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Thread: Managing gassiness through breastfeeding

  1. #1

    Default Managing gassiness through breastfeeding

    I have a 10 week old who is exclusively bf. Right from birth she has been incredibly gassy and this causes her a lot of discomfort, especially in the evenings. (At worst screaming till 2am).She is also on medication for reflux. Initially I was blockfeeding (which helped a little but not much) but this stopped a couple of weeks ago when DD got sick and was not feeding well so i started feeding both breasts again to keep supply up (baby is well now). I have been dairy free since 4 weeks and no coffee or chocolate. A friend of mine recommended a baby whisperer who came out and recommeded we put our baby on a rigid schedule to help manage these issues. We tried it for a couple of days. DD was hungry in between scheduled times so we couldn't stick to the routine completely anyway, but her gassiness was hugely improved. The down side was my supply was quickly dropping in the evenings and not feeding on demand went against my instincts.I am back to demand feeding and he gassiness and spilling is back. Just wondering if anyone else has found a good balance to manage gassiness through feeding?

  2. #2
    Join Date
    Jun 2009

    Default Re: Managing gassiness through breastfeeding

    Hi! Welcome to the forum. It is really hard when baby is in pain, so I hope we can help. I have lots of questions just to get a more clrea picture.
    When you say gassiness, can you be more specific on what you mean?
    Except for when baby was on a schedule, symptoms have been the same for 10 weeks- since birth?
    Baby is on reflux meds. How was reflux diagnosed? Are the meds helping with baby's symptoms?
    Have the food eliminations seemed to help in any way? Did you eliminate systematically, or several foods at once?
    You say you had oversupply, so then block nursed. When did block nursing commence? How did you know you had oversupply, and later, how did you know it was too little? How long did you block nurse for, and how did you do it? (How long was each block)
    How is baby's weight gain?
    we put our baby on a rigid schedule to help manage these issues.
    can you tell me more about the schedule that you actually did? (How often did baby nurse, one or both sides at a time etc.)
    Now that you are back to cue feeding, about how many times about in 24 hours does baby nurse? how long will baby nurse for, typically? One side or two, etc?
    When you nurse does baby eve seem to have difficulty handling the flow?
    Is baby crying more when laid flat, or put down to sleep, or at some other particular position, or is there just as much crying when baby is being held?

    I am wondering if this is actually more of an OS and/or forceful letdown issue, but I don't want to miss anything else. that is why all the questions. Sorry!
    Last edited by @llli*lllmeg; June 28th, 2014 at 12:07 AM.

  3. #3
    Join Date
    May 2006

    Default Re: Managing gassiness through breastfeeding

    Excellent questions from LLLMeg!

    I'm really sorry your friend handed you that stupid Baby Whisperer book. In my opinion, it's a good one to use underneath wobbly tables or for propping pen a door, but not for much else. This is a good review of why it isn't a pro-breastfeeding book: http://kellymom.com/parenting/review...babywhisperer/

    It's really common and really normal for babies to have a fussy period in the evenings. Sometimes the fussiness is so severe that people refer to it as "evenings-only" colic. Some things which may help you through the witching hours include:
    - Calm house. Keep lights, TV, and stereo down or, preferably, off.
    - Natural light. Make sure your baby is exposed to as much as possible over the course of the day- it will help her set her internal clock.
    - White noise. Radio static, machine noise.
    - Motion. Put baby in a sling, swing, or stroller, rock her in a rocking chair, bounce her on an exercise ball.
    - Warm water. Give baby a warm and soap-free bath in the sink, with the water continually running over her body.
    - Change of scene. Take baby outside into the fresh air.
    - Closeness. Cuddle baby close to bare skin.
    - Nurse. Nurse nurse nurse nurse nurse! As much as baby is willing. It's impossible to cry when you have a breast in your mouth.
    Last edited by @llli*mommal; June 28th, 2014 at 05:22 AM.

  4. #4

    Default Re: Managing gassiness through breastfeeding

    Thanks for the reply and the welcome. I will try and answer the questions below:

    The gassiness is lots of burping and intestinal wind (the intestinal wind is the one that really bothers her and I wind her during feedings).
    The symptoms (gassiness, hiccups, regurgitation, some spilling, unable to lie down) have largely been the same since birth, but do seem to be getting a little better as she gets older, but were definitely less on the schedule. I have always noticed the more I feed in the evenings the more upset she gets in and she will reach the point where she arches away and pulls off and can't latch on.
    The reflux meds were prescribed by the GP. She could not lie down without screaming, was regurgitating and although not spilling a lot, could still spill an hour and a half after a feed (very thick). My first also had reflux. I think the meds have made some difference as she can lie down more comfortably now.
    With the food, it has mainly been dairy, but also gassy foods (e.g cabbage and broccoli) and acidic foods. This was all at the same time. I think this has made some small difference but not a lot, although she was more unsettled on a day when I did eat dairy.
    The block nursing started about 3 weeks on recommendation of my midwife who thought this might help the reflux symptoms and she had a lot of green poo. The blocks were 4 hours and she was nursing about every 2-3 hours about 20 mins at a time. She was also unable to cope with the letdown at the beginning of feeds and would gag and pull off but she can manage this now. The green poo lasted till about 8 weeks and then stopped but is back today.
    She usually gains about 4-5oz per week.

    With the schedule it recommended both breasts per feed about 20 mins each every 3 1/2 - to four hours in the morning and more frequently in the afternoon/evening. She could not last more than 3 hours so I fed her anyway. The schedule recommended 6-7 feeds a day. I knew my supply was dropping as her afternoon/evening nappies were less and she was more hungry overnight.

    Now I am demand feeding again she usually feeds every 2 1/2 - 3 hours (sometimes more frequently and for about 40 mins at a time). I had been doing both breasts, although yesterday just fed from one at each feeding (she seems quite happy to) although the green poo is back today so not sure if that is related. She normally has 7 - 9 feedings in a day. Now that I am demand feeding again she is less comfortable on her back and more refluxy. I normally sleep her upright on me for at least an hour before putting her in her cot at night. When she is gassy she is uncomfortable in any position, but more so lying down.

    Hope that answers all of your questions and thanks for your help.

  5. #5
    Join Date
    Jun 2009

    Default Re: Managing gassiness through breastfeeding

    Ok. Thank you so much for answering my many many questions! Here is what I suggest.

    Burps and spit ups and hiccups and other end gas and green poops are all within the range of normal. If baby is uncomfortable, there are usually things to do to relieve that a bit. But these are not medical issues.

    Do not block nurse again. baby is not gaining fast enough for that to be warranted or safe. Baby should be gaining extremely rapidly for block nursing to not be potentially dangerous to milk production and baby weight gain. Over 8 ounces a week.

    So why did the schedule help? I expect you do have overactive or "forceful" letdown. IN part this is caused or exacerbated by the infrequency baby has nursed. I think that perhaps the schedule reduced your production to the point the forceful letdown decreased. But schedules are not the way you want to deal with either overproduction (which again, is not really indicated) OR forceful letdown (which is.) Because schedules cause too many other problems that are far more serious.

    Instead, I suggest, try things to help flow be less and to help baby handle what flow there is. These would be:

    Nursing more often, at least 10 times a 24 hour day, but more than that is fine. Try to not go more than 4-5 hours without nursing overnight, (this one time stretch can be extended to 6 or so when the issues cease, assuming baby agrees) and nurse much more often the rest of the time. You cannot nurse too often. Here is why this should help:

    More frequent feeds = less time for milk to build in the breasts= less foremilk (This is the ONLY time foremilk may be an issue in breastfeeding) = less lactose = less gas (the other end kind) and discomfort and green poops.
    Also, More frequent feeds = a little less milk into baby each time, less rapid flow, less gasping, less air, less burping, and possibly, less spittups.

    If flow is really bad, take baby off, let flow go into a cloth, and relatch baby after the letdown slows a bit.

    Nurse one side at a time unless baby indicates baby wishes to nurse the other as well. There is never a need to actively encourage a baby to nurse both sides at a time every feeding unless weight gain is in question, (it's a milk production increasing technique) Yes, it will be suggested by baby trainers. Because they know that if baby is being held to a feeding schedule that is far too infrequent, and 6-8 times a day is too infrequent, this will often tank milk production and even possibly lead to failure to thrive. This is why baby training, by any name, is so questionable.

    Diet: I suggest, Go back to eating whatever you like while you assist baby with handling the flow better. If baby continues to have extreme discomfort after the forceful letdown has been improved on, you may want to revisit the allergy issue. Allergies are fairly uncommon via breastmilk but certainly, can occur. Signs include Blood in stool, failure to gain normally, skin rash, and unusual discomfort and sleep disturbance. If you want to try an elimination diet, eliminate one thing, starting with dairy, by far the usual culprit (vegetables almost are never an issue) and eliminate all dairy for two weeks. If no improvement, eat it again. If there is improvement, wait another week, and drink a big old glass of milk, and see if baby appears to react again. Because it may have just been a coincidence. You can keep repeating this with other suspect foods (soy, gluten, etc-link below has a list of common and not so common culprits) as long as you want, but remember to always add the food back into your diet if there is no improvement when it is eliminated! Or you end up eating nothing.

    If your baby has reflux, being laid flat is likely to be uncomfortable, even on meds. In fact, most babies prefer to be held more or less upright, as much as possible. So I would suggest, yes, hold baby, as much as possible, especially after nursing. You got it. Let baby be snuggled up against you, head above tummy. To get a break, you can pass baby to someone else who can hold baby like this. A sling or wrap may be very helpful for mom with the baby who does not enjoy being laid down.

    Hope this helps. Please let me know if you have concerns about any of my suggestions.

    Suggested articles: Forceful letdown (no need to read the part about overproduction or block nursing. Read the first part) http://kellymom.com/bf/got-milk/supp.../fast-letdown/

    colic in the breastfed baby: http://www.breastfeedinginc.ca/conte...gename=doc-CBB Overall helpful article for fussy baby. Good info on elimination diets at bottom: http://www.breastfeedinginc.ca/conte...gename=doc-CBB

    allergy in breastfed baby from academy of breastfeeding medicine http://www.bfmed.org/Media/Files/Pro...ish_120211.pdf
    Last edited by @llli*lllmeg; June 28th, 2014 at 08:00 PM.

  6. #6
    Join Date
    May 2006

    Default Re: Managing gassiness through breastfeeding

    What LLLMeg said! Couldn't have put it better.

  7. #7

    Default Re: Managing gassiness through breastfeeding

    Thanks for the comprehensive advice. I will give this a try.

  8. #8
    Join Date
    Jun 2009

    Default Re: Managing gassiness through breastfeeding

    Ooops, forgot to mention positioning. Laid back and also sidelying. These positions also seem to help if baby is having difficulty handling a fast flow, plus, these are often nice comfortable positions for mom.

    Laid back: Here is some info on laid back nursing aka Biological Nurturing: http://www.llli.org/docs/00000000000...astfeeding.pdf

    I like this video from the biological nurturing website. Turn the sound on to hear the IBCLC explain what is happening. Also shows nice early cuing: http://www.biologicalnurturing.com/video/bn3clip.html

    This video on this page is an ad for the BN DVD. You do not need the DVD. The ad shows you in pictures many ways moms "do" laid back nursing. :http://www.geddesproduction.com/brea...-laid-back.php

    And here are some other positioning ideas including sidelying: http://www.llli.org/faq/positioning.html

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