Because you will be pumping AT WORK to provide baby with milk for the next day-correct?

    Use your instincts about nursing. You are right, no reason to upset baby. If baby is not hungry he is likely to not want to nurse, and that is fine. If a baby is hungry he will figure it out with your help. I suggest work on making nursing a more relaxing time for you and baby, try the ideas I posted.

    Right now your milk production is probably at its ‘peak’ naturally. It takes time for production to "calm down" naturally, but that will happen at least to some degree in the next few weeks just naturally-with your not doing anything- as long as you DO NOT PUMP MUCH. Milk production calming down on its own is fine and normal and I think your baby will still get plenty of milk. I Caution against ‘true’ block nursing because it causes rapid and perhaps to much of a reduction in production.

    As long as your baby is able to nurse exclusively then no reason to have any treatment earlier than planned. HOWEVER, if your child's physical challenges begin to make it difficult for baby to exclusively nurse, remember that not nursing has lifelong health consequences. If you begin to feel your child would benefit from earlier treatment, maybe your family can assist you and your husband, perhaps with helping you have a longer stay in the US for one or both of you, or something. While it is never a sure thing locally, with a little research and willingness to travel, it is very possible to find a doctor or dentist who will treat tongue tie in the US.

    As far as tt treatment-are there any breastfeeding support groups/organizations where you live? They may be able to suggest a doctor or dentist for you?

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