4 week old suddenly very fussy while nursing!

[KMET]

My ds is 4 weeks old today and for the last day or so, he has been incredibly fussy while nursing unless he is almost asleep while nursing (generally night feeds are okay). He is okay at the beginning (so I don't think it is a let-down issue) but then after between 5-10 minutes he keeps unlatching and then relatching, but then he will only nurse for a minutes or so before doing again. During this time, he is grunting and waving his arms around at the same time. I will try and burp him, which sometimes is successful, but other time is not. I am quite confused at what can be happening because as a result his nursing time is much reduced and I am concerned he is not getting enough, although he is still having many wet diapers a day. Could this be something like reflux, or could he be such an efficient feeder that he is finished after 10 or 15 minutes? How long might I expect him to feed for at this age (I understand that there is a huge variability)? Thanks

[hlatreille]

It doesn't sound like he is an efficient eater simply because he seems aggitated by something, either he isn't getting enough and he is still hungry or it could be reflux. 

First, I would try doing a yeild on yourself to make sure you are producing enough.  He should be eating 2-3oz at a feeding at this age.

You really should be nursing at least 15-20 miutes per side because you want to make sure he is getting your hind milk.  If he is only nursing for 5-10 minutes, chances are he isn't getting that milk, which in turn could result in him not gaining weight (like what happened to me).  When I did a yeild I was shocked at how little I was getting even though my breasts felt full.  I eventually had to switch him to formula as he just wasn't gaining weight.

Don't worry, we will help you figure it out!!   

[KMET]

Thanks for the advice, can you remind me again how to do a yield -when do I do it - after a feed? before a feed? I have never pumped before.

[squeaky's mum]

Hi There,

I'm not really in a position to advise on whether your lo has reflux or is still hungry, but I was thinking you might find it useful to ask yourself some of these questions in order to figure out what is going on.

When your lo is having a feed, does he suckle for most of the 5-10 minutes that he is feeding, or does he have long pauses when he isn't doing anything? If the former - he may well be getting enough milk and just be an efficient feeder, if the latter, its less likely. My lo is 3 weeks old and has only ever really fed for 10 mins on one side at each feed every 2-4 hours.

Does he seem more unsettled between feeds? Is he waking more often for feeding? Both possibly signs that he is hungry.

Is he like this throughout the day, or is it at particular times of the day? I think very little babies often have an unsettled patch at some point. Tom is very unsettled between 8 and 10 pm. Your post describes his bhvr to a 'T'.

Is he putting weight on?
Have you noticed any changes in his weeing and pooing?

Just a word of caution about doing a yield. I have never ever been able to pump that much milk, so a yield could be very unrepresentative of how much milk your lo is actually getting. They are much more efficient at extracting milk than we are, especially when we are not actually practised at expressing.

Its unlikely that you are not producing enough milk. I would keep an eye on the situation for a bit longer and it will probably pass. My biggest lesson with dd has been that whatever challenge you are currently being faced with, it will pass, sooner or later.

Good luck, hopefully some of the more experienced Mums will also be able to help you out.

Claire

[binxyboo]

Hi there, and welcome to BW!

Congrats on your little one. I wouldn't worry about doing a yield. With my first lo, I breastfed him successfully for over a year, and could never pump much at all. The pump is not as efficient as your baby at all, I think it is more of a "learned skill" than anything.

You say diaper count is still good, this is great. My children would become fussy at the breast for a number of reasons, if they had gas, needed to be burped, were having a bowel movement, or if they were simply done and I was trying to get them to nurse longer. They can suddenly get more efficient overnight as well.

How long does your lo go between feeds when this happens? Also, at growth spurt times, Kate gets a bit fussier at the breast as well. When you end the feeding at that stage, how does your lo react to that? Does he calm down or still fuss?

Hang in there and don't panic. Your lo is still so young and it could be any numbr of things causing this, not neccessarily anything to worry about. Just keep an eye on diaper output, what goes in must come out!

[binxyboo]

Posted same time as pp, sorry for the repetition!

[Samuel's mum]

It sounds to me like an efficiency thing. My LO was never going longer than 10 minutes at that age and was doing just fine It is possible for some LOs to reach the hindmilk in a surprisingly short time.
My dd never went more than 10 minutes (often 5 minutes) and was going from the 9th to the 50th percentile at the same time. If I had tried to get her to continue at the breast she'd be behaving just as you describe I'm sure. Sounds like, "mum - I'm done" signals to me. If you have winded and ruled out gas I feel that's what you are seeing.

Kmet - I would get your baby weighed. Weight isn't everything but in this case it would give you a pretty immediate picture of whether you need to be concerned.

I agree with pps about a yield test. See our 'low supply' FAQ. This is an area the bf mods feel Tracy may have come to feel differently about if we were still lucky enough to have her with us.

[EllenS]

How long has it been since your lo pooped?  You say this behavior is only the last day or so.  When my lo was that age, she would sometimes go several days without a poo, and was fussy - hungry and wanting to eat, but no room because she was full of poo, if that makes sense.  I should think whatever it is, it will likely pass in a day or so - everything changes so fast at that age.

[KMET]

Thanks for all of your advice - we are going for our one month check-up tomorrow, so we will get a weight then. His diapers are wet with lots of poops so, I think that my supply is okay, but I guess you never know. Although he is feeding less, he still seems to be napping well during the day, going approx. 3 hrs between feeds. Although last night was an interesting night as he was up every 2.5 hours, and I am not sure if this is just what he needed, or if it was because he wasn't taking so much at each feed? He is so drowsy during the night that it is very difficult to feed him for much more than 10-15 minutes at best and it is so difficult to put him in his crib awake as i really cannot wake him! Perhaps this is contributing to him waking up more often. Maybe it is just that he is 4 weeks old - I am happy to get up to feed him if he needs it. I am hoping that as you say, this is just something that will work itself out in a few days. Perhaps he is going through a growth spurt.

[EllenS]

With that extra description, it does sound rather like a gs, 2.5 hour feeds would be quite normal for a gs at that age.

Hugs!  I know it's tough.