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Thread: 2 month old fussy at the breast, HELP!

  1. #1

    Unhappy 2 month old fussy at the breast, HELP!

    Hello there! I'm going to start with a little back story. My 2 month old, ever since she was around 5 weeks old has been battling with acid reflux and stuffy colds. She recently also just recovered from RSV. We've always battled fussy evenings. At around 6 o'clock it's game on. She'll scream for an hour or so until she gives in and nurses to sleep. Recently, it's been extending into daytime hours. Sometimes it seems like she just screams at the breast all day. She'll suck on her hands so I assume she's hungry. That's always been her hunger cue. Lately, she'll scream if I try to give her the breast but if I put her on my shoulder she'll try to root and suck then get frustrated. We went to the doctor a week or so ago and she only gained 5 oz. which is abnormal for her. She's had healthy weight gain before all of this. She averages about 8 oz. to 1 lb. a week so I'm a little worried. Especially since the doc wanted me to watch for signs of dehydration, which has me on edge. I called the doctor and we're going to try some Zantac but i'm hoping to get some advice that might help even if the medication doesn't work. Thanks guys in advance!

  2. #2
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    Default Re: 2 month old fussy at the breast, HELP!

    Hi, I am sorry you are having this difficulty. I have a bunch of questions, I am sorry but it will help us troubleshoot to know more.

    Can you possibly give us a complete weight check history? A list, with weight and day or week of life?

    Also note when different scales were used, or if for any other reason you think the weight check may have been done incorrectly or the number recorded incorrectly.

    Does baby still poop every day? If not, when did poops frequency start to reduce? How much did baby poop when gaining more rapidly and about how often does baby poop now and what does it look like and about how much is it each time (estimate- such as, teaspoon, tablespoon, ladle...)

    This is the prime age for colic. Colic can be very hard to live through for everyone, but it is not in and of itself anything medically serious. So whether or not baby is truly not gaining normally or not is key. And if baby is not gaining normally, why. A fussy baby who cries a lot who is gaining overall normally there is probably no problem.

    baby gained pretty fast early on it sounds like. Did you ever notice signs that you were overproducing or that your milk flow was particularly fast? If so, has that changed?

    It would also help to know how frequently baby nursed (how many times total in 24 hours) before 5 weeks, and how that total daily number has changed since 5 weeks. I am assuming baby is only breastfed- if baby gets bottles of your expressed milk or formula, please include that info as well- how much and how often for each.

    You say baby is "battling acid reflux." How was that diagnosed?

    When baby is fussy, crying, won't nurse, does anything calm baby even temporarily? Such as changing sensory input (noise of a loud fan or vacuum, movement, going outside, etc.) Does baby seem to prefer being held upright? Or some other way?

  3. #3

    Default Re: 2 month old fussy at the breast, HELP!

    Q: Can you possibly give us a complete weight check history? A list, with weight and day or week of life?
    A: Yes!
    1/25 (birth): 7 lbs. 10 oz.
    1/27 (2 days): 7 lbs. 4 oz.
    1/29 (4 days): 7 lbs. 8 oz.
    1/31 (6 days): 7 lbs. 10 oz.
    2/8 (2 weeks): 8 lbs. 10 oz.
    3/10 (7 weeks, 2 days): 11 lbs. 8 oz.
    3/20 (8 weeks, 5 days): 12 lbs. 11 oz.
    3/28 (9 weeks, 6 days): 13 lbs. 2 oz.
    4/7 (11 weeks, 2 days): 13 lbs. 7 oz.
    All of these weights were taken at her doctor's office on the same scales.

    Q: Does baby still poop every day? If not, when did poops frequency start to reduce? How much did baby poop when gaining more rapidly and about how often does baby poop now and what does it look like and about how much is it each time (estimate- such as, teaspoon, tablespoon, ladle...)
    A: Yes, she poops about every diaper change. 1-2 tablespoons, wet, mucousy, yellow green. I noticed that week she had very little almost green sticky poop that was quite a bit different. She's back with good stool this week.

    Q: baby gained pretty fast early on it sounds like. Did you ever notice signs that you were overproducing or that your milk flow was particularly fast? If so, has that changed?
    A: I've had oversupply issues with all my babies and a very rapid let down. No, it hasn't changed, I believe.

    Q: It would also help to know how frequently baby nursed (how many times total in 24 hours) before 5 weeks, and how that total daily number has changed since 5 weeks. I am assuming baby is only breastfed- if baby gets bottles of your expressed milk or formula, please include that info as well- how much and how often for each.
    A: She's only breastfed. No bottles as of yet. Before 5 weeks it was about every hour. After I want to say about 4-7 times a day. Sometimes she feeds 5 minutes, sometimes for 20. Some days she eats more some days less. She's not an impossible baby to schedule.

    Q: You say baby is "battling acid reflux." How was that diagnosed?
    A: She vomits at times, lots of spit up, choking, gagging, sputtering, arching of back. She went in a few times because of these issues and the doctor finally gave her a prescription for Zantac.

    Q: When baby is fussy, crying, won't nurse, does anything calm baby even temporarily? Such as changing sensory input (noise of a loud fan or vacuum, movement, going outside, etc.) Does baby seem to prefer being held upright?
    A: Since she's been about 4 or 5 weeks she refuses to be held like a baby. You can only handle her upright without her getting upset. Usually I have to get up with her upright on my shoulder and bounce/walk. This soothes her but not for long.

  4. #4
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    Default Re: 2 month old fussy at the breast, HELP!

    Great, thanks. So, first, that is a lot of weight checks! I assume that is because baby has been ill so you have been in to see the doctor a lot. The bad thing about so many close together weight checks is that normal and expected changes in rate of gain might seem alarming.
    So it might help to first step back and look at overall gain. Since baby was back to birth weight at day 6 as would be normal, I will throw out the first few and go from day 6.

    So this is interesting. Between day 6 and the 2 week check, a total of 9 calendar days, baby gained a whole pound! This averages out to 1.75 ounces a day or about double typical average gain.
    Then from 2/8 until 3/10, or 30 days, baby gained almost 3 pounds. Again, much faster than the general average, but a tiny bit slower than before. Per day average for your baby was a little over an ounce and a half a day.
    From 3/10- 3/20, 10 days, gain averages faster than ever, 1.9 ounces per day.
    from 3/20 to 3/28, 8 days, gain is 6 ounces. So, that is a big drop in gain rate, but with it, baby is only down to what would be considered normal average gain.
    Then from 3/28 to 4/7, 9 days, baby gains 5 ounces, which is dipping every so slightly below average gain, but is not terrible gain especially because baby gained so fast before and is two months old at this point.

    So, what does this mean, and what does it not mean?

    First off I do not see how your baby could be dehydrated. Not with close to normal gain and pooping that much. It does not make sense.
    There is a clear drop off in gain rate after 3/20. But is that a problem? Maybe, but not necessarily that big of a problem. Here is why. No baby gains exactly the same one week to the next. Increases and decreases in gain rate are entirely normal.

    To put this into another perspective, we can imagine you had brought baby in for that 7 week check on 3/10 and the next check was one month later on 4/7, with no checks in between. After all if baby were not ill, that is more like the typical spacing for checks.
    Between 3/10 and 4/7, 4 weeks, baby gained 2 pounds. The exact average gain for this period. So if those were the only checks, baby's gain would have been seen as entirely normal and unless the doctor noticed some other signs of illness or poor development I do not think there would have been any alarm.

    On the other hand, since we have it, we can look at this history and see something that may be unusual. Your baby gained much faster than average up until 3/20, nothing wrong with that. But then very suddenly gain dropped to average and then even a little below average quickly. So the question is, what happened after 3-20?

    But do not forget, it is natural that gain would slow down somewhat. All babies see a slow down in gain rate at around 3-4 months of age. If a baby gained very quickly early on, as this baby has, then the slowdown could normally be both earlier and more dramatic than typical. Yet, this slow down is so early and dramatic I think it means something, but I do not think it means your baby is in any danger of dehydration or in not getting enough to eat at least not yet. You report that your baby has been ill. Illness would easily explain a temporary reduction in weight gain rate. Also, it sounds like baby dropped down a huge amount in nursing frequency. You could look no further than that for an explanation for slow down in gain.

    Ok, I hope that did not just confuse you further. Here are some more thoughts.

    A: Yes, she poops about every diaper change. 1-2 tablespoons, wet, mucousy, yellow green. I noticed that week she had very little almost green sticky poop that was quite a bit different. She's back with good stool this week.
    A baby who is pooping that much is not dehydrated, I promise. You may see a reduction in frequency of poop out put now (or any time after this age) do not let that scare you, it is normal and expected. Also green poops are not "bad" they are in the range of normal color. On the other hand, illness or over production might cause green poops.

    A: I've had oversupply issues with all my babies and a very rapid let down. No, it hasn't changed, I believe.
    Ok that makes sense. OP is indicated with that very rapid gain. You have not tried to block feed or anything else to reduce production have you? If you have been doing that, I think you should stop because of the slow gain.

    After I want to say about 4-7 times a day. Sometimes she feeds 5 minutes, sometimes for 20. Some days she eats more some days less. She's not an impossible baby to schedule.
    Wow that is a huge drop in nursing frequency. So that alone would explain any slow down in gain. A baby this age usually needs to nurse at least about 8-10 times a day. Yes it would vary day to day, but while there is no need to do any feeding schedule with a baby, it is important they nurse often enough overall. So, no matter how much you offer baby will not nurse more than 4-7 times a day? This could be a problem. How are you feeling? I mean, are you feeling really full with such a big drop in nursing frequency? I have OP too and I often had to encourage my kids to nurse often enough so I did not get uncomfortable.

    The other problem with such low nursing frequency is that it tends to make fast letdown worse. (the longer milk sits in the breast, the faster the letdown) Fast letdown, if it bothers baby, might explain baby not staying at the breast longer or not wanting to nurse more often. So weirdly, getting baby to nurse more might get baby to nurse more, if that makes sense. So I think encouraging baby to nurse more often is something to try (or keep trying if you are already doing that.)
    She vomits at times, lots of spit up, choking, gagging, sputtering, arching of back. She went in a few times because of these issues and the doctor finally gave her a prescription for Zantac.
    I am not saying your baby does not have reflux, however these are all considered signs of OP and fast letdown.

    : Since she's been about 4 or 5 weeks she refuses to be held like a baby. You can only handle her upright without her getting upset. Usually I have to get up with her upright on my shoulder and bounce/walk. This soothes her but not for long.
    Do you mean she does not typically like to be held "cradled" on her back? None of mine liked that either. A baby preferring to be held upright is entirely normal. But this could be another sign of possible reflux. Both being on their backs or cradled so they are in a "C" position is uncomfortable when a baby has reflux.

    Ok sorry for the long post.
    Last edited by @llli*maddieb; April 15th, 2017 at 04:52 PM.

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