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Thread: Need help! poor latch? Sleepy feeder, snacker, not efficient

  1. #1

    Default Need help! poor latch? Sleepy feeder, snacker, not efficient

    Hi...I've been reading through this forum for a few weeks now, and I finally decided to post my plea for help.

    I am a first-time mom to a four week old. I had great dreams of the breast-feeding experience, but now that I'm four weeks in and really having a lot of struggles I don't know how much longer I'm going to make it!

    With all the reading and the research that I've done on this forum and other websites, I've gathered the following issues with my son:

    1/ not efficient at the breast
    2/ constantly sleepy at the breast -will feed sometimes for as short as 3 to 4 minutes and then completely fall asleep
    3/ potentially might be a "snacker" or has associated the breast with just comfort
    4/ not a strong, good latch?

    So then what is happening is when he's throwing an absolute tantrum...I try to keep breast feeding, but the above 4 things 'happen' and then ultimately I'll give him expressed milk from a bottle. Please understand that this is painfully my last resort...and it's often after 2 hr feeding session (or attempt at a feeding session)...that goes a little like feed for a few minutes, fall asleep, spend some time trying to wake him, maybe do a diaper change, he awakes, cries & fusses, so then try again with the breast. This cycle can repeat itself 4-5x in one session...which ends up being around 2+ hrs! And at the end...he may fall asleep for 20-45 min at most... & when he wakes & goes crazy...I can't keep going, so I give him a bottle, which he will guzzle down.

    I originally thought I wasn't producing enough...but I think my production is decent (not a ton, but it's decent & getting better). I do know & believe that he doesn't have a good latch (the LC at the hospital mentioned this...as he wasn't grabbing all the aureola in his mouth) but would fixing this, fix all the other problems? I'm not sure...

    I finally broke down & called a lactation consultant this morning, referred by our pediatrician...it took a lot for me to finally call her..& then I was completely disappointed that she never returned my phone call. I don't know why...but I was very nervous to blindly call her...

    I fear he's going to start getting used to feeding from the bottle & will never be a good feeder at the breast. I'm exhausted & can't keep doing these 2+ sessions back to back all day. I'm already fearing how this is all going to turn out when I have to return to work in 8 weeks.

    Any advice on how to turn things around before I give up? I won't give up on giving breast milk, but I probably won't be able to breastfeed if it continues like this. Oh, another note is some really bad days, we'll supplement w formula, too.
    Last edited by @llli*gholly; December 16th, 2013 at 08:56 PM.

  2. #2
    Join Date
    May 2006
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    20,847

    Default Re: Need help! poor latch? Sleepy feeder, snacker, not effic

    Welcome to the forum and congratulations on the new baby and on making it to 4 weeks of breastfeeding!

    First, let's forget about what the hospital LC said about your baby's latch. What the latch looks like from the outside matters much less than what it feels like on the inside. So, how does it feel when your baby does latch on and nurse? Is it comfortable, or are you in pain? And if you're in pain, please describe when it happens and what it feels like.

    Second, what got you into bottles in the first place? Was there a problem, and if so, what was it? Or was this more of a choice, perhaps a daily bottle for dad or a bottle to get your baby used to it, for when you return to work? The reason I ask is that if bottles entered your life by choice, it will be easier to put them aside for a while.

    Now, on to your list.
    First, how do you know your baby is "not efficient at the breast"? Was there a problem with diaper output or weight gain?
    Second, how are you responding when your baby falls asleep at the breast? What would happen if you let him go to sleep and set him down- would he wake up again very soon thereafter?
    Third, snacking and associating the breast with comfort. Both are entirely normal. Snacking is a normal feeding pattern for a young baby. Most kids require snacks until well into childhood- the snacks just change from being breastmilk to being goldfish crackers or whatever. Do you feel like your baby ONLY uses the breast for comfort, or does he also nurse for nutrition? Or is nutrition primarily coming from bottles?
    Fourth, can you describe the latch a little more? What makes you think it's not good?
    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

    Default Re: Need help! poor latch? Sleepy feeder, snacker, not effic

    Thanks so much mammal! So...to answer your questions.

    The latch feels fine...not painful. On a rare occasion, I may feel a needle-like pain in the nipple...but when I do, I unlatch him & try again. The reason though why I thought it was a poor latch, in addition to what the LC said at the hospital, is that my nipple does have a slight lipstick shape when he comes off...which I read is also an indication of a poor latch. I also feel he has a small mouth, which doesn't allow him to open wide enough to grab more breast in his mouth...and he doesn't really have/do the flared fish lips.

    For the bottles, it was bc he lost a bit of weight in the hospital...8-9% of his birth weight, so they were concerned, as my milk really wasn't coming in, so we had to supplement w formula. Even after he was discharged, he lost even more weight at his first ped visit, so we had to keep supplementing. And now, the bottle still continues b/c he doesn't eat enough at the breast when he turns into the sleepy eater....if I don't, I am literally feeding him all day long, which has completely drained me.

    His diapers have been good from day 1...a good amount of pee & poopy diapers. Probably too many poopy the first 4weeks!
    When he turns into the sleepy feeder, I tickle his chin, but that only works so much. So I will unlatch him, and spend 5-10 min trying to wake him up...burp him, sit him up, change his diaper, talk to him. But often after he does wake up, he'll fall asleep again within 5 min or so when I put him back at the breast. If I leAve him to sleep, more often than not, he'll awake within 5-8 min & then fuss & cry like crazy, turning his head & trying to eat his hands bc he's still hungry. It's an utterly tiresome, vicious cycle that can drag on & on & on.

    For the snacking...I'm not sure...I guess the breast is comfort & nutrition. But the nutrition he gets is not enough. When we give a bottle, he will actively & efficiently guzzle it down. Why can't he just guzzle at my breast?!

  4. #4
    Join Date
    Nov 2013
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    Columbus, OH
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    142

    Default Re: Need help! poor latch? Sleepy feeder, snacker, not effic

    I don't have helpful advice because I'm a beginner myself. I'll only say: I totally recommend finding a great lactation consultant. Me & baby were really struggling & I was feeling really unconfident. But we found a great LC through a more breastfeeding friendly hospital than the one where I delivered & she got us on a plan & it's *working*! I have to say that just knowing there was a plan & having some supportive guidance has been so flipping helpful! And it's made all the incredibly hard work feel like it's getting us somewhere! Getting help is good parenting!

    (Are all my exclamation point too much? I'm just really thrilled with our LC...especially after a less than awesome experience with the LC at the hospital).

  5. #5
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    Jun 2009
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    Default Re: Need help! poor latch? Sleepy feeder, snacker, not effic

    I finally broke down & called a lactation consultant this morning, referred by our pediatrician...it took a lot for me to finally call her..& then I was completely disappointed that she never returned my phone call. I don't know why...but I was very nervous to blindly call her...
    gholly, I also had lots of fear about calling an ibclc when I was having trouble nursing my first baby. I also had fear about calling a LLL Leader. So much so that I almost never called anyone. If I had let that fear stop me, I would not be here today, on this forum. Finally I did, and it was so amazing to get in person help, it not only saved my breastfeeding relationship with my baby but it changed my life. The first IBCLC I saw was very sweet but she only got us so far. Ultimately I had to see two different IBCLCs for 3 appts to begin to feel out of the woods. But it was worth it 1000 times over!

    I do not know the situation of the IBCLC you called but most private practice IBCLCs I know work out of their homes. They may have other jobs. They usually have kids. Maybe she is ill, or on vacation, or was out shopping all day. Maybe she retired and your doctor is unaware. Maybe her voicemail malfunctioned or she did not catch your number. It has only been one day, right? Maybe she had several appts today and simply did not have time to call you back yet!

    Call her again. I know it’s hard, I know that fear feeling, but please, call her again! Then call any IBCLC who is at all close enough for you to see until you find the right one for you. Call your local LLL (but remember LLL Leaders are volunteers and all I wrote above applies for them as well.) Please do not stop trying to get help because one person did not call you back. Have a family member call if you can't do it. But get help. You and your baby deserve it. Of course we can offer you lots of suggestgions and support here, but there is nothing like in person help from someone who knows what they are doing.
    Last edited by @llli*lllmeg; December 19th, 2013 at 10:06 PM.

  6. #6
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    Default Re: Need help! poor latch? Sleepy feeder, snacker, not effic

    that goes a little like feed for a few minutes, fall asleep, spend some time trying to wake him, (why?) maybe do a diaper change, (Why?) he awakes, cries & fusses, so then try again with the breast. (And will baby nurse at this point?) This cycle can repeat itself 4-5x in one session...which ends up being around 2+ hrs! (What happens if you let baby nurse a short time and then just sleep -preferably in your arms or in the same room as you at least- until baby wishes to nurse again? And at the end...he may fall asleep for 20-45 min at most... & when he wakes & goes crazy) (How do you mean crazy? Crying? refusing to nurse?) I can't keep going, so I give him a bottle, which he will guzzle down.
    how big is the bottle? Why not just nurse again?

    There may be a breastfeeding problem, maybe baby does not transfer milk well and so baby is getting frustrated and/or sleepy at the breast-ok. You see an IBCLC for that, to make sure baby cantransfer milk normally and to fix it if baby cannot.

    But in the newborn period, both short and long feedings, short sleeps, nursing to sleep, nursing for a bit, falling asleep, and wanting to nurse again just a few minutes later are all entirely normal. I think you may have gotten tied up in knots with the early supplementation and the hospital lc saying baby should have the whole areola in his mouth for the latch to be good. This is simply not true, or even possible, physically, in most cases.

    But the nutrition he gets is not enough.
    So-baby is not gaining normally? Because that would be the only reason to say your baby does not get enough. Maybe it is enough, but you think it is not enough, because of your history with the early weight loss (which may have been normal btw.) and now, baby gets so fussy nursing, you give baby bottle. Baby is filled up with bottles and so 1) is not hungry enough to be motivated to nurse normally and so seems sleepy to you at the breast and 2) baby finds it is much easier to get milk out of a bottle and so refuses & gets fussy at the breast. This is how nipple/flow confusion starts, so it becomes unclear after a bit what is causing what.

    When we give a bottle, he will actively & efficiently guzzle it down. Why can't he just guzzle at my breast?!
    Because breasts are not bottles. Milk is extracted completely differently. This is by natures brilliant design. We (humans) are supposed to work a bit for our food. An infant "guzzling' milk from a bottle is as unnatural as if an adult put all their food in a blender and drank nothing but liquefied foods through a straw. Yes it’s easier to not have to chew. But not healthy.

    Looking at your post, here is what I am hearing
    1) baby is gaining normally (I assume due to the appropriate poops?)
    2) baby is still being supplemented-even with formula at times-despite that baby is gaining normally
    3) baby gets very fussy and/or sleepy and will not nurse for longer than a few minutes.
    4) baby nurses/feeds frequently
    5) baby sleeps short durations
    So, 2 may not be needed, and only 3 is possibly abnormal. All else is entirely normal for a one month old.
    Last edited by @llli*lllmeg; December 20th, 2013 at 12:54 AM.

  7. #7

    Default Re: Need help! poor latch? Sleepy feeder, snacker, not effic

    Thanks for all the replies! And apologies for the slow follow up response. So baby is now 6.5 wks old & not much has changed since my original post, I'm sad to say. I did finally get in touch w that LC & she suggested coming to see her at a New Moms group she runs at a hospital...so I went. She felt the latch was fine considering...she agreed he has a small mouth in relation to the size of my nipple which, I guess, is on the larger side. We did a pre/post feed weight check & sadly, what I had suspected was confirmed - 20-25 min on ea breast, he only consumed about 1.9 oz.

    She suggested:
    1/ help massage breast while feeding to help flow of milk
    2/ supplement immediately after feeds (she said she is not against supplementing for baby & mommy's sanity & stress)
    3/ keep at it & hopefully baby will grow into it...& will learn as he gets older how to become a better eater

    I also believe he went through (maybe still going on) a 6 week growth spurt, which brought with it 3 days of massive fussiness & bad nights in terms of sleeping. I believe his appetite is on the large side, which has made the bfing not any easier.

    I visited a different new moms group again today led by another LC...she wouldn't really spend 1 on 1 time with people, so I was disappointed to not get another perspective & help/advice. But we did manage to do another feeding weight Check, although only on 1 side this time...& yes, after. 25 min feed on 1 breast, he only consumed 0.9 oz...so no change from a couple weeks ago. This LC is most concerned with my supply given the circumstances. I wonder now if I should try mothers milk tea? Does anyone have suggestions on what kind I should buy? I haven't done any research but I imagine there are a lot of different brands?

    Ugh...I'm tired, don't know how much longer I can continue if he's only getting 2oz off the breast & is hungry after every time, all the while his appetite seems to be growing. I also noticed his daytime naps are now becoming more difficult & non existent. Not 100% sure if it's because he's getting older! or if it's because he is never full & satisfied after any feed.

    Any thoughts, advice are very very welcome.

  8. #8
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    Default Re: Need help! poor latch? Sleepy feeder, snacker, not effic

    When it comes to increasing supply, no tea or herb will do a tenth as much good as either nursing more or frequent pumping with a high-quality double electric pump. When I was in a situation similar to yours, a bottle of fenugreek- which is the primary ingredient in the teas- cost $15 and lasted me for about a week, whereas renting a hospital-grade pump was $3 per day. If I had to choose between the two, I would absolutely and unquestionably choose the pump, and I would use that pump frequently, at least 8 times a day and preferably after every feeding. Pumping up your milk volume may mean that it's easier for your baby to get more milk in a shorter time period.

    I'm glad you did the weigh-feed-weigh measurement with the LC. But I would encourage you not to base any firm conclusions off of just 2 measurements. Intake can vary a lot at the breast, and it's quite possible that your baby's average feeding is better than recorded on either LC's scale. Would it be possible for you to rent a professional scale and do your own measurements? A few days' worth of data will be much more informative than 2 isolated measurements which took place in unfamiliar locations, where your baby may have nursed differently from the way he does at home.

    2 oz is actually a normal feeding. Most breastfed babies take just 2-4 oz at the breast when they nurse, which is something that comes as a surprise to a lot of moms, who are often used to seeing the much larger amounts taken from bottles by formula-fed babies.

    I'm sorry you haven't seen a big improvement in the last couple weeks, and I'm sure the last thing you want to hear is to keep doing what you're doing, or to do more. I wish there was a magic bullet for this sort of situation, but really the only thing that works is... Work.
    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!"

  9. #9

    Default Re: Need help! poor latch? Sleepy feeder, snacker, not effic

    When he breastfeeds, does he actively and methodically suck or does he pull off and fuss, or just lay there, latched, not doing anything?

    Since I'm not sure about the specifics of your baby, here's my experience if it will help any!

    I had a slightly premature, 5 pound jaundiced, sleepy baby, 10 weeks ago, who would need to be woken up for each feed, and over and over during each feeding, and would not stay latched after 2-3 sucks. It was very difficult! Here's what I've done which has helped me - I actually have been lurking here a bit and learned a lot from this forum. My baby had difficulty staying latched on so I did the 'instant reward' techniques that I learned here to encourage baby to stay on and keep sucking - I would pump until letdown occurs, then latch baby on -- this way baby won't have to work for letdown and wouldn't grow impatient (since they don't have to work for letdown with the bottle). Any time baby pops off I have a bottle of expressed milk next to me, and I put a drop on my nipple to get him to relatch. Each feeding session I'd start at the breast with this, and work with him for 10 minutes at breastfeeding, then, if he didn't want to continue, after that I would supplement from a bottle of expressed breast milk. Baby would even have a lot of trouble with not eating much from the bottle either at the beginning, but I'd cap it at 1 hour working with him/fighting to keep him awake, before letting him go back to sleep.

    Then, I'd pump 15-20 minutes to have a bottle ready for the next session. I think its important that you pump after each feed to improve your supply. By doing this every time, my supply was very, very good. I'd recommend a hands free pumping bra. It will help save your wrists from pain and will leave your hands free to do things like eat. This was invaluable for me, as 1 hour of feeding him and ~25 minutes to pump (including cleaning time) every 3 hour session means little sleep for you, and it is an exhausting schedule to keep. But capping breastfeeding at 10 minutes before giving the bottle of EBM (capping it only if he was fussing the whole time, if he wanted to go more, I'd let him!) and capping repeatedly waking him up to feed from the bottle for 1 hour max really helped my sanity. But slowly baby started eating more strongly at the breast, and I've been able to wean supplementing down to a few times a day

    Things still aren't perfect, but he's so much better than what he used to be, and the sleepiness is much improved. I wish you luck! Please do consider pumping after each feeding session Its hard but worth it!

  10. #10
    Join Date
    Nov 2013
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    Default Re: Need help! poor latch? Sleepy feeder, snacker, not effic

    My situation sounds a whole lot like Ayrie's and the solution (pumping after nursing to supplement &increase supply) was the same!

    Also, I also had a .9/.9 transfer but then put her back to each breast for another round and she got an additional .5oz total. I was super pleased by this transfer. I wonder if your baby is consistently efficient or if you could move him to the second breast when he wasn't really getting much at all anymore. And then take him back for another round getting him well past the 2oz mark?

    Also, that's awesome that you have two NewMoms groups in your area that are led by LCs! If you're craving the one-on-one, I bet they have individual sessions you can pay for.

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