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Thread: Nursing taking a turn for the worse, doubting myself...

  1. #1
    Join Date
    Nov 2015
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    Default Nursing taking a turn for the worse, doubting myself...

    Hi,

    Sorry for posting yet again but I'm really starting to doubt myself. I wrote in earlier about my son being very fussy at the breast. I tried laid back nursing and more frequent sessions which took the edge off his fussiness but the fussiness is back with a vengeance since last week. He is now 10 weeks old. He used to nurse both sides for an hour and now he will only take 1 side for 2-10 minutes. After that he cries hysterically while continuing to display hunger cues like frantic rooting. I've tried giving him a break and trying when he is calmer, but as soon as the breast comes back out he goes back to hysterics. This happens every feed, except sometimes in the middle of the night. I had to go to urgent care the other day (injury so no meds or sickness that would impact my milk) and he gulped down a bottle of breast milk with no protests (it was a paced feed, so gulped is relative...) so he has an appetite and the milk itself does not appear to bother him.

    He is now eating (if you can call it that) every 1.5 to 2 hours. He spits up rarely and gas does not seem to bother him. If he burps, he goes right on crying after so it does not seem to give him any relief. Diaper output is 6-ish wet, 1-2 dirty per day. This is down from last week where we had 10 wet and 3-4 dirty. Today one of the dirty ones looked mucus-y, although not sure if this is problematic... Since we are away for the holidays I cannot get a weight check or visit the LC until after Christmas. I worry that if I keep this up he will get dehydrated or lose weight before I can get him checked.

    I feel terrible - like I am forcing him to bf when he would be more comfortable with a bottle. Besides the nutritional benefits, I was hoping bf would be a comforting experience for my son but he seems so upset. I worry I am being selfish by not switching to a bottle. Also, I thought bf would be established by now. I see other mothers in our local bf group and their babies are calm as can be. I feel like I must have really screwed up and perhaps it is too late to fix it.

  2. #2
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    Jun 2009
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    10,754

    Default Re: Nursing taking a turn for the worse, doubting myself...

    Hi, I know you are worried, and it must be frustrating after seeing some progress. Additionally, you are travelling and probably staying in unfamiliar surroundings, which is usually quite stressful for everyone including baby no matter how welcoming and comfortable the situation.

    What makes you think the issue is about breastfeeding? Some babies are just really fussier than others. Usually this is personality thing, but some babies really are suffering from something. But nursing is not the usual issue.

    Sometimes, (although rarely) babies really are having an issue with the breast milk because they are having a reaction to something mom is eating. But aside from that, why would this issue be specifically about how or what baby is eating?

    Aside from the rare possibility baby is having issues with the actual milk due to a food protein sensitivity, there are two reasons a baby would have trouble (excess fussiness) while nursing at the breast. One is, not enough milk, frustrating baby. The other, way too much milk, overwhelming and upsetting baby. That is pretty much it. (Although either might be exacerbated if baby has difficulty with milk transfer for some physiological reason.) Is it possible either is going on and what have you done about it?

    I am really not sure what else to tell you. Studies have shown that the least stressful way to feed a baby is at the breast. Bottles are a very recent invention and are designed the way they are to mimic the breast, which they do pretty poorly. The infants of mammals nurse at the breast, and have since the dawn of mammals. That is the one and only natural, normal way to feed a human infant. So I do not see how you can be selfish for trying to make what is normal and natural and best for both you and baby work.

  3. #3
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    May 2006
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    Default Re: Nursing taking a turn for the worse, doubting myself...

    with MaddieB. You are NOT being selfish when you nurse your baby, and you cannot "force" him to breastfeed. Nursing is literally the most unselfish thing you can do for your child, and it's worth the struggle to make it happen.

    What is your baby doing in between feeds? Is he in a crib or a bassinet, or snuggled up close in a sling? Most babies are more content when held close to mom, and being unrighteousness between feeds would probably be very helpful if there is a reflux angle going on here.

  4. #4
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    Nov 2015
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    Default Re: Nursing taking a turn for the worse, doubting myself...

    Thanks, Maddieb and Mommal. To answer your questions:

    Why I think breastfeeding is the issue: I think breastfeeding is the issue because he only fusses around the breast. He does not fuss with a bottle and he does not fuss when not feeding.

    Too much/too little milk: I suspect that he may have some trouble with my let down because he often pops during that point. Milk is not spraying across the room or anything, but it does come out steadily, usually a trickle but sometimes a stream an inch or so past the breast. I'm not sure if this is forceful enough to qualify as an overactive let down, but I nurse him laid back or sitting up just in case. He still fusses though. I also wait for the flow to slow (using a towel) but by that time he is pretty frustrated and won't come back to the breast.

    Where baby stays: He's pretty much attached to me all day and night. We bed share and I carry him in my arms or a carrier during the day. He spends a lot of time upright (carrier and sitting on my lap).

  5. #5
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    Default Re: Nursing taking a turn for the worse, doubting myself...

    I don't think there is some specific flow that would be a fast flow. Basically if baby thinks the flow is too fast it's too fast. Some babies love a fast flow and some babies have difficulty. Sometimes there really is an issue with latch that makes it particularly hard for a baby to handle "normal" flow. Assuming that is not the problem, here is what I suggest for bby having an issue with fast flow.

    Adjust nursing position. This usually means laid back or sidelying, but that does not mean that always works the best. My middle child preferred if I sat more up, but he was in a straight up and down position (think baby giraffe) So I often nursed him on the couch, siting toward the edge of the couch, so his legs had room to hang down between my legs. (He was a big baby)

    Nursing frequency. After having three children and a experiencing fast letdown with all three, I am more and more convinced that nursing frequently is key to helping baby manage fast letdown.

    Avoiding bottles and pumping. Pumping, you run the danger of further increasing milk production, making fast letdown worse. Bottle feedings tend to increase the time between nursing sessions, making fast letdown worse.

    Letting/encouraging baby to nurse one side at a time. This is usually plenty if baby is nursing frequently enough and mom has fast letdown.

    Time. Fast letdown accompanies overproduction the majority of the time. Most mothers with overproduction see that issue lessen considerably sometime between 6 weeks and 4 months all on its own, unless they are doing something to prolong overproduction, like taking galactagogues or pumping too much or unnecessarily.

    As I said, I had OP and fast letdown with all three of my kids. All are the picture of health. The kind of kids the pediatrician smiles joyfully when they come in the door. Yes it could be a challenging issue in those early months, but in the long term it never hurt them a bit.
    Last edited by @llli*maddieb; December 18th, 2015 at 08:31 PM.

  6. #6
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    Nov 2015
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    Default Re: Nursing taking a turn for the worse, doubting myself...

    Thanks again, Maddieb. I've done the laid back and sitting up positions, but maybe I need more practice. We have not been able to do side lying because he gets frustrated so I only try for a few minutes.

    Regarding more frequent feeding, we've been doing that and he still gets frustrated, but maybe there is still time before it will naturally even out? He's 10 weeks. Lately the feedings have been super short - 10 minutes tops and only one breast. I have a hard time believing that this is all he needs since he used to nurse for an hour or more just a week or two ago. I'm willing to stick it out with the fussiness, but I worry about whether he is actually getting what he needs. Diaper output is down but within the range considered acceptable by his pediatrician and with the fussiness it is hard to tell whether or not he is "satisfied" at the end of a feed. My breasts feel pretty soft most of the time so I can't tell if he has "softened" them enough during the feed. If I go by diaper output alone, will I be missing some red flags?

  7. #7
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    Default Re: Nursing taking a turn for the worse, doubting myself...

    Has there been some issue with weight gain being slow up until this point? Weight gain, accurately measured, is your best indicator. However, if baby is gaining slowly, then I have to wonder if the issue is fast letdown at all, as that would be atypical of fast letdown.

    By about 2 or 3 months, you cannot go by how you feel, because even if baby is getting lots of milk, most moms start to experience breast softness even in between sessions around this point, and if baby is nursing more frequently that is even more likely. You cannot go by output, since many babies normally stop pooping daily after 6 weeks, some even going several days between poops. (Wets alone are not enough information to draw conclusions about adequate intake.) You cannot go by how long baby takes to nurse, because as baby gets bigger and stronger and better at nursing, many babies indeed can get plenty of milk in 10 minutes. Or less.

    But unless there has been a slow weight gain issue prior to this, as long as baby is nursing at least 8-12 times a day, or you have done anything to decrease your milk production, it is unlikely that gain would suddenly become an issue.

  8. #8
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    Nov 2015
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    Default Re: Nursing taking a turn for the worse, doubting myself...

    I appreciate the response!

    No issues with weight gain so far. He was born 7lbs 7oz, lowest weight was 7lbs 3oz (hospital discharge) and was 13lbs at his 2 month checkup. What concerns me is the sudden decrease in feeding duration. If he was gaining great with 1 hour feeds, I worry what 5 minute feeds mean. The change was so sudden, pretty much overnight.

  9. #9
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    Default Re: Nursing taking a turn for the worse, doubting myself...

    It can be completely normal to go from long, leisurely feeds to very short ones. Sometimes it's related to an uptick in mom's milk supply- more milk in the breast means faster letdowns and baby getting full faster. Sometimes it means that baby has simply become a much more efficient feeder, and can now get the same amount of milk in 5 minutes as he used to get in 20. If fast feedings worry you, you try to offer more often, and you keep a careful eye on pee/poop output and weight gain. As long as those two things continue to be normal, you don't need to worry. If they aren't normal, you see the doctor because it's very unlikely that a healthy baby who has been nursing well for 10 weeks and maintaining a good supply for 10 weeks is suddenly unable to maintain your milk supply or withdraw enough milk when nursing.

  10. #10
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    Default Re: Nursing taking a turn for the worse, doubting myself...

    with mommal. 10 minutes is plenty of time for many a baby this age to get enough milk, especially if mom has fast letdown. Additionally, if you are encouraging baby to nurse more often, that will often result in baby nursing a shorter amount of time each time as baby needs smaller meals. Small feedings are easier to digest, so this is not a problem. It may be baby is simply getting better at regulating intake and is stopping when baby is full.

    So I am looking at the weights. If my math is correct, and please check it, baby is gaining faster than average, which you would expect when mom has OP. Guessing baby was discharged at a week old (I realize it was probably a few days earlier) and that the 2 month check was at 8 weeks, then baby gained almost 5 pounds in 7 weeks. This would be an average gain of ~11 ounces per week. At this point I think it is entirely normal for a baby who has been gaining so well to move to shorter sessions. Also be aware that gain rate begins to slow after about 3 months, typically. If a baby has gained quickly before that, as your baby has, sometimes that drop off is dramatic. This is entirely normal.

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