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Thread: 2 week old very angsty while breastfeeding

  1. #1

    Question 2 week old very angsty while breastfeeding

    Hi there! I'm really hoping someone can help me with this. I had my baby just under two weeks ago, at 37 weeks. She had jaundice, and we were re-admitted to the hospital for one night for some photo therapy. She had also lost 8% of her body weight since birth, so our pediatrician has us supplementing her feedings with about 2 oz of breastmilk from a bottle (she'd like for her to get up over 7 lbs again). My baby gets extremely fussy now during breastfeeding, right at the start. She screams, claws at her face, claws at my breast, scratches her face, and even pulls at her ears and hair. I'm trying to relax and breathe through these episodes, and if I'm lucky, she'll calm down and nurse for about 4 or 5 minutes…if I'm unlucky, she'll go from 60 to zero, and will pass out in the middle of fussing. Alternately, she is 100% calm when I start feeding her the bottle afterwards. I've become grateful for the bottle, only because I know she's actually getting some nutrition, and getting full. Each feeding session is now clocking in at over an hour between breast and bottle. I am so frustrated, and am worried that she now prefers the bottle to the breast, which I had ultimately feared. Does anyone have any insight on this? Thank you in advance!

  2. #2
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    Default Re: 2 week old very angsty while breastfeeding

    Hi and welcome.
    When a two week old baby is unable to transfer enough milk while nursing to gain normally, and consequently requires supplements of mom's milk or formula, that is one of the two situations where I think seeing a board certified lactation consultant (IBCLC) asap is definitely called for. (the other is un-resolving nursing pain for mom.) Have you seen an IBCLC for an in person, private consult that lasts at least 60 minutes? If not, Would that be possible for you? If you did, and are still struggling, can you contact the IBCLC again for follow up?

    Babies this age are unlikely to prefer the bottle on any kind of permanent basis, although as time goes on the risk increases. If baby is upset at the breast, that possibly suggests a problem with milk transfer.

    Of course, some fussiness. popping off, and the other behaviors you describe are entirely normal. It is a matter of degree and whether baby is getting enough milk or not.

    Here are some general tips I suggest.

    Encourage baby to nurse frequently. No need to wait until baby "cues." Normal nursing frequency at this age is 8-12 times in 24 hours AT LEAST. More frequent nursing may reduce feeding length, but long nursing sessions are the norm as well at this age.

    Once baby is latched, if you think the milk flow might be a little slow, try breast compressions to help baby get more at the breast. Switching sides a few times during the feeding might help here as well.

    Consider an alternative to bottles for supplementing. Open cups, spoons, or syringes all work well and may reduce the risk of bottle preference. Paced bottle feeding may help as well, but in my opinion, when baby is this little and only needs a little bit at a time, bottle alternatives can work really well. At this age supplements usually need not be much at a time at all- a half ounce to an ounce at once is usually ample. (Obviously this amount depends as well on how much milk baby is transferring at the breast, which again is something to get professional help to try to figure out.)

    If baby is upset, try giving baby a little milk in a spoon etc. before baby nurses and then try at the breast again. Supplementing before nursing at least some of the time, instead of after, may also help reduce the risk of breast refusal and also may help you with your time management, always a challenge when mom is pumping and supplementing as well as nursing.

    If supplements continue to be needed, it might make good sense to get an at the breast supplementer so some or all supplements can be given while baby nurses. Greatly reduces risk of bottle reference and helps with time management, plus baby learns to nurse better while being supplemented.

    Please let me know if you would like more info on anything I have suggested.
    Last edited by @llli*maddieb; April 15th, 2016 at 12:28 PM.

  3. #3
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    Default Re: 2 week old very angsty while breastfeeding

    I forgot to add, also try positioning adjustments. Try anything you like, there is no wrong way to position baby, but I do suggest trying laid back positioning (mom leaning back, baby kind of on top) and play around/adjust as needed. Try to bring most of baby's front and her limbs in contact with your body. Sometimes the face clawing etc. is misdirected kneading behavior. It is normal for a baby to clutch at mom and knead the breast. if it is hurting, try cutting or biting and/or filling her nails.

    More on this positioning idea: http://www.nancymohrbacher.com/blog?...+Breastfeeding

  4. #4

    Default Re: 2 week old very angsty while breastfeeding

    Oh my! Thank you for such a detailed and thoughtful response! I have met with an IBCLC, who was great, and got me started with the football hold and the cross cradle hold, but I'm very interested in learning more of a variety, especially holds that are more portable. Perhaps I should schedule to meet with her again. Yesterday, I tried feeding more often after your initial response, and that helped tremendously with the angst and fussiness. I'll certainly try the hold from your latest response, though I'm not entirely sure I'll be able to do it, as so far, my baby will only nurse with a nipple shield (my nipple shape is not as pronounced as she would like). Thank you again for getting back to me on this - it is much appreciated!

  5. #5
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    Default Re: 2 week old very angsty while breastfeeding

    You are welcome. I m glad nursing more often helped. Since you are using a shield, here are a few more thoughts. I also used a shield with my oldest child.
    Nipple shields can be helpful tools, but the 'problem' they address is usually a temporary one. I doubt there is anything about your nipple shape that your baby does not prefer- but learning to nurse can take time, and a more pronounced/firmer nipple is easier to get a good latch on for a few anatomical reasons I will not bore you with. Many things that are happening in the early days contribute to a less firm, less pronounced nipple (medication, mom being engorged, fluids during delivery, etc.) These are all temporary issues. Nursing itself with act to 'draw out' the nipple. So anytime you feel up to it, you can start the process of weaning baby off the nipple shield. That will make nursing less fiddly for both of you. Learning to help baby get a better latch without the shield, using a variety of positioning and latch techniques, will help.

    Nipple shields have one possibly serious drawback, and that is that they may reduce milk flow and possibly, over time, act to reduce milk production. So when using shields it is important to monitor weight gain and/or the frequency of baby's poops. Also, it may be smart to keep pumping a few times a day even if you have reduced or eliminated supplements. It is not always needed, but is a smart precaution when shields are used. Of course if it becomes clear you are making enough milk, then you can ease off pumping.

    This article is a good overview of many latch and positioning ideas. If any interest you further I can send links to more info about most of them. http://feedthebabyllc.com/latch-and-positioning/

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