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Thread: 15w old only nurses when asleep/prefers right breast

  1. #1

    Default 15w old only nurses when asleep/prefers right breast

    My daughter has gotten to where she will only get good feedings in at night or if very sleepy. Up until about a week before Thanksgiving, she would eat for 10-15 minutes on each side, usually before a 45-90min nap. Now, she will only eat for 2-3 min on each side and often refuse the left breast completely. At times I know she pulls off at letdown, but often there is no spray when she pulls off and refuses to relatch, so I am hesitant to believe this is an overactive letdown issue, especially because she was handling it well before. I have to pick her up and try several times to even get to 3 minutes. She also will only nap 30 minutes at a time now. The doc diagnosed reflux due to these issues as well as wet coughing after feeding and spitting up, so we are on day 12 of Zantac with very little improvement (if any.. perhaps we are just coping a little better). He ok'd us to up her dose, which I plan to do if a second chiropractor appointment on Friday does not help.
    I'm concerned about my supply and about her getting enough to eat. Is it possible feedings this short are sufficient? Her diaper output has not changed as far as I can tell, although she did have a few green poops last week. She is a big, healthy girl, 16# and 24in at the reflux appt two weeks ago. I'm also concerned she will develop a habit of getting most of her calories at night if this continues, and that we will never be able to leave the house for longer than an hour in order to be home in time for her combined nap/feeding. If I only counted feedings longer than 7 minutes, I would say she eats maybe 4-5 times a day, ALWAYS when asleep or extremely drowsy. Also, possibly related, she will not take a bottle. Help!

  2. #2
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    Default Re: 15w old only nurses when asleep/prefers right breast

    Hi. It is very typical for nursing habits to change in the 3-4 months of age range, it is also typical for a baby to be a fussy nurser around this age. Some typical aspects of this are baby nursing less often than before, OR nursing more often, baby nursing one side at a time when previously baby usually took both sides, OR vice versa, shorter nursing sessions, fussiness at the breast, and a general change in nursing patterns.

    There are several ways people describe this phenomenon. In The Womanly Art of Breastfeeding (8th edition) it is called the "4 month fussies'. In his book My Child Won't Eat, this type of behavior is part of what pediatrician Carlos Gonzalez describes as the "Crisis at Three Months." These are both excellent sources of information and I encourage every parent to read these books.

    Why this happens is not entirely known, but it is probably in part due to the fact that a baby typically grows/gains VERY fast the first three months, and starting at about 3 months, growth/gain noticeably slows. At the same time, milk production changes or has been changing. A mom who perhaps made an overabundance of milk the first few months might see her production go down to more exactly what is needed, and so the milk flow become less fast. This sometimes seems to bother some babies, even though it is normal and does not mean there is not enough milk! These are natural, normal changes that are biologically expected.

    Some things that might also interfere with normal nursing patterns are not as 'natural'- giving baby bottles, mom pumping, pacifier use, sleep training, meal scheduling. Some of these things (like bottles and pumping due to separations) are unavoidable, but in those cases, there are precautions that can be taken to reduce any possible issues.

    It would help to know how many times a day baby is nursing, including the short sessions. While yes it is possible that SHORT nursing sessions allow for plenty of milk transfer at this age, what might be concerning to me is the nursing only when sleepy, refusal of one breast, or baby not nursing a minimum of 6-8 times in 24 hours.

    As far as going out and naps- I would strongly suggest to not make much effort in arranging your schedule around the shifting sleep and eating patterns of a baby this young. It is likely futile and frustrating and unnecessary. Babies are pretty good at sleeping when they are tired in most situations. If your are concerned because some suggest that sleep/eat/nap patterns need to be 'established' at this age or they never will be, please know there is not a shred of evidence supporting this idea.
    Last edited by @llli*maddieb; January 1st, 2015 at 02:34 PM.

  3. #3

    Default Re: 15w old only nurses when asleep/prefers right breast

    Quote Originally Posted by @llli*maddieb View Post
    Some things that might also interfere with normal nursing patterns are not as 'natural'- giving baby bottles, mom pumping, pacifier use, sleep training, meal scheduling. Some of these things (like bottles and pumping due to separations) are unavoidable, but in those cases, there are precautions that can be taken to reduce any possible issues.

    It would help to know how many times a day baby is nursing, including the short sessions. While yes it is possible that SHORT nursing sessions allow for plenty of milk transfer at this age, what might be concerning to me is the nursing only when sleepy, refusal of one breast, or baby not nursing a minimum of 6-8 times in 24 hours.

    As far as going out and naps- I would strongly suggest to not make much effort in arranging your schedule around the shifting sleep and eating patterns of a baby this young. It is likely futile and frustrating and unnecessary. Babies are pretty good at sleeping when they are tired in most situations. If your are concerned because some suggest that sleep/eat/nap patterns need to be 'established' at this age or they never will be, please know there is not a shred of evidence supporting this idea.
    Thank you for the quick reply!
    I would estimate that I offer probably 3-4 times a day when she is awake, and those feedings are usually 1-6 minutes long. I offer both breasts and she typically will initially latch on either but refuses the left after less than a minute. I have been trying to pump on my left side a couple times a day to try to keep my supply up. Those are in addition to the estimated 4-5 "good" feedings when she is asleep.

    We aren't doing any kind of scheduling or sleep training. She is breastfed on demand (although her cues are difficult to read and sometimes seem constant.. and lately I've been offering before nap time, and she will do her awake refusal pattern, and scooping her up as she wakes, desperate to get a long sleepy feed in. I assume she wouldn't eat if she wasn't hungry?) and we put her down when she seems tired (about every 2 hours). Before I figured out she would eat well just as she was waking up, she would simply not get any good feeds in that day except for during the night. She only uses a pacifier if we are stuck in the car when she is upset or sometimes she will take one for a few minutes before falling asleep at naps. She has taken a few bottles in her short life, but has been refusing them for over a month. We would like for her to be able to take one occasionally.

    She does do ok napping in public, but the problem is feeding in public. Since she doesn't feed well when awake, it's very difficult to feed her while we're out. Hence hurrying home to avoid a tired/hungry meltdown and/or missing an opportunity to feed.
    Last edited by @llli*ashputt; January 1st, 2015 at 06:06 PM.

  4. #4
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    Default Re: 15w old only nurses when asleep/prefers right breast

    Before I figured out she would eat well just as she was waking up, she would simply not get any good feeds in that day except for during the night.
    But how do you know these were not 'good' feeds? Short nursing sessions does not necessarily equal a 'bad' nursing session.

    I am not saying there is nothing wrong, there may be, it is just hard to say as again this is a typical age for these kinds of nursing issues, which sound like distraction issues to me, primarily. I would suggest seeing a lactation consultant to help you figure out if baby is having issues with latch or sucking. Another thing to try are trying different positions. There might be some issue with positioning discomfort on the one side. Or maybe breast compressions for a slow flow?
    She is breastfed on demand (although her cues are difficult to read and sometimes seem constant.. and lately I've been offering before nap time, and she will do her awake refusal pattern, and scooping her up as she wakes, desperate to get a long sleepy feed in. I assume she wouldn't eat if she wasn't hungry?)
    Sometimes I think there is some confusion about what is meant by 'demand feeding' aka 'cue feeding.

    Cue feeding means that breastfeeding seems to go smoothest when a baby is nursed whenever baby cues. (and cues are often subtle.) If cues are constant, there is nothing wrong with that. Cues may occur when baby is asleep or awake. If baby is gaining normally, then frequent cueing does not even signal a possible issue. Cue feeding just means that in general, assuming baby is cueing often enough and gaining normally, mom follows babies cues of when to nurse, how long to nurse, and when and if to switch sides. If this is done, nursing generally goes smoother and baby gets plenty of milk and milk production is normal.

    Cue feeding also means it is fine for a mother to OFFER to nurse whenever she feels like it, as you are doing. Basically, a baby cannot nurse too often. Does this mean a mom must always drop everything and nurse the moment a baby cues? No. Obviously a baby may cue while you are driving somewhere, or in the shower, or emptying a pot of boiling spaghetti, etc. in those cases, you nurse when you can.

    Babies do not typically only cue if hungry or thirsty. A baby nurses for many reasons. So called "comfort nursing" is a normal and important and usually necessary aspect of normal breastfeeding. All nursing is comforting.

    As far as NIP, all I can say is practice really helps. It often takes time and opportunity for moms and babies to get comfortable nursing in public. All babies are apt to do things that make nursing in public seem hard (Popping on an off, cueing but then not being very interested, fussing, pulling the blanket or nursing cover off, etc. etc.) Yet many mothers find they can NIP despite these issues. There are many great videos and tips for NIP. I suggest going to an LLL meeting or other breastfeeding or new baby support group as a great place to get ideas and for you and your baby to 'practice' NIP. I have often seen reluctant nursers nurse great when they see other babies nursing. Also, if your baby does not nurse when out, so what? A baby is not going to starve during a short outing. For meltdowns, what other comfort measures may help? Have you tried a wrap or carrier?

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