Author Topic: Breast Refusal or Forceful letdown?  (Read 2545 times)

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Offline olkan

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Breast Refusal or Forceful letdown?
« on: September 05, 2010, 09:04:06 am »
Hi,
DS is 3.5 months old. His feeds during the day are erratic and he only takes about 1/3 of the amount he'd used to take before (he had 1 feed at 3 am, no DF, which I consider STTN) - and now he's up every 2-3 hours, every time taking a decent feed, and wouldn't settle without one. I do try to feed right after the nap in the dark room, but it makes some difference, but not much, after 5 min he turns his head away and screams if I try to put him back on the boob.  I express what he had left in the boob (normally 60-80ml) and give it in the bottle, this way he probably takes further 30-40 ml, but I feel it's still not enough, and he used to down one breast and have a decent sip from the other one for each feed, now it's 1/2 breast only.
We moved to 4 hr easy but it doesn't seem to help. He holds it easy and doesn't seem to be too hungry. He actually refuses a feed at all when he wakes up in the morning, so I feed later during A time.
I have a spirited toddler and really not ready to coop with crying at night, if he wakes up DD she would be a nightmare to settle back, so I do my best to try to settle with the paci, but if he starts crying, I give in and feed.

Not sure how else can I make him take more during the day...
What if I actually feed more often during the day - for example do EAES? I have a forceful letdown so there is no fear he'd fall asleep on the breast if I do it closer to the sleep time... wonder if anyone tried that? It's a bit of snacking but at the same time he'd take more overall, don't you think?

He falls asleep independently with the paci & white noise (I still have to reinstall the paci a few times, so I do stay in the room, but not that he sees me) for both naps and the night. I still AP for sleepcycle transition as he wakes at 35 min and then at 50 min and 1 hr marks - so I come, reinstall the paci and rock the crib a bit, but nothing related to falling asleep on the breast etc. For NW when I feed, again he never falls asleep on the breast, I put him back to the crib awake and then hear him babbling a bit and falling back asleep within 5-30 min.
I tried feeding right after the naps when he just woke up, but didn't seem to help much, he does take more milk, but again not enough I feel. Unfortunately worst is the morning, as I have to deal with the toddler around, and she never allows me to feed quietly, and DS is very distracted. I end up feeding him a bit when he wakes up in the morning (whatever I can achieve with DD throwing some unhappy tantrums around, and then I go to put him down for the first nap and he's giving me full blown hungry signs, and I feed then again before the nap. As I said I then put him to the crib and he fell asleep within 5 minutes.  At this time as the room is set for the nap and he's tired, he actually feeds much better. I did this morning and will try to have one feed during next A time, but probably closer to the nap again. I know it's not ideal but I did this 2 feeds during A time yesterday and he had 2 NW at 2:30 and 5:30 am which is better then 4-5 NW I had a few nights before.

There is also something going with the breast refusal of some scale, at 5:30 this morning he had 2 sips, then started crying and turning his head away, and I walked with him and calmed him down for about 10 min, and then he took the breast and had a small feed. To be honest I'm so lost as to why (I ruled out bottle, neck problems, any mouth infections, teething), my only other guess is forceful letdown, but then again he had it from birth, and should have coped with it by now.

If the baby is not falling asleep on the breast, what is wrong with feeding closer to the sleep, rather then right after? He gets hungrier after decent amount of A time, so takes bigger feed?

TIA
« Last Edit: September 05, 2010, 19:58:26 pm by Tay »



Offline mamat

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RBreast Refusal or Forceful letdown?
« Reply #1 on: September 05, 2010, 18:40:19 pm »
olkan, we get a lot of the same refusal and I have yet to figure our why especially when I know she is getting lots of milk! I am finding that if she gets lots before bed at night, she will sleep a little better so I def dream feed (although sometimes it wakes her right up!). Last night she went from 10:30 df till 5 am!

Tara-mama to Alexa(9) Angie (6) Jaxon (6) and Marlee, March 5th, 2010

Offline Tay

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RBreast Refusal or Forceful letdown?
« Reply #2 on: September 05, 2010, 19:26:28 pm »
Olkan - when you say there's some breast refusal, is it the same at every feed or is it just the morning one?

If the baby is not falling asleep on the breast, what is wrong with feeding closer to the sleep, rather then right after? He gets hungrier after decent amount of A time, so takes bigger feed?
I guess it's a matter of association, even if the baby doesn't fall asleep on the breast, your LO would still associated being fed to being put down for a nap/ BT. Having said that, I think it's more of problem if that is always a pattern, I mean, if it only happens on one nap of the day, or bedtime, then it shouldn't be an issue (DS is on such long A times now for example that his second nap is just after a feed - a make a point of getting his nappy changed in between and feeding him downstairs and only going up to his room once it's actually to put him down for his nap).
xxx


Offline Tay

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Re: Breast Refusal or Forceful letdown?
« Reply #3 on: September 05, 2010, 20:01:23 pm »
Could you post us your EASY so we can get an idea if there are maybe other issues at play?


Offline olkan

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Re: Breast Refusal or Forceful letdown?
« Reply #4 on: September 05, 2010, 22:47:46 pm »
Tay - I can't figure out why and when he refuses the breast, it's erratic, sometimes as soon as I move him closer he starts fighting, sometimes I force him on the breast and he takes a feed, sometimes he screams and doesn't, sometimes he just goes onto the breast himself and eats well. I was trying for the last 3 weeks to make any sense out of that. For example tonight he totally refused a breast, I gave him a bottle and he took 100 ml, then I gave him a breast - he refused, I offered another one - he took the full feed, I put him back on the one he refused, he happily had more. Generally he eats better when he's sleepy and not distracted, but one feed he's happy with the breast and spits the bottle out, another one - he wants the bottle and nothing else, another one he wants nothing of BM:)

My EAS looks as follows:

WU & E - 7:15 (may take a small sip if I'm lucky)
I try to offer breast again at 8, he may eat a bit more. Today he refused at 8, 8:30, so I fed him right before the nap.
S: 9:00 - 10:50
E: (because he's not hungry at 10:50) 12:00
S: 12:30 - 14:00
E: 14:00 - takes a little. I offer again before the next nap.
S: 16:00 - 17:40
E:  18:15 - refused
bath
E: 19:00 1.5 breasts + 100 ml of EBM from the bottle (a lot!)
asleep by 19:45

NW: 21:30 - settled with the paci
NW: 23:00 - wouldn't settle with the paci, took decent feed.
NW: 2:40 -  settled with the paci
NW: 5:00 - took a feed, was awake until 6:00, needed white noise to fall asleep.
(the NW are erratic, yesterday it was only 0:00 & 5:00, the day before - every 2 hours).

Also, if one of his naps are not long enough, I offer a 20 min catnap, so we end up with 4 naps on those days. His morning wake  up time could also be anywhere between 6:45 & 7:30, he is usually stirs at 6 am and needs some white noise/paci/rocking to stay asleep until 7ish.



Offline Tay

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Re: Breast Refusal or Forceful letdown?
« Reply #5 on: September 07, 2010, 20:03:51 pm »
Hiya,
 Sorry for taking so long to reply, things have been busy at home...
I'm trying to help you figure out what is going on and I noticed that because your LO is not feeding properly you're ending up feeding more frequently, is that right? (like feeding at 12 and then again at 2pm)
My guess would be that what is happenening is that your LO is not hungry enough for a feed, therefore end sup feeding very little - which in turn makes you worried that he is not getting enough and you offer him another feed in a couple of hours time and the cycle continues... Would that make sense?
Have you tried sticking to a 3hr EASY? What I'm thinking is that maybe you should try to avoid feeding in between feeds (if that makes sense... ;) brain is mush).
So let's say, if he has a good feed at 6am, don't feed him until 9am (unless he is really showing signs of hunger) and continue with the feeds and your EASY from that 6am time.
What do you think?
xxx


Offline olkan

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Re: Breast Refusal or Forceful letdown?
« Reply #6 on: September 08, 2010, 15:31:39 pm »
Hi Tay - this was my first thought, but after a week I was continuously engorged, he didn't eat much better with 3 hr (that's why I tried to push him to 4 hr easy), and he LOST WEIGHT! That's why I'm so worried and try to feed whenever as long as he eats.
He is hungry, takes a breast, makes a sip, then arches his back and turns away, does it a few times and then totally not turning his head back, even if he ate 3 hrs before and not too much...
I'm almost thinking maybe something with his tummy, though he looks healthy but only has 1-2 poo a day. I'm probably try to see pediatrician.



Offline Tay

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Re: Breast Refusal or Forceful letdown?
« Reply #7 on: September 10, 2010, 13:34:25 pm »
Sorry again... Life is just hectic after school started...
I'm definately thginking: reflux. Is there any chance? Have you been to the doc yet?


Offline olkan

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Re: Breast Refusal or Forceful letdown?
« Reply #8 on: September 13, 2010, 07:55:39 am »
Could the reflux had started after 3 months? Cause he used to eat perfectly before...
I'm now trying to stick to 3 hr sharp, he's definetely more hungry, but eats about 100-120ml (3-4 oz) at most, whilst his norm would be 150-180 ml. He also now wakes every 2 hr at night at at 6 am, I think there is a bit of 3-4 nap transition involved, but things seem to be so mixed up, that I'm lost where to start.
I'll probably write to EASY board as well.



Offline Tay

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Re: Breast Refusal or Forceful letdown?
« Reply #9 on: September 13, 2010, 18:54:23 pm »
Do write on the EASY board to see what comes up.
I'm not too sure about the reflux, but I know that with DS we had signs before it really got bad (DS was alwayys a good feeder, even during the worst of the reflux - to soothe). I guess what I'm trying to say is that you would have probably noticed some signs before now.
Let mw know how you get on
xxx


Offline olkan

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Re: Breast Refusal or Forceful letdown?
« Reply #10 on: September 13, 2010, 22:09:55 pm »
Thanks Tay - the thing is he doesn't cry or show any discomfort, just turns the head away after a few sips.



Offline knackered

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Re: Breast Refusal or Forceful letdown?
« Reply #11 on: September 14, 2010, 10:04:25 am »
Hi there. Can I jump in here? Do you have a very fast let down? I'm wondering if your LO is struggling with the flow. This happened with both mine - they fed great til about 6 weeks then it got more and more difficult to feed during the day. With my DS1, he would do exactly as you're describing - cry, arch his back, turn his head away. It was very distressing. He'd often go with very little during the day, then make up for it at night with 2 or 3 big feeds.

For me it was all down to position. In the cradle hold, the flow of milk was just too much for both my LOs. I'd do the feed either lying down or leaning right back and it was so much better. It also helped doing it in a darkened room too, so that there were less distractions. Obviously if your LO has got in to the habit of doing his eating at night, you may need to start restricting these feeds so that he feels hungry enough during the day.

HTH. Let me know if this is useful or not....

Anna xx
Anna x

Offline aidenmc

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Re: Breast Refusal or Forceful letdown?
« Reply #12 on: September 16, 2010, 00:28:27 am »
I would love to follow and see how you get on. I have been having feeding problems with my 9.5 week old. He is often very gassy which I think is in part cause and part consequence of his feeding. He will show hunger signs, latch on then come off and get upset. It also affects our whole routine (which I now consider an attempt at routine  ::)) as I am sometimes trying to feed over the course of a few hours...curious to see if you figure it out.
Becky,
Mom to Kieran (10/15/2000); Aiden, (7/ 8/ 2005); and Samuel (7/10/2010)

Offline olkan

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Re: Breast Refusal or Forceful letdown?
« Reply #13 on: September 16, 2010, 21:41:29 pm »
Hi Anna - yes I have forceful letdown and I thought its an issue, but he does exactly the same thing (arching his back etc) with EBM in the bottle. Also, he was fine (choking but eating like a champ) until about 3 months, you would expect they actually get over forceful letdown as they grow, not the other way around.
I've been to peds today and he confirmed reflux and prescribed something. Started giving it, will see if it gets better.
It was all getting worse last few days,  he actually started crying with pain during feeds, and would do the same with 3.5 h between the feeds as well: nurse for a minute or so, then turn away and cry and get hysterical if I try to put him back. Then I reassure him, at some point (in 5-20-45 min) he actually starts making hungry rather then unhappy cries, and nurses again - so we pretty much fight and nurse for 2/3 of our 2h A time, and I only manage to get about 100 ml into him (and his norm is 150-180).
So he now wakes 5-7 times at night, I try to resettle with the paci where I can, but I end up with 3 feeds during the night, and I don't know how to restrict them, as it's not habit but hunger, and I also don't want to do any crying to wake my toddler up.

No good news for now, I can't believe 3 weeks ago he was sleeping 8 h stretches at night (sigh)



Offline Tay

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Re: Breast Refusal or Forceful letdown?
« Reply #14 on: September 18, 2010, 18:40:46 pm »
If it's any comfort I pretty sure that as soon as the meds start to work properly he will go back to sleeping well.
My measure of when DS needs his meds increased is exactly when he starts waking up at night for feeds.
xxx