9 week nursing issues

[@llli*brooklyn.henry]

This is my first post although I have found much useful information here since my son Henry was born 9 1/2 weeks ago. Sorry if this is too long, I figured background info is good to get the most useful advice.

Henry could not latch at all in the hospital and we eventually ended up using a nipple shield which worked great - he went from 7.9 lb at birth to 12.15lb at 8 weeks. I have an abundant supply and was only feeding on one side which would keep him going for 2 1/2 - 3 hours before getting hungry again. In the last couple of weeks he was starting to do a good 5-6 hour stretch in the evening. He even did one 7 1/2 hr stretch! All was going well but I really wanted to get rid of the shield for all the usual reasons. It obviously didn't solve the underlying problem which turned out to be a tongue and lip tie. We had both clipped 5 days ago and he can now latch beautifully without the shield. He was always a bit gassy, however since getting rid of the shield he is spitting up a LOT after every nursing session and takes forever to settle. Our normal nighttime routine now goes like this:

-Nurse for approx 10 mins on one side until he pops off with the drunken milk face
-20 mins fussing, burping, holding upright on my chest (several large burps and significant spit up 2-3 times during this time). Eventually he will settle and become very relaxed and sleepy
-Swaddle
-10 mins - rock to sleep
-Put down in bouncy chair (recommended by pediatrician to keep him at an angle)

He will now sleep for 20-30 mins and then wakes himself up needing to burp or spitting up more. I'll burp him, rock back to sleep, which lasts 20-30 mins or maybe up to an hour, and then the whole routine repeats until he's hungry again. Since getting rid of the shield he hasn't really slept continuously for more than 1 hour at night. His daytime naps are also much shorter and we have a similar fussing/burping/spitup situation in the daytime too.

I think I may have a fast letdown as he often seems unable to cope with the flow at first. The shield used to fill up and a lot would leak out so I guess it protected him from that.

Things I've tried:
-Unlatching him once letdown starts and spraying into a cloth before it slows down
-side lying and laid back nursing
-burping mid-feed (doesn't like this - screams as he's still hungry)

I feel like we've taken one step forward and two steps back. Also I don't feel comfortable nursing in public anymore due to the fussing and mess, and I'm getting half as much sleep as before! I REALLY don't want to go back to using the shield but right now I feel we are both suffering.

Thanks for reading and I would really appreciate any advice.

Kate

[@llli*lllmeg]

So are you concerned about the short sleeps or the forceful letdown?

I don't see where you have taken a step back. You have gotten off the nipple sheilds and are exclusively nursing at the breast without them. Your baby is nursing with high frequency (at least I hope you are nursing him when he wakes, assuming, he would like to) frequent nursing will help with the forceful letdown and in levelling out your production to normal if it is too much right now, This won't happen overnight, but it will happen. As long as baby is gaining normally this all sounds like only steps forward to me. Are you thinking that your baby should be 'going' a certain length of time between nursing? Or sleeping some specific lenght of time at night? I mean, yes, of course, it would certainly be nice if baby slept a longer stretch of 3 or 4 hours here and there, but it is not neccesarliy going to be at night, although eventually it will.

Why is baby being put to sleep in bouncy chair? to prevent spitting up? Or Some other reason? Is baby sleeping better, worse or the same, in the bouncy chair? When you or someone holds baby on your chest, head above tummy, snuggled comfortably for adult and baby, does baby sleep longer? Where would baby sleep at night if NOT in bouncy chair?

[@llli*mommal]

Welcome to the forum and congratulations on making it to 8 weeks of nursing! You've already overcome some pretty significant challenges- the tongue and lip ties, the shield, the initial difficulties with getting the baby to latch. So no matter how frustrating things are today, I hope that you will pat yourself on the back and be proud of what you've achieved!

As always with young babies, there is probably a combination of factors that are responsible for the difficulty in getting baby settled, the fussing, the spit-up, and the short sleep intervals. Here are the ones I think may be to blame:
1. Baby's age/stage of development. Fussiness often peaks between 3 weeks and 3 months. This is especially true of evening fussiness. If you find that your baby is generally happy in morning and then gets progressively fussy as the day wears on, perhaps with a full-on fit towards bedtime, the primary explanation for his behavior may simply be developmental.
2. Fast letdowns. Having baby pull off and fuss during letdowns, and having to catch the spray into a cloth- those are textbook fast letdown experiences.
3. Getting rid of the shield. One thing that shields do is to slow the flow of milk to the baby. This is actually the primary drawback of shields for some moms! But for you, slowed milk flow was a benefit. I would guess that part of the reason your baby is spitting up so much is that every time he nurses, he gets full to the brim. Fuller tummy = increased likelihood that some tummy contents will come back up.
4. Getting the tongue/lip ties fixed. Now that your baby has a more mobile mouth, he's probably even more able to stimulate a fast flow of milk than he was before you got the ties fixed. Result: increased frustration due to fast flow.

So, what do you do? Here's what I think:
1. Really think hard about whether or not you want the shield back in your life. It would slow milk flow and maybe make things easier for the baby. But on the other hand, this adjustment period is temporary. If you roll with this frustrating phase, your baby will eventually figure out how to nurse without getting blasted by a fast letdown, and he'll also figure out how to stop nursing before his tummy is brim-full and likely to result in an unpleasant spit-puppy burp.
2. Keep trying the reclined and side-lying positions, and allow the letdowns to flow into a cloth. I used to keep a roll of TP nest to my nursing chair, to deal with fast letdowns.
3. Think about where the baby sleeps. A possible explanation for the frequent waking: he has learned that he doesn't like being alone. Co-sleeping has saved a lot of moms from going bonkers, and it is possible to co-sleep safely.
4. See a lactation consultant, preferably an IBCLC.
5. If you feel like your supply is really on the high side- you're frequently feeling full or engorged, you are leaking a lot, you're able to pump a lot of milk with ease (if you're pumping), the baby is gaining really well- block feeding may be advisable.

[@llli*brooklyn.henry]

Thanks for the reply.

So are you concerned about the short sleeps or the forceful letdown?

I'm concerned that my son, who was previously a happy and contented baby, is now distressed and in pain during and after every nursing session. Since this seems to be caused by the my letdown, then yes that is what I'd like some advice on.

at least I hope you are nursing him when he wakes, assuming, he would like to) frequent nursing will help with the forceful letdown and in levelling out your production to normal if it is too much right now, This won't happen overnight, but it will happen.

YES of course I'm nursing him when he wakes. However, I worry that he's waking/crying not because he's hungry but because of gas pains or spitting up, and then I'm nursing to calm him down which could make him worse by over-filling him again.

Are you thinking that your baby should be 'going' a certain length of time between nursing? Or sleeping some specific lenght of time at night? I mean, yes, of course, it would certainly be nice if baby slept a longer stretch of 3 or 4 hours here and there, but it is not neccesarliy going to be at night, although eventually it will.

Well, since he was 'going' for longer before I stopped using the shield, this leads me to believe that he is now waking for reasons other than hunger (see above). You seem to be implying that I'm more concerned with my sleep than with my baby's wellbeing. This is categorically not the case.

Why is baby being put to sleep in bouncy chair? to prevent spitting up? Or Some other reason? Is baby sleeping better, worse or the same, in the bouncy chair? When you or someone holds baby on your chest, head above tummy, snuggled comfortably for adult and baby, does baby sleep longer? Where would baby sleep at night if NOT in bouncy chair?

He's in the chair because it's at an incline. Yes, it helps- he awakens after 5-10 minutes if I put him down on his back, whether that's in his bassinet or in our bed. He often naps on my chest during the day for 1/2 an hour or so after nursing which is lovely, but that isn't really feasible all night long. And unless I wedge my bed up at a 30 degree angle, I don't think co-sleeping will help.

[@llli*brooklyn.henry]

Thanks so much mommal - yours was a really helpful reply. I read that he will eventually be able to cope better with the fast letdown as he grows and develops - but do you think that he can learn to do this sooner if I persist without the shield, or is it just something that will come naturally with time?

Regarding co-sleeping - see my reply to the previous poster, I think the problem is being flat on his back rather than proximity to me. His bouncy chair is right next to me - less than 1 foot away, so he's pretty close by. He was also not waking up so frequently before we stopped using the shield. I'm not anti-co-sleeping but I'm not sure it will solve our problem. I often bring him into bed with me in the morning but he doesn't really settle.

Thanks again. I'm going to see an IBCLC later this week hopefully.
Kate

[@llli*lllmeg]

okey dokey. I guess my reply angered you but I am not sure why. I was not implying anything-I directly asked you if you thought your childs sleep pattern change meant something was wrong WITH YOUR BABY. I said nothing about YOU, except to suggest that it would be nice to get a longer sleep stretch, which I assumed, perhaps incorrectly, we can all agree on, is nice. It was a question, not an accusation. And I asked it because 1) you compared your childs previous sleep pattern to the pattern now and 2) Many people DO see long sleep stretches as an indication nursing is going well, and short sleeps as a sign it is not, and neither is an indication of either on its own. It does not mean sleep or nursing pattern is irrelevant, it's just not nearly the whole story.

Anyway, If you have forceful letdown, the usual suggested approach to that is doing the things you are already doing, including nursing very frequently, and giving it a little time. If you have overproduction, then you might want to think about if block feeding is something you want to try, after making sure baby's weight gain continues to be very fast post tt release. The ibclc should be able to walk you through that or we can direct you to some articles if you like.

YES of course I'm nursing him when he wakes. However, I worry that he's waking/crying not because he's hungry but because of gas pains or spitting up, and then I'm nursing to calm him down which could make him worse by over-filling him again.

nursing to calm him down is not going to hurt him. Frequent nursing is helpful for both forceful letdown and painful reflux, if that is suspected as well.

I had some pretty bad forceful letdown & op with my three babies. Believe it or not, I get your concerns. I am sorry my post seemed accusatory.

[@llli*mommal]

I read that he will eventually be able to cope better with the fast letdown as he grows and develops - but do you think that he can learn to do this sooner if I persist without the shield, or is it just something that will come naturally with time?

It will happen naturally if you persist without the shield, though WHEN it will happen is very much an open question, because every mama and every baby and every nursing journey is different. What generally happens is that as the baby gets bigger and stronger, and more adept at nursing, he becomes better able to handle a fast flow. At the same time, most moms find that overproduction settles down as time goes on, and when supply and demand are more in sync, the letdowns slow down.

Regarding co-sleeping - see my reply to the previous poster, I think the problem is being flat on his back rather than proximity to me. His bouncy chair is right next to me - less than 1 foot away, so he's pretty close by. He was also not waking up so frequently before we stopped using the shield. I'm not anti-co-sleeping but I'm not sure it will solve our problem. I often bring him into bed with me in the morning but he doesn't really settle.

Co-sleeping may not solve the problem, but it's still worth a try. If it works, Yahtzee! If not, well, you go back to what you were doing before or try something else. Like having baby sleep swaddled, or in a swing- we had something like this for our kids: http://www.target.com/p/fisher-price...FWdnOgodNh0AXw

I think that one thing to keep in mind is that long sleep stretches are a gift from the universe that may be recalled at any time. My first kid woke every 1-3 hours from birth until 4 months. At 4 months, she suddenly slept 11 hours in a row. I was so happy! But of course it didn't last- after 3 blissful if somewhat engorged nights, she went right back to waking up 6-8 times. My point being that the long sleep stretches you got in the past and the lack of them you're seeing now... Might just be the universe toying with you, rather than something going "wrong" with nursing. I mean, it's absolutely possible, even likely, that the nursing frustrations you're having are connected with the interrupted sleep! But it's also possible that they're unconnected.