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Thread: 5 week old issues - frustrated FTM

  1. #1

    Default 5 week old issues - frustrated FTM

    Hi - new here. My baby has always had a great shark baby latch, has always eaten
    and slept well - through the night since day 5.
    about 1.5-2 weeks ago she started coming off the breast after 5-10 minutes, not latching back on, getting really frustrated and ended up crying inconsolably. It was nearly always at her last feeding at pm.

    little history: My milk came in on day 4 and has increased exponentially. During the middle of the night i can pump nearly 8 oz.
    i started pumping pretty early on and now 5 weeks later have nearly 100 oz frozen.

    she started doing the pull off thing at night and i would try and try to get her to keep eating because i knew she was still hungry and i knew she needed more.

    fast forward to about week ago, she started having green poop. every other diaper was dark green. It finally stopped last weekend, shes gained a full pound in a month, and shes had great wets and dirties. yet she is still pulling off and refusing to eat, even during morning and daytime feedings.

    my MIL claims its colic because her son had colic. I dont think thats it because she IS consolable, and she will latch back on if i just let her have a break and sleep for a while.

    I had her on a great schedule that was working great for her, then this started. (Dr Denmark schedule - every 4 hrs at 5, 9, 1.)

    Im not getting uncomfortably engorged and my milk doesnt spray out without me squeezing my nipple.
    Ive heard she gets frustrated that its not coming out fast enough, and ive heard babies just need to cry at night because they are overstimulated or dont know how to unwind from the day.

    i also am starting to think i possibly have thrush?
    I have an extremely high pain tolerance, but nipples are Super tender after feeding/pumping, they are pinkish/reddish after feedings and itch a little sometimes.
    Her mouth has white on her tongue but my MIL says its just "milk tongue" and its not all over her mouth or on my nipples.


    any help would be marvelous.

    thank you!!

  2. #2
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    Default Re: 5 week old issues - frustrated FTM

    Welcome to the forum!

    The first thing I encourage you to do is to abandon the schedule. I looked up the "Dr Denmark" plan and it is, for lack of a better word, DANGEROUS. I don't know how a baby can manage to get enough milk, or how a mom can maintain an adequate milk supply, with such infrequent nursing. Milk supply is created and maintained by demand. Most newborns need to feed at least 10-12 times per day, and most older babies (>6 weeks) require at least 8 feedings per day in order to get enough milk and to maintain a decent milk supply in their moms.

    A lot of people will say "But wait a minute, scheduling is working great for me!" or "My friend has her baby on a schedule, and they aren't having any problems!" The key here is that scheduling often does work- at first. Most moms start out making more milk than their babies need. This is nature's way of making sure that a baby gets enough to eat while mastering the tricky art of breastfeeding. When a mom with oversupply puts her baby on a schedule, the baby may continue to get enough to eat because mom has so much excess milk. Even with restricted feeding opportunities, the baby is able to get enough milk. But this state of affairs is unlikely to last because a woman's body does not stay in overproduction mode forever. As time goes by, the body detects the number of times the baby nurses and the amount of milk that is left in the breast in between nursing sessions, and uses this data to tailor supply so that it matches demand very precisely. When a baby is being nursed on demand, this is beneficial because making extra milk is a waste of energy, puts mom at increased risk for plugged ducts and mastitis, and because oversupply causes rapid letdowns which can make nursing difficult for the baby. But when a baby is being scheduled, the adjustment usually results in insufficient milk, poor growth, a rapid introduction of supplemental feedings, and premature weaning.

    That all being said, it does not sound like the schedule has caused you to have low supply. This is probably because you picked up the pump so early. It's generally recommended that mothers wait about 4-6 weeks before they start pumping, but since your baby is only 5 weeks I am guessing you started well before that. At this point, how often do you pump, and how much milk do you pump each time? Let's work on getting you into a more normal, more fulfilling relationship with your pump- and your baby!

    Is baby being allowed to feed at night? It is completely false that babies "need to cry at night"- when a baby, especially such a young baby, is crying, that usually indicates one of the following things:
    1. Hunger
    2. Discomfort (e.g. wet diaper, getting blasted by a fast letdown, milk coming out too slow, too hot, too cold, lonely and needs mama, etc.)
    3. Normal baby fussiness (often intensifies towards evening)
    4. Colic

    Where is baby sleeping? Is she in bed with you, in a crib in your room, or in a different room in the house?

    When a baby is properly latched, nursing should not cause soreness, no matter how frequently the baby feeds or how long she feeds for. A gentle and rhythmic tugging is about all you're likely to experience. Pinkish/reddish nipples plus itchiness plus a white residue on the tongue is suggestive of thrush, so I encourage you to go in and see the pediatrician, who is probably more familiar with the diagnostic criteria for thrush than your MIL!

    Finally, I really hope none of this comes across as me scolding you for adhering to a schedule, or for doing what you felt was right. If I'm scolding anyone, it's this "Dr" Denmark guy, who sounds like a quack and a half for suggesting such a dangerous feeding schedule!
    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
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    Default Re: 5 week old issues - frustrated FTM

    Couple more thoughts:

    This is the extremely reputable kellymom.com's list of "Books to Avoid": http://kellymom.com/parenting/reviews/books-to-avoid/. The Dr Denmark book isn't on it (yet!) but BabyWise, a book that advises a very similar feeding approach, is. I strongly suggest checking out this site: http://www.ezzo.info/, which is all about BabyWise. It reviews the concerns associated with the book, and I especially suggest taking a look at the "Voices of Experience" section, here: http://www.ezzo.info/top-resources/voices-of-experience
    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!"

  4. #4
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    Default Re: 5 week old issues - frustrated FTM

    hi gbc528, welcome to the forum!

    I just want to get my mind around everything so,

    Can you tell us

    From what day of life to what day of life did baby gain a pound? Can you give a more specific weight check history?
    how many times a day does baby poop a 'scoopable' poop (not just a stain or streak)
    How many times in a 24 hour day baby nurses
    How many times in a 24 hour day do you pump and about how much milk is extracted via pumping each day
    Are you giving baby any bottles of your expreassed milk?
    If you are, how many each day and how much is in each bottle?
    When did the nipple pain start?

    The doctor denmark I found in a quick search was a woman. How do we know which dr. denmark we are talking?

  5. #5

    Default Re: 5 week old issues - frustrated FTM

    Okay - So Dr.Denmark is a female. She was doing pediatrics up until she was 100+ years old. Very reputable, and everyone who I've ever known to do her schedule has worked, all the way up until the baby was 1 year+. (Some of our very closest friends did it from the time they brought their babies home, and it worked! I understand what you're saying about babies getting enough to eat (I understand babies need to be gaining approx. 1 oz+ a day) and need to have plenty of dirty/wet diapers to know their eating good enough.

    I was pumping in between or after feedings, and was getting anywhere from 3-5 oz, and then up to 7.5 in the middle of the night (if I didn't wake baby up to eat.)

    I havent pumped in almost 3 days, because I've been trying to figure out what baby needs, and haven't felt overly engorged enough to pump.

    Yesterday, I fed her 10 times. I feel like if she doesnt have the good long feedings shes not getting enough to eat, or that shes only getting the foremilk and "feeling" satisfied, then it's digesting so fast that she just wants to eat all the time, and not getting a good full belly.

    She wasn't eating at night because she never cried at night, only stirred and grunted a little then went back to sleep.



    As far as your questions, lllmeg,

    Born at 7#15oz, leaving hosptial was 7#7oz. We went to doc 5 days later, she was 8# 4oz. The next week was 8#12oz, and then two weeks later 9#12oz.
    She has what we call "big/good" poops 4-6 times a day. And up to 10 peepee diapers (sometimes the diapers are soaked, sometimes it feels just like a few pees)
    She WAS Nursing between 5-8 times a day. 5 Long feedings and a few in between of a couple oz at a time.
    I WAS pumping between 1-4 times a day. Never more than 4, and sometimes not at all. I havent pumped in 3 days, and for the last two weeks, it has only been 1-2 times a day. I could get 3-5 oz during the daytime pumps and up to 7.5 during the middle of the night pumps.
    We were giving her a bottle with up to 5oz 1-2 times a day, or every other day (like if we went out somewhere)
    I haven't given her a bottle in 3 days.

    I only have nipple pain/soreness AFTER she nurses, and it doesnt get sore until about 5 minutes later, and stays sensitive for a few hours. Soreness gradually goes down. More in my left nipple than my right, because my left nipple is a little flatter. Right nipple is very everted, but left only everts when shes nursed.

  6. #6
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    Default Re: 5 week old issues - frustrated FTM

    I am so, so relieved to hear that you're nursing your baby more frequently! Good for you, mama. You really cannot nurse a baby too much.

    Don't worry about the length of a feeding. Babies vary a lot in their feeding speed, even very young babies. My first kid, for example, nursed for around 45-60 minutes at a time, while my second nursed for only 5-10 minutes. Both extremes were completely normal.

    Another thing that new moms worry about way too much is the whole "foremilk/hindmilk" issue. First, ALL milk contains everything a baby needs to grow and thrive. A baby who consumed nothing but so-called foremilk would still grow and develop completely normally, provided she got enough of it. She might be a little more gassy than average, but that's it. Second, there's no such thing as foremilk or hindmilk. There's no abrupt switchover from one type of milk to the other. Just a very gradual transition from milk that is relatively lower in fat, watery, lactose-rich, and refreshing, to milk which is relatively rich in fat and less watery. So you can kind of put the whole foremilk/hindmilk thing out of your mind for now. If after a few weeks of demand feeding you're seeing a big oversupply and a lot of green poops, check in with us and we'll troubleshoot again.

    Infant tummies are tiny, and breastmilk digests fast, usually in only 90 minutes or so. This is why new babies are naturally frequent nursers. They take in small amounts, usually just 2-4 oz per feeding, making up for the small size of the average feeding by eating very frequently. So please don't worry that your baby isn't "getting a good full belly." Demand-fed babies get what they need. They just don't take in massive amounts like formula-fed babies, who are routinely overfed, do.

    The soreness you're experiencing sounds like it could be vasospasm: http://kellymom.com/bf/concerns/moth...ple-blanching/. Try treating it with heat, for example a hot water bottle or rice sock applied to the nipple after nursing. Often vasospasms occur because of compression of the nipple, a.k.a. a shallow latch. This would explain why the problem is worse on the left, which is flatter and therefore harder to get into the ideal position in the baby's mouth. This problem should improve with time, as the baby's mouth grows.

    I don't want to beat a dead horse, but I really don't think Dr. Denmark's recommendations are at all good for breastfeeding. She got a book deal because she was America's oldest practicing pediatrician, not because she was the most knowledgeable when it came to breastfeeding. She was old enough to be of the medical vintage that literally destroyed breastfeeding in this country. Let me give you an example: back in the 1940s, when my grandmother was a new mother, her first baby's pediatrician took one look at her 2 day old baby, said " Oh, she lost weight. You don't make enough milk. Raise your child on boiled milk, water, and karo syrup, and don't bother trying to nurse any of your other children." That was typical breastfeeding advice at the time, and a lot of pediatricians never moved beyond that.

    If you want read the current American Academy of Pediatrics policy statement on breastfeeding, you can do so here: http://pediatrics.aappublications.or...115/2/496.full. This is the gold standard advice that pediatricians are supposed to uphold. I especially suggest reading recommendation #6: "During the early weeks of breastfeeding, mothers should be encouraged to have 8 to 12 feedings at the breast every 24 hours, offering the breast whenever the infant shows early signs of hunger such as increased alertness, physical activity, mouthing, or rooting.170

    Crying is a late indicator of hunger.171 Appropriate initiation of breastfeeding is facilitated by continuous rooming-in throughout the day and night.172 The mother should offer both breasts at each feeding for as long a period as the infant remains at the breast.173 At each feed the first breast offered should be alternated so that both breasts receive equal stimulation and draining. In the early weeks after birth, nondemanding infants should be aroused to feed if 4 hours have elapsed since the beginning of the last feeding.

    After breastfeeding is well established, the frequency of feeding may decline to approximately 8 times per 24 hours, but the infant may increase the frequency again with growth spurts or when an increase in milk volume is desired."
    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
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    Default Re: 5 week old issues - frustrated FTM

    Totally forgot to address the pumping issue. Oops!

    Since you've been scheduling your baby, pumping was probably a good thing even though you started early and pumped more than recommended for a mom with a <6 week old baby. Without that extra demand from the pump, scheduling throws that whole supply = demand equation out of balance. And it sounds like you didn't go too crazy with pumping- we've seen moms here who have pumped themselves into such crazy oversupply that they could acrually feed twins, and you probably didn't go that far, or if you did you've managed to back away from pumping slowly enough that your supply has ratcheted down to a more normal level.

    If you're planning to feed on demand at this point, there's no need for the pump and bottle routine unless you want or need to make it part of your life. If you're returning to work, for example, then you probably want to continue to pump at least 1x per day so that you can keep baby used to a bottle and can build up a stash in the fridge- though it sounds like you already have a super-abundant stash so there's no real need to add lots of milk to it. If you want to do bottles in public, that's a legitimate choice- but nursing in public (NIP) is usually much, much easier than messing with bottles and pumps, so if you want tips on how to NIP, we're happy to provide them.

    Demand-fed babies typically take about 1.5 oz of milk per hour. So unless you were out in public for over 3 hours, a 5 oz bottle was probably excessive. A more typical amount for a bottle for such a young baby would be 2-3 oz.
    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!"

  8. #8
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    Default Re: 5 week old issues - frustrated FTM

    1. Born at 7#15oz, leaving hosptial was 7#7oz. We went to doc 5 days later, she was 8# 4oz. The next week was 8#12oz, and then two weeks later 9#12oz.
    ok so baby gained a pound in two weeks-that is good average gain. I thought you said a pound in 1 month, which would be slow but possibly ok gain. Basically after the first week or so, (when gain is normally very little) average gain in the first few months is an ounce per day.

    She has what we call "big/good" poops 4-6 times a day. And up to 10 peepee diapers (sometimes the diapers are soaked, sometimes it feels just like a few pees)
    ok sounds like good poops. btw As long as baby poops that much no need to worry about wets. Also, be aware that anytime after about 6 weeks, poops may become much less frequent, which is still normal.

    She WAS Nursing between 5-8 times a day. 5 Long feedings and a few in between of a couple oz at a time.
    OK and now baby nurses more like 10 times a day, correct? Normal nursing frequency for these early weeks is 10-12 or more times per 24 hour day. Some babies do gain fine nursing less often, but others must nurse even more often! (More on this at the end of my post.) It is normal for session length and time between sessions and intake per session to vary quite a bit.
    I WAS pumping between 1-4 times a day. Never more than 4, and sometimes not at all. I havent pumped in 3 days, and for the last two weeks, it has only been 1-2 times a day. I could get 3-5 oz during the daytime pumps and up to 7.5 during the middle of the night pumps.
    We were giving her a bottle with up to 5oz 1-2 times a day, or every other day (like if we went out somewhere)
    I haven't given her a bottle in 3 days.
    Before, when baby was nursing less frequently you felt you had to pump, am I correct? Your body said 'get this milk out', basically?
    So, Now that baby is at the breast more frequently, you may well find there is no need to pump or supplement if you choose not to. If you DO supplement, say with stored milk, it is best for milk production if you also pump around the same time.

    I only have nipple pain/soreness AFTER she nurses, and it doesnt get sore until about 5 minutes later, and stays sensitive for a few hours. Soreness gradually goes down. More in my left nipple than my right, because my left nipple is a little flatter. Right nipple is very everted, but left only everts when shes nursed.
    As mommal suggests pain after nursing is classic for vasospasm. Does that fit do you think? improving latch may help because a poor latch makes vasospasm pain worse, as would thrush. If you want latch ideas or more info on thrush let us know.

    Some moms with inverted nipples find a nipple shield helps, you can also try using your pump before nursing to help pull out the nipple. There is also a device that uses suction to evert an inverted nipple, but I am not sure if that is still being used… But often, simply nursing will over time ‘bring out’ an inverted nipple.

    If you cannot fix your nipple pain on your own, can you see an IBCLC for a consultation? Just for your pain, everything else sounds fine to me. Baby is gaining, baby is pooping, baby is fussy-that is all pretty normal. I know your original question was about fussiness, so I am linking a couple quick tip sheets on dealing with fussiness. Since it does not appear you have overproduction, the only reason you might have been seeing any foremilk/ hindmilk 'imbalance' is due to the long spacing between nursing sessions. So nursing more frequently may well take care of that.

    fussy baby ideas - http://www.llli.org/docs/00000000000...ybabyideas.pdf

    http://www.llli.org/docs/00000000000...t_partners.pdf

    OK, so if you are interested, here is why some moms can feed even a new baby only 6 to 8 times a day without a problem.- it has to do with a mothers individual milk production and storage capacity, and to some extent the individual baby and the baby's tolerance for very large feedings.

    Many mothers make more than enough milk, especially in the early weeks but some keep making more than enough for some time. And some mothers (but not always the same mothers) have lots of room in their breasts-their breasts hold more milk 'comfortably' at a time than the average mom. This storage capacity does NOT necessarily correlate to breast size.

    So if a mom makes a lot of milk, AND has a larger than average storage capacity, baby can (assuming baby is willing and able to eat more than an average amount at a time) get a larger than average feeding. So baby may get enough overall with fewer feedings because each feeding is unusually large. Also, since the breast storage capacity is large, that mom’s body does not get that signal of ‘fullness’ as often as the average mom. It is the full feeling that tells the body to stop making so much milk. So in this mothers case, she does not feel so full even when there is a lot of milk stored, so her milk production is not as severely curtailed by the infrequent feedings as the average mom.

    But for mothers with average production and capacity, or who have babies who are unwilling to get more than enough at every feeding, feeding with a low frequency will often cause low milk production. (UNLESS mom pumps to make up for the 'missed' feedings at the breast.) And the baby fed this way may not gain properly (UNLESS baby is being supplemented.)
    Last edited by @llli*lllmeg; July 5th, 2013 at 10:51 PM.

  9. #9

    Default Re: 5 week old issues - frustrated FTM

    Thank you for all the info and advice! She's still very fussy but I've figured out how to get her to nurse better at night. I will give her a good bath and massage, then feed her until she fusses and she ends up falling asleep for about 30-45 minutes and wakes up hungry again. She eats really well for about 15-20 minutes, then sleeps at least 3 or 4 hour stretches.

    She has been fussy at her mid morning and afternoon feedings too, and I'm still not sure what's going on with those. She also has had some green stools.. Probably 1-2 a day. (Not a full diapers worth, but definitely green mixed in or a diaper of just green.

    Today I was feeding her in front of my mom, and my mom says "wow, she's not latched on very deep." I looked and she was right. I tried to relatch her and she latched good then pulled right back.
    It doesn't hurt me at all, and i know she's eating, but maybe that's why she's fussy?
    If so, how do I get her to get on and stay latched deeper?

  10. #10
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    Default Re: 5 week old issues - frustrated FTM

    I think that if nursing does not hurt you and baby is getting enough milk (you know baby is getting enough if baby is gaining/pooping normally exclusively breastfed) then I would suggest, really no need to worry overmuch about latch. I suppose it is possible that baby is taking in a little air if her latch is not good??? and that might cause gassiness or something, but even in that case it is unlikely to be anything to worry about.

    This
    then feed her until she fusses and she ends up falling asleep for about 30-45 minutes and wakes up hungry again. She eats really well for about 15-20 minutes, then sleeps at least 3 or 4 hour stretches.
    sounds totally normal. Babies often want a "top off" before settling down for a longer sleep stretch. "snacking" is normal and healthy, nursing sessions are often different lengths and come at varying time spaces. And of course many babies this age don't even do a regular longer stretch at night yet.

    However for a baby who can latch well but then pulls back, and is fussy at feedings, I have two ideas. Maybe you have a little forceful letdown, so baby pulls back a bit as a way of dealing with the flow. OR, gravity is pulling baby off the breast. This can happen in most typically taught nursing positions where mom is sitting up straight.

    Nursing "reclined" with baby more upright (head about tummy) and kind of on top of you, front to front, can help with both those scenarios for different reasons. Like this picture, but you certainly do not have to be as laid back as this mom is. http://www.llli.org/docs/00000000000...astfeeding.pdf Even just leaning slightly back, like against the back of a chair or couch, works as well. Also baby can be in any position you like, but again, it may help if head is above tummy, which can be achieved even if baby is in cradle or cross cradle just by angling baby’s bottom down a bit. Basically do what is comfortable for you.

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