Frantic at the breast....please help

[can01b]

I am a first time mom and have a 7 week old baby boy.  Since he was about 2-3 weeks old, he has had trouble breast feeding.  He feeds well for the first 5-7 minutes until the milk flow slows down and he has to wait until the next letdown.  This can take 1-2 minutes.  During this time he becomes very frantic.  He starts kicking, pulling my nipple, and crying.  I have tried so many things, but nothing has worked.  We tried switching to the other breast once the milk slows.  This works until the milk flow stops in the other breast and then he becomes upset again.  We were struggling through each feeding, but were continuing to do so because his weight gain was so good.  However, I had to return to work last week so he was receiving pumped milk in a bottle 3 times a day.  Since we started this his behavior is worse.  He now becomes frantic after 3-4 minutes and starts screaming until you give him a bottle.  I have talked with 3 of my best friends who have successfully breast fed their children, as well as 2 lactation consultants.  No one has had any suggestions that worked. 

I spoke with one of the LLL consultants last week about the behavior.  She was very helpful and had lots of ideas, but unfortunately none of them helped this weekend.  She recommened lots of skin-to-skin contact, walking while he feeds, and trying a dental syringe when he becomes frantic.  We tried the syringe but placing it just on the inside of his cheek made him gag.  I can't continue to watch him scream and cry at the breast.  For the past 24 hours I have been pumping and giving him a bottle.  He is much happier, but I am sad about the situation and don't know if I will be able to keep up with him exclusively pumping.  I am only pumping bout 3-4 ounces every 3 hours and I believe he would take 5-6 ounces every 3-4 hours if I would give it to him.  I know if he is happier I should not be selfish about the problem.  I just really wanted breasting to be successful for both him and I.  Any suggestions? 

[cmailliw]

Hi,

I am sorry to hear that the nursing is not going well for you and your son.

Has he been checked by his pediatrician lately?
What did the doctor say?

Babies do like good flow of milk.

Lots of skin-to-skin contact is helps to coax the baby back to the breast. 
This contact triggers instincts your baby has to seek the breast and latch on.
Sometimes a warm bath together will relax baby and he will latch on to nurse.
If you notice baby in a light sleep, you can scoop him up and he may nurse. 
You can see that his little eyes are moving under his eyelids when he is in a light sleep.

If baby's caregiver is willing,
your milk can be offered to your baby by means other than a bottle while you are separated. 
He could be cup-fed with a small medicine cup,
 syringe-fed in the corner of his mouth,
 finger-fed with a lactation aid,
 or even spoon-fed. 
This may take time and may be messy but it would help him forget about the bottle.

When using a bottle, it is good to use a slow-flow nipple.
This page describes paced bottle feeding which interferes less with breastfeeding.
http://www.kellymom.com/bf/pumping/bottle-feeding.html

If possible, it would be good if someone else gives him the bottle at home,
so that you can just be associated with nursing.

Yes, you want your baby to have happy thoughts at the breast.   
It is best not to force the breast on him.

You may have better results if you offer the breast when he is not very hungry.
Or else give your milk by the other means or bottle for awhile to take the edge off of his hunger,
 then offer the breast.

A good time to get him to nurse is when he is sleepy. 
He may be more willing to try it then.
Walking while nursing is good to distract him. 
You might try to nurse him while wearing him in a cloth sling. 
The closeness when he is being carried with his tummy facing your tummy is helpful.

Anytime you notice he is putting something in his mouth or is making mouth movements,
you can try offering the breast for him to suckle instead.

There is no schedule with nursing. 
His hunger cues are alertness, mouth movements, hands to mouth; 
you know the signs I'm sure. 
Crying is a late sign of hunger.

This page on kellymom.com on coaxing the baby back to the breast is full of helpful tips. 
http://www.kellymom.com/bf/concerns/baby/back-to-breast.html#coax

If your baby does not empty the breast at a nursing,
you might want to pump then to keep your milk supply up. 
The more times the breast is emptied, the more milk you will have.

When you are off from work try to nurse all you can. 
If he won't nurse then pump at least every 2-3 hours  with a good pump. 
A hospital grade pump is the best kind of pump when you are doing pumped milk only breastfeeding.

It is normal for your milk supply to be down at the end of the work-week. 
When separated from baby you need to pump every two-three hours.

Any time your baby spends at the breast is worthwhile. 
You really have done well to nurse him.

Let us know how things go if you can.

Best wishes

[Kathy]

((((((((((((hugs)))))))))))))))
It is always so frustrating when baby gets frantic at the breast. I know I sit there saying "But its right there!"
Some more things to try-
Will your baby still swaddle?  

Breast Compression when the flow slows down
http://www.drjacknewman.com/help/Breast-compression.asp

Are you still paying close attention to positioning?  
Ear, shoulder, hip of baby lined up.
Baby facing you.
No gaps between your bodies?

I am so sorry- I have to come back to this later. If no one else answers tonight please feel free to call me tomorrow morning after 8:30
(I'll be away from my computer)  Here is my number
601-415-0671

Kathy

[Lorijaubert]

Your baby has excellent weight gain - good for you for sticking with it!   I'm sorry if separation and pumping has led to more challenges, but I'd encourage you to hang in there.   It could be that your baby's crying fits are caused by a growth spurt.  It's about the right time for one of those.  He may have an impatient personality, so it's a good thing that you are being so patient with him.

The leaders here have made some terrific and knowledgeable suggestions and I hope you will find some help in them. Just keep in mind that you know the full picture of what is going on in your family while I and others do not, so what you should really do is trust your own instincts.  Whatever seems to be the right course, whether it be to duck your head and keep on your current course, or try something new, is up to you.  You have a lot of experience with *your* 8 week old and it certainly sounds like you've done well by him so far, so I believe you have the strength and know-how to face these new challenges armed with your own experience, maternal ingenuity, and PERHAPS our suggestions, as well that of others you've spoken with of late. 

Please let us know how things go with you and your family.  

Lori

[can01b]

I want to thank all of you for being so helpful and supportive.  You have given me lots of good tips.  I did take him to the pediatrician and he said he looks great but that I just have an impatient baby.  We try to feed him as soon as we think he is hungry.  We have tried so many things....skin-to-skin contact, warm baths, breast compression, ect.  I wish I did not have to use a bottle at all.  However, I work about 10 hours a day and the daycare workers are too busy to take the time required to feed him in other ways.  I was not aware of paced bottle feeding so we will try that.  I hope it works, but he is such an aggressive eater that when my husband tries to burp him half way through the feeding he just screams and cries.  I try to catch him when he is still sleepy and it does seem to be a little better. 

Again, I really appreciate the advice and support.  I am not giving up yet.  I pumped every 2 hours yesterday and today when I tried to feed him at the breast he fed for about 3-4 minutes on each breast and then I pumped.  I will continue doing this as long as I can! 

Candice

[espresso2go]

*hugs*

How is it going now? Have breast compressions helped at all?

Here's another webpage that you might find helpful:
http://www.kellymom.com/bf/supply/letdown.html

Here's another great resource that describes paced feeding:
bfar.org/bottlefeeding.pdf


I would recommend sharing the paced feeding information with your daycare provider (DCP) and ask them to be SURE to pace your baby's feedings at the bottle. Many daycares are short staffed and short on time, so they sometimes rush through feedings so that they can move on to the next baby that needs their care. I encourage you to talk to your DCP about your baby needs and how you would like him to be fed.

Would it be possible for you to go to your baby on your lunch break? Nursing upon drop-off, during lunch (if possible), and upon pick-up will decrease the total number of bottles your daycare will have to feed and decrease your baby's exposure to fast paced bottle feeds (especially if your DCP is reluctant to try paced feeding).

Best wishes!

[Lorijaubert]

I know this is a little late, but after my first response, I was reminded that sometimes nursing baby more frequently, even for shorter durations, during times like this might be beneficial, in both increasing supply and helping your impatient, little one feel more satisfied.  I seem to remember my baby boy acting up if I didn't nurse him every 30 minutes for a week or so!  Not practical to do that, I know, but it was just a phase he went through. 

[can01b]

Sorry it has taken me so long to reply.  Unfortunatly, my son continues to have a problem waiting on the next let down.  The breast compressions helped a little, but not enough.  Since I work all day I was not able to increase his feedings on the breast very much and the paced bottle feedings don't seem to make a difference.  He still quickly cries if we take the bottle out of his mouth before he is finished.  But the good news is he is still getting breast milk and no supplementation!  I am exclusively pumping and although it is very hard to pump 7-9 times a day, it is working.  I still attempt to feed him on the breast at least once a day and sometimes he does well during the night if he has slept 4-5 hours and my breasts are engorged.  He doesn't have to wait then because there is so much milk already there.  So far I am able to pump more than he is taking in the bottle.  He is doing well and growing like a weed.  I just want to say thanks again for all the suggestions and support.  Hopefully with the next baby it will be a little easier! 

[Lorijaubert]

Wow, that's a lot of pumping - I'm so proud to hear that you and your little one are managing so well, and that you're able to provide him with breast milk without supplimentation - YAY!