Snacking at the breast, then nurses to sleep.

[kandashee]

Hi everyone!  I am hoping to get some help about an issue I'm having with my little one snacking during the "E" time and then having a short "A" time before he's hungry again and then goes to sleep.  His naps seem short if I deny him the breast before he sleeps...probably because he's hungry.  How can I get him to eat a full meal during "E"?  I've tried a 2.5 and 3 hour EASY, but in both situations this happens.  I think part of the problem is that he doesn't want to work to stimulate multiple milk ejections, and just gets one on each side then calls it quits.  He takes in about 2 oz. and feels somewhat satisfied for his short "A" time, but then seems to want more.  When I try to get him to relatch, he cries and refuses.  I'm going kind of insane with this unpredictability...any advice would be greatly appreciated. Thanks a ton!  Keri

[~ Vik ~]

Hi Keri, and welcome to the boards!

Could you post what your day typically looks like?  Feeds, A time, naps, nights?  And how old is your lo? Any reflux issues, allergies, or the like?  Teething?

[kandashee]

Thanks for your response!  Sure - my lo is 11.5 weeks.  Since the beginning we've had breastfeeding issues and have been seeing a lactation consultant.  Apparently, she thinks that my baby's tongue isn't cupping correctly and therefore it is tough for him to get milk ejections.  Our day looks roughly like this (this is what it was today):
7am - wake and feed
7:40-8:20 - Activity
8:20 - Nap (doesn't last long - 30 mins at most - maybe because he's not full??)
8:50-9:10 - Awake time before next feed (refuses to continue napping)
9:10 - feed
10-11 - Nap (Again, doesn't last very long.  His naps in his crib last the shortest.  The swing, car, Bjorn seem to be best.)
11-11:30 - Awake time before feed
11:30 - feed
12-12:45 - Activity
12:45-1:30 - nap
1:30-2:15 - Awake time before feed
2:15 - feed
2:45-3:15 - Activity
3:15-5:30 - nap (usually a longer one)
5:30 - feed
6:00 - bath and wind down
6:45 - cluster feed
7:00 - bed
10:00 - Dreamfeed
Anywhere from 1:30-4:30 - Middle of the night feed
Anywhere from 5-7 a.m. - Wakes up.  If he wakes up at 5, we try to put him back down until closer to 7.

No reflux or allergies that we know of, and I don't think he is teething yet.  Wondering if his "snacking" is really just all he can get because of his tongue.  I have been tracking his weight gain.  Two weeks ago he gained 14 oz. in two weeks.  Last week, I changed nothing (one bottle per day, the rest breastfeeding) and he didn't gain a single ounce.  Makes me feel so bad...like I am starving him (although his weight is fine and he's in the 50th percentile).  I just want him to be steadily gaining.  Sometimes I feel like my milk flows - no problem.  Other times, I sense he is getting frustrated.  I know it's not a supply issue because after his middle of the night feed, I pump about 4-5oz total!

Would love suggestions of how to manage this...TIA. 

[LifeGiver]

I had a similar problem.
In my case, my baby wouldn't feed well because she was too sleepy. It was like magic: she could be very alert on my arms, in her cot or whatever, I'd put her on the breast she would fall asleep in 5 minutes. And I was getting very upset because I was trying to put EASY into practice but I couldn't really keep her awake after the feed because it was such a huge workout to keep her awake to feed for 15 minutes...
I was very frustrated, routine not working, baby not gaining weight properly, so I talked to a lactation consultant. I found out my milk supply was low because she was not feeding much in the first weeks. Now we're managing to put things on track because I solved the milk supply problem.

If I were you, I'd concentrate on solving his feeding problem first, then focus on the EASY routine. That was what worked for me. I was demand feeding until maybe 2 weeks ago and by baby is now 3mo. It was tough, yes, but it was worth it!

[~ Vik ~]

If you're seeing a LC in real life, that's fantastic!  When there are breastfeeding issues there's nothing better than having someone experienced be able to help you out

Wondering if his "snacking" is really just all he can get because of his tongue.

It's definitely possible...  What does the LC think?  And if that is the case, I would do as pp suggested and feed on demand.  It's not EASY, true, but you have to do what's best for you and your lo!  For example, many reflux babies do better on small, more frequent feeds, so their routines look more like EAEAS.  You could always do something like that too, even just for a week or so, to see if it makes an impact on weight gain.
Looking at your routine and knowing that he takes smaller feeds, I wonder if your short naps could be caused by hunger - might explain why he resists extending so much?  Just guessing though...  When you do A time before a feed, what is his behaviour like?  Is he fussy or giving hunger cues at all, or is he generally happy?

Sometimes I feel like my milk flows - no problem.  Other times, I sense he is getting frustrated.

Have you thought about pumping or hand expressing *just* to the point of let down?  Especially later in the day, when milk supply is lower, that might help prevent him from getting frustrated?  There would be some more instant gratification for his efforts.

I'm going to see if I can get someone to take a look at your routine in general.  Though I'm good with breastfeeding, I'm not so hot with routine tweaking!   Your nights look really good though - a dreamfeed and one (even 2!) night feeds is great at this age! 

[kandashee]

Lifegiver - Thanks for the advice.  I think you're right - I need to work out feeding before I can worry about a routine.

Vikki - Thanks so much for your thoughts.  I am working with a great lactation consultant.  She is stumped, but she seems to be leaning toward the fact that his tongue is making it difficult for him to eat well.  It's weird though because once in a while a feeding will go great!  You'd think if his tongue was the problem, every feeding would be bad.  I do think that his short naps are because he wakes up hungry...although, that "A" time before feeding, he's usually pretty content.  He doesn't show any hunger signs, and when he does, I feed him.  That said, I'm sure if I put him to my breast right after waking up from a short nap, he'd eat...just not sure how much.  He's a tough one to read!  Maybe I'll just go with a modified EASY for now (EASYAE) until he starts to eat and nap better.  My other thought was that we both have thrush.  We were treated for it about a month ago (LO is still receiving treatment 4x per day), but I'm feeling like it might be coming back a bit.  Maybe his mouth is sore?  He does this chewing on his tongue thing too. And, sometimes he sucks his fists almost frantically.  Not sure if this is at all related, but I've heard thrush can make nursing painful.  Great idea to express until let down...I think I'll try it.  I've been giving him about an ounce from a bottle prior to feeding so that he gets satisfied and is more patient for the breast.  Then, he gets full on the breast and hopefully associates fullness with breastfeeding vs. the bottle.  I dunno - just trying out methods b/c I want him to gain weight! 

It's tough - I always envisioned breastfeeding to be so easy, but it's so hard!  Very worth it to me, but quite a challenge.  I am still hopeful that one day it will be easier for us.

Thanks for the encouragement about our nights - I do feel lucky in that respect.  Would love to have someone look at our routine!  Thanks so much again.

[Jiinx]

Hi there,
 Just wanted to jump in and take a look at your routine. From an A time perspective, the first A looks pretty bang on. If he's giving you a short nap, like 30 minutes, perhaps you could take it down to 1 hour and 10 minute and see if that makes a difference?

 You mentioned that he takes better naps in a swing/car seat? that set off a small alarm bell in my head - could he have minor or silent reflux? that would also make breastfeeding very painful. Some babies, like mine, would suck suck suck bc the milk would soothe her - other babies just don't want to suck bc the pain from the milk is outweighing their need to continue to suck. I don't want to scare you..but it is a possibility? Especially if the A times are correct. Does he feed better at night?

Just thought I'd post this link...
* http://babywhispererforums.com/index.php?topic=654.0
 
Other than that, if he short naps you - the next A time needs to be very short. It's basically a feed, then a diaper change and off to bed...

HTH?
sarah

[kandashee]

Sarah,

Thanks for your response and advice.  I will take a look at the reflux info.  I think it's more the motion that helps him nap better because at night he sleeps fine in his bassinet while lying flat.  Maybe there is some slight reflux though and that is causing the irritability while he eats.  He definitely eats best when he is sleepy.  In fact, I think he is pushing back against EASY because he likes to nurse right before he sleeps.  The feedings always seem the best then.  Yes, he seems to do better at night and in the evening before bed.  Also no problems with the dreamfeed, although he'll only take one side.  Does that sound like reflux to you?  He doesn't really have many of the other symptoms.  He does seem somewhat gassy, but I feel like that's pretty common.  I don't know...

So, what if he falls asleep while nursing (like he just did at 10:20)?  I hate to rouse him if he's beat.  This time, I just moved him to his swing...he woke slightly, but is now currently sleeping.  I just don't want to get in the habit of nursing to sleep.  I want him to be able to fall asleep on his own for naps just like he seems to be able to do at night.  That's why I like EASY...but I guess the most important thing for now is that he's gaining weight...

Anyway, thanks again!

Keri

[Jiinx]

It could be, dear. With reflux and eating - I'm afraid I only know the screaming part of it. There is a range though. Feeding better when sleepy could just be a comfort thing and trying to get sleepy. However, if he's squirming and not taking a lot in during the day and MORE at night then it is something to consider.

I know it's hard to rouse them when they're sleeping As he gets older, his memory is going to get better and he'll just want to feed to sleep - it's soo comforting for them! Having them rouse and just do a small activity will help them establish that connection that feeding does not equal sleep. Up  until a couple of weeks ago, I was giving my lo a feed before nap and doing my wind down after. Now that i've taken it out, she doesn't miss it - bc she didn't need that feed for her sleep.

Hope that helps? *hugs* We're here for you with whatever questions or concerns you have!

[~ Vik ~]

I'm glad Sarah jumped on!  She's much better with routine stuff than I am

Just wanted to add this link too that you might find helpful (don't know why I didn't think of it right away ):  http://babywhispererforums.com/index.php?topic=63428.0

[suevcameron]

Hi - just thought i'd add something. My DS always screamed when i fed him from ab out 8 weeks til i can't remember. After much experimenting i realised that he was really sensititve to caffeine - if i cut it out the screeming seemed less. The other thing that really helped was hand expressing off the first part of my milk. I had a really strong let down, this seemed to mean that when the milk slowed down he would scream, whether that was due to wind or frustration, i don't know. He would feed much better at night. Another thing that i remembered i did was wake my LO up from his naps so that he was sleepy when he first latched on, it seemed to help. Ewan's naps were always really hard work but am not sure if it had anything to do with feeding. He was spirited and very easily overstimulated and was very hard to read when he was tired and wind downs were hard so really struggled until he was about 12-14weeks, then it improved. The good news is with perserving with EASY he is a really good sleeper and has been for a very long time (he's 2 1/2 now). The reason why i remembere all this so well is because i have a 8 week old that seems to be doing exactly the same thing. Hope this is helpful.