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Thread: 2 month old fussy while nursing, HELP!

  1. #1

    Default 2 month old fussy while nursing, HELP!

    Suddenly last week my normally easygoing child began fussing at the breast. He opens his mouth like he is goign to try to latch and then pushes against me so that his mouth jsut hovers and he shakes his head. After holding him there he might try to actually latch but he screams and gets red in the face. I can usually fight him for a couple minutes and then he will settle enough that we can nurse. Sometimes though he keeps fussing. he will also pop off every so often. He seems to do better when I am fuller, like in the early morning. He has also been nursing for way shorter periods but I think this is normal for his age range? He has normal wet diapers and otherwise seems happy. He does seem to not satisfy as well as he had been and I have had to supplement with breast milk again.

    Some history on our BF story: He was born with transient tachypnea and went straight to the NICU. (no skin-skin ) I had to pump that night and the next day before he had his oxygen removed and I could begin nursing him in the NICU. After he joined me in the room on the 3rd day we nursed with LOTS of help. He developed jaundice then and was a sleepy eater. I had to constantly keep him awake enough to eat. We came home after 4 days and after getting home I could not latch him on myself. We then began bottlefeeding expressed milk. This was per the nurses instructions. I began seeing the IBLC at least once a week as well as the pediatrician. She got him back to the breast and gaining weight. I had to pump after every-every other feed and take fenugreek. I tapered the fenugreek over 4 weeks and after he began gaining weight and was back to his birth weight the pediatrician said it was OK to wean off pumping. (I did not need to see the IBLC after he was back to birth weight) Everything has been great since then. Until last week.

    Again this was very sudden. He does get at least 3-4 bottles a day when I work. He has continued to have a supplement bottle every night before bed and has done great with our system. I cannot stop using bottles completely since I am away from him. I know I have had an oversupply for weeks and possibly he got used to that flow? Now that maybe its regulated he wants a faster flow? He does try to knead with his hands and pulls his head back while still attached. I love BF and dont want it to end! (I also started taking fenugreek and eating oatmeal again in hopes it would help)

  2. #2
    Join Date
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    Default Re: 2 month old fussy while nursing, HELP!

    many babies just start nursing differently or fussily at some point fro no particular reason, and it goes away after a while. If usually occurs a bit later though, 3-4 months, which is why such behavior is sometimes called the "four month fussies" However, I see no reason it might not happen earlier.

    But I do wonder if bottles are part of the issue here? Bottle or nipple or flow "confusion," leading to breast refusal, is real and is usually a gradual occurrence. The risk is greater if a high number of baby's feedings each day are with a bottle, and/or bottles are introduced early, and also if pacifiers are also used with regularity. Basically, what occurs is that over time, baby is inadvertently trained to bottles (and pacifier if they are used) and away from the breast.

    So when a baby must have regular bottles, bottle confusion is something that must be actively resisted. Generally, this means, bottles are given only when needed, pacifiers avoided especially when baby is with mom and can nurse, and bottles are given in a breastfeeding supportive way.

    So that leads me to a few questions?
    How is weight gain now? Did baby have a 2 month weight check?
    Baby gets 3-4 bottles each day-how big are they? How much does baby usually get total each day in ounces, for how long a separation?
    Do you pump for around each time baby gets a bottle generally?
    How many times does baby nurse each day?
    Is baby nursing overnight?
    Is your baby's caregiver being careful about how baby & the bottle are positioned during feedings to prevent a constant flow? And making sure baby takes pauses while getting bottle, and is baby fed on cue? Collectively this is called paced bottle feeding and is believed to help prevent flow confusion that can lead to baby refusing to nurse/getting frustrated with the breast. If you would like more info, let us know.

    He does seem to not satisfy as well as he had been and I have had to supplement with breast milk again.
    Unless, of course, supplemental (additional) feedings are needed due to poor gain, I would suggest, try not to give bottles when you are there to nurse, even if baby is refusing or "wanting more" or not getting satisfied. If baby wants more, baby can nurse more, and if baby will not nurse more, maybe baby wants to be comforted another way. Sometimes a small amount in the bottle will calm baby and baby will nurse, or you can start with the bottle and switch to breast. In those cases, the bottle is being used to encourage nursing. And that is probably ok to as long as it works for getting baby to the breast.

    Do you have oversupply or undersupply, fast letdown, or slow letdown? I am confused on that point. When supply seems to be too little, then too much, then too little again, in quick succession, that sounds strange to me.

  3. #3

    Default Re: 2 month old fussy while nursing, HELP!

    How is weight gain now? Did baby have a 2 month weight check? He goes for his 2 month next week so we will see, but since his jaundice and trouble feeding early we have had regualr weight checks/visits. He was gaining well at his last chekc 2 wks ago.
    Baby gets 3-4 bottles each day-how big are they? How much does baby usually get total each day in ounces, for how long a separation? He gets around 3-4 oz about 2x. Maybe 8-12 oz I think for a 6 hr seperation.
    Do you pump for around each time baby gets a bottle generally? I pump once at work, which is 4 hrs after I nurse him last and it will be about 4 hrs until I nurse him after work.
    How many times does baby nurse each day?About every 2 hrs, or more. After writing down SO many things CONSTANTLY in the beginning I have not been taking note as well.
    Is baby nursing overnight?Yes. He might sleep 3.5-4 hrs at the longest now and then 2 hrs again after that. So about 2:00 and then again at 4-5 o clock
    Is your baby's caregiver being careful about how baby & the bottle are positioned during feedings to prevent a constant flow? And making sure baby takes pauses while getting bottle, and is baby fed on cue? We had been doing the give a few sucks and let him rest part of it and informed his grandparents that's how he needs to feed. I reiterated the whole shebang this morning so I hope they do. I also found a great article on paced rhythm feeding that includes a more natural style of giving the bottle to him in general that I sent my mom.

    Also we had only been supplementing when he seemed unsatisfied (right before bed) per advice from our IBCLC. It's usually only about 1-2 oz. Sometimes might be a little more. Any other time I try to put him back to the breast.

    Additionally He has had a soothie pacifier since being in the NICU and I will start weaning him from that.

    From reading on here and kellymom from all of the pumping etc. I did before I had an oversupply. Only just recently has it seemed that is not the case. I assumed this was just normal stabilization but baby was not liking the change in flow. That just what I can guess from reading articles. I do know that I have had a fast letdown and seem to still do.

  4. #4

    Default Re: 2 month old fussy while nursing, HELP!

    Also since he is used the faster flow/fast let down is there anythign I can do to help him adjust to a slower flow while nursing? Or do I just need to do things to keep an oversupply since he nurses better? Kind of confused about that! There is just so much information out there to try to piece together

  5. #5
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    Default Re: 2 month old fussy while nursing, HELP!

    :/ Maintaining an oversupply is not something you want to do- in general. Most of the time, it's best to allow the baby to learn how to deal with the flow you have rather than trying to increase supply so that nursing is easy for him, because that just traps you in an endless cycle of adjusting your supply until baby is perfectly happy. But I can see the rationale for it in your case, with a baby who is acting extremely fussy at the breast and getting a lot of bottles during the day. If you decide to do it, I would aim for a small increase and aim to do it only in the short term. I'd also want to cut out that supplemental bottle before bed. You want baby to think "When I'm with grandma and grandpa, I get a bottle. But mom seems not to have those, so I'd better just nurse instead of acting all fussy until she caves and bottlefeeds me."
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
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  6. #6

    Default Re: 2 month old fussy while nursing, HELP!

    To allow him to adjust do I just nurse him as frequently as possible, will he get used to it in time? What do I need to do when he becomes agitated and not easily calmed enough to nurse? Also to eliminate the bedtime bottle do I gradually cut it out or just stop it entirely?

  7. #7
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    Default Re: 2 month old fussy while nursing, HELP!

    Ok overall your routine sounds good. I would suggest a couple things.

    If baby is reacting negatively to a SLOW flow, try breast compressions and switching sides when baby fusses, and maybe hand expressing to get the milk flowing before baby latches. Jack Newman has a good description of breast compressions.

    If baby is reacting to a too FAST flow, try leaning back when nursing baby and nursing more often, hand expressing a little milk just prior to nursing so that first letdown occurs prior to latching baby, also try nursing one side at a time unless baby indicates baby wants other side.
    If you have oversupply, don't take galactagogues.
    Actively encourage baby to nurse as much as you like when home. Don't force, but offer. Baby cannot nurse too often. yes I do think that The more baby BREAST feeds the faster baby will adjust to normal changes in flow.

    Since you were told to supplement at "bedtime" by the IBCLC, you can go back and ask if that suggestion can be eliminated. I agree with mommal, unless baby needs this to gain normally, I don't see what good it does and it may do harm. it probably can simply be stopped-its only a couple ounces, right? Baby may not sleep as long without it, possibly, at least at first.

    During a 8 hour separation, a baby would typically need from 8-12 ounces total. So That part is fine. But I do think breaking those bottles up a bit may help, as a 3-4 ounce feeding is on the large side.

    I would love to know what article you gave to baby's grandparents, always looking for good resources! I also like this video as it SHOWS the proper positioning. http://www.bing.com/videos/search?q=...FD00534CAAC56E This can be really hard for people who are used to being admonished to make sure baby never gets any 'air bubbles' while getting bottle. With paced bottle feeding, baby may get a little air. It's fine. The only thing I don't like is she talks about going a certain amount of hours between feedings. It's not wrong exactly, just confusing IMO. A baby should ideally be fed on cue, whether breast or bottle fed, unless baby is not cuing with enough frequency. In other words, if baby takes two ounces at 1pm and another ounce at 2, that is entirely normal and fine.

  8. #8

    Default Re: 2 month old fussy while nursing, HELP!

    I do believe it is from too slow since he fusses after a hile after letdown and tries to compress himself lol. As far as supplementing I was jsut told to supplement if baby does not seem satisfied after nursing, which is typically at night. He normally eat 3-4 oz and is satisfied. If we give him less, even more often, he doesn't act satisfied. He was nursing about 2 oz at our LC appointments a month ago.

    The article is http://www.austinbabyguru.com/paced-bottle-feeding.html

  9. #9
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    Default Re: 2 month old fussy while nursing, HELP!

    I think that is a large bottle to be given to a baby when mom is there and baby is able to nurse normally and is gaining normally. It is possible this bottle may actually be replacing more than one nursing session.

    Also, baby Being able to get "satisfied" is not necessarily about how much into tummy but how long at the breast.

    Babies nurse for 2 reasons. comfort AND food. There is little or no difference between the two for the young baby. Both are a vital and integral part of normal breastfeeding. This is one reason why nursing frequency and duration varies so much from baby to baby, and why cue feeding is so vital. When baby is encouraged (even when it is necessary!) to meet either need with something that is not mothers breast, breastfeeding issues often occur.

    He was nursing about 2 oz at our LC appointments a month ago
    .

    2 ounce transfer is a good, normal transfer for a single feeding at the breast(s) in a baby over two weeks of age.

    thanks for the article I will check it out right now gotta run I think my kids are killing each other in the other room.

  10. #10
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    Default Re: 2 month old fussy while nursing, HELP!

    ok they were just wrestling. Loudly!

    Thank you, I really like most of that article-very clear description of paced bottle feeding, really helps you picture it. My only ? is I think her suggested normal per bottle amounts for one month and older are on the high side.

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