I need help

[@llli*mackeroo2013]

I gave birth to my son, Titus, September 27th of this year. I have been exclusively breastfeeding him since birth and need expertise since I am about to throw in the towel and switch to formula. I desperately want to keep breastfeeding, however since he was 2 weeks of age nursing him is a constant battle. Feedings for the exception of middle of night feeding (now down to one) he latches on, sucks for 2 minutes then pulls off and cries. I feed him every 2 hrs or so, sometimes I feed him more than that depending on his temperment. It has gradually gotten worse since two weeks and now it's just terrible all the time. I have researched and tried everything. I have spoken to two different breastfeeding educators (one being the classes you offer at Finley) and both have told me he is latching on ok, my nipples are "perfect" and our position is fine.

Since two weeks of age I have tried relaxation breathing, block feeding, pumping before he nurses in case letdown is too fast, pumping often, tried him on top of me, lay down position, nursing sitting him up straight. I have also tried feeding him often and then tried feeding him every 3 hours---it's all the same.

He occasionally chokes I have noticed and then cries. People have said when you feel let down, remove him and let it spray in a cup. I don't really know what let down feels like, but I have tried this when I have anticipated him starting to cry (he often kicks, gets red in the face), but nothing ever sprays out. I don't leak during the day and I don't get overly full. I defiantly get full, but not un-bearingly. I don't need to wear nursing pads only occasionally at night.

No one can help me and I really want to make this work. I know this is not normal and it's NOT enjoyable or something we can bond over. He takes a bottle of expressed breast milk just fine from my husband after offering the breast and him not nursing(this is occasionally). I refused to give a bottle in the beginning, but after weeks of frustration I have given in.

My main concern now is our nursing relationship has resulted to 5 minutes total during most feedings...8 minutes if I'm lucky (after he wakes up from a nap and he is drowsy). So, I offer him my breast often during the day. One educator said he may be efficient at getting your milk out, but since he cries a lot at night I'm wondering if he's only getting fore milk during these "snackings" and is not getting the nutrition he needs. 3-5 minutes can't possibly be enough! It could explain why he seems to be a fussy baby!?! He has dark yellow stools(not seedy really) and plenty of wet diapers throughout the day. I can't understand how he can have enough wet diapers since it seems he does not feed enough!!!! All I know is the crying and little time on breast does not seem normal.

[@llli*mackeroo2013]

I think I may have been to generous with the time. Most feedings are like 3 minutes sometimes 5 minutes. He starts to cry at around 2 minutes and can make it another minute or so before I can't feed him anymore.

[@llli*mommal]

3-5 minute feedings can be totally normal. My second kid fed in under 5 minutes from about 1 week of age on. She was a very efficient feeder and I had a large milk supply. Lots of milk generally results in fast letdowns, which means that the baby can get all she needs in just a few minutes. My kid also did a lot of the behavior you're describing- crying and fussing at the breast, pulling off and screaming, choking. The fact that you still feel full at the 1 month mark means that you're probably still producing somewhat more milk than your baby needs, and that generally means fast letdowns.

If your baby is having enough wet/poopy diapers and is gaining weight appropriately, then breastfeeding is going right at the most basic level, and all you need to do is work on the fine points and wait for your baby to mature a bit. New babies tend to be fussy because that is their default. If they are hungry, they fuss. If they are full, they fuss. Full of gas or needing to poop- fuss. Tired- fuss. If the milk comes out to fast or too slow, they fuss. Etc.

Does the baby's fussiness tend to intensify over the course of the day, or peak at any one time of day?

How often does the baby feed?

How has his weight gain been?

Does he ever make a click, cluck, splutter, cough, or gag noise while nursing?

[@llli*mackeroo2013]

He started out at 7 pounds 11 oz at birth and now...7 weeks later he is at almost 13 pounds. He generally is a fussy baby. Seems to have gas a lot. Grunts a lot. He gets fussier at night...at around 7-10 or so. What do you mean by clicking and spluttering? I may have seen this before, if we are talking about the same thing.

[@llli*mommal]

Weight grain is great, so that means that breastfeeding is going really well on the most basic level. No matter what else is going on, you should feel really proud of how well you've fed your little guy!!!

Clicking- if you click your own tongue, that's what it sounds like. Spluttering is the same sound you'd make if you were drinking and suddenly got too much water going down at once and you were kind of coughing/choking/sneezing it out. Both sounds are often associated with the baby getting too much milk at one time; spluttering means the baby got too much milk at once, clicking means that baby is breaking suction in order to control/stop/slow milk flow.

Since your baby's weight gain has been on the high side despite fast feedings, because you are still feeling full pretty often, and because you are seeing fussing/pulling off/choking and maybe clicking and spluttering, I'm thinking that you probably have some degree of oversupply and fast letdowns. Maybe not a huge amount, because you're not seeing milk spray out, you're not seeing a lot of leaking, and you're not feeling engorged (which could be described as unbearable or at least uncomfortable fullness). Not feeling letdowns doesn't mean anything- not all moms experience the letdown sensation. I nursed 2 kids and never once felt a letdown- I had to learn to identify them by what the baby was doing. If the baby was suddenly swallowing really rapidly, that was a letdown.

Gas and grunting are normal. Spit-up, too, though you didn't mention that. The only concern I would have would be if a gassy, grunty baby weren't gaining weight properly and/or if the baby seemed in severe pain. If that were the case, I would want to talk about the possibility of reflux with the pediatrician.

Another thing that is textbook normal is for a fussy baby to get fussier towards evening. Some babies have periods of inconsolable screaming that can be defined as colic (i.e. inconsolable crying in an otherwise healthy baby between 2 weeks and 4 months of age, lasting for 3 or more hours per day, 3 or more days per week, for 3 or more weeks). These bouts tend to be worst in the late afternoon/evening, and even when they don't rise to a level that is intense enough to be defined as colic, there are still widely understood terms for them, like "the witching hour(s)".

The best way to deal with fussy evenings is to change the baby's incoming sensory stimuli. No one technique will work for long, so you need to switch it up- the moment one technique stops working, you try another. Here are some things that work for evening fussathons:
- Nurse, if the baby is willing!!! Not all babies are- neither of mine were.
- Calm house. Lights, TV, and stereo down or preferably off. Cranky babies are often overstimulated babies- remember that they cannot tune out or ignore unwanted stimuli as effectively as adults can.
- White noise. Radio static, heartbeat or breathing noises (cuddle baby close to your bare skin), vacuum cleaner or dryer sounds, road noise, etc.
- Motion. Rock in a rocking chair, bounce on an exercise ball, put baby in a swing, put him in a sling or stroller and go for a walk
- Warm bath in the sink or in the tub with mom or dad. This worked like a charm for my second kid! Warm baths are also great if baby is upset by having a fart or poop that he can't quite work out- the water can relax him enough to let things fly!
- Trip outside into the fresh air, or if it is too cold/wet to go out, try taking baby to a window and attracting his attention to light by tapping on the glass
- Closeness. Cuddle baby close to bare skin, in arms or in a sling

[@llli*debbers]

If you want to continue BF I say you should understand this all sounds normal, commit and know it will get better. We had 3 months of fussiness. It felt unbearable. I nursed round the clock, which is draining physically and mentally. She was never a good sleeper either. Fast forward to today - 16 months, STILL BF (now like a pro) with the hard times a distant memory. You can do it. The time passes quickly and one day you realize it's easier.

[@llli*mackeroo2013]

Thank you for the responses. I found out a bit more. I saw the head lactation specialist at the hospital. We don't have any La Leche reps around here...at all. I nursed my son for her who said my milk is coming out too fast, but what was more concerning to her was that he seems to have a hard time coordinating his suck/swallow/breathe. He will gasp for air because he forgets to breathe (this only happens occasionally) and he will choke. She said he may or may not get better. I don't want him to associate me with pain---he does not do this with a bottle. The only thing propelling me to continue is the hopes that he will outgrow it. She looked at his mouth and said he does not have tongue tie.

[@llli*mommal]

I'm going to vote for "this will get better as time goes on", because of my experience with my second child. I had oversupply with her and very fast letdowns, and that caused her to have problems keeping up with the flow. Her nursing/breathing rhythm was very different from that of my first baby, who didn't have to deal with oversupply or fast letdowns. My first baby's sucking rhythm was a classic "suck-swallow-breathe, suck-swallow-breathe" during letdowns. My second baby did more of a "suck-swallow-swallow-swallow-swallow-gasp for air- pull off and cry-latch back on-suck-swallow-swallow-swallow-gasp for air". But it only lasted for the first maybe 1-3 months, when she was small and relatively weak and my milk was at its most abundant.

Trust me, your baby will NOT associate you with pain! If that were the case, my second daughter- the one who had to deal with the crazy fast letdowns- would have weaned herself as soon as possible, instead of nursing very happily until age 3, and telling me sweet things like "I love your pupples (breasts)" and "Your milk tastes best, mommy."

Hang in there!!! This is not a forever problem.

[@llli*sonogirl]

I'm going to vote for "this will get better as time goes on", because of my experience with my second child.

I'm voting for this, too! Oversupply and overactive letdown were never part of my personal nursing experience, but my now 5 month old niece had the same sort of suck/swallow coordination problem in the early months due to my sister-in-law's massive oversupply/OALD. It took time, but she learned how to deal with her mom's flow issues, and she nurses like a champ now. No more problems with coughing or choking.

Stick with it. Your baby won't associate you with pain. It will get easier!

[@llli*lllmeg]

Your baby does not 'do this' with the bottle.

Well, yes, that makes sense. Breastfeeding works every muscle in baby's face & jaw and bottles do not. Normal development of the jaw and oral gravity-half your baby’s facial structure-depend on breastfeeding. This is just the mechanics of one way breastfeeding is different- importantly different-than bottle feeding.
I am sorry you are having so much frustration. Does the fast flow make sense to you as being the major issue? What have you tried for that?